Madreporic coral: a new bone graft substitute for cranial surgery

1988 ◽  
Vol 69 (4) ◽  
pp. 510-513 ◽  
Author(s):  
François X. Roux ◽  
Daniel Brasnu ◽  
Bernard Loty ◽  
Bernard George ◽  
Geneviève Guillemin

✓ Since 1985, the authors have been using madreporic coral fragments (genera Porites) as a bone graft substitute. Of the 167 coral grafts implanted, 150 were coral “corks” used to obliterate burr holes (diameter 10 mm), five were large implants (length 20 to 40 mm) to repair skull defects, and 12 were coral blocks to reconstruct the floor of the anterior cranial fossa. Previous experimental studies suggested that coral grafts would be well tolerated and become partially reossified as the calcific skeleton was resorbed. The authors describe their experience and detail the main biological properties of these materials, which appear to be very promising for use in cranial reconstructive surgery.

1990 ◽  
Vol 72 (3) ◽  
pp. 513-516 ◽  
Author(s):  
John A. Persing ◽  
John A. Jane ◽  
Paul A. Levine ◽  
Robert W. Cantrell

✓ A technique to expose the anterior cranial base is described with entry through the anterior and posterior walls of the frontal sinus. Burr holes are avoided in the visible portion of the forehead. Expansion of the operative field may be accomplished, if necessary, by supplemental superior frontal or supraorbital rim osteotomy. The technique is rapid, safe, and provides excellent operative exposure and superior cosmetic results.


1979 ◽  
Vol 51 (6) ◽  
pp. 870-871 ◽  
Author(s):  
L. Anne Hayman ◽  
Alfonso E. Aldama-Luebbert ◽  
Robert A. Evans

✓ A large air-filled intracranial extradural diverticulum of the frontal sinus mucosa was removed from the anterior cranial fossa of a 47-year-old man 2 years after fracture of the posterior sinus wall during craniotomy.


2001 ◽  
Vol 94 (1) ◽  
pp. 76-81 ◽  
Author(s):  
Paul D. Sawin ◽  
Curtis A. Dickman ◽  
Neil R. Crawford ◽  
M. Stephen Melton ◽  
William D. Bichard ◽  
...  

Object. The use of corticosteroid agents during the healing phase after spinal arthrodesis remains controversial. Although anecdotal opinion suggests that corticosteroids may inhibit bone fusion, such an effect has not been substantiated in clinical trials or laboratory investigations. This study was undertaken to delineate the effect of exogenous corticosteroid administration on bone graft incorporation in an experimental model of posterolateral lumbar fusion. Methods. An established, well-validated model of lumbar intertransverse process spinal fusion in the rabbit was used. Twenty-four adult New Zealand white rabbits underwent L5–6 bilateral posterolateral spinal fusion in which autogenous iliac crest bone graft was used. After surgery, the animals were randomized into two treatment groups: a control group (12 rabbits) that received intramuscular injections of normal saline twice daily and a dexamethasone group (12 rabbits) that received intramuscular dexamethasone (0.05 mg/kg) twice daily. After 42 days, the animals were killed and the integrity of the spinal fusions was assessed by radiography, manual palpation, and biomechanical testing. In seven (58%) of the 12 control rabbits, solid posterolateral fusion was achieved. In no dexamethasone-treated rabbits was successful fusion achieved (p = 0.003). Tensile strength and stiffness of excised spinal segments were significantly lower in dexamethasone-treated animals than in control animals (tensile strength 91.4 ± 30.6 N and 145.3 ± 48.2, respectively, p = 0.004; stiffness 31.4 ± 11.6 and 45.0 ± 15.2 N/mm, respectively, p = 0.02). Conclusions. The corticosteroid agent dexamethasone inhibited bone graft incorporation in a rabbit model of single-level posterolateral lumbar spinal fusion, inducing a significantly higher rate of nonunion, compared with that in saline-treated control animals.


1997 ◽  
Vol 86 (4) ◽  
pp. 670-685 ◽  
Author(s):  
Giorgio Macchi ◽  
Edward G. Jones

✓ The nomenclature most commonly applied to the motor-related nuclei of the human thalamus differs substantially from that applied to the thalamus of other primates, from which most knowledge of input—output connections is derived. Knowledge of these connections in the human is a prerequisite for stereotactic neurosurgical approaches designed to alleviate movement disorders by the placement of lesions in specific nuclei. Transfer to humans of connectional information derived from experimental studies in nonhuman primates requires agreement about the equivalence of nuclei in the different species, and dialogue between experimentalists and neurosurgeons would be facilitated by the use of a common nomenclature. In this review, the authors compare the different nomenclatures and review the cyto- and chemoarchitecture of the nuclei in the anterolateral aspect of the ventral nuclear mass in humans and monkeys, suggest which nuclei are equivalent, and propose a common terminology. On this basis, it is possible to identify the nuclei of the human motor thalamus that transfer information from the substantia nigra, globus pallidus, cerebellum, and proprioceptive components of the medial lemniscus to prefrontal, premotor, motor, and somatosensory areas of the cerebral cortex. It also becomes possible to suggest the principal functional systems involved in stereotactically guided thalamotomies and the functional basis of the symptoms observed following ischemic lesions in different parts of the human thalamus.


2015 ◽  
Author(s):  
Hera Wu ◽  
Shuting Lei

Hydroxyapatite, a bioactive ceramic, has been combined with biodegradable polymers to create composite three-dimensional interconnected porous scaffolds for bone graft substitutes. The materials and fabrication methods of these composite scaffolds are reviewed. The resulting mechanical and biological properties of scaffolds produced from the combination of certain materials and fabrication methods are analyzed. Requirements for a bone graft substitute and third generation scaffolds with the addition of osteoinductive and osteogenic features to composite scaffolds including biomolecule delivery and cell seeding are also introduced. Finally, the benefits of using additive manufacturing technologies to enable high level of control over the design of interconnected pore structure are discussed.


1971 ◽  
Vol 35 (1) ◽  
pp. 90-94 ◽  
Author(s):  
G. Vasudeva Iyer ◽  
N. D. Vaishya ◽  
A. Bhaktaviziam ◽  
G. M. Taori ◽  
Jacob Abraham

✓ The rare occurrence of angiofibroma as a primary intracranial tumor in the middle cranial fossa is reported in a young woman, and related reports are reviewed.


1983 ◽  
Vol 58 (2) ◽  
pp. 284-286 ◽  
Author(s):  
Larry A. Rogers

✓ An acute subdural hematoma dissecting into the posterior cranial fossa and resulting in death is reported. The patient had undergone spinal puncture by the lateral cervical technique prior to development of the hematoma. Autopsy demonstrated that the source of hemorrhage was an anomalous intraspinal vertebral artery.


2004 ◽  
Vol 1 (1) ◽  
pp. 87-89 ◽  
Author(s):  
Dean Chou ◽  
Phillip B. Storm ◽  
James N. Campbell

Object. Autologous bone graft harvesting from the iliac crest remains the gold standard for fusion surgery. One disadvantage of autologous bone harvesting is the patient's enduring postoperative pain at the donor site. Nerve injury is one of the postulated mechanisms that may account for this pain. The object of this study was to determine whether the lateral cutaneous branch of the subcostal nerve is vulnerable to injury in the process of obtaining grafts from the anterior iliac crest. Methods. Anatomical dissections were performed on 10 cadaveric specimens to ascertain the size of the T-12 subcostal nerve and its position in relation to the iliac crest. Conclusions. The lateral cutaneous branch of the subcostal nerve may lie as close as 6 cm from the anterior superior iliac spine. This nerve is very vulnerable to injury when harvesting bone from the anterior iliac crest. Knowledge of the anatomy may decrease the risk of injury to this nerve.


1974 ◽  
Vol 41 (6) ◽  
pp. 724-727 ◽  
Author(s):  
R. C. Saxena ◽  
M. A. Q. Beg ◽  
A. C. Das

✓ The dura mater of the posterior cranial fossa of 86 adult human cadavers has been examined grossly after the injection of India ink through the confluence of sinuses in order to visualize the extent, communications, and tributaries of the straight sinus. Variations from the textbook description of formation by the union of the inferior sagittal sinus and the great cerebral vein are described and discussed.


1977 ◽  
Vol 47 (4) ◽  
pp. 551-555 ◽  
Author(s):  
Donald H. Wilson ◽  
Dwight D. Campbell

✓ Anterior cervical discectomy without bone grafting may become the procedure of choice for acute cervical disc protrusions. This operation was performed on 71 patients, all of whom were followed from 1 to 6 years. Complications were minor in nature. The results were excellent and sustained.


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