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Biomedical subjects

P Guigui

Publications and source records attributed to P Guigui.

43 records · Page 3Linked to original sources
PubMed1994

Experimental model of posterolateral spinal arthrodesis in sheep. Part 1. Experimental procedures and results with autologous bone graft.

OBJECTIVES: The authors evaluated the reliability in obtaining a posterolateral spinal arthrodesis (PSA) with autologous bone graft. SUMMARY OF BACKGROUND DATA: Posterolateral spinal arthrodesis using autogenous cancellous bone graft is the most simple and efficient technique to get a spinal graft. No extensive biomechanical study of PSA is available. Thus, an experimental model of PSA is needed. METHODS: Eleven sheep underwent lumbar autologous bone grafts and Cotrel-Dubousset instrumentations, and four sheep were used as controls. Sacrifice and biomechanical evaluation of the lumbar spines were performed after 1 year. RESULTS: All grafts appeared continuous. A large decrease of flexibility (in rotation and in translation) was found in grafted spines in every direction. Failure in extension occurred at a mean value of 35.26 +/- 3.71 Nm. CONCLUSION: A constant and homogenous PSA appears to be obtained in sheep under conditions close to the human surgery.

Animals↗
PubMed1994

Experimental model of posterolateral spinal arthrodesis in sheep. Part 2. Application of the model: evaluation of vertebral fusion obtained with coral (Porites) or with a biphasic ceramic (Triosite).

OBJECTIVES: The authors evaluated two bone substitutes in a posterolateral spinal arthrodesis (PSA) model in sheep: coral porites (99% calcium carbonate, Biocoral, Inoteb, France) and a biphasic ceramic (BCP) (65% hydroxyapatite and 35% B tricalcium phosphate, Triosite, Zimmer International). SUMMARY OF BACKGROUND DATA: Bone substitutes would be of great interest for PSA. Previous trials began with two kinds of biomaterials: natural coralline calcium carbonate, and phosphate calcium ceramic. METHODS: A lumbar PSA was performed in 11 sheep (coral group) and in 9 sheep (BCP group). Sacrifice and biomechanical tests were performed after 1 year. RESULTS: A large decrease of flexibility in all directions was obtained with both coral PSA and BCP PSA similarly to autologous graft. No nonfusion case was observed. CONCLUSION: In conditions close to the human surgery, a PSA can be obtained using either coral porites or BCP as bone substitutes.

Animals↗
PubMed1994

[Assessment of the use of the Graf ligamentoplasty in the surgical treatment of lumbar spinal stenosis. Apropos of a series of 26 patients].

PURPOSE OF THE STUDY: The aim was to determine the usefulness of a flexible stabilization system associated with neural decompression in the treatment of lumbar spinal stenosis. 2 points were especially studied: low back pain at follow up and Graf system ability to prevent postoperative instability. PATIENTS AND METHODS: 26 patients were screened retrospectively with an average follow up of 29 months. Clinical results were appreciated on the functional Beaujon's score. Preoperatively all of the patients had static and dynamic standard X-rays. The evaluation of sagital olisthesis was done by using displacement of the posterior border of the vertebral body (Wiltse and Winter method's). On the dynamic X-Rays we accepted as criteria of instability an olisthesis of 2 mm or more, an angular displacement equal or superior to 14.3 degrees in L2 L3, 15.5 degrees in L3 L4 and 18 degrees in L4 L5 according to the Dvorak's criteria, or a rotatory dislocation. Neurological compression was studied from CT scan and dynamic and static myelogram. RESULTS: According to our classification results were excellent in 8 cases, good in 6 cases, fair in 9 cases and poor in 3 cases. Generally results were good on the neurological symptoms (neurological claudication, radiculalgia at rest or at exertion) and fair on the low back pain. Only one half of our patients had improvement of back pain and 15 per cent were worsened. A postoperative destabilization occurred in 27 per cent of our patients (7 levels, 7 patients). The dynamic preoperative X-rays of these destabilized levels detected always 2 or 3 criteria of instability: hypermobility, olisthesis of 2 mm or more on the flexion X-rays or rotatory subluxation. For the remaining cases only one criteria of instability was found (hypermobility or olisthesis on flexion X-rays). CONCLUSIONS: Concerning the postoperative low back pain using of a flexible system associated with a neural decompression did not improve the results. Concerning the prevention of postoperative instability the Graf system did not avoid the slipping of the most instable levels.

Female↗
PubMed1991

[Reoperation in failure of surgical treatment of sciatica].

39 patients have been reoperated on for failed lumbar discs. In this series enhanced MRI, enhanced CT scan and disco-CT have been used. These modern imaging means allowed a better assessment for the causes of failure; thus, only in 4 patients was a pure periradicular fibrosis disclosed. The results of reoperations are significantly better than those of a previous series of the same institution, where these imaging devices could not been used. 76% of the patients benefited from reoperation.

Adult↗
PubMedDate not supplied

[Lateral lumbar disk herniation].

A retrospective study of 41 lateral discal hernias observed between 1984 and 1991 were studied among the 1080 discal hernias treated during this period. CT scan, performed in all cases, distinguished several different types of hernia: foramen hernias (26), extraforamen hernias (12), mixed forms (5) associated with canal component (11). Thirteen disco scans were required. Nucleolysis was performed in 24 patients (58%) and surgical treatment was the first intention choice in 17 (41%). Outcome, evaluated with a function score developed in the unit were good in the 17 surgery cases (100%). In the nucleolysis patients results were good or excellent in 13, average in 4, and poor in 7. Five of the nucleolysis failures were later operated leading to good results in 3, average in 1 and no change in 1. Indications for surgery are more frequent in this type of discal hernia and results in our surgical series were better than those for chemonucleolysis.

Adult↗