[Fracture of the odontoid process and C1-C2 lateral luxation. 2 cases].
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Biomedical subjects
Publications and source records attributed to A Autricque.
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The approach of thoracocervical spine junction is sometimes difficult. The authors expose a technique to realize the exposition of the lower cervical spine and upper thoracic vertebrae (T1 to T4). An anatomical reconstruction is performed. Advantages and inconveniences of this approach are exposed before underline its indications.
The authors describes the technique of mobilization of orbito-zygomatico-malar bloch. In some affections it is justiciable to use this approach which provides an excellent view of the lateral region of the skull base and permits the access to the base of the tumour in some indications and always extracerebral approach.
The mobilization of the medial fronto-orbital ridge improves the transbasal approach described by Derome. This one reported by Cophignon can be realized by a monobloc bone flap. The authors describe technical aspects and their experience of this route.
The authors report their experience of the intermaxillohyoido-retro-pharyngeal approach and acrylic prosthesis for metastasis of upper cervical spine. The underline the effect of osseous anterior compression and immediate stability obtained with this technique.
A technique is proposed for the anterior approach to the cervicothoracic intervertebral joint which allows access to the first four thoracic vertebrae and is based on the insertion of a sterno-biclavicular piece respecting insertion of sternocleidomastoid muscles.
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Thirteen patients with thoracic disc herniation have been operated on between 1960 and 1984. Nine presented with a progressive cord compression syndrome affecting sensory function more than motor. Four patients presented with acute cord compression. During this period, the authors have abandoned medullary angiography and myelography. The diagnosis is now based on computerised myelotomography. Three cases were treated by laminectomy with two postoperative deteriorations. Two cases were treated by a transthoracic approach which seemed to be too risky. Eight cases were treated through a postero-lateral approach, six being through a transverse arthropediculectomy using a microscope for better dissection of the vessels and Harrington rods to avoid secondary kyphosis. Seven of 9 cord syndromes were improved. Four cases with predominantly radicular syndromes were all improved.
The authors describe the use of body vertebral graft in post-traumatic cervical spine injuries. They underline its advantages.
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The authors report their experience of the posterolateral approach for the treatment of spinal dorsolumbar metastasis. They underline the effect of osseous posterior wall compression. In this way the classical laminectomy is not indicated.
Panmedullary ependymoma is an unusual disease last reported by Fuentes in 1986. The present case is the first to have been studied by magnetic resonance, using gadolinium. The findings indicated a panmedullary lesion rather than a tumour. Histopathological investigation confirmed the hypothesis.
Dorsal spinal tumours have sometimes an intrathoracic development. The authors report the technique that permits by transversoarthropediculocostectomy the complete removal of these hourglass lesions by one approach. The advantages and inconveniences are analysed and its indications discussed.
A critical study of 11 cases of rheumatoid arthritis with neurological complications due to involvement of the cervical region of the spinal column induces the authors to reconsider their therapeutic strategy. After reviewing the various neurological complications and mechanisms involved, they propose wider use of surgical treatment within limits defined on the basis of neurological and radiological criteria and the risks of the respective methods.