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Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves

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Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves Acta Neurochirurgica Supplements Editor: H.-J. Steiger Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves Edited by Alberto Alexandre Marcos Masini Pier Maria Menchetti Acta Neurochirurgica Supplement 108 SpringerWienNewYork Alberto Alexandre European Neurosurgical Institute, Centro per lo studio e la cura delle malattie del sistema nervoso periferico 31000 Treviso, Italy Marcos Masini School of Medicine, University of Planalto Central and South Lake Hospital, SCN Qd 05 Bl. A Sala 912, Brasilia, Distrito Federal, Brazil Pier Maria Menchetti Florence University, Via Jacopo Nardi, 15, 50132 Firenze, Italy This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re use of illustrations, broadcasting, reproduction by photocopying machines or similar means, and storage in data banks. Product Liability: The publisher can give no guarantee for all the information contained in this book. This does also refer to information about drug dosage and application thereof. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. # 2011 Springer-Verlag/Wien Printed in Germany SpringerWienNewYork is part of Springer Science+Business Media springer.at Typesetting: SPI, Pondichery, India Printed on acid free and chlorine free bleached paper SPIN: 12674503 With 172 (partly coloured) Figures ISSN 0065 1419 ISBN 978 3 211 99369 9 e ISBN 978 3 211 99370 5 DOI: 10.1007/978 3 211 99370 5 SpringerWienNewYork Preface On behalf of the International Study Group on Spinal Degenerative Pathologies (ISSDP) (head Dr Alberto Alexandre) and the Committee for Peripheral Nerve Surgery of the World Federation of Neurosurgical Societies (head Dr Eduardo Fernandez) and sponsored by EU. N.I., European Neurosurgical Institute, the Sixth Symposium on Peripheral Nerve Microsur- gery and Minimally Invasive Treatments for Spinal Diseases was held in Treviso with wide international participation. The course was also supported by the European Association of Neurosurgical Societies and by the Latin-American Federation of Neurosurgery. Peripheral nerve problems were discussed and problems concerning differential diagnosis were highlighted, i.e. differential diagnosis in special situations such as between radicular and peripheral nerve trunk lesions, pinpointing the significance of different diagnostic tools. Minimally invasive techniques, utilized nowadays to minimize bone demolition, scarring and risk of recurrence, were carefully analyzed. Microdiscectomy was compared with the results of intradiscal techniques, and new methods were discussed in the face of problems such as epidural fibrotisation, microinstability, osteoporotic or neoplastic or postraumatic vertebral lesions. The different minimally invasive methods were discussed with participation of radiologists, orthopedic and neurological surgeons as well as physical medicine specialists coming from different countries. A new, exciting field of interest is the use of autologous blood elements in order to favor healing processes in spinal degenerative processes, where demolitive surgery tends to be substituted by nourishment of tissues and reorganisation of function. Authors from different countries in the world have contributed to this volume, for which we express our thanks. This bespeaks the wide interest that exists in the matter of minimal invasiveness and shows how widely this philosophy of treating patients is entering into neurosurgery. We are especially grateful to Prof. Armando Basso for his attentive, continuous intellectual support of our philosophy of work underlying the different clinical and surgical problems, and his contribution to building up a more physiological and anatomically-minded way of treatment. Also, we thank Acta Neurochirurgica for having dedicated this special issue to the Course in Treviso. Once again this is a good opportunity for underlining the importance of a common understanding of peripheral-nerve and spinal surgery problems in order to obtain a more perfect differential diagnosis between problems so closely related and which have quite a similar physiopathology. Treviso, Italy Alberto Alexandre Brasilia, Brazil Marcos Masini Firenze, Italy Pier Maria Menchetti v Contents Surgical Anatomy of the Sacral Hiatus for Caudal Access to the Spinal Canal ....... 1 Andrea Porzionato, Veronica Macchi, Anna Parenti, and Raffaele De Caro Radiologic Anatomy of the Sacral Canal ............................................... 5 Veronica Macchi, Andrea Porzionato, Aldo Morra, Carla Stecco, and Raffaele De Caro Imaging in Degenerative Spine Pathology .............................................. 9 Cesare Colosimo, Simona Gaudino, and Andrea M. Alexandre Operative Management of Lumbar Disc Herniation ................................... 17 F. Postacchini and R. Postacchini Philosophy and Concepts of Modern Spine Surgery ................................... 23 Soriano-Sa´nchez Jose´-Antonio, Marcos Baabor-Aqueveque, and Francisco Silva-Morales Minimally Invasive Treatment for Refractory Low Back Pain, Targeted by Epidural Endoscopy with O2/O3 and Steroid Therapy ............................. 33 Marcos Masini and Aldo Calac¸a Epidural Injections: Past, Present and Future ......................................... 39 Marcos Masini Long Term Intrathecal Infusion of Opiates for Treatment of Failed Back Surgery Syndrome ................................................................ 41 Nilton Alves Lara Jr., Manoel J. Teixeira, and Erich T. Fonoff Modic Changes: Anatomy, Pathophysiology and Clinical Correlation ................ 49 C.C. Quattrocchi, A.M. Alexandre, G.M. Della Pepa, R. Altavilla, and B.B. Zobel Periduroscopy: General Review of Clinical Features and Development of Operative Models .................................................................... 55 W. Raffaeli, D. Righetti, J. Andruccioli, and D. Sarti The Effectiveness of Endoscopic Epidurolysis in Treatment of Degenerative Chronic Low Back Pain: A Prospective Analysis and Follow-up at 48 Months ....... 67 A. Di Donato, C. Fontana, R. Pinto, D. Beltrutti, and G. Pinto vii viii Contents Endoscopic Approaches to the Spinal Cord ............................................ 75 Erich Talamoni Fonoff, William Omar Contreras Lopez, Ywzhe Sifuentes Almeida de Oliveira, Nilton Alves Lara, and Manoel Jacobsen Teixeira Application of Pulsed Radio Frequency to the Dorsal Horn and Dorsal Roots ....... 85 Omar Omar-Pasha MD Automated Nucleotomy and Nucleolysis with Ozone .................................. 97 Marcos G. Baabor, Pedro F. Va´zquez, and Jose´A. Soriano Sa´nchez Treatment of Discogenic Low Back Pain with Intradiscal Electrothermal Therapy (IDET): 24 Months Follow-Up in 50 Consecutive Patients ................. 103 Roberto Assietti, Mario Morosi, Giovanni Migliaccio, Luigi Meani, and Jon E. Block Percutaneous Coblation Nucleoplasty in Patients with Contained Lumbar Disc Prolapse: 1 Year Follow-Up in a Prospective Case Series ...................... 107 Tariq Sinan, Mehraj Sheikh, Josip Buric, Khalida Dashti, and Ali Al-Mukhaimi Plasma-Mediated Disc Decompression for Contained Cervical Disc Herniation: Results Through 5 Years ................................................. 113 Alessandro Cesaroni and Pier Vittorio Nardi Percutaneous Laser Discectomy: Experience and Long Term Follow-Up ............ 117 P.P.M. Menchetti, G. Canero, and W. Bini Mechanism of Action of Oxygen Ozone Therapy in the Treatment of Disc Herniation and Low Back Pain ............................................... 123 Emma Borrelli Treatment of Symptomatic Lumbar Spinal Degenerative Pathologies by Means of Combined Conservative Biochemical Treatments .......... 127 A. Alexandre, L. Coro` , R. Paradiso, R. Dall’Aglio, A.M. Alexandre, F. Fraschini, and P.G. Spaggiari Oxygen–Ozone Therapy for Degenerative Spine Disease in the Elderly: A Prospective Study ................................................................... 137 Matteo Bonetti, Alessandro Fontana, Francesco Martinelli, and Cosma Andreula Ozone the One and Only Drug ........................................................ 143 Pepa Osvaldo Alberto Vertebral Augmentation: 7 Years Experience ......................................... 147 Giovanni Carlo Anselmetti, Giuseppe Bonaldi, Paolo Carpeggiani, Luigi Manfre` , Salvatore Masala, and Mario Muto Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures (VCF) ....................................................................... 163 Guillermo Saul Fernandez Molina, A. Campero, R. Feito, and S. Pombo Experience with Coflex Interspinous Implant ......................................... 171 F. Villarejo, F. Carceller, A. Go´mez de la Riva, and M. Budke Contents ix DIAM Device for Low Back Pain in Degenerative Disc Disease .................... 177 Josip Buric, Massimiliano Pulidori, Tariq Sinan, and Sheikh Mehraj Percutaneous Surgical Treatment in Lumbar Spinal Stenosis with AperiusTM–PercLIDTM: Indications, Surgical Technique and Results .......... 183 P.P.M. Menchetti, F. Postacchini, W. Bini, and G. Canero Six Level Cervico-Thoracic Circumferential Reconstruction: Report of the Second Case of the Literature .........................................
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