Stabilization of cervical spine: problems and techniques.
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Biomedical subjects
Publications and source records attributed to M Boni.
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The authors describe a surgical procedure called multiple subtotal somatectomy. This operation is indicated when canal stenosis is caused by posterior protrusions of the anterior wall of the spinal canal (due to osteophytes, posttraumatic deformities, or tumoral lesions) involving three or more cervical segments. The procedure's principal phases are (1) removal up to the posterior longitudinal ligament of the central portion of three or more vertebral bodies, and (2) insertion into the prepared trench (15-mm wide) of an autologous graft, previously obtained from the iliac wing. Thirty-nine cases are presented (29 spondylosic myelopathies, 10 posttraumatic myelopathies), with follow-up periods varying from 6 months to 13 years. All grafts united, and 36 patients were benefited, while only three failed to improve.
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Duodenal diverticulum is not a rare disease, with a frequency of 1-3% in radiologic review and of 2.8-20% in pathology review; The spontaneous perforation of a perivaterian duodenal diverticulum is a rare complication, with about 100 cases reported in the literature. The post-traumatic perforation of a perivaterian diverticulum is an exceptional event, reported in single cases of the oriental literature. The authors report their personal experience about two cases of diverticular duodenal perforation, one spontaneous, the other post-traumatic, discussing the surgical problems that this rare complication present.
Castelman disease (CD) is a rare lymphadenopathy that usually presents as a solitary, slow growing mass; its etiology is still unknown. The authors described a case of CD localized in the retro-pancreatic space. A 33-year old patient, female, underwent abdominal ultrasonography because of upper right abdominal pain. The ultrasound showed gallbladder stones and a mass of 4 cm in diameter behind the pancreatic head, modifying the shape of the inferior vena cava. The patient underwent surgical excision and histological examination showed a hyaline type of CD. In the 70% of the cases, the disease is located in the mediastinum, only in 14% of the cases in the retroperitoneal space. The case we report is a hyaline type of CD that is the most frequent histological type, constitutes 90% of the cases, occurs usually in the young population and after surgical excision has a very good prognosis. Different is the clinical behaviour of the plasma cell type of CD that has an aggressive and often fatal clinical outcome. The patient we treated is still free of any symptoms one year after the operation.