Results of Operative Treatment of Protruded and Ruptured Lumbar Discs

Gurdjian, E. S.; Ostrowski, Andrzej; Hardy, Warren N.; Lindner, Dror; Thomas, L. M.

doi:10.3171/jns.1961.18.6.0783

Cited by 52 publications

(12 citation statements)

References 7 publications

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“…In the occipital route, the burr hole location is established in a standard fashion, located 60-80 mm above the inion and 30-40 mm lateral to the midline. 4,7,10,11,14,18) On the other hand, the external aim point has been variously described in surgical textbooks, especially with reference to the sagittal plane, as the nasion, 18) the tip of the top of the ear, 11) or not specified 14) for cerebrospinal fluid sampling or temporary drainage; and the middle of forehead, 10,16) 10 mm above the nasion, 4) and the medial canthus 7,10,15) for shunt placement. This situation is confusing for trainee neurosurgeons and standard manual puncture sometimes results in incorrect ventricular catheter placement.…”

Section: Discussionmentioning

confidence: 99%

Manual Occipital Ventricular Puncture for Cerebrospinal Fluid Shunt Surgery: Can Aiming Be Standardized?

Shimizu

Tanaka²,

Iida

et al. 2004

Neurol. Med. Chir.(Tokyo)

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The manual occipital ventricular puncture is a standard surgical procedure, but specific targeting has not received sufficient attention despite the experience of anatomical disorientation. This study tried to identify an exact site for the ideal trajectory with this method, especially in the sagittal plane, which avoids contact with the choroid plexus that may be the major source of complications. A total of 44 consecutive adult cases undergoing cerebrospinal fluid shunting through the occipital route for hydrocephalus were retrospectively reviewed for the following: correlations between burr hole site, direction of puncture, and location of the ventricular catheter based on postsurgical radiological studies; calculation of the ideal trajectory to place the catheter tip in the anterior horn of the lateral ventricle without contact with the choroid plexus through the standard occipital burr hole. In addition, the relationships between the location of the ventricular structure, the cranial base line connecting the nasion and inion, and the size of the ventricle were evaluated. Incorrect catheter emplacement was found in five cases, which suggested that this procedure using the standard burr hole site and aim point might result in incorrect catheter placement. The ideal external aim points were widely distributed because of the variable heights of ventricular structures from the cranial baseline. No correlation between the locations of the anatomical points and ventricular size was found. The present study could not define a standard external aim point. Tailored preoperative planning of the trajectory is recommended.

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Section: Discussionmentioning

confidence: 99%

Manual Occipital Ventricular Puncture for Cerebrospinal Fluid Shunt Surgery: Can Aiming Be Standardized?

Shimizu

Tanaka²,

Iida

et al. 2004

Neurol. Med. Chir.(Tokyo)

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“…Rawlings 55 saw only one patient out of 27 showing ESR below 20 mm/h, but this was a patient treated with steroids. Only Lester 35 reports a considerable number of spondylitis patients with normal ESR (8 out of 22). No mention was made of time and number of investigations.…”

Section: Discussionmentioning

confidence: 99%

Infection of the intervertebral space following conventional and microsurgical operation on the herniated lumbar intervertebral disc a controlled clinical trial

Dauch

1986

Acta neurochir

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SummaryReview of the literature reveals "chat considerable knowledge has accumulated on intervertebral space infection following lumbar disc surgery. This is based on more than 400 observations. There are, however, no unifying concepts regarding the pathogenesis of the condition. While the reported incidence has seemed to increase in the last three decades, we noticed a significant reduction in frequency of this important complication of lumbar disc surgery after introducing microsurgical techniques. The significance of this finding is discussed with respect to pathogenesis.

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“…5 First of all, it is important to prevent the formation of these meningocoeles by tightly suturing all the dural lacerations that may occur at the time of hemilaminectomies performed for the treatments of lumbar disc herniations, whenever possible. As first noted by Swanson and Fincher (1947), and later reiterated by Gurdjian et al (1961), as well as by Rinaldi and Peach (1969), gelfoam and/or muscle are poor substitutes for a careful, watertight suture.…”

Section: Diagnosismentioning

confidence: 94%

“…The dural dehiscence was sutured. Gurdjian, Webster, Ostrowski, Hardy, Lindner, and Thomas (1961) analysed 1,176 cases of lumbar disc operations performed by the usual method of partial hemilaminectomy. They recognized that if the dura is torn inadvertently, it should be repaired if necessary by an exposure through a more complete laminectomy.…”

Section: Review Of Literaturementioning

confidence: 99%

Iatrogenic lumbar meningocoele: report of three cases

Rinaldi

Hodges

1970

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY We have reported three cases of iatrogenic lumbar meningocoeles after surgery for herniated lumbar intervertebral discs. We reject the term spurious, pseudo, or false as given by earlier writers. We feel that, in reality, these sacs are true meningocoeles, with complete arachnoidal lining and freely communicating with the intraspinal subarachnoid space. We have also given a brief outline of the clinical features, elucidated the mechanisms operative in the production of symptoms, and suggested the cardinal features of radiographic diagnosis. Prevention is, of course, the best way to avoid this complication. If a dural tear does occur, every effort should be made to suture it in a watertight manner.

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Results of Operative Treatment of Protruded and Ruptured Lumbar Discs

Cited by 52 publications

References 7 publications

Manual Occipital Ventricular Puncture for Cerebrospinal Fluid Shunt Surgery: Can Aiming Be Standardized?

Manual Occipital Ventricular Puncture for Cerebrospinal Fluid Shunt Surgery: Can Aiming Be Standardized?

Infection of the intervertebral space following conventional and microsurgical operation on the herniated lumbar intervertebral disc a controlled clinical trial

Iatrogenic lumbar meningocoele: report of three cases

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