Treatment of chronic pain by spinal cord stimulation

Failed back surgery syndrome (FBSS) is often used to describe the condition of patients who have experienced continued pain after surgery. It is of multifactorial genesis and may be the consequence of various lumbar spinal diseases; lumbar disc herniation surgery or spinal canal stenosis laminectomy. The presented series included 13 patients affected with chronic pain related to FBSS who underwent implantation of spinal cord stimulation. The mean percentage of pain relief was 90 % for all patients. 60% of the patients were in a better psychological status and the intake of analgesic medications has been reduced of more than 70%. More than 50% of the patients could resume professional activities. Analysis of the risks and benefits comes in favour of spinal cord stimulation

Geomatic Approach and Geophysical Interpretation of the Hydrogeological Basin of the Hassi Naga Region (Algerian Southwest)

In this work, we propose a model of Geomatics in the Hassi Naga region, which is located in the Hamada of Tindouf, southwestern Algeria, about 70 km to the northwest of the region. This approach is based on prospecting and thematic analysis of the distribution of Geoelectrical measurements in order to better estimate and manage the Hydrogeology of this region of the Tindouf basin. The results of the geophysical survey allow us to design a complete model that meets the needs of Hydrogeology, whose methodology we have applied consists of decomposing our subject into three classes of entities: Geomatic, geophysical and hydrogeological, discovering the relational links, doing the thematic analysis and ending with results that help to solve the problem of water (Hydrogeology) of the area studied

Skull metastasis of hepatocellular carcinoma in normal liver: Case report

Background: So far hepatocellular carcinoma (HCC) is the most common liver malignant tumour; it is rarely encountered on a healthy liver (9). The metastasis from HCC cancer are seen in lymph nodes (16%–40%) and lungs (34%–70%), (1,3,4,5,7,8), bone metastasis is unusual and some locations stay rare among them the skull (2,4,5). We report here a case of a patient operated in our department for skull metastasis. That patient was followed for hepatocellular carcinoma in digestive surgery department. Case presentation: The patient is a 57 years old male presenting HCC on healthy liver, the patient was referred to our department by digestive surgery colleagues to manage a parietal subcutaneous mass; brain CT scans were performed objectified a calvarial osteolytic process. We remove the tumour and we put a cranioplasty using surgical cement, later the histological studies were in favour of secondary location of hepatocellular carcinoma. Conclusion: Skull metastasis from hepatocellular carcinoma is rare, reporting such cases strengthen the idea of evoking HCC metastasis in the differential diagnosis of cranial subcutaneous mass

Resection of giant invasive thoracic schwannoma: Case report

Even though spinal nerve sheath tumours, presented especially by schwannomas, are considered to be mostly benign; they can gain a huge size and have an invasive behaviour, causing spinal cord compression, bone destruction, and make the total removal of the tumour a real challenge for the surgeon. This type of tumours is recently described as giant invasive spinal schwannoma (GISS), this type rarely reported in the thoracic region; deserve a special studying vis-a-vis the diagnosis and the management of both the tumour and the bone destruction.       &nbsp

Early diagnosis and management of traumatic dura tear with brachial plexus injury without spinal lesions in childhood

Although the dura is a thick membrane, it could be severed in spine surgery and less frequently by a traumatism (7,8,10); in this case, it is usually accompanied with bone or ligamentous injury (2). Rare cases are reported of a traumatic dura tear without spinal lesion and would suspect in the first place a brachial plexus injury (2,8). Dura tears are rarely seen in childhood (3). We report a case of early diagnosis of dura tear in brachial plexus injury without bone or ligamentous lesions on a child of 4 years old and we discuss the diagnostic and treatment modalities

Communicating spinal epidural thoracic arachnoid cyst en-bloc resection: A case report

Background: Spinal extradural arachnoid cyst is an uncommon, expanding lesion which may communicate with the subarachnoid space, The etiology still remains unclear, but the most accepted explanation is the existence of areas of weakness in the spinal dura , Spinal arachnoid cysts are usually in the thoracic spine, and they may cause symptoms due to spinal cord compression. Case Presentation: Patient is a 54-years-old female who presented with progressive back pain and motor deficit, Magnetic resonance imaging (MRI) study revealed an extradural cyst extending from T2 to T4 isointense with the cerebrospinal fluid (CSF) on all sequences and did not enhance on T1-weighted post-contrast MRI. Patient underwent T2-T4 laminectomy, en-bloc resection of the lesion was achieved and the histopathological examination objectified an arachnoid cyst. Conclusion: Spinal extradural arachnoid cyst can cause neurologic deficit and the mainstay of treatment in patients with neurological symptoms is surgical removal of the cyst together with ligation of the communicating pedicle and closure of the dural defect

Analysis of a Hybrid Solar Collector Photovoltaic Thermal (PVT)

AbstractA solar hybrid photovoltaic thermal (PVT) is a set of combined solar collector, which consists of a photovoltaic module (PV) for the conversion of electrical energy and solar plan for the high efficiency thermal energy conversion, in the same frame.An attempt made to analyze the hybrid solar collector using Computational Fluid Dynamics (CFD) to simulate the PVT solar collector to a better understanding of heat transfer capabilities in this type of systems. In the present work, the fluid flow and heat transfer in the module are studied using the ANSYS14 software. The heat transfer phenomenon conjugate between the photovoltaic cells and the coolant is modeled using the FLUENT software. The transfer of heat by the solar radiation is not modeled; however, the effects of radiation are taken for consideration when calculating the conditions for heat flux limit for the collector region. The geometric model and fluid domain for the CFD analysis is generated using ANSYS software DesingModeler, mesh geometry is carried out by ANSYS Meshing Software

Thermal Performance of Hybrid PVT Collector with Natural Circulation

Hybrid photovoltaic thermal (PVT) collectors allow simultaneous production of electrical energy thus heat energy. There are several configurations of hybrid collectors (to produce water or air). For hybrids water collectors, there are several configurations that differ by the nature of the absorber (serpentine, tubes...). In this paper, an absorber tank is studied. The circulation of the coolant is natural (we do not use the pump). We present the obtained results in our experimental study and we analyzed the data, and then we compare the results with the theory practices. The electrical performances of the hybrid collector are compared with those of conventional photovoltaic module mounted on the same structure and measured under the same conditions. We conducted experiments with natural circulation of the coolant (Thermosyphon), for a flow rate of 0.025kg/m²

Otospongiose : a propos de 149 cas

Introduction : L’otospongiose est une ostéodystrophie de la capsule otique se traduisant par une surdité de transmission ou plus rarement une surdité mixte d’apparition progressive. Le but de notre travail est d’analyser les caractéristiques épidémiologiques, cliniques, paracliniques et comparer les résultats en fonction de l’âge, du stade de l’ostéodystrophie, de la technique chirurgicale et de la prothèse.Patients et méthodes : notre étude est rétrospective portant sur 124 patients (149 oreilles) colligés sur une période de 9 ans (2000-2008).Résultats : notre population a comporté 86 femmes et 38 hommes. La moyenne d’âge à l’intervention était de 39,82 ans. La surdité était bilatérale dans 61,3% des cas et unilatérale dans 38,3%. Les seuils moyens préopératoires de la conduction osseuse et aérienne étaient respectivement de 17,33 dB et 52,52 dB, le rinne moyen était de 35,19 dB. La tomodensitométrie a été réalisée chez 63 patients. On a réalisé 21 platinectomie totale, 24 platinectomie partielle et 101 platinotomie calibrée. Selon la classification de Portmann, on a trouvé une répartition sensiblement égale entre les stades II, III et IV. On a utilisé un piston téflon 6/10 mm dans 119 cas et 4/10 mm dans 27 cas. Le rinne moyen postopératoire était de 15,95 dB. a 1 an, le rinne était de 14,81 dB avec un résultat satisfaisant de 94,2%.Conclusion : Il ressort de notre travail que certains facteurs semblent prédictifs de bons résultats et qui sont : le sexe féminin, l’âge <50 ans, le stade chirurgical< stade IV, la platinotomie, et le piston 0,4 mm.Mots clés : otospongiose, conduction osseuse, conduction aérienne, platinotomie, platinectomie.Objective : Otosclerosis is a common disorder of the otic capsule characterized by the presence of a progressive conductive or rarely mixed hearing loss. The aims of this study were to analyses the epidemiologic, clinical, paraclinical characteristic and compare our results according to age, stage, surgical technique and prosthesis. Patients et méthodes : Our study is retrospective about 124 patients (149 ears) in the period of 9 years (2000-2008).Results: Our population included 86 female and 38 male patients. mean age at intervention time was 39,82 years. The hearing loss was bilateral in 61,3% of cases and unilateral in 38,3%. The bone and air conduction threshold was 17.33 dB and 52,52 dB, the air-bone gap was 35,19 dB. The CT scan was realized in 63 patients. We have realized 21stapedectomy, 24 partial stapedectomy and 101 stapedotomy. In accordance with Portmann classification, the distribution between II, III and IV stages was almost equal. We used 6/10 mm Teflon piston prosthesis in 119 cases and 4/10 mm in 27 cases. The postoperative air-bone gap was 15,95 dB. after 1 year, the air-bone gap was 14,81 dB with a satisfying results in 94,2%.Conclusion: it seems that some factors are predictive for good results like a female sex, age<50 years, stage< stage IV, platinotomy and piston 4/10 mm.Keyswords : otosclerosis, bone conduction, air conduction, stapedectomy, stapedotom

Spinal epidural angiolipoma causing spinal cord compression: A case report

Background. Spinal angiolipoma (SAL) is a rare tumour with double component mature adipose tissue and proliferating abnormal blood vessels, which result in spinal cord compression requiring an urgent surgical removal. We report a case of woman with spinal angiolipoma. Case presentation. The patient is a 26 years old woman with past medical history of a low grade urothelial bladder carcinoma removed 4 months before she consults at our department, 2 months later the patient presented a lower limbs weakness. The clinical exam at the admission found a patient with paraparesis, hypoesthesia at the level of Th4 and urinary urgency. The spinal MRI objectified a spinal cord compression by a lesion located at the epidural space from Th2 to Th4. The patient was operated and a fatty well vascularized tumour distinct from the epidural fat was removed through a Th2 to Th4 laminectomy. The pathology study was in favour of an angiolipoma. Days after the operation the patient recovered totally, the weakness and the urinary urgency disappeared. The patient is flowed since 24 months she got pregnant. Conclusion. Spinal angiolipoma is a rare tumour with a clinic of spinal cord compression, MRI is the gold standard in diagnosis it shows a fatty lesion with a large enhancement, surgery is the perfect treatment with good outcome and exceptional recurrence