Неврология и нейрохирургия. Восточная Европа最新文献

{"title":"Results of using intraoperative ultrasound in surgery of neurodegenerative disorders of the lumbar spine","authors":"M. N. Aslanukov, S. A. Vasilyev, R. S. Levin, S. K. Oshchepkov","doi":"10.17650/1683-3295-2023-25-3-59-68","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-59-68","url":null,"abstract":"Aim. To evaluate the results of intraoperative ultrasound examination (IOUS) in surgery of degenerative diseases of the lumbar spine. Materials and methods. To evaluate the results of the use of IOUS in the surgery of degenerative diseases of the lumbar spine, an analysis of prospective examination data of 147 patients operated on for degenerative diseases of the lumbar spine in the neurosurgical department of the B.V. Petrovsky National Research Center of Surgery from 2014 to 2018. To study the accuracy of the ultrasound method for determining the level of surgical access and assessing the degree of radiation load reduction, to study the quality of ultrasound imaging of the structures of the spinal canal, a descriptive study was conducted that included 100 patients (a group of method descriptions). To determine the effectiveness of the use of IOUS, a randomized controlled trial was conducted based on a statistical comparison of the results of surgical treatment of 2 similar parallel groups of patients (control and experimental) consisting of 47 patients each, who differed only in the use of IOUS. Patients of the control group were selected from the method description group. The control and experimental groups of patients were compared according to the following criteria: the duration of surgery, the volume of intraoperative blood loss, the duration of hospitalization, the degree of root pain after surgery, the level of quality of life after surgery, the number of recurrences of herniated disc. For IOUS, we used BK Medical Pro Focus 2202 and BK Medical Flex Focus 400 ultrasound machines with neurosurgical sensors Craniotomy 8862 and Burr-Hole 8863. We performed IOUS before flavotomy, after flavotomy and after decompression of nerve structures. Results. The method of determining the level of surgical access using IOUS has a high accuracy (100 %) and allows you not to use radiography and reduce the radiation load (on average by 0.02 mSv per patient). IOUS allows to adequately visualize the structures of the spinal canal in patients with degenerative pathology of the lumbar spine: the sensitivity of the method before flavotomy is 93 %, after flavotomy – 97 %, and after decompression of nerve structures – 100 %. Due to the high sensitivity of the IOUS method, it allows optimizing surgical access, controlling the radicality of decompression of nerve structures, documenting the fact of their decompression. The use of IOUS in patients with degenerative diseases of the lumbar spine can improve the results of surgical treatment by reducing the number of recurrences of disc herniation, reducing the degree of radicular pain after surgery, reducing the duration of surgery and the volume of intraoperative blood loss. Conclusion. IOUS is a simple, harmless and widely available method of intraoperative imaging, which allows to improve the results of surgical treatment of patients with degenerative pathology of the lumbar spine.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135618926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior lumbar interbody fusion (ALIF): a review of the procedure and associated complications","authors":"G. Musa, R.E. B. Castillo, D.T. K. Ndandja, B. M. Mwela, G. E. Chmutin, G. I. Antonov, M. V. Slabov","doi":"10.17650/1683-3295-2023-25-3-119-125","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-119-125","url":null,"abstract":"Degenerative disc disease and facet joint disease involving the lumbar spine are common in the aging population and are the most frequent causes of disability. Surgical interbody fusion of degenerative levels is the most common management technique. This is an effective treatment option to stabilize the spine and reduce mechanical pain and provides indirect decompression of the neural elements while restoring lordosis and correcting the deformity. Depending on the direction of the approach to the vertebral column, various techniques have been described. Anterior lumbar interbody fusion (ALIF) offers clear and wide visualization of the disc allowing the use of large interbody grafts, which provide a significant biomechanical advantage over other types of fusion. The transperitoneal approach is a much older technique and it is not commonly performed unless in isolated cases with extensive retroperitoneal scaring following multiple abdominal surgeries. The transperitoneal approach has been associated with higher rates of bowel injury, ileus, and retrograde ejaculation, and is limited at the L5–S1 segment, hence many spine surgeons favor a retroperitoneal approach. The major setback of ALIF is the need for great vessel mobilization. This manipulation of the vessels may lead to deep vein thrombosis and a direct vascular injury. This makes vascular anatomy studies in the preoperative stage invaluable in avoiding vascular injury. Other complications include possible injury to intraperitoneal and retroperitoneal organs, especially in patients with previous surgery and adhesions. Manipulation of the intestines causes postoperative ileus which lasts a few days. Sexual dysfunction in form of retrograde ejaculation is another complication seen in patients following ALIF and this has been attributed to injury to the superior hypogastric sympathetic nerves in the lower lumbar region. This article reviews the ALIF procedure i. e., transperitoneal and retroperitoneal approaches, and the associated intraoperative, early, and late complications.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological disorders imitating spinal stenosis in elderly patients. Series of clinical observations","authors":"E. G. Seliverstova, A. Y. Kordonskiy, E. S. Druzhinina, E. K. Romanenko, A. A. Grin","doi":"10.17650/1683-3295-2023-25-3-100-110","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-100-110","url":null,"abstract":"Spinal stenosis is a pathological narrowing of the central spinal canal, lateral pocket, or intervertebral foramen due to age‑related changes, including pathology of the discs, facet joints, ligament hypertrophy, osteophyte formation and destruction of the arches. Clinically, the disease can manifest itself with pain, as well as numbness, or weakness in the arms or legs. The complexity of differential diagnosis is due to the lack of correlation between the degree of stenosis according to neuroimaging data and the severity of clinical manifestations. Spinal stenosis among 21 % of people may have an asymptomatic course. Spinal stenosis has to be differentiated from atherosclerosis of the vessels of the lower extremities, rheumatoid arthritis, piriformis syndrome, sacroiliitis, spondylitis/spondylodiscitis, amyotrophic lateral sclerosis, Guillain–Barré syndrome and other polyneuropathies. Isolated weakness should be of a particular concern in the clinical picture. Muscle hypotrophy, brisk tendon reflexes, the presence of pyramidal signs, muscle fasciculations, as well as patients’ complaints of simultaneous weakness in both the upper and lower extremities accompany them. We present and discuss three clinical cases of patients with a presumptive diagnosis of spinal stenosis. Two of them were held surgical treatment, which did not produce the expected result. Subsequently, it was found that the cause of progressive muscle weakness in the limbs was amyotrophic lateral sclerosis in two patients and the third one had Guillain–Barré syndrome, a form of acute demyelinating polyneuropathy.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jugular foramen meningeal melanocytoma","authors":"I. O. Kugushev, T. Yu. Bezborodova, V. K. Poshataev, D. S. Kim, K. V. Shevchenko, R. A. Sultanov, V. V. Karnaukhov, S. V. Tanyashin, V. N. Shimansky","doi":"10.17650/1683-3295-2023-25-3-111-118","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-111-118","url":null,"abstract":"Meningeal melanocytoma is a pigmented tumor arising from leptomeningeal melanocytes and occurring with a of 1 case per 10 million people. The main method of diagnosing meningeal melanocytoma is contrast‑enhanced magnetic resonance imaging, however, it is quite difficult to distinguish it from other skull base tumors. We present a case of successful treatment of a patient with this rare pathology","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphogenetic characteristics of glial tumors in adults per the WHO classifications of 2007, 2016, 2021. Changes in the classifications and their significance for clinical practice","authors":"V. V. Krylov, G. Yu. Evzikov, G. L. Kobyakov","doi":"10.17650/1683-3295-2023-25-3-135-148","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-135-148","url":null,"abstract":"The presented lecture is dedicated to analysis of morphogenetic characteristics of glial tumors in adults in the framework of the World Health Organization (WHO) classifications of 2007, 2016, 2021, changes in the classifications and their significance for clinical practice. This topic is important because the most difficult changes for neurosurgeons to understand in comparison of the WHO classifications of 2007, 2016 and 2021 involved sections on glial tumors and children’s tumors. The authors focus on increasing practical significance of genetic component in tumor characterization. The classification of 2007 was the last purely morphological classification of central nervous system tumors, it did not include genetic principles of tumor division in different groups. In the following years, knowledge on the significance of various mutations for prognosis of glial tumor progression and selection of optimal treatment based in genetic characteristics of the neoplasm has been actively accumulated. In the 2016 edition, morphological and genetic tumor characteristics were consolidated for the first time which was unquestionably a necessary step. Complex integrative analysis of glioma genomes has shown that genetic characteristics have higher prognostic value compared to the WHO Grade. In the classification of 2021, names of the tumors proposed in 2016 were changed, and practical significance of the genetic component in tumor characterization was increased. However, this can further complicate interpretation of histological diagnosis by practicing neurosurgeons. Implementation of the 2021 WHO classification in clinical practice assumes expansion of the spectrum of genetic diagnostic methods. The neurosurgical community should be ready to interpret morphogenetic results and select treatment tactics in tandem with oncologists based on genetic characteristics of the tumor.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basal forebrain: anatomy and clinical presentation of injury","authors":"R. E. Ishkinin, D. I. Pitskhelauri, A. E. Bykanov","doi":"10.17650/1683-3295-2023-25-3-126-134","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-126-134","url":null,"abstract":"The basal forebrain is a complex anatomic region with a lot of nuclei and fibers. Tumors or direct lesions of this area do not always manifest clinically despite it taking a part in behavior, emotion and cognition. A deep understanding of the anatomy of the gray matter and associative pathways passing through the basal forebrain allows us to take a different look at clinical manifestations in the preand postoperative period. Based on the literature review, we tried to describe the anatomical, phylogenetic and functional connections of the basal forebrain with surrounding regions and analyze what changes in clinical symptoms appear when it is locally damaged.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Third All-Russian Neurosurgical Forum","authors":"D. D. Eliferov","doi":"10.17650/1683-3295-2023-25-3-149-151","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-149-151","url":null,"abstract":".","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ligamentum flavum ganglion cyst of the cervical spine: a rare cause of myelopathy. Clinical observation and literature review","authors":"I. V. Basankin, A. A. Gyulzatyan, S. B. Malakhov, V. G. Didenko, M. I. Tomina, I. E. Gritsaev","doi":"10.17650/1683-3295-2023-25-3-88-92","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-88-92","url":null,"abstract":"Juxtafacet cysts include both synovial cysts directly from the facet capsule and ganglion cysts arising from the ligamentum flavum. Ganglion cysts of the cervical spine are extremely rare benign masses. The inner surface of the capsule of ganglion cysts consists of fibroblasts and has no anatomical connection with the capsule of the facet joint. Magnetic resonance imaging is the method of choice for the diagnosis of ligamentum flavum cysts, with a hyperintense round mass on T2‑weighted images with clear margins and no perifocal edema. On T1‑weighted images, an isointense signal is noted, and with contrast enhancement, the cyst wall more often accumulates a contrast. The method of choice in the surgical treatment of cysts is their total removal with sparing bone resection of the posterior vertebral structures. The outcome of surgical treatment of these formations is good with no risk of recurrence.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thalamotomy with focused ultrasound in the treatment of musician’s dystonia","authors":"V. M. Dzhafarov, A. I. Kholyavin, M. E. Amelin, M. Yu. Dzhafarova, K. S. Zolotareva, I. V. Senko","doi":"10.17650/1683-3295-2023-25-3-93-99","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-93-99","url":null,"abstract":"Background. Approximately from 0.5 to 8 % professional musicians may suffer from focal dystonia. Stereotactic surgery is option if conservative therapy is failed. Thalamotomy has been reported in limited series in the world literature. Aim. To demonstrate a clinical case of thalamotomy with focused ultrasound in a professional guitarist with focal dystonia of the hand. M ate ri als a nd me t h o d s. A 40‑year‑old patient suffered from spasms of the fingers while playing the guitar since 2009. Patient lost professional skills and changed his activities due to progression and severity of disease. He visited our clinic for surgical treatment, stereotactic ventro‑oral thalamotomy by transcranial focused ultrasound was considered. Results. Thalamotomy provided complete reduction of dystonia without complications. On the 2nd day after the procedure, the patient discharged. In a week mild dysarthria was noticed, which did not affect daily activities and completely regressed within a month. A month later, the patient was able to return to concert performance. The follow‑up period was 6 months with no symptoms of the disease. Conclusion. Successful clinical case of focused ultrasound thalamotomy in patient with musician’s dystonia is presented.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135781355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resection of giant sigmoid cancer metastasis in the skull bone with extra-, intracranial distribution","authors":"N. E. Voinov, A. Yu. Ulitin, P. V. Lavrovsky, M. V. Dikonenko, B. I. Safarov, S. S. Sklyar, D. A. Sitovskaya, A. S. Nechaeva, A. E. Vershinin, I. A. Sokolov","doi":"10.17650/1683-3295-2023-25-3-78-87","DOIUrl":"https://doi.org/10.17650/1683-3295-2023-25-3-78-87","url":null,"abstract":"The most common secondary target organs in patients with colorectal cancer are the liver and lungs. Cranial metastases from sigmoid colon cancer are rare. Giant cranial metastases are currently diagnosed in exceptional cases. The article presents a clinical case of a secondary extra‑intracranial lesion with a stable primary tumor focus in the sigmoid colon in a young patient with a high functional status.","PeriodicalId":24052,"journal":{"name":"Неврология и нейрохирургия. Восточная Европа","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135943108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}