Acta Neurochirurgica
Supplements
Editor: H.-J. Steiger
Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery
Edited by
A. Alexandre, A. Bricolo, and H. Millesi Acta Neurochirurgica
Supplement 92
SpringerWienNewYork
Prof. Dr. Alberto Alexandre
EU.N.I. European Neurosurgical Institute, Treviso, Italy
Prof. Dr. Albino Bricolo
Neurosurgical Department, Verona University, Verona, Italy
Prof. em. Dr. Hanno Millesi
Boltzmann Institut fu¨r Experimentelle Plastische Chirurgie, University of Vienna, Austria
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Preface
On behalf of the Committee for Peripheral Nerve Sur- gery of the World Federation of Neurosurgical Soci- eties, and sponsored by EU.N.I., European Neuro- surgical Institute, the Third Course on peripheral Nerve Microsurgery and on Minimally Invasive Treatments for Spinal Diseases was held in Treviso, February 9–11, 2004.
In the course, which was also supported by the European Association of Neurosurgical Societies (EANS), the Latin-American Federation of Neuro- surgery, and the Italian Neurosurgical Society, the di¤erent minimally invasive techniques were analyzed which are presently used in order to minimize bone demolition, scarring, and risk of recurrence. The re- sults of intradiscal techniques were compared with those of miscrodiscectomy, and new methods were discussed in face of problems such as epidural fibro- tisation, microinstability, osteoporotic or neoplastic or postraumatic vertebral lesions. The di¤erent mini- mally invasive methods were discussed with participa- tion of specialists from di¤erent countries. At the same time peripheral nerve problems were discussed and di¤erential diagnosis problems highlighted.
As in past years, the course included conferment of the Hanno Millesi Award. This prize was conceived by the Committee of Peripheral Nerve Surgery of the World Federation of Neurosurgical Societies in honor of this Father of Surgery in the field. The prize consists of a financial support to a young researcher to help him going ahead with his studies on new perspectives in the field of nerve biology and surgery. The prize is
financed by EU.N.I., European Neurosurgical Insti- tute, and is assigned upon evaluation of the best paper presented.
This year Prof. Millesi, Dr. Giocoli, and members of the commission awarded Dr. A. Gravvanis and co- workers from the General State Hospital of Athens, Department of Plastic Surgery and Microsurgery &
Burn Center of Hellenic Pasteur Institute, Greece. Dr A. Gravvanis presented the paper ‘‘The e¤ect of ge- netically modified Schwann cells in end-to-side nerve grafting’’. The concept investigated by him is whether collateral nerve regeneration is feasible through sili- cone tubes, as previously he had demonstrated in rat models that Schwann cell lining of tubes improves sig- nificantly the regeneration rate and fiber maturation, but Schwann cell lining of tubes did not ensure col- lateral nerve regeneration in all cases. Hence the aim of the study was to improve these results by lining the silicone tubes with genetically modified Schwann cells with increased motility.
We are especially grateful to Acta Neurochirurgica for having dedicated this Special Issue to the Course in Treviso. In this volume we present papers on pe- ripheral nerve surgery and on spinal surgery in order to underline the relevance of a common understanding of the clinical problems, in order to obtain a more perfect di¤erential diagnosis between problems so closely re- lated but so di¤erent in their management.
Alberto Alexandre, Albino Bricolo, and Hanno Millesi
Foreword
‘‘This Special Issue of Acta Neurochirurgica is dedi- cated to the publication of the papers which were pre- sented in the IIIrd Course on minimally invasive neu- rosurgery, held in Treviso under the organisation of the Committee for Peripheral Nerve Surgery of the WFNS. Discussion has moved through new trends on peripheral nerve surgery, and pain treatments, which are a challenging interdisciplinary matter for many professionals. Moreover analysis of di¤erential diag- nosis with spinal degenerative diseases has called the attention of participants. This Committee of the WFNS has increased his activities through the years, and symposia have been organized by it, in di¤erent continents. But the one in Treviso remains each year a regular recurring appointment open to interdisciplin- ary discussion and to the presentation of new trends and points of view.
Certainly Neurosurgery is a continuously evolving world, and each and everyone of us is compelled to critically consider the techniques he is employing and to analyze the results he is obtaining. There are dis- eases whose physiopathology is not yet clearly under- stood, and the mechanism of generation of such a dif- ficult and complicate matter as pain remains under several aspects a dilemma. The discussion over these conditions involves interdisciplinary cooperation.
This is why similar meetings, during which we feel to be conducted through a careful analysis of new tech- niques and reconsideration of routinary trends, are useful and welcome. The participation of such a large group of experienced and outstanding professionals has made these days of great concern for all partic- ipants.
The special event of the attribution of the Hanno Millesi Award, conceived and o¤ered by EU.N.I. to the WFNS, has further increased the interest of the appointment. An important paper on nerve regenera- tion stimulated by genetically modified Schwann cells, by Andreas Gravvanis has been awarded this year.
This paper is in the line of the research awarded last year, the big progress that came from Fausto Viterbo who in Butucatu could demonstrate nerve regenera- tion by terminolateral anastomosis. We, who initiated the Committee of peripheral nerve surgery, are proud to observe that great attention is paid to young re- searchers.’’
Madjid Samii, M.D., Ph.D.
PastPresident of the WFNS President of INI
Contents
Part I: Advanced peripheral nerve surgery Mazal, P. R., Millesi, H.:
Neurolysis: Is it beneficial or harmful? . . . 3 Crotti, F. M., Carai, A., Carai, M., Grimoldi, N., Sgaramella, E., Sias, W., Tiberio, F.:
TOS pathophysiology and clinical features . . . 7 Crotti, F. M., Carai, A., Carai, M., Sgaramella, E., Sias, W.:
Post-traumatic thoracic outlet syndrome (TOS) . . . 13 Padua, L., Aprile, I., Caliandro, P., Pazzaglia, C., Conti, V., Tonali, P.:
Brachial plexus injuries: regeneration timing and prognosis in patients without need for urgent operation.
Preliminary results on truncus primarius superior . . . 17 Alexandre, A., Coro`, L., Azuelos, A., Pellone, M.:
Thoracic outlet syndrome due to hyperextension-hyperflexion cervical injury. . . 21 Schenardi, C.:
Whiplash injury. TOS and double crush syndrome. Forensic medical aspects. . . 25 Busetto, A., Fontana, P., Zaccaria, A., Cappelli, R., Pagan, V.:
Vascular thoracic outlet syndrome staging and treatment . . . 29 Coro`, L., Azuelos, A., Alexandre, A.:
Suprascapular nerve entrapment . . . 33 Pazzaglia, C., Caliandro, P., Aprile, I., Mondelli, M., Foschini, M., Tonali, P. A., Padua, L.:
Multicenter study on carpal tunnel syndrome and pregnancy incidence and natural course. . . 35 Quaglietta, P., Corriero, G.:
Endoscopic carpal tunnel release surgery: retrospective study of 390 consecutive cases . . . 41 Zala‰, A., Mariottini, A., Carangelo, B., Buric, J., Muzii, V. F., Alexandre, A., Palma, L., Rovere, A.:
Wrist median nerve motor conduction after end range repeated flexion and extension passive movements in Carpal Tunnel Syndrome. Pilot study . . . 47 Alexandre, A., Coro`, L., Azuelos, A.:
Microsurgical treatment of lumbosacral plexus injuries . . . 53
Azuelos, A., Coro`, L., Alexandre, A.:
Femoral nerve entrapment . . . 61 Aprile, I., Caliandro, P., Giannini, F., Mondelli, M., Tonali, P., Foschini, M., Padua, L.:
Italian multicentre study of peroneal mononeuropathy at the fibular head: study design and preliminary
results . . . 63 Crotti, F. M., Carai, A., Carai, M., Sgaramella, E., Sias, W.:
Entrapment of crural branches of the common peroneal nerve . . . 69
Part II: Minimal invasive spinal surgery Nardi, P. V., Cabezas, D., Cesaroni, A.:
Percutaneous cervical nucleoplasty using coblation technology. Clinical results in fifty consecutive
cases . . . 71 Alexandre, A., Coro`, L., Azuelos, A., Buric, J., Salgado, H., Murga, M., Marin, F., Giocoli, H.:
Intradiscal injection of oxygen-ozone gas mixture for the treatment of cervical disc herniations . . . 79 Alexandre, A., Coro`, L., Azuelos, A., Pellone, M.:
Percutaneous nucleoplasty for discoradicular conflict . . . 83 Bonetti, M., Fontana, A., Albertini, F.:
CT-guided oxygen-ozone treatment for first degree spondylolisthesis and spondylolysis . . . 87 Buric, J., Molino Lova, R.:
Ozone chemonucleolysis in non-contained lumbar disc herniations: a pilot study with 12 months
follow-up . . . 93 Cervellini, P., De Luca, G. P., Mazzetto, M., Colombo, F.:
Micro-endoscopic-discectomy ( MED ) for far lateral disc herniation in the lumbar spine.
Technical note. . . 99 Degobbis, A., Crucil, M., Alberti, M., Bortolussi, A.:
A long-term review of 50 patients out of 506 treated with automated percutaneous nucleotomy according to onik for lumbar-sacral disc herniation . . . 103 Fabrizi, A. P., Zucchelli, M.:
Surgical intradiscal decompression whitout annulotomy in lumbar disc herniation using a coblation
device: preliminary results. . . 107 Marı´n, F. Z.:
CAM versus nucleoplasty . . . 111 Quaglietta, P., Cassitto, D., Corriero, A. S., Corriero, G.:
Paraspinal approach to the far lateral disc herniations: retrospective study on 42 cases . . . 115 Ra¤aeli, W., Righetti, D.:
Surgical radio-frequency epiduroscopy technique (R-ResAblator) and FBSS treatment: preliminary
evaluations . . . 121 Reverberi, C., Bottoli, M. G., Pennini, M., Gabba, E.:
Disc coablation and epidural injection of steroids: a comparison of strategies in the treatment of
mechanical spinal discogenic pain. . . 127
X Contents
Mariottini, A., Pieri, S., Giachi, S., Carangelo, B., Zala‰, A., Muzii, F. V., Palma, L.:
Preliminary results of a soft novel lumbar intervertebral prothesis (diam) in the degenerative spinal
pathology . . . 129 Dallolio, V.:
Lumbar spinal decompression with a pneumatic orthesis (orthotrac): preliminary study. . . 133 Paradiso, R., Alexandre, A.:
The di¤erent outcomes of patients with disc herniation treated either by microdiscectomy, or by
intradiscal ozone injection . . . 139 Caliandro, P., Aulisa, L., Padua, R., Aprile, I., Mastantuoni, G., Mazza, O., Tonali, P., Padua, L.:
Quality of life, clinical and neurophysiological picture in patients operated on for lumbar stenosis . . . 143 Facco, E., Ceccherelli, F.:
Myofascial pain mimicking radicular syndromes . . . 147 Gambardella, G., Gervasio, O., Zaccone, C., Puglisi, E.:
Prevention of recurrent radicular pain after lumbar disc surgery: a prospective study. . . 151 Author index . . . 155 Index of keywords . . . 157 Listed in Current Contents
Contents XI
