PubMed Health⌕ Search

Biomedical subjects

M Sames

Publications and source records attributed to M Sames.

11 recordsLinked to original sources
PubMed2004

[The anterior approach in treatment of subaxial cervical spine injuries. (A group of 75 patients)].

AIM: The aim of the study was to evaluate long-term results of the subaxial cervical spine injuries treatment, using splint and bicortical screws stabilization via frontal access, as well as to describe the opinion on subaxial cervical spine injuries treatment methods development. METHODOLOGY: During a twelve-year period, starting in 1990, 75 patients suffering from subaxial cervical spine injuries were treated by the authors' work-team. In 96% of the cases, decompression followed by frontal access stabilization using the Caspar technique with a splint and bicortically inserted screws was performed. The Ducker and Cooper classification scale was employed to classify the fracture type. A neurological deficit was classified according to Frankel. The trauma mechanism was determined, as well as peri- and post operation complications and the patients survival rate. Furthermore, the graphic documentation taken during the observation period was assessed. RESULTS: In the patient group, the number of male subjects was three times higher and 56% of the patients under the age of 30 were reported. 40% of the patients were injured in conjunction with a traffic accident, 27% were injured following a fall from a height and 15% after jumping into unknown water. 30% of the patient fractures were classified as flexion-compression types, 30% as flexion-dislocation types, 32% as burst-compression types and 6% as extension fracture types. 22% of the patients were accepted as Frankel A, 7% as B, 5% as C, 14% as D and 52% were Frankel E. 91% of the patients suffered from monotrauma. 96% of the patients, using the frontal access exclusively, were treated with splints, bicortical screws and autologic grafts. The neurological picture improved in 8% of the patients, 15% died in the first year. CONCLUSION: The surgical treatment should be aimed at the earliest possible decompression of the neurological tissue, followed by re-introduction of the stable situation. The frontal access may be, in the majority of cases, considered the access of choice.

Adolescent↗
PubMed2004

[Results of reinnervation after peripheral nerve repair by a microsurgical technique used in 1996-1998].

PURPOSE OF THE STUDY: The authors present the results of a retrospective study of reinnervation after peripheal nerve repair by a microsurgical technique between 1996 and 1998. This is a development of a previous study by their colleagues. MATERIAL: Between 1996 and 1998, 113 injured peripheral nerves were treated by epineuroperineural suture (Ethilon; thickness, 8/0-10/0) under a microscope. To achieve a homogeneous group, 12 median and 13 ulnar nerves were included and evaluated in this retrospective study. All nerves studied were completely severed at the distal forearm and had sharply cut ends. METHODS: The results of reinnervation were retrospectively analyzed and classified according to the British Medical Research Council system (Seddon, 1972). The patients were followed up for 3 years. The patient's satisfaction with hand function was rated according our own classification. Tinel's sign and scar tenderness were evaluated. RESULTS: 17 patients (68%) achieved motor function M3 or higher and 16 patients (64%) had sensation S3 or higher. Better motor function was achieved after repair of the median than the ulnar nerve (M3 and higher in 91% and 46%, respectively). Better sensory recovery was achieved after repair of the ulnar than the median nerve (S3 and higher in 77% and 50%, respectively). Tinel's sign was positive in 68% of the patients; 10% of the patients complained of scar tenderness. DISCUSSION: Our results are comparable with the studies published so far. The patients with median nerve lesions showed better improvement after repair than those with ulnar nerve lesions and the outcome was better in hands with injury to only one nerve than in those with both nerves injured. The factors that influence peripheral reinnervation and the recovery of hand function are discussed. The surgical technique used, patient's age, regenerative capacity of the peripheral nerve affected, the interval between injury and the definitive microsurgical procedure and the quality of postoperative care are considered to be most important. CONCLUSIONS: Lesions of the peripheral nerve require special attention by a neurosurgeon competent to provide appropriate microsurgical treatment. The interval between injury and definitive treatment should be as short as possible. Postoperative care (rehabilitation and regular neurological examination) is also an important part of treatment.

Adolescent↗
PubMed2003

[The lumbar infusion test and transcranial Doppler ultrasonography in the diagnosis and treatment of normotensive hydrocephalus. Prospective evaluation of a group of patients from 2000 to 2002].

BACKGROUND: The normal pressure hydrocephalus syndrome (NPH) is characterized by the presence of a clinical triad comprising dementia, motor apraxia, and sphincter complaint, along with the presence of distinct dilatation of the ventricular system in the absence of major cortical atrophy. The diagnosis of NPH must be confirmed by including dynamic liquor tests into the algorithm of examination. The lumbar infusion test (LIT) represents the "gold standard" of liquor dynamic tests. METHODS AND RESULTS: The authors present 24 patients in a prospective managed study. Indication of shunt surgery was based on the result of LIT. At the time of assessment of the diagnosis 28% of the patients were greatly dependent on the nursing care; after the shunt implantation only 7% were still greatly dependent. Shunt implantation brought about increased percentage of patients who were evaluated as quite independent (rise from 14% to 64%). Control group consists of 10 patients with negative LIT results; there were no changes in evaluated parameters in this group. The coincidence of cerebrovascular diseases is probably the most common reason of nonresponsibility to shunt implantation in LIT positive patients.

Cerebrospinal Fluid Pressure↗
PubMed2001

Anterior approach for vertebral artery occlusion in a rabbit.

BACKGROUND AND PURPOSE: Various research protocols call for the vertebral artery (VA) occlusion. MATERIAL AND METHODS: The anterior aspect of the cervical spine was exposed, the small medial parts of two adjoining pedicles were removed and the VA was occluded by a small hemoclip. RESULTS: The vertebral artery was successfully occluded in 36 experimental animals. In 22 animals the occlusion was confirmed. CONCLUSIONS: The technique proved to be very reliable and rather easy. Its main advantage seems to be the possibility of simultaneous access to vertebral and carotid arteries.

Animals↗
PubMed2000

[Normal pressure hydrocephalus--a rare late complication of radiography of the spine using contrast media].

The aim of the study is to inform professionals about a serious complication--the liquor malabsorption--developing in relation to the routinely performed roentgen-contrastive examination (PMG). It also demonstrates advantages of the lumbal infusion test (LIT) as a part of the algorithm of the shunt operation in patients with supposed pathology of liquor malabsorption.

Contrast Media↗
PubMed1998

[Development of peripheral nerve surgery].

In the submitted review the author deals with the development of peripheral nerve surgery (PN) from ancient times to the present time incl. hithero unpublished details. He analyses in great detail the period of the last 40 years which is divided into three stages--the mechanical, biological period and the period of neurotrophism. From the Second World War to the sixties the period bears the term mechanical. The results of reinnervation during this period were not satisfactory as the nerves were connected without the use of a microscope, in major defects they were connected under considerable traction and the only criterion was the resistance against dehiscence. Significant improvement of results of regeneration of PN was recorded during the biological period. Mechanical ideas were overcome and biological and physiological reactions of the peripheral nerves were taken into account. Suture of nerves under traction was refuted and into clinical practice the surgical microscope, microsurgical technique and microsurgical autotransplantation with a nervous graft were introduced. The anatomical structure of the nerve with a plexiform pattern of the fascicles became however the limitation of surgical methods. After discovery of NGF (nerve growth factor) we can speak of the onset of a new period, neurotrophism. In laboratory experiments many substances are studied and theoretically new non-surgical possibilities how to promote regeneration lie ahead. However they cannot be applied yet in clinical practice. In injuries of peripheral nerves the only correct reconstruction method is still microsuture of the nerve and in case of losses microsurgical autotransplantation using a nerve graft.

History, 18th Century↗
PubMed1997

Surgical approach to the rabbit sciatic nerve. Technical note.

A description with anatomical pictures of a simple and gentle dorsolateral approach to the rabbit sciatic nerve are presented. Blunt separation of the septum between the semitendinosus muscle and the caput pelvinum bicipitis femoris muscle, allows for excellent access to the nerve along a considerable length. The dorsolateral subfascial vein of the thigh is an easily identifiable landmark of this septum. This gentle approach ensures very smooth healing.

Animals↗
PubMed1997

Comparison of microsurgical suture with fibrin glue connection of the sciatic nerve in rabbits.

The regeneration of the sciatic nerve after microsuture was compared with the connection of transected nerve with a coagulum of autologous blood plasma in 20 rabbits. The epineuroperineural suture was performed in 10 rabbits (group A). The severed nerve was approximated with fibrin glue of autologous blood plasma in 10 rabbits (group B). Their skin sensation margin during a 3-month-period of regeneration was examined, 90 days after surgery the connection was inspected and the nerve conduction velocity was measured across the site of the anastomosis. The microsuture was found to be firm in all 10 animals of group A. On the other hand, in 2 animals of group B, the glue failed to keep the nerve stumps approximated (dehiscence occurred in 20% of the animals). There were no significant differences found on clinical and electrophysiological testing of regenerated nerves of both groups. The method of autologous fibrin glue in the repair of peripheral nerve transection does not provide a sufficiently firm connection. This procedure with the preparation of the centrifuged plasma is a more time-consuming method in comparison with the microsuture. Epineuroperineural microsuture with maximal effort to adapt the corresponding nerve fibres remains the method of choice for peripheral nerve reconstruction.

Animals↗
PubMed1993

[Results of regeneration after peripheral nerve injuries].

Based on a group of distal injuries of the median and ulnar nerve the authors evaluate the results of peripheral nerve regeneration. For evaluation of the results and comparison with other work they emphasize the necessity of adherence to objective criteria of a useful degree of reinnervation. In their opinion the most suitable criterium is evaluation of sensitive reinnervation respecting the discrimination test up to 12 mm in the entire autozone of the nerve. The results of suture depend on the technique, interval (injury-operation) and the patient's age. In acute operations 45% of the patients of all age groups achieved the useful grade of sensitive regeneration. In late operations, where the degree of useful regeneration was achieved only in 19% of patients, the authors draw attention to the fact that a successful outcome was achieved only in patients under 30 years. The main prerequisite of successful regeneration of peripheral nerves in according to the authors early diagnosis and treatment in the acute period. With regard to the declining regeneration potential with advancing age early treatment is much more important in patients older than 30 years. Microsurgical technique is a condition sine qua non.

Adolescent↗