Bilateral C1-C2 Claw for Atlantoaxial Instability

OBJECTIVE: Atlantoaxial stability can be achieved by laminar hook systems via posterior approach. This technique is much more safer than using screws. We presented our experience with the C1-C2 claw procedure

Hakan HANIMOGLU Bilateral C1-C2 Claw for Atlantoaxial Instability Atlantoaksiyel ‹nstabilite için C1-C2 Pençe Uygulamas›

ABSTRACT OBJECTIVE: Atlantoaxial stability can be achieved by laminar hook systems via posterior approach. This technique is much more safer than using screws. We presented our experience with the C1-C2 claw procedure. METHODS and MATERIAL: Seven patients with atlantoaxial instability were operated by using C1 and C2 hooks, rods and transverse connector at Neurosurgery Clinic of Istanbul University Cerrahpasa Medical Faculty between the years 2005 and 2008. RESULTS: Satisfactory stabilization was achieved in all patients. Operative complication or instrumentation failure was not observed. CONCLUSIONS: C1-C2 claw is a safe technique and adequate stabilization is achieved with the use of a transverse connector

Intracranial hypotension following scoliosis surgery: dural penetration of a thoracic pedicle screw

The authors report on a 14 years old female with intracranial hypotension who had a history of spinal instrumentation surgery for scoliosis 3 months prior to her admission. She had been diagnosed with migraine in a neurology clinic and was under medical therapy when presented. During the investigation process, a right thoracic pedicle screw, which was penetrating and transversing the dura mater at the T3-T4 level was identified. The diagnosis and management of such a case is discussed. Knowledge of this entity is of extreme importance to spine surgeons, in order to prevent delayed diagnosis and possible complications

Duraplasty Using Autologous Fascia Lata Reenforced by on-site Pedicled Muscle Flap: Technical Note

Objective: Postoperative cerebrospinal fluid (CSF) leak is a common complication in the practice of neurosurgery, and various surgical techniques were described to overcome and manage this problem. Besides not applying watertight closure of the duraplasty, the inviability and the poor vascularization of the graft and/or the dura (eg, reoperations, multiple operations, or cranial radiotherapy) may lead to delayed healing of the Suture site and resultant persistent CSF leaks. We present a simple technique that uses on-site muscle flap with pedicle to supply and vascularize the autologous fascia lata, preserving the viability of the graft and reenforcing its healing ability

An experimental model of traumatic nasoethmoidal cerebrospinal fluid fistula

Cerebrospinal fluid fistula secondary to head trauma is a potentially dangerous problem and precise localization and radical treatment is mandatory. The diagnostic technique is either computed tomography cisternography or MR cisternography. For evaluating the safety of diagnostic modalities and efficacy of treatment especially in terms of surgery, animal studies demonstrating traumatic cerebrospinal fistula model are indispensable not only for neurosurgeons but also for neuroradiologists. The authors in this paper describe a traumatic cerebrospinal fistula in an animal model using rabbits. The cerebrospinal fluid leakage was demonstrated successfully in all eight rabbits and was verified by computed tomography cisternography. The results led us to conclude that rabbit model of traumatic cerebrospinal fluid fistula is safe and has low mortality and morbidity rates. Further studies including larger number of animals should be considered in order to verify safety more accurately

Investigation of Survivin Gene Polymorphism and Serum Survivin Levels in Patients with Brain Tumors

Background/Aim: The single nucleotide polymorphism -31C/G identified in the survivin gene promoter seems to be associated with over-expression of survivin, an anti-apoptotic protein. In gliomas, increased survivin expression correlated with decreased survival. The aim of the study was to investigate whether survivin gene polymorphism associates with benign and malignant brain tumors and whether it affects survivin serum levels. Patients and Methods: Survivin polymorphism -31C>G was genotyped in 82 patients with brain tumors and 65 healthy controls by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and survivin levels were evaluated by enzyme-linked immuno sorbent assay (ELISA) in patients and controls. Results: Serum survivin levels in patients with malignant tumors were higher than patients with benign tumors (pG did not differ between patients and controls. Conclusion: Survivin promoter -31C>G gene polymorphism seems to be associated with serum survivin levels in brain tumors of different grades and histologies