ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVE AND IMPORTANCEIntravascular papillary endothelial hyperplasia (Masson’s vegetant hemangioendothelioma) is a rare condition affecting the neuraxis. In the literature, only one case of this lesion involving the vertebral canal with spinal cord compression has been reported. We present a case of cauda equina compression due to this abnormality.CLINICAL PRESENTATIONA 17-year-old boy was admitted at our hospital with pain, numbness, paresis of the left lower extremity, and bladder dysfunction of approximately 1 month’s duration. Computed tomography and magnetic resonance imaging of the spine revealed a tumor within the spinal canal at the T12–L1 level.INTERVENTIONThe patient underwent a T12–L1 laminectomy. An epidural red nodular tumor was visualized and totally resected. The findings of the pathological examination were compatible with intravascular papillary endothelial hyperplasia. At follow-up examination 1 month after the operation, the patient had complete resolution of the pain, and the motor deficit and bladder dysfunction had improved significantly.CONCLUSIONThis rare benign vascular lesion may be clinically and histopathologically mistaken for an angiosarcoma. Because the intravascular papillary endothelial hyperplasia can be cured by complete surgical resection, it is important to distinguish between these two lesions to avoid inappropriate aggressive treatment.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVETo achieve satisfactory cervical spinal cord decompression with minimal removal of bone.METHODSThe open-window corpectomy technique is designed to remove a minimal amount of bone and achieve satisfactory decompression. With the use of a high-speed drill under a surgical microscope, only the dorsal surface of the corpus is removed after appropriate microdiscectomies. This leaves the anterior and the lateral portions of the vertebral corpus intact.RESULTSIn a 15-month period, a total of 11 patients were treated with this technique. Five patients improved, and the remaining six patients remained the same neurologically during a mean follow-up period of 8.3 months. No complications were observed in any patients.CONCLUSIONThe open-window corpectomy provides satisfactory spinal cord decompression in a biomechanically sound manner.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVEWe describe an easy and useful method for treating hemifacial spasm related to the vertebral artery.METHODSThe technique entails the manufacture of a dural belt harvested from the cerebellar convexity dura and a dural bridge made at the petrous dura combined with the use of an aneurysm clip. The dural belt holds the vertebral artery and is anchored to the dural bridge by fixation with an aneurysm clip after the vertebral artery is transposed to an appropriate position.RESULTSThe technique proved to be safe and effective in a series of six patients with hemifacial spasm who were followed up for a period of 2 months to more than 10 years after surgery. All patients were affected on the left side. Multiple offending arteries were present in three cases. Hemifacial spasm completely disappeared in all patients.CONCLUSIONThis method represents a feasible option for the treatment of hemifacial spasm caused by a tortuous, elongated, or enlarged vertebral artery.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

OBJECTIVEIn an effort to lessen surgical trauma, neurosurgeons are developing more contained approaches requiring minimal or no brain retraction. The mobility of traditional microsurgical tools within such narrow corridors is severely restricted. A substantial portion of the surgical field may be obscured by the relatively large size of these instruments. To overcome some of these problems, the author has designed a set of new, low-profile, coaxial microinstruments.DESCRIPTION OF INSTRUMENTATIONThe coaxial shaft of these instruments is obtained by coupling a tube and a rod, rotating in opposite directions along their major axis. The rotational movement is delivered by compressing and releasing a spring-loaded, bayonet-shaped handle. The tips are obtained by flanging the two elements of the shaft. The initial set includes microscissors and microforceps, as well as tumor-grasping forceps. The two elements of the shaft can be disengaged easily by releasing a catch at the end of the shaft and disassembled for cleaning and basic maintenance purposes.DISCUSSIONThe design of the present set of instruments combines a low-profile coaxial shaft with well-established ergonomic features, such as a pencil grip handle and an angled bayonet.CONCLUSIONThe use of the least possible number of moving components enhances the reliability of these tools. The different profiles and angles of the tips partially compensate for the absence of a rotatable shaft, a potential shortcoming of these instruments.

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0148-396X    

出版商:OVID    

年代:1999

数据来源: OVID