Biomedical subjects
Publications and source records attributed to F Lesoin.
The authors report about the use of Cotrel and Dubousset osteosynthesis, which had been designed for operative treatment of spinal deformations, for other dorso-lumbar pathology in 15 of their own patients with due to trauma or tumour instable lesions. They underline its advantages in application to trauma or tumour cases.
The authors analyze a series of 53 patients who presented with unruptured intracranial aneurysms. Fifty were operated upon, 2 died during the post-operative period, 5 were left with their pre-operative neurological deficit, 43 were cured and have not subsequently presented with any cerebral or meningeal haemorrhages. None of the 3 patients who were not operated upon has since presented with a cerebro-vascular accident. Twenty-five aneurysms were asymptomatic, discovered fortuitously during angiographic examination, and their size was generally between 3 and 6 mm. Twenty-eight aneurysms presented with various neurological signs and symptoms (headaches, facial pain on 9 occasions, ischaemic vascular accidents on 7 occasions, ocular signs on 8 occasions and generalized epilepsy on 4 occasions), with a range in size from 7 to 10 mm. The clinical and autopsy series published in the literature show the usefulness of surgery when certain factors come together and increase the risk of rupture: middle-aged patients (between 40 and 65), arterial hypertension, aneurysm located on the anterior part of the circle of Willis and with a diameter close to the critical size (10 mm) for rupture.
Surgical access to the anterior frontal region of the skull base is facilitated by the removal of a fronto-orbital bone flap. This technique was first described as a two-step procedure by Cophignon. We recently devised a simplified one-step approach in which a single bifrontal supra-orbital bone flap is removed. This report is a technical description and resume of our experiences.
The authors report on their experience with the bilateral anterolateral approach to the cervical spine, emphasizing its advantages and disadvantages and discussing its indications.
Tumors that are strictly intracavernous remain rare and their management is a subject of controversy. The authors describe the direct surgical approach to these lesions and consider this approach necessary to determine the exact nature of the intracavernous process. The subsequent treatment, radiotherapy in particular, will depend on this assessment.
The authors report on the use of transcervical approach and screw fixation for upper cervical spine pathology. They describe the direct osteosynthesis for odontoid fractures and atlantoaxial fixation using a screw fixation of the articular processes. The surgical technique is described and its advantages and disadvantages are discussed as are its indications.
Three cases of extraneural metastases of pineal tumors are reported from a series of 81 cases collected between 1949 and 1982. The diagnostic, etiopathic and therapeutic problems arising from these cases and from a review of the literature are considered.
A unilateral pseudobulbar syndrome consequent to unilateral capsulothalamic infarction is described. Motor deficit of the face was associated with marked velar and pharyngeal unilateral palsy; paresis of limbs was mild. ACT scan revealed a circumscribed infarction of the genu of the internal capsule. This raised the problem of unilateral supranuclear pharyngeal palsies and of the precise anatomy of the genicular tract in the genu of the internal capsule.
The authors report 6 cases of thoracic disk herniations in patients with Scheuermann's disease. They underline the relationship between the neurological symptomatology and Scheuermann's disease by the herniation and evolution in their treatment by a new surgical approach.
The authors report their experience with cervical foraminal disc herniation. The importance of the computed tomographic scan in its diagnosis is emphasized, and discoforaminotomy is described.
Thirty-four patients were operated for dorsal disk pathology by a postero-lateral approach. The first cases have been followed-up for over 4 years and have shown this method to be reliable. When associated with the "harpoon" marker technique, the surgical indications now include not only patients with progressive radiculo-medullary symptoms, but also cases of sudden decompensation and those limited to radicular symptoms.
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The authors report their experience of the antero-lateral bilateral approach for the treatment of inferior spinal cervical metastasis. They underline the effect of osseous posterior wall compression.
The authors report their experience of cervical foramina disk herniation. They underline the interest of C.T. scan for its diagnosis and use for the approach a combined antero- and lateral approach by diskoforaminotomy.
The authors report their experience of anterolateral bilateral approach of cervical spine. They underline the advantages and inconvenience of this route and discuss the indications.
Diastematomyelia is rarely diagnosed in adulthood, and apparently 8 cases only have been reported. We report here a 59 year-old woman who recently experienced backpain with irradiations to lower limbs, mild distal weakness and sphincter disturbances. Diastematomyelia was suspected because of a history of lumbar "cutaneous malformation" operated when 4 month old, and a hairy patch over the lumbar spine. C.T. scan showed diastematomyelia and revealed a posterior spur of bone protruding into the sagittal plane from the posterior part of L3 and L4 and dividing the posterior part of the low inserted spinal cord. It appears that, when diastematomyelia has been diagnosed in adulthood, the level of the malformation was lower than when diagnosed in childhood.
The authors report their experience of radiculomedullary transposition for the treatment of neurological complications by kyphosis or kyphoscoliosis. They use a posterolateral approach by transversoarthropediculectomy. They underline the necessity to treat all etiopathological aspects.
The authors report the use of direct osteosynthesis for odontoid fractures by screw. The approach is a transcervical approach. Its advantages and inconvenients are reported. Its indications are discussed.