Biomedical subjects

N Gangnet

Publications and source records attributed to N Gangnet.

3 recordsLinked to original sources

PubMed2006

[T1-T2 disc herniation: two cases].

We report two cases of exceptional first thoracic disc herniation in a 60-year-old man and a 55-year-old woman. The man was treated surgically and the woman medically. Osteoarthritis appeared to be the predominant cause of the disc herniation in both patients. Unlike the usual calcification in the medioposterior position for middle or lower thoracic spine herniations, a soft posterolateral herniation was observed here. The symptoms are limited, as observed in both patients, to a T1 radiculopathy, to be distinguished from C8 radicopathy. Myelopathy is rare. Claude-Bernard-Horner syndrome is not constant but highly suggestive. Both of these signs were absent in our patients. T1-T2 disc herniation should be suspected in patients presenting cervico-brachial medial neuralgia. MRI provides the diagnosis. Anterior surgery can be achieved without sternotomy. Careful radiographic analysis is needed preoperatively to identify the upper limit of the sternum.

Female↗

PubMed2003

Variability of the spine and pelvis location with respect to the gravity line: a three-dimensional stereoradiographic study using a force platform.

Analyzing standing posture requires a precise measure of the orientation of the various body segments with respect to the gravitational vector. We studied the posture variability of 34 healthy upright standing subjects. Using a force platform combined with a powerful stereoradiographic technique, we acquired the spine and pelvis three-dimensional (3D) geometry and located it with respect to the gravity line. For our data set, the mean 3D distance between the geometrical center of each vertebral body and the gravity line was 28 mm with a standard deviation of 5.6 mm. The vertebrae location variability, defined as plus or minus twice the mean standard deviation, was +/-40 mm in the sagittal plane and +/-25 mm in the frontal plane. The line connecting the middle of the external acoustic meatus (center of both acoustic meati: CAM) to the middle of the bi-coxo-femoral axis (hip axis: HA) was almost vertical. Its mean distance to the gravity line was 30 mm. Our data show a left lateralization, with respect to the gravity line, of the "Head-Spine-Pelvis" segments. The mean distance was 7.6 mm (SD 1.6 mm). This might be due to uneven partitioning of the body mass on each side of the sagittal plane.

Adult↗

PubMed2001

Minimally invasive endoscopic approach to the cervicothoracic junction for vertebral metastases: report of two cases.

The anterior cervicothoracic junction is difficult to expose and many techniques have previously been described. Most of them require an extensile exposure, which can lead to significant morbidity. The aim of this study is to present a less invasive approach, allowing the same exposure on the spine as a larger one. The approach begins with the same incision as the Smith-Robinson technique: a blunt dissection of the posterior face of the manubrium is performed with the finger. An endoscope is inserted through 10-mm trocars, one above the manubrium and the second through the second rib space. The upper mediastinal space is exposed; the dissection is performed on the left side, between the esophagus and trachea medially, between the innominate vein and brachio-cephalic artery distally, and between the left common carotid and internal jugular vein laterally. The recurrent nerve must be protected. Two patients with spine metastases underwent this new approach. A strut graft was fixed anteriorly after decompression of the spinal cord. Levels T1-T3 can be well exposed through this approach, allowing complete vertebral body removal at level T1 or T2. After body removal, the posterior longitudinal ligament is well exposed, allowing complete release of the spinal cord. The use of the endoscope is the key to providing a good view of the spine without an extensile exposure. This new approach is technically feasible. The exposure is sufficient for vertebral body resection and reconstruction by strut graft. The procedure is less aggressive and painful than sternotomy.

Cervical Vertebrae↗