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Alexandre A.,European Neurosurgical Institute EUNI | Alexandre A.M.,Catholic University of the Sacred Heart | Zalaffi A.,University of Siena
Acta Neurochirurgica, Supplementum | Year: 2011

Anterior interosseous syndrome (Kiloh-Nevin syndrome) refers to that constellation of signs and symptoms referable to weakness of the pronator quadratus, the flexor pollicis longus, and the flexor digitorum profundus to the index finger. We present our series of 9 patients, affected by AIN Syndrome, and a group of 4 patients affected by pseudo-AIN neuropathies. In the literature there is considerable controversy concerning the treatment, but we agree that understanding of anatomical variants of innervation combined with a thorough physical examination can provide important clues as to where pathology resides. Proper treatment needs a precise and accurate diagnosis; in fact medical treatment which we present is effective for nerve dysfunction and may avoid surgery, but surgical exploration is mandatory when EMG is suggestive of a severe lesion, and localizes the specific site on anterior interosseous nerve entrapment. © 2011 Springer-Verlag/Wien. Source


Alexandre A.,European Neurosurgical Institute EUNI | Coro L.,European Neurosurgical Institute EUNI | Paradiso R.,European Neurosurgical Institute EUNI | Dall'Aglio R.,European Neurosurgical Institute EUNI | And 3 more authors.
Acta Neurochirurgica, Supplementum | Year: 2011

Research in spine surgery has proposed new soft and less invasive techniques. These are the results of our experience with oxygen-ozone therapy, which we could experiment within the Italian National Health System over 3 years. A total of 1,920 patients were admitted on the basis of unselected enrolment because of lumbosciatic pain. Patients were divided into three groups: (A) Patients with degenerative disc disease and arthropathy: 509 (26.5%), (B) Patients with failed back surgery syndrome (FBSS): 1,027 (53.489%), and (C) Patients with pure herniated lumbar disc: 384 (20%). The rationale of the treatment for all these different pathologies we have taken into consideration is the biochemical mechanism by which they can engender pain and dysfunction. Treatment for group A: paravertebral injection and phleboclysis (two cycles of 6 sessions, one each 3 days) +endoscopic neurolysis. Treatment for group B: paravertebral injection and phleboclysis (two cycles of 6 sessions, one each 3 days) + endoscopic neurolysis with intradiscal procedure (named percutaneous peridurodiscolysis). Treatment for group C: paravertebral injection (two cycles of 6 sessions, one each 3 days) + percutaneous discolysis. The perceived quality of result for this minimally invasive procedure makes oxygen-ozone therapy an interesting weapon in the hands of doctors. Furthermore, if the technique loses its clinical effectiveness, it can be repeated without harm for the patient, and costs for the health organization are notably very low, above all if compared to surgical procedures. We underline the need that this treatment should be performed in protected structures, in operative rooms, under anesthesiologic control, and in the hands of specialists. © 2011 Springer-Verlag/Wien. Source


Alexandre A.,European Neurosurgical Institute EUNI | Coro L.,European Neurosurgical Institute EUNI | Paradiso R.,European Neurosurgical Institute EUNI | Dall'Aglio R.,European Neurosurgical Institute EUNI | And 3 more authors.
Ozone: Science and Engineering | Year: 2012

This work presents results of our experience with oxygen-ozone therapy, which we could experiment inside the Italian National Health System through 3 years. A total of 1920 patients were admitted to our evaluation on the basis of unselected enrollment because of lumbosciatic pain. Patients were divided in three groups: (A) Patients with degenerative disc disease and arthropathy: 509 (26.5%), (B) Patients with failed back surgery syndrome (FBSS): 1027 (53.489%), and (C) Patients with pure herniated lumbar disc: 384 (20%).The perceived quality of result makes oxygen-ozone therapy a useful weapon in the hand of the doctors. © 2012 Copyright 2012 International Ozone Association. Source


Alexandre A.,European Neurosurgical Institute EUNI | Alexandre A.M.,University Cattolica | De Pretto M.,European Neurosurgical Institute EUNI | Coro L.,European Neurosurgical Institute EUNI | Saggini R.,University of Chieti Pescara
BioMed Research International | Year: 2014

Purpose. New interspinous process decompression devices (IPDs) provide an alternative to conservative treatment and decompressive surgery for patients with neurogenic intermittent claudication (NIC) due to degenerative lumbar spinal stenosis (DLSS). HeliFix is a minimally invasive IPD that can be implanted percutaneously. This is a preliminary evaluation of safety and effectiveness of this IPD up to 12 months after implantation. Methods. After percutaneous implantation in 100 patients with NIC due to DLSS, data on symptoms, quality of life, pain, and use of pain medication were obtained for up to 12 months. Results. Early symptoms and physical function improvements were maintained for up to 12 months. Leg, buttock/groin, and back pain were eased throughout, and the use and strength of related pain medication were reduced. Devices were removed from 2% of patients due to lack of effectiveness. Conclusions. Overall, in a period of up to 12-month follow-up, the safety and effectiveness of the HeliFix offered a minimally invasive option for the relief of NIC complaints in a high proportion of patients. Further studies are undertaken in order to provide insight on outcomes and effectiveness compared to other decompression methods and to develop guidance on optimal patient selection. © 2014 Alberto Alexandre et al. Source

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