[A new human machine interface in neurosurgery: The Leap Motion(®). Technical note regarding a new touchless interface]. / Un nouvel interface homme machine en neurochirurgie : le Leap Motion(®). Note technique sur une nouvelle interface homme machine sans contact.

Currently, cross-sectional imaging viewing is used in routine practice whereas the surgical procedure requires physical contact with an interface (mouse or touch-sensitive screen). This type of contact results in a risk of lack of aseptic control and causes loss of time. The recent appearance of devices such as the Leap Motion(®) (Leap Motion society, San Francisco, USA) a sensor which enables to interact with the computer without any physical contact is of major interest in the field of surgery. However, its configuration and ergonomics produce key challenges in order to adapt to the practitioner's requirements, the imaging software as well as the surgical environment. This article aims to suggest an easy configuration of the Leap Motion(®) in neurosurgery on a PC for an optimized utilization with Carestream(®) Vue PACS v11.3.4 (Carestream Health, Inc., Rochester, USA) using a plug-in (to download at: https://drive.google.com/?usp=chrome_app#folders/0B_F4eBeBQc3ybElEeEhqME5DQkU) and a video tutorial (https://www.youtube.com/watch?v=yVPTgxg-SIk).

[Learning curve for lumbar disc surgery]. / Courbe d'apprentissage pour la chirurgie de la hernie discale lombaire.

BACKGROUND AND PURPOSE: Various techniques are available for lumbar disc surgery. But failure and severe adverse events still occur during such procedures. Recent work concluded that the use of microscope was not mandatory for such procedures. METHODS: The first 70 spinal procedures for lower limb radicular syndrome by a surgeon at the beginning of this activity where studied. Particular interest was paid on adverse events, especially complications and failures. RESULT: Average duration of surgery (50min) and rate of reoperation (six reoperations needed out of 65 patients, five of them by the same surgeon) where, as expected, a bit higher than published in experienced hands. But no battered-root syndrome, injury to neighboring structures or other severe complication was observed. Noteworthy is that no patient was neurologically worsened by surgery. CONCLUSIONS: If the use of microscope may not be needed for lumbar disc open surgery in experienced hands, we strongly advice surgeons at the beginning of their practice to use it. At least, to avoid unforgiving mistakes such as picking out the root instead of the herniation.

[Chronic subdural hematoma in the elderly and computerized tomography. Study of 80 cases]. / Hématome sous-dural chronique des personnes âgées et scanner. Etude de 80 cas.

The pathogenesis of chronic subdural hematoma, especially the reason why it becomes chronic is still under discussion. A series of 80 patients older than 60 years (47% older than 75 years) were studied clinically and by CT. As compared with angiography, CT allows the subdural hematoma to be detected earlier. In some cases the subdural hematoma might have been missed without CT. The indication for surgery remains unchanged and surgical techniques too. In 80% of the patients good results from the clinical point of view could be achieved. There was no correlation between clinical signs and the findings obtained by CT. Postoperatively it usually took 60 to 70 days for CT findings to disappear. The prognosis of subdural hematoma in the elderly remains guarded. The mortality rate in our series was 11% possibly as a consequence of age.