Stereotactic radiosurgery. A review of "gamma knife" and "linac knife" technology and the unit at the Wake Forest University Medical Center.
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Brain Neoplasms↗
Biomedical subjects
C L Branch
Publications and source records attributed to C L Branch.
Thoracic disk herniation.
Symptomatic thoracic disk herniation is unlikely to be encountered with significant frequency in clinical practice. Subtle manifestations required a high index of suspicion if the work-up is to be efficient. In the appropriate candidate, magnetic resonance imaging is the best screening tool, and it may be the only diagnostic study required. In the symptomatic patient with neurologic dysfunction or persistent pain refractory to nonsurgical therapy, surgical diskectomy is a safe and effective treatment with limited morbidity.
Adult↗
Fixation of fractures of the lower cervical spine using methylmethacrylate and wire: technique and results in 99 patients.
Surgical stabilization of traumatic fracture-dislocations of the lower cervical spine with wire and methylmethacrylate remains a controversial procedure. Yet, the resultant immediate fixation with minimal patient morbidity seems to indicate that this method provides an ideal stabilization construct. We describe and report the outcome of a technique of posterior cervical fixation with methylmethacrylate and wire for stabilization of traumatic fractures of the lower cervical spine. Over a 12-year period, 124 fracture-dislocations of the lower cervical spine in 99 patients (mean age, 32 years; range, 15-76 years) were treated at this institution using a posterior methylmethacrylate and wire technique. Eighty-two patients had a posterior element fracture; 28 had a vertebral compression with posterior ligamentous injury; and 14 had a ligamentous injury alone. Thirty-six patients were neurologically intact upon admission, while the rest had radiculopathy or partial or complete myelopathy. Ninety-one patients were available for follow-up [mean, 18.6 months; range, 1-100 months (8.33 years)]. Eighty-eight patients (97%) had a stable fixation and 77 (85%) had resumed preoperative activity or were working but with a residual deficit. Complications included fixation failure requiring a second operation in 3 patients, nonlethal pulmonary embolism in 2 patients, lethal pulmonary embolism in 1 patient, and a superficial wound infection in 3 patients (none affected the underlying fixation construct). These results indicate that this technique is a safe, simple, and effective method for stabilizing the lower cervical spine that allows rapid patient mobility with minimal morbidity.
Adolescent↗