[Surgical management of the failed back surgery syndrome (FBSS) using posterior lumbar interbody fusion (PLIF) with posterior transpedicular stabilization]. / Chirurgické riesenie failed back surgery syndrómu FBSS pomocou zadnej lumbálnej medzitelovej fúzie PLIF so zadnou transpedikulárnou stabilizáciou.

INTRODUCTION: One of possibility of treatment FBSS is posterior lumbar interbody fusion, PLIF with posterior transpedicular stabilization. MATERIAL AND METHODS: Between January 2005 and December 2007, the prospective study of treatment failed back surgery syndrome patients with posterior lumbal interbody fusion and posterior transpedicular stabilization was performed at the Department of Neurosurgery University Hospital FNLP in Kosice. Physical examinations were performed before surgery, after surgery 30 days, and at 4 follow-up visits (3 months, 6 months, 12 months and 24 months). At each interval, patients outcomes measures, including visual analog scale pain rating VAS and Oswestry Disability Index ODI. RESULTS: At the Department of Neurosurgery, 58 failed back surgery syndrome patients were operated on between 1.1.205 and 31.12. 2007. Long term follow up was investigated in 47 patients, 11 patients were lost to follow-up. Postoperative complications were controlled 30 days after surgery. They were presented in 9 patients (19.14%). No patient died after surgery. The working ability was found in 23 patients 49%. Before surgery all patiens used analgesic, after surgery there were present decrese in using analgesic. Improvement quality of life and decrease pain measured with ODI and VAS were investigated. ODI before surgery was 71.7 and 24 months after surgery ODI was 37.7. VAS before surgery was 7.95 and 24 months after surgery VAS was 2.82. There were found statistically significant influence on decrease pain mesuares ODI and VAS after surgery p < 0.0001. CONCLUSION: Our study results show that PLIF with posterior transpedicular stabilization can be safely perfomed and that can allow decrease pain and improve quality of life in FBSS patients.

[Interbody spacers in the treatment of cervical spine disorders]. / Náhrady medzistavcových platniciek v liecbe degeneratívnych ochorení krcnej chrbtice.

Degenerative conditions of the spine represent a group of most common lifestyle associated diseases with significant medical and important social impact. Clinical symptoms and syndromes of surgically considerable degenerative diseases of the spine mostly result from nerve root or spinal cord compression caused by a herniated intervertebral disc or a dorsal osteophyte. Therefore, the main goal of the surgical treatment is decompression of the neural structures by complete removal of the intervertebral disc and the osteophytes followed by insertion of an artificial disc spacer into the remaining space. The most frequently used procedure for treating such findings is called anterior cervical discectomy. Since its first introduction in 1950, several modifications of the original technique have been introduced. Their common feature is that removal of the degenerated intervertebral disc or the osteophytes requires stabilization of the adjacent segments by fusion. Thus, implantation of an interbody spacer results not only in intervertebral space reconstruction, but by immobilizing the adjacent vertebral bodies also in forming a firm bony bridging between them--and ultimately a solid bony block. Our paper provides a review of cervical interbody spacers in the order of their evolution from auto- and allografts, through compact materials, cages and dynamic artificial disks. Furthermore, different types of cage filling materials used for fusion augmentation are also discussed.

[Injuries of the intracranial part of the carotid artery]. / Poranenia intrakraniálneho úseku karotickej tepny.

The objective of the submitted work was to draw attention to different types of injuries of the intracranial portion of the carotid artery and some problems associated with its solution. The investigated group comprised 7 subjects (2 women, 5 men) aged 19 to 76 years who attended between Jan. 1, 1995 and Feb. 29 2000 the Neurosurgical Clinic in Kosice with sequelae of injuries of the intracranial carotid artery. Two patients developed a pseudoaneurysm. In one case it was manifested by subarachnoid haemorrhage on the 24th day after a crash, in one instance by diplopia six weeks after a retrobulbar injection. Injury of the intracavernous portion of the artery was manifested in one instance by profuse epistaxis on the 17th day after a fall from a bicycle, four times by the development of a carotid-cavernous fistula several days to 3 years after the head injury. In the diagnosis classical as well as MR and digital subtraction angiography were used. In the patient with epistaxis classical carotid angiography was 3 times negative. The results are comparable with data in the literature. In three patients the problem was resolved by ligature of the common carotid artery on the neck. In another three it was necessary to use extra-intracranial trapping. One patient will be subjected to endovascular surgery. Two patients died (a 76-year-old woman from bronchopneumonia, a 19-year-old man from meningitis, despite a liquor fistula treated correctly by a patch).