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FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOJOURNAL OF NEUROSURGICAL SCIENCES

Rivista di Neurochirurgia


Indexed/Abstracted in: e-psyche, EMBASE, PubMed/MEDLINE, Neuroscience Citation Index, Science Citation Index Expanded (SciSearch), Scopus
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Journal of Neurosurgical Sciences 2007 Giugno;51(2):93-8

 TECHNICAL NOTES

Endoscopic anatomy of the thecal sac using a flexible steerable endoscope

Mourgela S. 1, Anagnostopoulou S. 2, Sakellaropoulos A. 3, Koulousakis A. 4, Warnke J. P. 5

1 Department of Neurosurgery “Agios Savas” Anticancer Institute, Athens, Greece
2 Department of Anatomy, Medical School University of Athens, Greece
3 Department of Pulmonary and Critical Care Medicine, Athens, Greece
4 Department for Functional and Stereotactic Neurosurgery University of Cologne, Cologne, Germany
5 Department of Neurosurgery, Paracelsus Clinic Zwickau, Germany

In this study the ability for upward-orientated endoscopic visualization of thecal subarachnoid space using a flexible steerable endoscope was evaluated in order to compare endoscopic anatomical findings with the already known macroscopic ones of the incontained structures and to test the approach for clinical employment. For this purpose, four adult phenol-formalin embalmed cadavers were used and the approach selected was through a laminectomy window at the S1-S2 level. The dura mater was opened and a flexible steerable endoscope (Storz, of 2.8 mm external diameter with one working channel) was inserted subarachnoidally for upward-orientated observation of the content of thecal sac. By using this approach filum terminale, lower lumbar, sacral and coccygeal nerve rootlets were identified and observed in detail. By moving the endoscope even more upwards, inspection of the upper part of the thecal subarachnoid space and conus medullaris was also possible. The findings collected from the study indicate that this approach for upward-orientated intradural subarachnoid endoscopy gives an appropriate working and inspecting window to the lower, as well as to the upper part of the thecal subarachnoid space and even of the conus medullaris. Furthermore, inspection and identification of lower lumbar, sacral and coccygeal nerve rootlets is possible and efficient and the endoscopic anatomical observations coincide with the already known gross-anatomical ones.

lingua: Inglese


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