Chapters authored
Radio Frequency in the Treatment of Lumbar Facet Joint Arthropathy: Indications and Technical Notes
Low back pain is one of the most reported symptoms in adult life. Different etiologies have been evoked. Degenerative disease of the spine is the most common cause. Facet joint arthropathy is the second leading cause of low back pain in degenerative disease. Failure of medical treatment will lead to more invasive therapeutic option. Radio frequency is a well-known therapeutic option for refractory low back pain related to facet arthropathy. We present our results analyzed retrospectively between January 2015 and March 2018. In addition, we describe our workflow, our procedure technique, and our results. According to our findings, 73% improved their VAS pain score by at least 50% over 3 months. Twenty-seven percent failed to improve with this procedure. There was a 20-point improvement on the SF-36 QOL; the overall satisfaction was high. When patients are selected carefully, radio-frequency ablation technique is a safe and efficient procedure. Its complication rate and cost are low. We recommend it as one of the therapeutic tools in the management of low back pain related to facet joint disease.
Part of the book: Chronic Pain
Neuronavigated and Laparoscopic-Assisted Ventriculoperitoneal Shunt Placement
Hydrocephalus is an abnormal accumulation of excess cerebrospinal fluid (CSF) in the brain causing increased intracranial pressure, which can arise from a variety of causes, including congenital, acquired, or idiopathic pathologies. Ventriculoperitoneal (VP) shunting is most commonly used to treat hydrocephalic patients, relieving the increased intracranial pressure by draining excess CSF from the ventricles to the peritoneal cavity. VP shunts are primarily completed using either an open or a more minimally invasive neuronavigated laparoscopic-assisted surgical technique. There is a high level of surgical complications, shunt failures and revision rates following VP shunting. It is suggested that different surgical techniques are associated with varying degrees of patient outcomes, surgical complications, and revision rates, with the less invasive laparoscopic-assisted approach producing improved results. We present our results on 14 consecutive hydrocephalic patients, analyzed retrospectively between 2017 and 2019, investigating the benefits offered by the neuronavigated laparoscopic-assisted insertion of VP shunts. Additionally, we explain our workflow and procedural technique. By investigating these differences, changes can be implemented in current routine procedures to ameliorate patient safety, surgical complications, and revision rates.
Part of the book: New Insight into Cerebrovascular Diseases