Biomedical subjects

Jan Frédérick Cornelius

Publications and source records attributed to Jan Frédérick Cornelius.

4 recordsLinked to original sources

PubMed2006

Microsurgical cervical nerve root decompression by anterolateral approach.

OBJECTIVE: Cervical radiculopathy caused by a posterolateral soft disc herniation or spondylosis is a common pathology. METHODS: Decompression of a stressed cervical nerve root is a routine neurosurgical procedure. Most of the time it is achieved through an anterior approach and, less frequently, through a posterior approach in specific indications. RESULTS: According to the principles that an anterolateral compression must directly be reached and that working in the vicinity of the vertebral artery is safe under visual control, we developed the anterolateral approach to the cervical intervertebral foramen and the nerve root using a minimally invasive technique to remove the offending process. CONCLUSION: Microsurgical cervical nerve root decompression by anterolateral approach is a minimally invasive technique, permitting one to remove the offending process staightforwardly. The disc and bone resections are minimal. This method avoids osteoarthrodesis or arthroplasty with disc prosthesis. This technique is efficient with good results and low morbidity.

Cervical Vertebrae↗

PubMed2006

Anterolateral approach to the V1 segment of the vertebral artery.

OBJECTIVE: We describe the normal anatomy, variations, and the surgical technique to expose and control the V1 segment of the vertebral artery (VA). METHODS: The VA V1 segment extends classically from the subclavian artery to the C6 transverse foramen. It courses obliquely upwards and posteriorly in the cervical fat tissue, at a distance of 5 to 10 mm from the C7 vertebral body. Along its course, the VA V1 segment is crossed by the inferior thyroid artery, the thoracic duct, and the sympathetic chain. For neurosurgeons, the safest approach is to expose the distal part of the V1 segment at the C6 transverse foramen level through an antero-lateral approach. Otherwise, direct exposure of the subclavian artery requires vascular surgery expertise. RESULTS: Surgical exposure of the VA V1 segment can be indicated on approaching the C6-C7 intervertebral disc space for degenerative disease or on treating tumoral processes in its vicinity. With developments of endovascular techniques, revascularization procedures are more rarely indicated nowadays. CONCLUSION: Perfect knowledge of the anatomy and of the surgical technique permits a safe exposure and control of the VA V1 segment.

Anatomy, Artistic↗

PubMed2005

Osteoid osteomas and osteoblastomas of the occipitocervical junction.

STUDY DESIGN: We describe our surgical experience to remove osteoid osteomas and osteoblastomas of the occipitocervical junction. In this location, vertebral artery vicinity requires special consideration. OBJECTIVES: We illustrate our surgical approaches to remove lesions confidently, while minimizing bone resection to preserve stability. SUMMARY OF BACKGROUND DATA: Up until now, osteoid osteomas and osteoblastomas of the occipitocervical junction are reported as case reports. Several treatment methods have been described to treat osteoid osteomas. Nevertheless, surgery is the treatment of choice for lesions located in the C0-C2 region. METHODS: A retrospective review of 7 patients, including 5 men and 2 women, with a mean age of 21.0 years (range 3.0-38.0) was conducted. Clinical outcomes were evaluated immediately and after a mean follow-up of 27.6 months. RESULTS: There were 6 and 1 patients who underwent surgery with the anterolateral and posterolateral approaches, respectively. In osteoid osteomas, the nidus was removed, and the peripheral condensation was drilled up to normal bone (n = 4) or partially resected (n = 2). One osteoblastoma was removed extensively up to soft tissues. No osteo-arthrodesis was performed. Before surgery, all patients complained of pain, 3 presented with neck stiffness, and 2 with a torticollis. Immediately after surgery, all complaints disappeared. One patient underwent repeat surgery 15 months later for a recurrence. At the end of the follow-up, all patients were symptom-free, and partially resected peripheral condensations were stable on computerized tomography. CONCLUSIONS: Removal of osteoid osteomas and osteoblastomas of the occipitocervical junction is safe and efficient. Stability is preserved if more than half the joints are preserved with a proper surgical approach that minimizes bone resection.

Adolescent↗

PubMed2005

Progression of an osteoid osteoma to an osteoblastoma. Case report.

The authors report the unusual case of a 25-year-old man with occipitocervical pain related to a lesion of the C-1 lateral mass. Initially this lesion measured 8 mm and exhibited radiological features of an osteoid osteoma. Seven years later, as pain increased and became unresponsive to antiinflammatory drugs, computerized tomography scanning demonstrated progression to a 16-mm lesion, highly suspicious of an osteoblastoma. After mobilization of the vertebral artery from the C-1 groove, the lesion was completely resected via an anterolateral approach. Complete symptomatic relief, restoration of cervical range of motion and preservation of cervical stability were achieved immediately after surgery, and the results were confirmed at the 4-year follow-up examination. Pathological examination of tissue samples confirmed the diagnosis of osteoblastoma. Osteoid osteoma rarely evolves to osteoblastoma. Deterioration of a patient's ability to control pain is a warning sign. Insight into such cases underlines the importance of close long-term radiological follow-up examination in patients with conservatively treated osteoid osteomas.

Adult↗