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Biomedical subjects

J Benezech

Publications and source records attributed to J Benezech.

61 records · Page 4Linked to original sources
PubMed1977

[The arthritic narrow lumbar canal. Anatomoradiologic study - technical considerations].

The Narrowing of the lumbar canal by spondylosis appears as a frequent factor of cauda equina compression. There is a wide range of symptomatology : common low back pain and sciatalgia; neurogenic claudication with sensitive, motor or sphincter disturbance; radicular deficit at one or several levels. Radiological measurement of the anterior-posterior diameter of the lumbar canal does not give a good evaluation of the lesion. Qualitative analysis of spondylosis must be performed by special radiological investigation : plain X ray film and tomography shows the osteophytics spurs and articular hypertrophy; sacco-radiculography (Dimer X) with tomography and flexion-extension films shows the changes on the dural sac. Three types of lesions can be distinguish on anatomical and radiological grounds which carry a special operative management : the anterior type should be treated by discectomy, at one or more level; the posterior type needs facetectomy with or without laminectomy; the mixed type must be treated by combined operative procedures. Laminectomy only does not permit the cure of lateral radicular entrapment. Our results seem much better in our series since this diagnostic and therapeutic attitude is considered.

Aged↗
PubMed1976

Sectorial posterior rhizotomy, a new technique of surgical treatment for spasticity.

After their experience of Foerster's operation and its technical modifications in 80 cases the authors report a new concept of analysis and treatment of spasticity in lower limbs. Spasticity of the different muscle groups is classified either as "useful spasticity" or "handicapping spasticity". The first has to be preserved, the second must be reduced. In order to achieve this purpose a new technique is presented, based on operative sectorial identification of the posterior rootlets subserving the "handicapping spasticity" by electrophysiological stimulation, muscle testing, and E.M.G. studies. The conus medullaris and cauda equina are exposed by T 11-L 1 laminectomy, performed in the lateral position. The clinical and E.M.G. evaluation of responses to stimulation enables the surgeon to establish a map of rootlet groups which are marked with coloured threads. Selective resection of "handicapping posterior rootlets" is then performed after several tests of the mapping. The rootlets subserving useful spasticity are carefully preserved. Ten cases are reported, comprising five cases of cerebral palsy operated upon since 1974 and five cases of posttraumatic spastic paraplegia from the same period. Pre and postoperative findings are summarized. The technical features of this procedure are discussed and compared with other surgical procedures. The problem of the rootlet reflex arch is considered in the light of the effects of stimulation of anterior and posterior rootlets at the same level.

Adolescent↗
PubMedDate not supplied

[Evoked brain stem potentials in cases of traumatic coma of: value in determining the degree of brain stem dysfunction (author's transl)].

Auditory brainstem potentials were recorded in 22 comatose patients in whom the level of brainstem dysfunction was defined by the clinical assessment of brainstem reflexes and posture. The patients with cortico-subcortical or diencephalic levels showed normal brainstem potentials. The other patients showed a relationship between the abnormalities of the different components of the brainstem potentials and the clinical levels of brainstem dysfunction caused by the rostro-caudal evolution. Alteration of wave V seemed to be related to a midbrain dysfunction, alteration of wave III to a pontine dysfunction and alteration of waves I and II to a lower brainstem dysfunction.

Brain Injuries↗
PubMedDate not supplied

[Arthrodesis of the sub-occipital spine by screwed occipito-cervical plate. Clinical case and technical notes].

The authors report a new technique in arthrodesis of the sub-occipital spine which has been experienced since 1973 in case of metastases at CI-C2 level. An occipitovertebral metal plate, inverted Y shaped has been realised after anatomical and biomecanical studies. It is adapted to the occipito-vertebral curvature and screwed in the articular processes of C3 and C4 (14 mm screw), and in the pedicles of C2 (32 mm screw). At the upper part, the occiptal ridge offers fixation by 12 and 14 mm Muller's screw. In addition CI is attached to the plate, by a nylon thread. After the report of the first clinical case with a nine month period of follow up technical features of the material as well as practical problems are exposed. Tomograms of the cervical spine as well as bilateral brachial angiography are of paramount value. The latter investigation may reveal anomalies of the vertebral artery that can hinder of forbid the pedicular fixation. Finally the authors discuss the extension of this technique to complexe trauma of the suboccipital column.

Arthrodesis↗