Penkert G
Neurochirurgische Klinik, Friederikenstift Hannover.
Handchir Mikrochir Plast Chir. 2003 Mar;35(2):117-21. doi: 10.1055/s-2003-40774.
Neurosurgery does not claim to have improved surgery of the brachial plexus. But achievements in microsurgery have advanced surgical possibilities in several faculties. Neurosurgery for example has introduced considerable improvements concerning the assessment of intraforaminal or intraspinal root injuries. Intraoperative inspections of roots via hemi-laminectomy allowed to determine specificity and sensitivity of modern radiological imaging by correlating intraoperative findings with the results of the radiological imaging. Using determined axial MRI with thin sections, we showed root avulsion in a very high quantity. These findings led us to modify our surgical concept. Operations with long exploration were reduced and preoperative planning of neurotisation was improved due to the preoperative diagnostics.
神经外科并不宣称已改进了臂丛神经手术。但显微外科的成就已在多个领域推进了手术的可能性。例如,神经外科在椎间孔内或椎管内神经根损伤的评估方面有了显著改进。通过半椎板切除术对神经根进行术中检查,通过将术中发现与放射影像学结果相关联,得以确定现代放射影像学的特异性和敏感性。使用确定的薄层轴向磁共振成像(MRI),我们发现了大量的神经根撕脱。这些发现促使我们修改手术理念。由于术前诊断,减少了长时间探查的手术,并改进了神经移植的术前规划。