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J Chabannes

Publications and source records attributed to J Chabannes.

At least 19 recordsLinked to original sources
PubMed1995

[Lumbar canal stenosis. Retrospective study of 158 operated cases].

The authors report the results of a retrospective study of 158 lumbar spinal stenosis (LSS), all operated (111 degenerative, 26 congenital, 21 mixed). Eighty seven percent of the patients had a low-back pain and 81.6% a radicular pain. Only 57.6% of them had a polyradicular claudication. A neurological deficit (motor, sensitive, or involving sphincters) was present in 36.6% of cases. A myelographic block was noted in 23.4% of cases, and in 20.3% a spondylolisthesis with an intact neural arch was found. Surgery consisted of a posterior lateral spinal canal calibration, sometimes associated with a ventral canal calibration (via the posterior route) (6.3%), and/or excision of a disc herniation at one (47.5%) or two levels (3.8%). Mean follow-up after surgery was 7.8 months. The global result was good or excellent in 75.2% of cases. Radicular pain was relieved in 89.1% of cases, and polyradicular claudication in 90.1% of cases. Neurological deficit improved in 50.6% of cases. In only 59.8% of cases relief of low-back pain was achieved. Statistically low-back pain (lasting for over 2 years) improved less, but a preoperative spondylolisthesis didn't influence the quality of the result regarding this symptom. Semiology, pathophysiology, and surgery particularly regarding spine stability are discussed.

Adult↗
PubMed1991

[Prevention of late post-traumatic epilepsy by phenytoin in severe brain injuries. 2 years' follow-up].

The high incidence rate and the invalidating nature of post-traumatic epilepsy after severe brain injury have encouraged the authors to review the prophylactic treatment of this type of epilepsy. Thirty-four out of 86 randomised patients with brain injuries admitted into a neurotraumatology intensive care unit were treated prophylactically, immediately after the injury, with an intravenous hydantoin injection in a dose sufficient to provide stable and effective blood levels. This was followed by dose-adjusted oral administration maintained for a minimum period of 3 months. After a 2 years' follow-up, there was a significant difference between treated and untreated patients, since only 6 per cent of the patients treated suffered from post-traumatic epilepsy, as against 42 percent in the untreated group.

Adolescent↗
PubMed1989

[Atlanto-occipital luxation and syringomyelia: 2 rare complications of cervical injury. Diagnostic and therapeutic effects. Apropos of a case].

The authors report the case of a 19 years old patient with an undiagnosed traumatic atlanto-occipital dislocation complicated after two years by a rapidly evolutive syringomyelia. This clinical case which associates two rare complications of cervical traumatology allows to discuss the problems of both pathologies especially on the following points: --The early diagnosis of the dislocation by tomography and CT scan is the only mean to treat totally these lesions and perhaps to avoid the complications like syringomyelia. --In case of delayed diagnosis, when the dislocation is "fixed" the complete decompressive surgery both by a posterior and a trans-oral way is for the authors the treatment of choice.

Adult↗
PubMed1988

[Diagnosis and surgical strategy in 3 cases of benign and unusual tumors of the occipito-cervical skeleton].

The authors report three cases of benign tumours of the occipito-cervical skeleton, remarkable for their rarity and especially by their unusual, even exceptional anatomic site: an osteoid osteoma, a pre-medullary chondroma and an extra-dural exostosis developing within a hereditary multiple disease. This presentation which allows to recall a few epidemiological and diagnostic problems is essentially focused on operative strategy and particularly on the choice of the best way to cope with surgical difficulties to be met. The osteoid osteoma whose diagnosis is difficult raises two surgical problems: the relation with the vertebral artery and the preservation of the atlanto-occipital joint. An approach through limited occipital craniotomy has allowed a perfect control of the vertebral artery and a complete removal without joint damage. Pre-medullary chondroma: a complete removal has been performed through the anterior way as described in rare observations of the literature. Post operatively, the patient had a complete neuro-orthopedic recovery. The antero-lateral exostosis has been removed through the posterior way by first resecting the basis of implantation, which has allowed the mobilization of the lesion without cord damage. Results have been good in the three cases both from neurological and orthopedic points of view.

Adult↗
PubMed1987

[Diagnostic and therapeutic problems of osteomeningeal defects and traumatic cerebrospinal fluid defects of the anterior floor of the base of the skull. Apropos of 95 cases].

The authors here report teaching drawn from the latest ninety five cases of osteo-dural defects in basilar skull fractures they have surgically treated. They particularly insist on the following points: Difficulties in establishing a clinical diagnosis when the traumatism is in its acute stage: initially 55% of patients do not show any symptom of rhinorrhea, so that the diagnosis is only based on X-ray data. Previous to any surgical treatment the number of serious septic meningitis is rather high in as much as it reaches 10.55% in this series. Risk of infection together with bone damages incite the authors to suggest a surgical treatment of dural defects in their acute stage, namely within the two weeks following the accident. The study of results shows that due to treatment complications, are not insignificant. The authors then tackle the problems of technics and osteo-dural restoration. They, at last, explain, in this series, the interest of preventive antiepileptic treatment by hydantoins during and after the operation. Despite complications due to treatment the results in this series appear to be significant enough to allow the authors to place the indication of the surgical treatment of traumatic osteo-dural defects in basilar skull at the acute stage of their evolution.

Bone Transplantation↗
PubMed1987

[Acute post-traumatic tetraparesis: a developmental complication of cervical arthrosis. Physiopathology, clinical study, prognosis. Apropos of 6 cases].

After dealing with the anatomo-pathology of arthrosis, and then the physio-pathology of cervico-arthrotic myelopathy, the authors describe just now six cases of acute post-traumatic tetraplegia happening as a complication of cervical arthrosis. They do insist on the circumstances of that unexpected coming of such neurologic accidents, on their prognosis very often pejorative, on the necessity of a preventive surgical treatment at the stage of cervico-arthrosis myelopathy not very evolved, which is the only one accurate device to avoid the acute decompensation, insisting at last on the functional sequela most often severe of these complications.

Acute Disease↗
PubMed1986

[Prospective trial of treating aneurysmal meningeal hemorrhage by delayed operation under cover of antifibrinolytic therapy].

Seventy patients with subarachnoid haemorrhage due to ruptured intracranial aneurysms were managed by delayed intervention (third week) along with the prescription of antifibrinolytic drugs (tranexamic acid 6 g/daily). During the pre-operative period, 41 patients stayed in the same clinical status as on admission or improved, whereas 29 deteriorated due to rebleeding (4 cases), vasospasm (18 cases), large hematoma (4 cases), hydrocephalus (2 cases) and postarteriographic accident (1 case). Clipping the aneurysm was finally achieved in 42 patients only; with 3 deaths, 3 severe sequellae, 8 light handicaps, and 28 patients considered as cured with returning to previous occupations. As far as the whole series is concerned, these results yield a 38.5% rate of mortality, 20% morbidity, and 41.5% recovery. It is concluded that 1) Tranexamic acid was effective in reducing the risk or rebleeding, 2) Third week delayed intervention associated with this drug significantly reduced the operative mortality, but probably favoured vasospasm, and finally had no beneficial effect on the overall results concerning the entire series of patients.

Adult↗
PubMed1984

[Bipedicular fractures of C2 and safety belts].

The authors have studied 10 cases of C2 bipedicular fractures which occur in automobilists having fastened safety-belt at time of collision. The description of the lesions presented by these patients and a literature review on the subject of safety-belt and cervical spine let them ask about the effectiveness of the safety-belt in prevention of cervical spine lesions.

Accidents, Traffic↗
PubMed1984

[Early per- and postoperative epileptic seizures during operations on osteomeningeal breaches. Value of preventive treatment with hydantoins].

The value of prophylactic anti-epileptic treatment in surgery of osteomeningeal breaches has been studied. This surgery exposes to a high risk of seizures, 20 to 25 of our cases after conventional surgery. 74 operated cases of osteomeningeal breaches, among then 38 under preventive anti-epileptic therapy are reviewed. The pre and postoperative epileptic fits up to 24 hours after the operation were taken in consideration.

Craniocerebral Trauma↗
PubMed1984

[Fractures of the posterior arch of C2. Apropos of 34 cases].

The authors preferred the term of "fracture of the posterior arch of the axis", rather than the restrictive terms of bipedicular or bi-isthmic fractures commonly referred to in the literature. It was possible, from 34 cases to joint out 4 different figures of fractures of the posterior arch of axis: isthmus, body and articular process, pedicle and lamina. From this classification it is possible to get indications for surgical treatment, as some of those fractures need internal fixation and others not. On completing Xrays study with research of instability between C2-C3 it's possible to fix a standard management for those fractures. --at first reduction for many patients, then --immobilisation by a minerva cart in mostly cases --or surgical approach and internal fixation in case of diastasis or of bad reduction --anterior arthrodesis if needed (anterior instability) --or both posterior fixation and anterior arthrodesis.

Adult↗
PubMed1982

[Our experience with vertebral grafts in the surgery of recent severe fractures of the dorsolumbar spine].

The authors report their experience of spine fusion in the management of fracture dislocations of the thoracic and lumbar spine. In a series of over a hundred surgical stabilization, plate instrumentation alone was orthopedically unsuccessful in 20% of cases after plate removal. Instrumentation is but a tutor, whereas spine fusion is an element which brings definite spine stability. Clinical and roentgenographie results are given. Based on the different types of spine injuries, indication are discussed as well as surgical approach and technique with a possible association of several methods applied to the same patient.

Adolescent↗
PubMed1981

Fractures of the frontal sinus.

Fractures of the frontal sinus are frequently seen in patients with cranio-facial injuries. Trauma to the posterior wall and more deeply located tissues: anterior fossa, dura and brain, give an indication of the seriousness of such injuries. We point out some particular aspects of our experience; in the neurosurgical approach to such lesions; we use a classification based on treatment: -when the posterior wall of the sinus is not, or only slightly damaged, we drain it using a thin suction catheter pulled through the fronto-nasal duct, kept in place for six to ten days. -when a comminuted fracture of the frontal arch occurs in the sinus area, a large cortico-cancellous onlay bone graft is used to rebuild a harmonious frontal contour and avoid the risk of secondary deformity.

Adolescent↗
PubMed1981

[Acute arachnoid cysts in traumatic vertebro-medullary pathology (author's transl)].

The authors report seven cases of arachnoid cysts of the spinal cord discovered in the immediate post-traumatic period of spinal trauma. Five cases were dorso-lumbar traumas which often did note appear serious on roentgenograms. Similar groups of symptoms were encountered in the different cases, particularly the initial symptomfree period. Immediate surgery is mandatory and the subsequent prognosis is good. Two cases of cervical cysts have a less typical symptomatology and a less favorable operative outcome. The pathophysiology of this acute and evolutive affection is unclear.

Adolescent↗
PubMed1975

[Frontobasal injuries and csf fistulas. Attempt at an anatomoclinical classification. Therapeutic incidence].

The authors present a classification of trauma to the cranial base, based on observation in 80 cases. There are five types. Type I : involves only the anterior wall of the frontal sinus. Type II : involves the face (craniofacial disjunction of the Lefort II type or crush face) and extend upward to the cranial base and, in occurency, to the anterior wall of the frontal sinus, because of the facial retrusion. Type III : ivolves frontal part of the skull and extend down to the cranial base. Type IV : is a combination of types II and III. Type V : involves only ethmoidal or sphenoidal bones. Cerebrospinal fluid leak is unfrequent in types II, and transitionnal, if it occurs ; but it often occurs in types III, IV and V which include in every case a dural tear. Correct diagnosis facilitates treatment. Fractures of types I and II can be fully treated by maxillo-facial surgeons, whereas for types III, IV, and V, they need the help of a neuro-surgeon.

Brain Injuries↗