Abstract: Introduction. Percutaneous ozone discolysis consists of the intradiscal injection of medical ozone for therapeutic purposes. This is an innovative per cutaneous surgical treatment of which the use is recent in our department. The purpose of this work was to report our experience on this practice in our country where the neurosurgeon is the first and only recourse in case of disc LBR with failure of conservative treatment. Methods. This was a retrospective study from 2016-2021, including all consenting patients in whom the diagnosis of disc LBR with failure of conservative treatment was retained and who benefited from ozone discolysis. These patients were reassessed (VAS, Lasegue sign and neurological examination) at one week, two weeks, one month, three months. Results. Lumbar ozone discolysis was performed in 298 patients or 84.4% of lumbar disc herniation surgeries. This discolysis indication was mainly disabling LBR (68.8%) and hyperalgic LBR (24.8%). Discolysis concerned 1 level (48.0%); 2 levels (43.3%) and 3 levels (8.7%). At 1 week, 2 weeks, 1 month and 3 months there were respectively 61.1%; 79.2%; 90.3% and 93.6% asymptomatic cases. Pending conventional surgery, discolysis was performed in 19 cases (6.4%) of paralyzing LBR resulting in total recovery. No complications were noted. Conclusion. Ozone discolysis was currently the most commonly used treatment for the management of disc LBR after failure of conservative treatment. Patients’ favorable clinical evolution in the short and medium term indicates the efficacy of the treatment.Abstract: Introduction. Percutaneous ozone discolysis consists of the intradiscal injection of medical ozone for therapeutic purposes. This is an innovative per cutaneous surgical treatment of which the use is recent in our department. The purpose of this work was to report our experience on this practice in our country where the neurosurgeon is the first an...Show More
Abstract: Introduction. Cystic craniopharyngiomas are the most common form of craniopharyngiomas. The treatment is still debated. The less aggressive and multidisciplinary approach is more recommended. Methods. We describe 4 cases of cystic craniopharyngiomas managed in our department by implantation of an Ommaya reservoir. The diagnosis was retained on imaging and in front of the appearance of the cyst puncture fluid. Intracystic chemotherapy with bleomycin was performed in 2 cases. Results. Patient’s age was 3, 34, 51 and 65 years. There were 2 female and 2 male patients. Clinical signs were dominated by headache (4 cases) and visual disturbances (4 cases). The Ommaya reservoir was placed with an endoscope in 2 cases. Postoperative insipid diabetes was noted in these 2 cases. A puncture of the Ommaya reservoir was performed on average every 3 weeks (2 cases) in the absence of Bleomycin. Infection was noted in these 2 cases. The evolution was favorable in 3 cases including the 2 cases of Bleomycin injection. Conclusion. Ommaya reservoir implantation was a satisfactory alternative to surgical excision of craniopharyngiomas. The use of the endoscope increased the risk of developing insipid diabetes. Close punctures of the reservoir increased the risk of infection. Intra-cystic Bleomycin stopped the punctures of the reservoir.Abstract: Introduction. Cystic craniopharyngiomas are the most common form of craniopharyngiomas. The treatment is still debated. The less aggressive and multidisciplinary approach is more recommended. Methods. We describe 4 cases of cystic craniopharyngiomas managed in our department by implantation of an Ommaya reservoir. The diagnosis was retained on imag...Show More
Abstract: Subjecte To investigated the characteristics and diagnosis and treatment which were pre-hernia intervention of cascade hernia. Reduce rate of mortality and disability that is attention must be paid to prehospital intervention before the formation of a true cascade of brain herniation. clinical series of pre-hernia manifestations were rapidled that from sequential brain tissue displacement in part patients, and by developmenting. Leading to a clinical series of pre-hernia by fromed. The effect of pre-hernia intervention on prognosis which from timely onec. methods From June 2015 to December 2022, the 61 patients with unilateral acute frontotemporal parietal subdural hematoma were treated. From June 2015 to December 2022, 61 patients with unilateral frontotemporal acute subdural hematoma were evaluated according to GCS. Twenty-five patients with cascade cerebral hernia and 36 patients with cascade cerebral hernia before hernia underwent dynamic CT examination, and patients with pre-herniation of brain cascade hernia were treated with early intervention. Results The patients were followed up for 6 to 12 months. According to the Glasgow Outcom scale (GOS), there were 25 patients in the brain cascade hernia group; either with 3 cases of 1 point, 4 cases of 2 points, 5 cases 3 points, 4 cases 3 points, 2cases of 4 points, and 9 cases of 5 points. There were 36 patients in the prehernia group: 1 case of 1 point, 3 cases of 2 points, 4 cases of 3 points, 11 cases of 4 points and 17 cases of 5 points. Conclusions Unilatera supratentorial acute frontotemporal parietal acute subdural hematoma leading to the cascade cerebral hernia is easy to lead to instability of clinical vital signs or respiratory and circulatory failure. Patients were must be treated promptly at the early stage or stage I- III or in IV of cascade cerebral hernia in this group Pre-hernia intervention is the key to reduce e mortality and morbidity.Abstract: Subjecte To investigated the characteristics and diagnosis and treatment which were pre-hernia intervention of cascade hernia. Reduce rate of mortality and disability that is attention must be paid to prehospital intervention before the formation of a true cascade of brain herniation. clinical series of pre-hernia manifestations were rapidled that ...Show More
Abstract: Introduction: Spinal synovial cyst is a rare lesion in the general population, the frequency of symptomatic synovial cysts in the population is between 0.5 and 2.3%. They are more frequent in the lumbar region, leading to unilateral or bilateral lumboradiculalgia. Diagnosis is made on imaging and treatment involves percutaneous techniques or surgery. We report a case of lumbar synovial cyst treated surgically. Observations: A 54-year-old female patient, with a history of gonarthrosis, was seen in consultation for a right lumbosciatica of type L5 associated with a painful radicular claudication reducing the walking perimeter evolving for about 1 year. On admission, the patient was found to be overweight with a positive Lasègue sign on the right and pain on extension of the spine. The CT scan revealed a rounded lesion at the right L4-L5 level and conflicting with the ipsilateral L5 root at its emergence, continuous with the joint space. The indication for surgery was based on the severity of the radicular pain. The postoperative course was simple, with pain regression the day after surgery. Conclusion: The lumbar synovial cyst is a rare lesion most often manifested by radiculalgia. The diagnosis is made on imaging and surgical removal is the standard treatment.Abstract: Introduction: Spinal synovial cyst is a rare lesion in the general population, the frequency of symptomatic synovial cysts in the population is between 0.5 and 2.3%. They are more frequent in the lumbar region, leading to unilateral or bilateral lumboradiculalgia. Diagnosis is made on imaging and treatment involves percutaneous techniques or surger...Show More
