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Surgical navigation is a technique that has evolved greatly in recent years. It allows surgeons to navigate through the surgical field in real time, and helps to locate anatomical structures or lesions and to place devices in complex anatomical regions with relatively high accuracy. In this article, we describe the application of surgical navigation in temporomandibular joint (TMJ) arthroscopy using an optical surgical navigator for a more precise diagnosis and to accurately place instruments in the desired position, especially in lateral pterygoid myotomy. We believe this technique will extend our understanding of the TMJ anatomy and will improve functional results in TMJ arthroscopy., Depto. de Cirugía, Fac. de Medicina, TRUE, pub

Purpose. To improve the results of surgical treatment of lumbar pain syndromes and radiculopathy caused by the multilevel displacement of the intervertebral discs in the lumbosacral spine.Materials and methods. During 2014 through 2018, we examined and treated 3,045 patients with lumbar pain and radiculopathy caused by the displacement of the lumbar intervertebral discs. Seventy-two per cent of patients with the multilevel displacement of intervertebral discs were examined and treated in I.I. Mechnikov Dnipropetrovsk Regional Clinical Hospital, 21 % of patients — in the medical centre “Endoscopic Neurosurgery” and 7% of patients were operated in the medical centre “Clinic of Family Medicine”. The mean age of the patients was 42.6 ± 5.4 years. All patients underwent a neurological examination with functional tests, a computer and magnetic resonance imaging, spondylography, electroneuromyography. The effectiveness of the selected surgical treatment method was evaluated by VAS scale, static and dynamic spine function testing before the intervention and in 2–3 weeks, 2–3 months and in 3–5 years after surgery. The days of disability were taken into account.Results. The patients underwent puncture laser microdiscectomy (PLM) and endoscopic microdiscectomy (EDE) (p<0.05) presented with the most significant relief of pain syndrome, and the microdiscectomy with instrumentation was associated with pain syndrome reduction at all stages. The indicators of static and dynamic function of the spine using the Schober test, lateroflexion, extension in the dynamics were also significantly better in patients after PLM and EDE in comparison with other methods of surgery. The lowest number of days of disability was observed in patients who underwent PLM (30.7 ± 6.3 days) and EDE (24.6 ± 5.2 days). Maximum number of days of disability was in 34 patients after microdiscectomy with instrumentation — 64.5 ± 10.7 days.Conclusions. When choosing a surgical tactic for two hernias located at

The aim of this chapter is to describe arthrography as method for diagnosing soft tissue derangements of the temporomandibular joint (TMJ) as well as a tool for guided administration of corticosteroids. The chapter includes numerous illustrations and five videos explaining the methods of arthrography, arthrotomography and contrast-guided administration of corticosteroids. MRI is the most common method for diagnosing soft tissue derangements of the TMJ. Yet, there are situations when arthrography is useful and superior to MRI, e.g. when the patient suffers from claustrophobia, has loose ferromagnetic objects in the body or metal objects in the head and neck region causing disturbances in the images (e.g. orthodontic devices). Arthrography is also useful if there is call for diagnosing soft tissue perforations in the disc or the posterior attachment, or adherences between the disc or the posterior attachment and the bony components that can be revealed during the real-time dynamic assessment. Filling the joint compartments can contribute to loosening of adherences and the anaesthesia preceding injection of contrast media constitutes a diagnostic tool by confirming origin of pain. Follow-up of splint therapy can be included in the examination. Finally, arthrography can be used as guidance for intervention with, e.g. corticosteroids.