[Surgical correction of post-vertebroplasty kyphosis by pedicle substraction osteotomy. Regarding three cases]. / Correction chirurgicale de la cyphose post-vertébroplastie par ostéotomie trans-pédiculaire. À propos de trois observations.

We report a case of three patients treated with pedicle subtraction osteotomy for post-vertebroplasty kyphosis. These patients were initially treated with a vertebroplasty for vertebral fracture (two cases) and spinal lymphoma (1 case). All of these patients worsened progressively on a clinical and radiographic level with progression of the spinal deformity in the form of kyphosis. The surgery consisted of transpedicular osteotomy instrumented at the level of the vertebra cemented with maximum removal of intra-corporeal cement. One of the three patients required a supplementary anterior approach to achieve good quality bone fusion. In all three cases the post-vertebroplasty kyphosis was able to be reduced by at least 50 % emphasizing the feasibility and relevance of the pedicle subtraction osteotomy in a context of cemented vertebra.

[Surgical treatment of stenosis-thrombosis of internal carotids by extra-intracranial arterial anastomosis and endarterectomy]. / Traitement chirurgical d'une sténose-thrombose des carotides internes par une anastomose artérielle extra-intracrânienne et une endartériectomie.

The surgery of the remaining carotid artery is a very difficult procedure considering the high risk related to the peroperative clamping. Extracranial to intracranial by pass of the thrombosed side permit to carry out in better conditions the contralateral endarterectomy without using intravascular shunt.

[Evaluation of the clinical benefit of decompression hemicraniectomy in intracranial hypertension not controlled by medical treatment]. / Evaluation du bénéfice clinique de l'hémicraniectomie décompressive dans l'hypertension intracranienne non contrôlée par le traitement médical.

Through the findings in the literature on the basis of 9 personal cases, we review the indications and value of decompressive hemicraniectomy with plasty of the dura mater in cases of medically uncontrolled and decompensated intracranial hypertension. Seven patients had a pseudo-tumoral brain infarction. Five patients survived and their functional recovery is consistent with an autonomous daily life. Another patient with acute traumatic sub-dural haemorrhage died. The ninth patient had presuppurative encephalitis and recovered with no disability. At the time of surgery, all the patients were comatose with herniation of the mesencephalon (n = 3), uncal transtentorial herniation which was either unilateral (n = 4) or bilateral (n = 2). ICP was between 25 and 60 mmHg before the operation. After flap removal, ICP decreased by 15% and, after opening of the dura, it fell a further 70%. In 6 patients we were able to carry out continued post-operative monitoring of ICP, which stayed below 50% of initial values. Decompressive hemicraniectomy is an effective means of treating ICH caused by carotid cerebrovascular accidents with a high degree of edema, where mortality rises to 70-85% when only medical treatment is administered. No haemorrhagic complications, which can occur during hemispherectomies, were observed during decompression.

[Idiopathic giant cell granulomas of the pituitary gland. Apropos of 2 cases]. / Les granulomes idiopathiques à cellules géantes de l'hypophyse. A propos de 2 cas.

Two cases are reported of two women who had developed progressive hypopituitarism without visual disturbances. Pituitary tumors were evoked by radiological findings. The patients underwent surgical removal of invasive intrasellar tumor by transphenoidal route. Giant-cell granuloma was histologically demonstrated with negative special staining for tuberculosis acid-fast bacilli, bacteria and fungi. Secondary granuloma due to tuberculosis, brucellosis or neurosarcoidosis was ruled out by serological grounds. The prognosis was discusses through a follow-up of 7 years in the first case and 7 months in the second one. The appropriately documented 31 cases collected from the literature were compared with our two cases.

[Use of Cotrel-Dubousset material in C1 C2 instabilities]. / Utilisation du matériel de Cotrel Dubousset dans les instabilités C1 C2.

The authors report their experience with the C.D. material for the atlantoaxial displacement. Four cases are presented. The characteristics and advantages of this material are discussed, and compared with the other methods of fixation specially the Knodt-Chirossel.