Lateral lumbar interbody fusion via a unilateral true percutaneous approach associated with minimally invasive pedicle screw fixation for degenerative disc disease and lumbar instability. A technical note.

In recent years, minimally invasive surgical techniques for lumbar fusion and fixation procedures gained worldwide popularity. Herein we describe a personal technique for percutaneous lumbar interbody fusion associated with minimally invasive posterior fixation for patients affected by degenerative disc disease and lumbar instability. The procedure is described in a step-by-step way and early results are presented. Although the present data reflect only an early experience, we believe that this is a straightforward procedure which may be more advantageous in terms of surgical invasiveness, potentially saving operative and recovery time and reducing risks compared to posterior or anterior approaches for lumbar interbody fusion.

Glossopharyngeal nerve schwannoma: report of a case operated on by the far-lateral transcondylar approach.

Complete resection with conservation of cranial nerves is the primary goal of contemporary surgery for lower cranial nerve tumors. We describe the case of a patient with a schwannoma of the left glossopharyngeal nerve, operated on in our Neurosurgical Unit. The far lateral approach combined with laminectomy of the posterior arch of C1 was done in two steps. The procedure allowed total tumor resection and was found to be better than classic unilateral suboccipital or combined supra- and infratentorial approaches. The advantages and disadvantages of the far lateral transcondylar approach, compared to the other more common approaches, are discussed.

Symptomatic cystic dilatation of V ventricle: case report and review of the literature.

We report a case of V ventricular cystic dilatation, presenting with specific neurological symptoms including low back pain, bilateral sciatica, weakness of dorsiflexion, and urinary retention. MRI showed a large cystic dilatation of the ventriculus terminalis. Surgical fenestration of the cyst allowed complete relief from symptoms and remission of the neurological deficit.

Cervical locked facet: operative management.

Cervical locked facet represent 5.6% of cervical lesion. If an identity of views is present in the use of tractions, we can't say as for the setting fixation techniques. Our cases histories (13 cases) and the experience of other authors incline us to support a precocious surgical treatment characterized by a posterior approach and then anterior in the not reduced cases and a single anterior approach in the reduced cases in anesthesia. The good alignment and the attain stability with the double access, but still more the convinction that the lesions of intervertebral disk and ligamentous tissues (as demonstration at the RMN) is always to remove, support us in the undertaken therapeutic attitude.

Halifax interlaminar clamps for posterior atlanto-axial arthrodesis with spinal fusion by "H" bone+graft.

The use of Halifax interlaminar clamps in posterior arthrodesis for atlanto-axial instabilities has recently been reported. The four Anderson II fractures submitted were surgically treated by posterior arthrodesis with Halifax clamps and bilateral "H" shaped bone-grafts obtained from the iliac crest. Only in the first case--initially treated without fusion--a review of the system became necessary due to the loosening of one clamp. No post-operative neurological complications appeared and non malunion or nonunion occurred at follow-up. Posterior arthrodesis with Halifax clamps does not involve any complication connected with the use of metal wire and the association of posterior fusion by lateral "H" shaped bone grafts ensures a stable and physiological reduction of dens fractures and atlanto-axial luxations/subluxations often associated.

Postoperative CSF problems after spinal and lumbar surgery. General review.

Although the dura is frequently traumatized in surgery, and during lumbar punctures, it is surprising that the "CSF problem" is a rare complication in the surgical treatment for herniated intervertebral disc (0.1%); and exceptionally rare at cervical or dorsal level. In the upright position the CSF pressure at the site of the potential leak is greater in the lumbar region, lumbar operations are more frequently performed than cervical, and, perhaps, also because cervical operations are performed by fewer surgeons with greater specific experience. The purpose of this work is to describe the etiopathology, the symptomatology, the diagnosis and treatment of early and delayed CSF problems.

[Intracranial mycotic aneurysms. Considerations apropos of 2 clinical cases]. / Aneurismi micotici intracranici. Considerazioni a proposito di due casi clinici.

Authors refer about the pathogenesis, the clinical and therapeutical problems, concerning two patients affected by mycotic intracranial aneurysms. They describe the anamnestical data of M.I.A., the clinic, the diagnostical and therapeutical measures in use.

Intrasacral meningocele associated to lumbar disk rupture. A case report.

A case of intrasacral meningocele associated to L4-L5 discal rupture is described. The possibility for this kind of malformation to be asymptomatic is emphasized.