11 results on '"Stéphane Fuentes"'
Search Results
2. PICA injury secondary to anterior odontoid screw fixation: Case report of an exceptional complication
- Author
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Kaissar Farah, A. Reyre, K. Cot, Mikael Meyer, and Stéphane Fuentes
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Male ,medicine.medical_specialty ,Subarachnoid hemorrhage ,Bone Screws ,Iatrogenic Disease ,03 medical and health sciences ,Pseudoaneurysm ,Fracture Fixation, Internal ,Young Adult ,0302 clinical medicine ,Cerebellar hemisphere ,Odontoid Process ,Medicine ,Humans ,Pica (disorder) ,Cerebellar ataxia ,business.industry ,Cerebral Arteries ,Subarachnoid Hemorrhage ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Radiological weapon ,Spinal Fractures ,Neurology (clinical) ,medicine.symptom ,Complication ,business ,Cerebellar artery ,030217 neurology & neurosurgery - Abstract
Background Odontoid fracture is a common injury in the upper cervical spine that can sometimes be managed by anterior odontoid screw fixation. Case description We report the first case of iatrogenic postero-inferior cerebellar artery (PICA) injury while performing anterior odontoid screw fixation for a type II odontoid fracture in a 22-year-old man. Fisher grade 4 subarachnoid hemorrhage secondary to iatrogenic pseudoaneurysm formation was managed by the endovascular neuroradiologist. Odontoid fracture was then managed posteriorly using Harm's technique. Postoperative 12-month follow-up revealed good clinical and radiological results. CT scan showed fusion. Complete exclusion of the pseudo aneurysm with a mild stroke in the inferior left cerebellar hemisphere were noted on the MRI. There were no cerebellar ataxia or swallowing disorders. Conclusion To the best of our knowledge, this is the first case report of iatrogenic PICA injury in anterior odontoid screw fixation. The patient was well managed in our institution within a multidisciplinary team. We recommend that surgical management of odontoid fractures should be performed in expert centres.
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- 2020
3. Minimally invasive posterior fixation and anterior debridement-fusion for thoracolumbar spondylodiscitis: A 40-case series and review of the literature
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Benjamin Blondel, Henry Dufour, Stéphane Fuentes, Hadrien Peyrière, Thomas Graillon, Kaissar Farah, and Solène Prost
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Spondylodiscitis ,Adult ,Male ,medicine.medical_specialty ,Percutaneous ,Discitis ,Adolescent ,medicine.medical_treatment ,Kyphosis ,Neurosurgical Procedures ,Spinal Cord Diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Lumbar ,Pedicle Screws ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Aged ,Retrospective Studies ,Aged, 80 and over ,Debridement ,business.industry ,Incidence (epidemiology) ,Lumbosacral Region ,Retrospective cohort study ,Bacterial Infections ,Length of Stay ,Middle Aged ,medicine.disease ,Internal Fixators ,Surgery ,Spinal Fusion ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Rare disease ,Follow-Up Studies - Abstract
Introduction Pyogenic spondylodiscitis is a rare disease, but incidence is increasing. Reported failure rates following conservative management range from 12% to 18%. The purpose of this study was to determine the safety and efficacy of posterior percutaneous pedicle screw fixation combined with anterior debridement and fusion (ADF) for infective spondylodiscitis in the thoracic and/or lumbar spine. Methods The retrospective study cohort comprised all patients without neurological deficit who underwent minimally invasive posterior and anterior surgery between April 2008 and April 2016 for thoracic and/or lumbar spondylodiscitis. Results Forty patients were eligible (16 female: 40%). The lumbar region was affected in 31 cases (77.5%). Source of infection was identified in only 22 cases (55%) and bacteriological identification was obtained in 32 cases (80%). Mean hospital stay was 14.8 days (range, 6–39 days). Complete recovery was achieved in 39 patients (97.5%) at 3 months’ follow-up. Mean preoperative local kyphosis angle was 16.1o, versus 14o at 1-year (P > 0.05). 36 patients (90%) had at least 1 year's follow-up, and fusion was obtained for all these cases. Conclusion Two-stage minimally invasive surgery is effective and safe for the treatment of single or two-level thoracolumbar spondylodiscitis. It could be an alternative to conventional open surgery or conservative treatment.
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- 2019
4. Management of two cavernous sinus dural arteriovenous fistulae by direct microsurgical approach and catheterization of the superior ophthalmic vein
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N. Serratrice, G. Baucher, Henry Dufour, Hervé Brunel, Stéphane Fuentes, and A. Reyre
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medicine.medical_specialty ,Catheterization, Central Venous ,Microsurgery ,medicine.medical_treatment ,Arteriovenous fistula ,Neurosurgical Procedures ,03 medical and health sciences ,0302 clinical medicine ,Complete occlusion ,otorhinolaryngologic diseases ,medicine ,Humans ,Dimethyl Sulfoxide ,Embolization ,Interventional neuroradiology ,Aged ,Central Nervous System Vascular Malformations ,business.industry ,Inferior petrosal sinus ,medicine.disease ,Cerebral Veins ,Embolization, Therapeutic ,Surgery ,030220 oncology & carcinogenesis ,Cavernous sinus ,Cavernous Sinus ,Female ,Polyvinyls ,Neurology (clinical) ,Neurosurgery ,business ,Superior ophthalmic vein ,030217 neurology & neurosurgery ,Magnetic Resonance Angiography - Abstract
Background In case of cavernous sinus dural arteriovenous fistula, transvenous embolization of the cavernous sinus via the inferior petrosal sinus is generally sufficient. However, when inferior petrosal sinus access is challenging, various alternative approaches have been reported, with corresponding difficulties and risks. Case reports We report the management of two cases of life-threatening cavernous sinus dural arteriovenous fistula revealed by a typical cavernous sinus syndrome. Conventional approaches were unsuccessful, and a direct microsurgical approach was performed, with catheterization of the superior ophthalmic vein. This combined approach safely accessed the cavernous sinus, and obtained complete occlusion of the fistulae by Onyx® embolization. Conclusions This procedure could be an interesting alternative option in the treatment of cavernous sinus dural arteriovenous fistula when conventional approaches are not possible.
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- 2019
5. History of degenerative spondylolisthesis: From anatomical description to surgical management
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Clémentine Gallet, Florian Bernard, Stéphane Fuentes, Edouard Mazerand, and Lucas Troude
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medicine.medical_specialty ,business.industry ,General surgery ,Spondylolysis ,Disease ,Minimally invasive spine surgery ,Degenerative spondylolisthesis ,medicine.disease ,Spondylolisthesis ,Neurosurgical Procedures ,03 medical and health sciences ,0302 clinical medicine ,Spinal Fusion ,030220 oncology & carcinogenesis ,medicine ,Elderly people ,Humans ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Medical literature - Abstract
This review of the historical medical literature aimed at understanding the evolution of surgical management of degenerative spondylolisthesis over time. The Medic@, IndexCat and Gallica historical databases and PubMed and Embase medical databases were used, with several search-terms, exploring the years 1700-2018. Data from anatomical, biomechanical, pathophysiological and surgical studies were compiled. In total, 150 documents were obtained, dating from 1782 to 2018: 139 from PubMed, 1 from Medic@, 7 from IndexCat, and 3 from Gallica. The review thus ranges in time from (1) description of the first clinical cases by several authors in Europe (1782), (2) the identification of a distinct entity by MacNab (1963), and (3) surgical management by the emerging discipline of minimally invasive spine surgery, to its subsequent evolution up to the present day. Spondylolisthesis is a frequent condition potentially responsible for a variety of functional impairments. Understanding and surgical management have progressed since the 20th century. Historically, the first descriptions of treatments concerned only spondylolisthesis associated with spondylolysis, especially in young adults. More recently, there has been progress in the understanding of the disease in elderly people, with the recognition of degenerative spondylolisthesis. New technologies and surgical techniques, aided by advances in supportive care, now provide spine surgeons with powerful treatment tools. Better knowledge of the evolution of surgery throughout history should enable better understanding of current approaches and concepts for treating degenerative spondylolisthesis.
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- 2018
6. Multiple neurosurgical treatments for different members of the same family with Currarino syndrome
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Didier Scavarda, N. Serratrice, Henry Dufour, Stéphane Fuentes, Faisal Albader, and L. Fievet
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Male ,medicine.medical_specialty ,Sacrum ,Meningomyelocele ,Anal Canal ,Context (language use) ,Neurosurgical Procedures ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Fecal incontinence ,Humans ,Cyst ,Neural Tube Defects ,Physician's Role ,Spina bifida ,business.industry ,Rectum ,Lipoma ,medicine.disease ,Tethered spinal cord syndrome ,Syringomyelia ,Surgery ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Child, Preschool ,Female ,Neurology (clinical) ,Filum terminale ,medicine.symptom ,business ,Digestive System Abnormalities ,030217 neurology & neurosurgery ,Currarino syndrome - Abstract
Introduction Currarino's syndrome (CS) is an autosomal dominant disorder of embryonic development causing a rare malformating syndrome characterized by a triad of an anorectal malformations, presacral mass (most commonly an anterior sacral meningocele) and sacral bony defects. Mutations of the HLXB9 gene have been identified in most CS cases, but a precise genotype-phenotype correlation has not been described so far. Family screening is obligatory. The diagnosis is usually made during childhood and rarely in adulthood. In this context, imaging, and especially MRI plays a major role in the diagnosis of this syndrome. Surgical management is provided by pediatric surgeons or neurosurgeons. Familial case report Here, we present a family case report with CS requiring different neurosurgical management. The son, a 3-year-old boy, developed a tethered spinal cord syndrome associated to a lipoma of the filum terminale, a sacro-coccygeal teratoma and an anal adhesion. A combined surgical approach permitted a good evolution on the urinary and digestive functions despite a persistent fecal incontinence. The 2-year-old daughter presented with a cyst of the thyreoglossal tract infected and fistulized to the skin. She was also followed for a very small lipoma of the filum terminale that required a neurosurgical approach. The father, 44-year-old, manifested functional digestive and urinary disorders caused by a giant anterior sacral meningocele. The ligation of the neck of the cyst and aspiration of the liquid inside in full through a posterior partial approach permit a complete collapse of the cyst with an instantly satisfactory clinical outcome. Conclusion In these cases, cooperation between pediatric surgeons and neurosurgeons was crucial. The follow-up of these patients should be done in a spina bifida clinic. A geneticist evaluation must be offered to the patient in the case of a CS as well as a clinical evaluation of the relatives (parents, siblings).
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- 2017
7. Adjacent level spondylodiscitis in a patient with thoracic spondylodiscitis: A case report and review of the literature
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Kaissar Farah, Stéphane Fuentes, H. Dufour, and Thomas Graillon
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Spondylodiscitis ,Male ,medicine.medical_specialty ,Spinal fusion surgery ,Discitis ,Thoracic spine ,Thoracic Vertebrae ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,medicine ,Humans ,18fdg pet ,Adjacent level ,Fixation (histology) ,Aged ,030222 orthopedics ,business.industry ,medicine.disease ,Pseudarthrosis ,Spinal Fusion ,Surgery ,Neurology (clinical) ,Anterior approach ,Radiology ,business ,030217 neurology & neurosurgery - Abstract
Introduction Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition. Case report We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with 18FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection. Discussion ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of 18FDG PET scan and surgery. Conclusion Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS.
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- 2017
8. Minimally invasive transmuscular approach for the treatment of benign intradural extramedullary spinal cord tumours: Technical note and results
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H. Dufour, Tarek Adetchessi, Stéphane Fuentes, Emilie Peltier, M. Afathi, and Thomas Graillon
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Ependymoma ,Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Kyphosis ,Neurosurgical Procedures ,Lumbar ,medicine ,Meningeal Neoplasms ,Humans ,Minimally Invasive Surgical Procedures ,Spinal canal ,Spinal Cord Neoplasms ,Aged ,business.industry ,Laminectomy ,Middle Aged ,Spinal cord ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Radicular pain ,Spinal fusion ,Spinal decompression ,Female ,Neurology (clinical) ,business - Abstract
Background Minimally invasive surgery has expanded over the past two decades and was initially used for the treatment of lumbar disc herniation. Later, this approach was used to treat other spine pathologies, as well as to perform spinal fusion and extended spinal decompression. In this study, we report our experience regarding the use of a minimal surgical approach in the treatment of intradural extramedullary spinal cord tumours. Methods Between January 2008 and July 2013, 18 patients with an intradural extramedullary tumour were included in the study (13 thoracic, 4 lumbar and one cervical tumours). The mean age was 59 years. We operated on 11 meningiomas, 6 neurinomas and one ependymoma. All patients underwent minimally invasive surgery using a tubular retractor system to perform a hemilaminectomy in order to access the spinal canal. Fifteen patients had a neurological deficit and 7 suffered from radicular pain prior to surgery. Results Gross completed resection was performed in all patients. Mean time of surgery was 95 min. Blood loss was less than 200cc. Fifteen patients out of 18 were able to get up the day after surgery. Mean hospital stay was 6 days. There were no complications. Conclusion A minimal surgical approach using a tubular retractor permits an effective resection of intradural extramedullary tumours. This procedure may be a useful tool to decrease the risk of secondary spine instability and postoperative kyphosis, and could also be used for spinal junctions and in fragile patients.
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- 2014
9. Metastatic odontoid fracture management by anterior screw fixation and kyphoplasty
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Stéphane Fuentes, F. Litré, H. Dufour, Benjamin Blondel, Thomas Graillon, and Tarek Adetchessi
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Male ,Invasive strategy ,medicine.medical_specialty ,Metastatic lesions ,Bone Screws ,Bone Neoplasms ,Balloon ,Screw fixation ,Fracture Fixation, Internal ,Postoperative Complications ,Odontoid Process ,Medicine ,Humans ,Kyphoplasty ,Odontoid fracture ,business.industry ,Middle Aged ,Neck mobility ,Kidney Neoplasms ,Surgery ,Treatment Outcome ,Radiological weapon ,Spinal Fractures ,Neurology (clinical) ,Anterior approach ,Radiology ,business ,Tomography, X-Ray Computed - Abstract
We report the case of a patient diagnosed with a pathological fracture of the odontoid dens related to a renal carcinoma metastasis and treated by an original technique. In order to achieve correct stabilization of the fracture and to preserve rotational neck mobility, an anterior approach combining an odontoid screw fixation and a balloon kyphoplasty was performed. This minimal invasive strategy provided satisfactory clinical and radiological results for this unstable lesion. To our knowledge, this technique has not been previously reported and could be a valuable alternative approach in the management of craniocervical metastatic lesions for these fragile patients.
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- 2013
10. Adult symptomatic and growing arachnoid cyst successfully treated by ventriculocystostomy: a new insight on adult arachnoid cyst history
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Stéphane Fuentes, Philippe Metellus, H. Dufour, Tarek Adetchessi, and Thomas Graillon
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congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Computed tomography ,Asymptomatic ,Cerebral Ventricles ,Ventriculostomy ,Arachnoid cyst ,medicine ,Humans ,Decompensation ,Cyst ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,medicine.disease ,nervous system diseases ,Hydrocephalus ,Surgery ,body regions ,Clinical Practice ,Arachnoid Cysts ,Treatment Outcome ,Female ,Neurology (clinical) ,Clinical case ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
Background Adult arachnoid cysts are known to be stable and asymptomatic but their history remains undefined. Case description The authors report the case of an 81-year-old woman with progressive hemiplegia and aphasia. CT scan revealed a voluminous left frontotemporal arachnoid cyst with a major mass effect on the midline and contralateral blocked hydrocephalus. Endoscopic ventriculocystostomy was performed with a spectacular neurological improvement. Discussion and conclusions Symptomatic adult arachnoid cysts are extremely rare. To our knowledge, no similar clinical case of a growing arachnoid cyst in elderly patients has yet been reported in the literature. The mechanisms of cyst enlargement and decompensation still remain undefined and debated. The possibility of adult arachnoid cyst growth has to be considered in clinical practice. Endoscopic ventriculocystostomy is as effective as in paediatric cases.
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- 2013
11. Modified posterior atlantoaxial screw-rod fixation in a case of persistent first intersegmental artery. Case report and literature review
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Stéphane Fuentes, P. Rakotozanany, G. Pech-Gourg, J. Duntze, G. Armaganian, and Tarek Adetchessi
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Male ,medicine.medical_specialty ,Vertebral artery ,Bone Screws ,Vascular anomaly ,Fixation (surgical) ,Fracture Fixation, Internal ,medicine.artery ,medicine ,Humans ,Spinal canal ,Intraoperative Complications ,Axis, Cervical Vertebra ,Vertebral Artery ,Aged ,Vertebral artery injury ,Neck Pain ,business.industry ,Foramen transversarium ,Angiography ,Anatomy ,medicine.disease ,Internal Fixators ,Surgery ,medicine.anatomical_structure ,Spinal Fusion ,Atlanto-Axial Joint ,Accidents, Home ,Spinal Fractures ,Accidental Falls ,Neurology (clinical) ,Dura Mater ,3d ct angiography ,business ,Tomography, X-Ray Computed ,Artery - Abstract
Objective This case reports atlantoaxial stabilization in case of V3 segment anomaly. Patient We report the case of a patient who was victim of a complex C2 fracture requiring atlantoaxial stabilization whereas the initial cervical 3D CT angiography showed a persistent first intersegmental artery consisting in a V3 segment of the vertebral artery penetrating dura-mater in the spinal canal below the C1 posterior arch without passing through the C1 foramen transversarium. Results This rare vascular anomaly described in 2 to 5% of the patients led us to modify the screw entrance over the C1 posterior arch in order to obtain a satisfactory stabilization and to limit the risk of vertebral artery injury.
- Published
- 2012
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