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Use of Porous Aluminium Oxide Interbody Cages for Interbody Fusion of the Cervical Spine
Kostyšyn, Roman ; Česák, Tomáš (advisor) ; Hrabálek, Lumír (referee) ; Filip, Michal (referee)
Use of porous aluminum oxide interbody cages for interbody fusion of the cervical spine Introduction: Anterior cervical discectomy and fusion (ACDF) is one of the most commonly used methods of surgical treatment for degenerative disease of the cervical spine. The primary goal of the surgery is to decompress the nerve structures. A secondary but equally important goal of the surgery is to provide intervertebral fusion as a prevention of subsequent instability or deformity. The selection of the optimal cage for disc replacement in ACDF takes into account the requirements for the speed and quality of interbody fusion and places demands on its safety. Aims: The objective of this prospective randomized monocentric study was to evaluate the speed and quality of interbody fusion of implanted porous aluminium oxide (Al2O3) cages, and compare with parameters of fusion of polyetheretherketone (PEEK) cages for anterior cervical discectomy and fusion (ACDF). Another aim was to compare the clinical results. Methods: A total of 111 patients were enrolled in the study. The 18-month follow-up was completed in 68 patients with an Al2O3 cage and 35 patients with a PEEK cage in one-level ACDF. Initially, the first evidence (initialization) of fusion was evaluated on computed tomography. Subsequently, interbody fusion...
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The Relationship Between the Function of the Spinal Cord and the Width of the Spinal Canal Depending on the Change in the Axis of the Cervical Spine
Žídek, Slavomír ; Holečková, Irena (advisor) ; Zeman, Jaroslav (referee) ; Česák, Tomáš (referee)
Introduction: The aim of our study was to assess the effect of dynamic changes in spinal flexion and extension assessed by dynamic magnetic resonance imaging(dMRI) on spinal cord functions assessed by dynamic evoked potentials(dEPs) in group of healthy individuals (group 1) and in group of patients with a small graphical pathology on cervical spine MRI in the neutral position, but with mild objective and progressive subjective difficulties (group 2). Methodology: 10 healthy individuals and 10 patients were included in the study. Examination of dMRI as well as dEPs was performed in neutral position, flexion and extension. The anterior (PD) and posterior spinal cord length (ZD), transverse (PR) and anteroposterior dimension (PZ) and spinal cord area (P) were measured on the cervical spine MRI. The median and tibial nerves SEPs (somatosensory evoked potentials) and BB, APB and TA muscles MEPs (motor evoked potentials) were performed as well. Results: In a group of patients we noticed a changes in the length and shape of the spinal cord but also spinal cord functions, already in the neutral position, even though there was no significant spinal cord compression. There were as well as healthy individuals elongation or shortening of PD and ZD during flexion and extension, There were, in contrast to...
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Biological properties of non-functioning pituitary adenomas.
Česák, Tomáš ; Náhlovský, Jiří (advisor) ; Smrčka, Martin (referee) ; Paleček, Tomáš (referee)
Introduction: Non-functioning pituitary adenomas (NFPAs) are regarded as benign, slowly growing tumours of the sella turcica region. Their growth is generally constantly exponential; however, rapid and aggressive proliferation is not the exception, especially in young patients. Treatment involves surgical removal. In literature, the role of postoperative irradiation of the residual tumour is controversial. Aim: The aim of this study was to investigate the natural growth patterns of NFPAs and attempt to identify the factors affecting their growth potential. As part of the study, nuclear marker Ki-67 was tested as a possible reliable indicator of adenoma proliferation, as well as it's role as a potential marker of postoperative remnant's growth potential. This would enable the identification of serious rapid growth in cases of tumour recurrence. Material: Our study is based on 105 patients operated for NFPAs between years 2000-2007. The fixed inclusion criteria of the study (a postoperative residue detected by 2 graphic examinations, absence of adjuvant therapy and the imunohistochemical determination of the proliferation marker) were fulfilled by 29 patients (22 men, 3 women). The average age of the patient group was 62.9 years. By large, the tumours were afunctional macroadenomas with gonadotrophin...
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