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Biomedical subjects

H Deramond

Publications and source records attributed to H Deramond.

At least 37 records · Page 2Linked to original sources
PubMed2000

Percutaneous vertebroplasty in benign and malignant disease.

Based on experience, published data, and published series, the authors recommend the use of vertebroplasty for painful destructive vertebral lesions. In the authors' opinion, the greatest difficulty lies in denying the treatment to patients with advanced metastatic disease, where other surgical or medical treatments may have greater morbidity and mortality. The few complications reported have been related to excessive PMMA injection, underlining the need for excellent imaging conditions to control the cement injection.

Hemangioma↗
PubMed1999

Temperature elevation caused by bone cement polymerization during vertebroplasty.

Percutaneous vertebroplasty (PVP), whereby polymethylmethacrylate cement is injected into the vertebral body (VB), has been used to successfully treat various spinal lesions. The mechanism responsible for the palliative effect of PVP is unknown, but it may be the result of neural damage caused by heat liberated during polymerization of the polymethylmethacrylate. The purpose of the current study was to measure in vitro temperature histories at three key locations (anterior cortex, center, spinal canal) in VBs injected with one of two different bone cements (Simplex P and Orthocomp) to determine the role temperature plays in PVP. Twelve VBs (T11-L2) from three elderly female spines were instrumented with thermocouples and injected with 10 cc of one of the two cements. Temperatures were measured with the VBs in a bath (37 degrees C) for 15 min after injection. A Student's paired t-test was used to determine differences in peak temperature and time above 50 degrees C between the two cement groups. Peak temperatures and temperatures above 50 degrees C were significantly higher and longer, respectively, at the center of VBs injected with Simplex P (61.8 +/- 12.7 degrees C; 3.6 +/- 2.1 min) than those injected with Orthocomp (51.2 +/- 6.2 degrees C; 1.3 +/- 1.4 min). There was no significant difference in peak temperature between cements at the spinal canal location; temperature there did not rise above 41 degrees C. Although thermal damage to intraosseous neural tissue caused by cement polymerization cannot be ruled out as a potential mechanism for pain relief experienced by patients subsequent to PVP, it seems unlikely based on the worst-case conditions tested in the current study.

Aged↗
PubMed1999

The effect of monomer-to-powder ratio on the material properties of cranioplastic.

Percutaneous vertebroplasty consists of injecting polymethylmethacrylate cement into the cancellous bone of vertebral bodies for the treatment of various lesions of the spine, including osteoporotic compression fractures. Clinicians practicing vertebroplasty commonly alter the mixture of monomer-to-powder recommended by the manufacturer in an effort to decrease viscosity and increase the working time. The purpose of the current study was to measure the effect that varying the monomer-to-powder ratio has on the compressive material properties of a cement (Cranioplastic) commonly used in vertebroplasty. Cylindrical specimens were prepared varying a monomer-to-polymer ratio of 0.40 to 1.07 ml/g and tested per the American Society for Testing and Materials standard F451. Specimens prepared at 0.53 mL/g, which is near the manufacturer's recommended monomer-to-polymer mixture of 0.57 mL/g, exhibited the greatest mean values for ultimate compressive stress, yield stress, and elastic modulus. Specimens prepared at higher or lower ratios exhibited diminished strength, in some cases by as much as 24%. Although altering the monomer-to-powder ratio affects the cement's material properties, it is as yet unknown if the decrease is clinically significant.

Bone Cements↗
PubMed1998

Percutaneous vertebroplasty with polymethylmethacrylate. Technique, indications, and results.

Percutaneous vertebroplasty with acrylic cement consists of injecting polymethylmethacrylate into vertebral bodies destabilized by osseous lesions. The aim is to obtain an analgesic effect by reinforcing lesions of the spine. The major indications are vertebral angiomas, osteoporotic vertebral crush syndromes, and malignant spinal tumors. The clinically significant complications occur predominantly in patients with spinal metastatics, but in the great majority of cases they resolve with medical treatment.

Anesthesia, General↗
PubMed1997

[Percutaneous vertebral surgery. Technics and indications].

Percutaneous vertebroplasty is a technique of interventional radiology, which allows to fulfill pathologic vertebral body with acrylic cement. This method is used to strengthen the vertebral body and reduce pain in some diseases involving the vertebra. Main indications are spine angiomas, metastases and osteoporosis. The vertebroplasty is realised under neuroleptanalgesia for cervical spine antero lateral way is used. For thoracic or lumbar vertebra, the way of approach is usually transpedicular; but in some cases, this approach is not possible: osteolysis of the pedicle, surgical osteosynthesis; in such cases, a postero lateral approach is realized. Technical incidents are not rare, but are usually asymptomatic. More frequent are venous filling with cement; the veins involved can be intra spinal (vertebral plexus) or paraspinal. Instead of this frequency pulmonary embolism in direct relation with the vertebroplasty where not reported. Extravasation in intervertebral disk or soft tissue can also be observed. This last incident can be in relation with the way of the needle or with a cortical rupture. Local complications are rare: rate of neurological deficit or infection is under 0.5%. Radicular pain is observed in 3.7% of cases. These complications are in close relation with the radiological involvement of the vertebra: cortical disruption, heterogeneous Lysis of the vertebral body. The frequency of complications is 1.3% in osteoporosis, 2.5% in spine angiomas and 10% in metastatic disease. Indications concern lesion involving the vertebral body: symptomatic spine angiomas; painful osteoporotic fractures after medical treatment or in patients with a high risk of decubitus complications; in metastatic disease, vertebroplasty is a way to consolidate the vertebral body and release pain. It can be usefull in recurrent pain after chemotherapy and/or radiotherapy, and also in unstable vertebra to obtain a stabilization before radiotherapic or chemotherapic treatment isolated or in combination with surgical osteosynthesis.

Acrylic Resins↗
PubMed1996

Preoperative percutaneous injection of methyl methacrylate and N-butyl cyanoacrylate in vertebral hemangiomas.

PURPOSE: To investigate the usefulness of preoperative percutaneous injections in vertebral hemangiomas. METHODS: Four patients presented with complicated vertebral hemangioma (spinal cord compression in three cases, intermittent spinal claudiction in one case). A three-part treatment was performed: initially, arterial embolization in three cases; 1 day later, percutaneous injections of methyl methacrylate into the vertebral body to strengthen it and of N-butyl cyanoacrylate into the posterior arch to optimize hemostasis during surgery; finally, the day after percutaneous injections, decompressive laminectomy and epidural hemangioma excision (when present). RESULTS: Laminectomy was performed with minimal blood loss. The epidural component present in three cases was excised without any difficulty. The follow-up (average, 20 months) showed no evidence of vertebral collapse. CONCLUSION: Percutaneous injections of methyl methacrylate and N-butyl cyanoacrylate might be useful before surgery for vertebral hemangiomas.

Aged↗
PubMed1994

[Value of vertebroplasty combined with surgical decompression in the treatment of aggressive spinal angioma. Apropos of 3 cases].

Vertebral hemangiomas can cause difficult-to-treat neurological complications. We report our experience with three such cases. Patients no. 1 and 2 were females aged 64 and 71 years, respectively; patient no. 1 had a two-year history of weakness in the lower limbs and patient no. 2 had a five-month history of back pain. Both these patients had a pyramidal syndrome in the lower limbs. Patient no. 3 was a 61 year old male with a one-year history of left sciatica. Roentgenograms were suggestive of a hemangioma occupying the entire T8 (cases 1 and 2) or L5 (case 3) vertebra. Computed tomography and magnetic resonance imaging confirmed this diagnosis and showed that patients 1 and 2 had an anterior epidural hemangioma opposite T8 impinging on the spinal cord. In patients 1 and 2, treatment consisted in embolization of T8 followed by transpedicular injection of 6 cc of methylmethacrylate into the body of T8. One cubic centimeter of histoacryl was also injected in each lamina. The third patient had a similar vertebroplasty procedure without prior embolization since he had no epidural hemangioma. One patient (no. 1) developed intercostal neuralgia of several hours duration after the procedure. All three patients subsequently underwent laminectomy (T7-T8 with removal of the epidural hemangioma in cases 1 and 2, L5 in case 3). The pyramidal syndrome resolved within 15 days in patients 1 and 2; the nerve root pain resolved within 48 hours in patient 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Destructive spondyloarthropathy with beta 2-microglobulin amyloid deposits in a uremic patient before chronic hemodialysis.

We report a case of erosive arthropathies discovered radiologically before dialysis in a uremic patient with Alport syndrome. This patient had no hereditary amyloidosis or causes of acquired generalized amyloidosis (no chronic infections or inflammatory disease, neoplasia, lymphoma or monoclonal gammapathy). Erosive spondyloarthropathies of the cervical spine at the C5-C6 and C6-C7 levels, erosive arthropathy of the right acromioclavicular joint, metacarpal lacuna of the right hand, and lacuna of the left femoral neck were discovered 24 months before starting dialysis in this patient with chronic renal insufficiency of 17 years duration. Puncture of the vertebral disc before starting dialysis took a fragment showing amyloid deposits with permanganate-sensitive Congo red staining and positive staining with anti-beta 2-microglobulin antibodies. This observation suggests that beta 2-microglobulin amyloidosis in uremia may not be exclusively related to chronic kidney replacement therapy, but to uremia per se, especially when the latter is of long duration.

Amyloid↗
PubMed1991

[Interventional neuroradiology].

Interventional procedures in neuroradiology have three great applications: endovascular therapy, stereotactic brain procedures, percutaneous therapeutic radiology of the spine. Endovascular therapies consist of occlusions of vessels or arteriovenous malformations, desobstruction of totally or partially occluded vessels and intraarterial chemotherapy. Stereotactic brain procedures consist of biopsies and stereotactic radiosurgery. Biopsy of the spine, facet joints infiltrations under fluoroscopic guidance, intervertebral disk infiltration, chemonucleolysis and percutaneous automated nucleotomy, vertebroplasties are the different interventional procedures of the spine. This activity with an increasing development must lead to the creation of interventional neuroradiology units associated with fundamental research.

Neuroradiography↗
PubMed1989

Membranous obstruction of the inferior vena cava associated with a myeloproliferative disorder: a clue to membrane formation?

Although membranous obstruction of the inferior vena cava is frequently assumed to be a congenital defect, it has recently been hypothesized that it could be acquired and secondary to thrombosis at the ostium of hepatic veins. We report the case of a membranous obstruction of the inferior vena cava responsible for isolated hepatomegaly in a young Frenchman. No known cause of thrombosis was found but spontaneous formation of erythroid colonies occurred on bone marrow cultures. This indicated the existence of a latent myeloproliferative disorder, a frequent cause of hepatic vein thrombosis. We suggest that this association of a membranous obstruction of the inferior vena cava with a known, albeit often overlooked, cause of hepatic vein thrombosis provides strong support to the thrombosis theory of membrane formation.

Adult↗
PubMed1987

[Pseudotumoral amyloidosis of the orbit].

A case of orbital amyloid pseudotumour is reported; this rare condition typically present as a ptosis followed by slowly growing orbital neoplasm, in middle-aged women. CT-scan disclose an extra-conal, extra-osseous, calcified mass; preoperative diagnosis of this rare condition might help in avoiding recurrence, probably due to incomplete excision. Pathophysiology of these amyloid deposits remain unknown.

Amyloidosis↗
PubMed1987

[Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty].

Findings in several cases are used to demonstrate that certain vertebral angiomas may not be congenital and can ultimately provoke medullary or radicular neurologic complications. Radiotherapy is the usual treatment but is not always accepted unconditionally close to spinal cord. Destruction of angioma and consolidation of vertebral column can be obtained by percutaneous intrasomatic injection of acrylic cement. The preoperative radiologic examination includes direct phlebography with insertion of trocar, the vertebroplasty being performed under television screen surveillance. Results in seven patients treated are very encouraging but the current 2-year follow up requires extension. However, the method appears to be able to be included amongst treatment for an affection of sometimes seriously questioned benign nature.

Adult↗