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Biomedical subjects

M Benoist

Publications and source records attributed to M Benoist.

At least 73 records · Page 4Linked to original sources
PubMed1984

[Complications and impact of sagittal osteotomy of the ascending ramus. Personal experience].

Results of a qualitative and non-statistical study of the various accidents and incidents occurring during sagittal osteotomy of the ascending rami are reported. Three types of complication were noted: vascular, nervous and bony. Vascular sequelae in one case are analyzed in greater detail. These accidents occasionally affect the vital prognosis. Stricter attention to certain points in the surgical technique used may avoid all these complications.

Acromegaly↗
PubMed1983

[Stenosis of the lumbar canal: nosologic and semeiologic study. 163 operated cases].

The authors report a retrospective study of 163 cases of degenerative or constitutional stenosis of the lumbar canal. In this series, the most frequent cause was osteoarthrosis and constitutional stenoses were relatively rare. The authors note that this is often a difficult aetiological distinction to make, especially in elderly patients and the anatomical deformities caused by osteoarthrosis lead to stenosis of the canal similar to that seen in constitutional malformations. Sensori-motor claudication is inconstant and was only found in one third of the cases in this series. More often, the lumbar stenosis presents as nerve root pain. It can be distinguished from root disease of disc origin by the frequent absence of Lasegue's sign and of spinal stiffness. When a herniated disc is associated with a stenosis, the clinical picture is altered and can then resemble that of disc sciatica. The diagnosis of stenosis depends on the radiological examination. This series confirms the diagnostic value of the abnormalities seen on standard X-rays, but the severity and the extent of the stenosis can only be assessed by performing tomography, water-soluble contrast myelography and C.T. scan. The authors discuss the limitations and degree of reliability of each of these investigations. The extent of the surgical decompression depends on the severity of the symptoms and on the results of this radiological survey.

Adolescent↗
PubMed1983

[The surgical treatment of lumbar stenosis and its results. A series of 163 operated cases].

163 patients were operated for degenerative lumbar stenosis (only 10 did not have osteoarthrosis), following the failure of medical treatment. The surgical decompression varied according to the anatomical type of the stenosis: central, lateral or mixed. In 13 p. cent of cases, it was followed by an arthrodesis. There were no deaths. The most frequent complications were: haematoma (6 p. cent), infection (5 p. cent), aggravation of the neurological disturbance (3 cases), breeches in the dura, practically inevitable in very tight stenosis (13 p. cent) and epidural fibrosis (4 re-operations). When there is no sliding prior to the operation, the risk of aggravation or appearance of sliding in cases of spondylolisthesis is somewhat higher (6 cases out of 64). The different symptoms are unequally improved by the decompression: root pain is the best relieved (69 p. cent cure, 20 p. cent improvement) together with intermittent claudication (75 p. cent cure, 14 p. cent improvement) and, to a lesser degree, back pain (48 p. cent cure, 32 p. cent improvement). There is a possibility of recovery even in the severe forms of motor disturbance.

Arthrodesis↗
PubMed1982

[Chemonucleolysis in the treatment of sciatica from herniated lumbar disc (author's transl)].

A proteolytic enzyme was used to dissolve the nucleus pulposus in 140 cases of sciatica from herniated lumbar disc. The results were satisfactory in 75% of 120 patients followed up for more than 6 months. This percentage of success, similar to that obtained with surgical excision of the disc, can only be achieved with a rigourous technique and, more importantly, with strict selection of the patients. Chemonucleolysis is indicated only for patients with unquestionable clinical and radiological evidence of herniated disc, in which case it can be considered as the ultimate medical treatment of sciatica associated with this lesion. No serious complications were observed in our series, but the risk of allergic reaction must be borne in mind.

Adolescent↗
PubMed1982

[Treatment of disk sciatica by chemonucleolysis. 120 cases].

One hundred and twenty patients suffering some sciatica due to disc herniation have been treated by chemonucleolysis. All the patients had received conservative treatment for at least four months. The minimum followup after nucleolysis was six months. In 114 patients, radiculography was positive and in 6, radiculography was negative but phlebography was positive. Patients with symptoms of spinal stenosis, or with signs of sequestrated disc or who had been previously operated on by laminectomy were excluded from the study. By a lateral extradural approach, 4000 units of chymopapain were injected into the disc under general anaesthesia after discography. All patients except 3 had only disc injected. Results were good in 92 patients. 21 of the 28 failures were operated on. In 18 cases, a mechanical cause was found at operation with 16 good results. Complications were rare and benign. No neurological complication was noted. It is concluded that chemonucleolysis should be the last step in the conservative management of sciatica.

Acute Disease↗
PubMed1982

[Diagnosis of extruded disk hernia].

The diagnosis of an extruded prolapsed intervertebral disc is a contra-indication to chymonucleolysis. The authors tried to define the diagnosis by comparing clinical signs, radiculography and operative findings in 98 patients. There is no characteristic clinical sign. On radiculography, there is no pathognomonic sign of an extruded prolapsed intervertebral disc, which is difficult to distinguish from an extra-ligamentous prolapse. However, the image of compression or amputation situated above or below the disc, especially when it is irregular should make one strongly suspect the diagnosis.

Diagnosis, Differential↗
PubMed1981

[Degenerative lumbar stenosis (author's transl)].

Sixty eight patients with degenerative lumbar stenosis have been operated on: 42 presented a degenerative spondylolisthesis (S.D) with predominantly central stenosis; while in 36 with arthrosic sciatica (S.A.), stenosis was rather lateral. In most cases clinical symptoms are different from those of disc herniation. Myelography with "amipaque" appears necessary to allow a really planified operation, with liberation of all the roots involved by bony compression. In these conditions, a high percentage of good results is obtained. Consequently, after failure of conservative treatment, open release of the compression is advisable, even in elderly patients. In some cases postero-lateral fusion should be performed in addition.

Adult↗
PubMed1981

[Lesion of the parotid, still known as Godwin's syndrome. A case report (author's transl)].

Parotidectomy with conservation of the facial nerve, followed by radiotherapy to lymph glands, was employed to treat a benign lympho-epithelial lesion in the parotid. Clinical characteristics, therapy, and prognosis of this rare affection are described though diagnosis is difficult, the presence of such a lesion should be considered in all cases of parotid tumours.

Aged↗