This work is been based upon the experience of performing 100 reconstructive microsurgical operations with transplantation of combined vascular-neural autografts, in 24 cases--with introduction cellular material into zone of transplantation. The complex approach aimed to creating optimal conditions for the functional regeneration of the spinal cord (SC), including neurosurgical methods restoring anatomical integrity of the organ and also multicomponent and staging rehabilitation of patients has been developed. On the base of complex approach during a postoperative period there has been put synchronous multifactorial action, consisting of functional multichannel electrical pacing of muscles simultaneously participating in tumble. The patient concentrates all his attention on the trial to tumble with paralized extremities by himself. At that the series and the site of application of these electrical impulses forms the algorithm of this tumble. Synchronism of produced afferent and efferent impulses creates new possibilities in activating of regenerating processes in the damaged area of the spinal cord. As a result of treatment within the bounds of the developed program the authors get clinically and electrophysiologically proved certain improvement that they can not only predict but guarantee patients of this group. Presented here results of the complex treatment of patients with trauma of the spinal cord within the framework of research international program confidently testify advantages of the new approach to solving of this problem. For the first time in history of medicine there is created close cooperation and regular continuity between molecular biology, neurosurgery and rehabilitation. This scientific alliance permits in proper time to keep a close watch, quickly correct and improve every stage of treatment. The effect of implement of innovations is been summarized at the each next stage of proposed complex treatment and eventually significantly elevates an ultimate result of medical rehabilitation of invalids with trauma of the spinal cord.
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Urologie
January 2025
Neuro-Urologie, Schweizer Paraplegiker-Zentrum, Guido A. Zäch-Straße 1, 6207, Nottwil, Schweiz.
A spinal cord injury (SCI) leads to neurogenic lower urinary tract dysfunction (NLUTD), which, if left untreated, can result not only in urinary incontinence and an increased risk of urinary tract infections and kidney dysfunction but may also pose a vital threat to people with SCI. Comprehensive neurourological assessments, including patient history and combined video urodynamics, are essential to accurately classify dysfunction and establish therapeutic strategies. Treatment options include, among others, medications for detrusor regulation, intermittent catheterization, and, if necessary, surgical interventions from intradetrusor botulinum toxin A injections to sacral deafferentation.
View Article and Find Full Text PDFEur Spine J
January 2025
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
Purpose: Spinal epidural abscesses are rare yet serious conditions, often necessitating emergency surgical intervention. Holospinal epidural abscesses (HEA) extending from the cervical to the lumbosacral spine are even rarer and present significant challenges in management. This report aims to describe a case of HEA with both ventrally-located cervical and dorsally-located thoracolumbar epidural abscesses treated with a combination of anterior keyhole decompression and posterior skip decompression surgeries.
View Article and Find Full Text PDFNeurochirurgie
January 2025
Department of Neurosurgery, Hôpital de la Timone, APHM. 264 rue Saint-Pierre, 13005, Marseille, France. Electronic address:
Objective: To report the outcomes of transoral C2 osteotomy (or partial odontoidectomy) and posterior fixation, regarding efficacy and safety, in patients with severe irreducible atlantoaxial dislocation (IAAD) following odontoid fracture.
Methods: Transoral C2 osteotomy, soft tissue resection, with or without facet joint release, followed by posterior fixation were performed on 3 patients (2012, 2016, 2023) who were suffering from severe IAAD after an odontoid fracture with spinal cord compression. The radiological and clinical outcomes were then assessed.
J Vasc Surg
January 2025
Vascular Surgery, University of Bologna, DIMEC, Bologna, Italy; Vascular Surgery Unit, IRCCS Sant'Orsola, Bologna, Italy.
Introduction/aim: The partial deployment technique (PDT) is an unconventional option of T-branch deployment to allow target arteries (TAs) cannulation/stenting from the upper arm access, in case of narrow (NPA: <25mm) or severely angulated (APA: >60°) aorta. Aim of this study was to report outcomes of the endovascular repair of complex aortic (c-AAAs) and thoracoabdominal (TAAAs) aneurysms by T-branch and PDT.
Methods: All consecutive patients underwent urgent endovascular repair of c-AAAs and TAAAs by T-branch (Cook-Medical, Bloomington, IN, US) and PDT from 2021 to 2023 were analyzed.
Clin Oncol (R Coll Radiol)
December 2024
South West Wales Cancer Centre, Swansea, UK; National Radiotherapy Trials Quality Assurance (RTTQA) Group, National Institute for Health and Care Research, UK; Swansea University Medical School, Swansea, UK.
Aims: The SCOPE2 trial evaluates radiotherapy (RT) dose escalation for oesophageal cancer. We report findings from the accompanying RT quality assurance (RTQA) programme and identify recommendations for PROTIEUS, the next UK trial in oesophageal RT.
Maetrials And Methods: SCOPE2's RTQA programme consisted of a pre-accrual and on-trial component.
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