By Alberto Alexandre, Albino Bricolo, Hanno Millesi
The papers during this quantity summarize information regarding the latest and potent concepts for treating diffcult sensible difficulties and painful events through the use of minimally invasive spinal surgical procedure recommendations. Spinal endoscopy either for diagnostic and therapy reasons is gifted in addition to microsurgical operations for spinal difficulties, intradiscal concepts for the remedy of disc degenerative pathology, and dynamic stabilization ideas including an up to date overview of physiopathology of the ailments. New traits in peripheral nerve surgical procedure are offered. additionally the matter of annoying nerve lesions in numerous anatomical districts is analyzed with certain cognizance at the topic of thoracic outlet syndrome. The posttraumatic elements of this disorder are mentioned either in admire of its causative mechanisms, and its medicolegal points.
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Additional info for Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery
No symptoms or signs of injury. ) A1 . Intermittent compression: irregular appearance of arm ‘‘claudicatio’’ symptoms; no anatomical local lesions. – Documented by ultrasound imaging (Doppler and plethysmography). ) A2 . Minimal anatomical local lesions: minimal stenosis with mild post-stenotic dilatation (less than twice the size of normal arterial diameter). – Ultrasound can only suspect the anatomical damage. – Conﬁrmation requires spiral CT or MRI 30 arteriography (traditional arteriography is reserved to particular questions).
When the inferior trunk was a¤ected, the most common neurological ﬁnding was a slight decrease of force in the hypothenar muscle group and interossei muscles as well as mild hypesthesia of the ulnar side of the hand, the inner side of the forearm and, occasionally, of the arm. When more than one trunk was involved various degrees of combination of the aforementioned signs was observed. Radiological ﬁndings All patients had an X-ray of the cervical spine taken immediately after the injury. Forty-ﬁve patients presented a straightening of the cervical vertebral column.
Alexandre et al. evaluating the summary results of nerve conduction studies and not the single tests. Electrophysiological tests were of the F wave type from median and ulnar nerves, SSEP (N9) from median and ulnar nerves, motor and sensory nerve conduction studies from median, ulnar and medial antebrachial cutaneus nerves and electromyography. The summary indexing of these paramethers in all the patients were positive for TOS. A control study (submitted for revision) was done with patients a¤ected by true neurological TOS and with normal control group.