Biomedical subjects
Publications and source records attributed to G Lozes.
The authors report a new technique which allows reduction and stabilization of cervical fractures healed in a vicious position. The procedure allows total removal of bony and discal protrusions, a correction of the pathological kyphosis by osteotomy of posterior facets. Advantages and drawbacks of this technique are discussed.
The authors report a new arthrodesis of the inferior cervical spine using a plate screwed into the pedicles by an anterior route. The procedure allows a complete and immediate stabilization of the cervical spine. Cervical orthosis is unnecessary in postoperative course.
In 1984, Aoki reported a new technique for treatment of chronic subdural hematomas in adults. This simple, effective technique and least invasive procedure lead us to use it. Our data seems encourageous as they were previously reported by Aoki.
Over a period of 18 years the authors have collected together 230 cases of herniation cervical discs. Multifactor analysis of the results of the various therapies is given. Surgical decompression has been done, mostly using an anterior approach, and it effectively treats the radicular damage; it stabilizes and improves spinal cord deficits whether the herniation is spontaneous or traumatic, acute or chronic. Computed tomography facilitates its anatomical identification and the decision regarding the therapy to apply.
The authors outline the possible approaches to vertebromedullary tumours of the thoraco-lumbar spine using unilateral or bilateral transverso-arthro-pediculectomy and corporectomy. In a personal series of 20 cases. The technique and indications are described and the results.
Surgery of the dorsolumbar spine is currently benefiting from diverse approaches and the advent of computed tomography. This report describes a bilateral posterolateral approach with transversoarthropediculectomy and corporectomy. The advantages and disadvantages of this approach and its indications are discussed.
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13 cases of severe intracranial postoperative infections, abscesses and/or empyema, are reported. These lesions, whose clinical diagnosis is often difficult, have benefited from C.T. scan. The diffusion of the infectious process in operatory focus, the frequency of Staphylococcal origin and the importance of high doses antibiotherapy must be underlined. This one is, of course, an indispensable complement to reintervention, but it may be utilized alone with success in selected cases, or insure the definitive cure when reintervention is partial.
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A 35 year-old caucasian man suffered from paroxysmal nocturnal haemoglobinuria (PNH) or Marchiafava-Micheli's disease diagnosed in 1976 and complicated by several thrombotic episodes. He developed a benign intracranial hypertension. A digitalized intravenous angiography showed occlusion of both lateral sinuses. Partial improvement followed lombo-peritoneal shunting and steroid therapy. Cerebral venous thrombosis is a well-known complication of PNH but only a few cases have been radiologically and/or pathologically proven. It usually involves the superior longitudinal sinus and/or cortical veins resulting in hemorrhagic infarction of poor outcome. Benign intracranial hypertension due to a venous occlusion is rare. In 3 published cases, as in our own, the neurologic outcome was good. Steroid therapy seems useful. The risks of anticoagulant therapy are discussed.
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Arteriovenous malformations of the brain generally make their presence felt before the age of 40 through cerebromeningeal hemorrhage (83 cases) or epilepsy (47 cases). In our series, 128 patients were operated upon and total resection of the malformation was performed on 119 occasions. The operative mortality rate was 12.5% and there were 70.3% good results from a long-term point of view. The essential benefit from surgical treatment is the elimination of the risk of hemorrhage. The effect on epilepsy is much less, and the natural development of nonhemorrhagic forms is not unfavorable over the long term. The prognosis for surgical treatment is linked to the size and the topography of the malformation, the number and the origin of the arterial afferent vessels, and, above all, to the mode of drainage into the venous system that may be malformed.
Lumbar surgery is currently benefiting from the development of anterior approaches to the spine and the possibilities of anterior arthrodesis. The transperitoneal approach is being replaced more often by an extraperitoneal approach that enables anterior access to the spine. The authors report an anterointernal approach to the lumbar spine.
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The authors report the intermaxillo-hyoido-retropharyngeal approach for cranio-cervical junction's pathology. They underline its advantages. It's indications are discussed by six personal cases.
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