Róbert Veres | University of Szeged (original) (raw)
Papers by Róbert Veres
Neurosurgical Review, Sep 10, 2014
PubMed, 1989
Authors report on their experiences gained in 5 cases with the Halo device. The method of treatme... more Authors report on their experiences gained in 5 cases with the Halo device. The method of treatment is described. On the basis of a literary overview the field of indication, the advantages and the disadvantages of the method are described. In the assessment of the method it is stressed that according to their opinion this is the best conservative method of treatment, and the results compete with that of the operative treatment.
PubMed, 1989
Ventral spondylodesis or ventrofixation is the most important surgical method for the treatment o... more Ventral spondylodesis or ventrofixation is the most important surgical method for the treatment of severe cervical spine injuries accompanied by instability. Its wide indications include fracture-dislocations, compression fractures of the vertebral body, injuries to the disc, luxations, 'tear drop fractures' as well as "hangman's fractures". The essential parts of its technique: previous reduction by traction, anterior cervical approach, removal of the injured parts of vertebral body and disc(s), replacement by corticocancellous bone graft with subsequent plate-screw fixation. The authors performed in their Institute nearly 100 operations of this type, in a 10-year period of which; detailed account is given. Good results of surgery can be expected only by ensuring adequate technical conditions and professional knowledge, performing the operations in centres having sufficient experience.
Journal of Neurosurgery, Nov 1, 2003
Journal of Neurosurgery, 1996
✓ Knowledge of the role and hazards of transoral surgery has expanded rapidly, but the applicatio... more ✓ Knowledge of the role and hazards of transoral surgery has expanded rapidly, but the application of this technique in children has been limited. To assess its usefulness, 27 pediatric patients who underwent transoral surgery between 1985 and 1994 were studied. Transoral surgery was performed for irreducible anterior neuraxial compression at the craniovertebral junction caused by basilar impression, atlantoaxial subluxation with pseudotumor, or chordoma. The patients ranged in age from 3 to 17 years. Symptomatic presentation varied widely, but 89% had significant neurological deficits before surgery. No patient with normal strength deteriorated after surgery. Of the 16 patients with a preoperative motor deficit, nine improved rapidly, three were unchanged, and four significantly worsened in the perioperative period. Those with mobile atlantoaxial subluxation were most vulnerable to surgically related neurological morbidity. Twenty-four patients were alive for long-term follow-up st...
Journal of Neurosurgery, 1996
✓ In this report the authors describe a device that consists of a transportable, radiolucent boar... more ✓ In this report the authors describe a device that consists of a transportable, radiolucent board that couples to a standard halo head ring. The board provides continuous cervical spine immobilization during all phases of acute medical treatment of cervical spine instability, including closed reduction, transport, radiographic imaging, and operative procedures. By combining the advantages of several existing systems, this immobilization device facilitates and improves the safety of comprehensive acute management of cervical spinal instability by eliminating the need for patient transfer from stretcher to radiography machine to operating table. Its radiolucent construction and its compatibility with standard operating tables allow unencumbered surgical access and ample room for biplanar fluoroscopy, thereby also facilitating operative procedures, particularly the placement of internal spinal fixation.
Trauma Case Reports, 2017
One blunt abdominal aortic disruption (BAAD) and one blunt thoracic aortic injury (BTAI) case are... more One blunt abdominal aortic disruption (BAAD) and one blunt thoracic aortic injury (BTAI) case are presented. Both aortic injuries were combined with spinal fractures. In the BAAD case the aortic pseudoaneurysm manifested just above the lumbar fracture while in the BTAI case the aortic injury appeared several vertebras below the thoracal fracture site, suggesting different mechanisms in the aortic wall damage. In both cases the aortic wall first was sealed, successfully, by endovascularly-placed stents, meaning the risks of open aortic reconstructive surgery could be avoided. The adjacent crucial vessel's preservation, despite the stent covering the left subclavian artery and the left common carotid artery in one of the cases was verified by post-operative computed tomography angiography (CTA) examination. In second stage those spinal fractures which were deemed unstable were stabilized by the fixateur interne (a transpedicular screw-rod system). With this treatment sequence we wanted to avoid the unnecessary risk of a possible rupture of the unsealed aortic wall during positioning for the spinal procedure and during the spinal surgery. Both patients recovered from their aortic and spinal injuries.
Ideggyogyaszati Szemle-clinical Neuroscience, 2012
Global Spine Journal, 2015
Orvosi hetilap, Jan 12, 2003
The authors present a case of medically refractory, neurogenic hypertension where the MR examinat... more The authors present a case of medically refractory, neurogenic hypertension where the MR examination revealed an odontoid compression of the anterior medulla as a consequence of a basilar impression. Following transoral odontoidectomy and craniocervical fixation, the blood pressure in the 24-year-old woman returned to normal, and 1 year postoperatively she remains normotensive and off all medication. This reported case provides further support to the theory that there is a subgroup of patients who may have a vascular compression of the medulla with no neurological symptoms other than hypertension.
Recent Advances in Neurotraumatology, 1993
Most of the severe theraco-lumbar spinal injuries need emergency surgery. Operation must be done ... more Most of the severe theraco-lumbar spinal injuries need emergency surgery. Operation must be done by well defined indications. Primary complete neurological lesion is not contraindication for emergency surgery. Reduction, decompression and stabilization have to be performed in the primary neurosurgical treatment. The stabilization method must be chosen with neurorehabilitation aspect. That is why segmental stabilization methods seem to be the best ones. Primary neurosurgical operation is one of the most important first steps of the complex, long-lasting rehabilitation, and has basic role both in neurological and motor-system improvements of the patient.
Journal of Neurosurgery, 2003
Ideggyógyászati Szemle, Nov 30, 2010
Ideggyógyászati Szemle, Jul 30, 2010
It is still challenging to perform the operation for the instability of the C1-C2 junction becaus... more It is still challenging to perform the operation for the instability of the C1-C2 junction because of the limited cases, unique anatomical landmarks, the potential or real injury of the neurological elements, the serious clinical state and the special technical and human background is demanding. With the aim of minimalize the risk the following method provide sufficient stability, successful and simple. The authors used the dorsally implanted screw-rod systems for operating 34 patient with C1-2 instability resulting clinically signs and symptoms. Depending the anatomical landmarks and the technical possibilities, the screw insertion method and the reinforced wire cable use was selected. Meaning the indication of the surgical treatment, the neurological signs, compromise of the spinal canal and pain resisting the conservative treatment was presented. The C1-2 dorsally fixation was performed to 34 patients. Both sided lateral mass screw was inserted in 30 cases (88.3%). Because of the...
Ideggyógyászati Szemle, Nov 30, 2007
The standard surgical procedures used in degenerative thoracic and lumbar spinal canal stenosis a... more The standard surgical procedures used in degenerative thoracic and lumbar spinal canal stenosis allows decompression of the neural structures by unroofing the spinal canal, often resulted in destruction or insufficiency of facet joints, sacrifice the interspinosus/supraspinosus ligament complexes and stripping of the paraspinal muscles altering an already pathologic biomechanical milieu causing segmental instability. Various less invasive techniques exists to save the integrity and prevent the instability of the spine and allow decompression of neural structures located in the spinal canal. The authors discusses the experiences with technique of unilateral laminotomy for bilateral decompression. The unilateral laminotomy for bilateral decompression technique was performed at 60 levels in 51 patients to decompress the symptomatic degenerative stenosis of the thoracic and lumbar spinal canal. The inclusion criteria were used as follows: symptoms of neurogenic claudication and/or radic...
Ideggyógyászati Szemle, Nov 20, 2006
Herniation of the meninges through a defect of the spinal canal is a spinal meningocele, and is u... more Herniation of the meninges through a defect of the spinal canal is a spinal meningocele, and is usually located dorsally in the lumbosacral region. Meningoceles are usually part of a complex developmental disorder, or of a systemic disease, or it can be iatrogenic, as well. We report a very rare case of a true anterior thoracic meningocele.
Ideggyógyászati Szemle, Mar 30, 2008
The conventional dorsal surgical approaches used in removal of intraspinal space-occupying lesion... more The conventional dorsal surgical approaches used in removal of intraspinal space-occupying lesions by unroofing the spinal canal, often result the destruction of dorsal bony structures, sacrifice the interspinosus/supraspinosus ligament complexes and stripping of the paraspinal muscles causing a pathologic biomechanical milieu may lead to spinal deformities, instability. Various less invasive techniques exist to save the integrity and to prevent the instability of the spinal column and allow removal of intraspinally located space-occupying lesions at the same time. The authors discuss the experiences with unilateral partial laminectomy approach in removal of intraspinally, mainly lateral, intra- or extradurally located pathologic lesions. The unilateral partial laminectomy, in which the laminas were preserved (hemi-semi laminectomy) was performed in 86 symptomatic patients to remove space-occupying intra- or extradurally located lesions of the cervical, thoracic and lumbar spinal ca...
Ideggyógyászati Szemle, Jan 20, 2003
Primary glioblastoma multiforme located intramedullary in the spinal cord is a very rare entity. ... more Primary glioblastoma multiforme located intramedullary in the spinal cord is a very rare entity. The authors report eight cases and discuss the clinical features, the possibility of diagnosis, combined treatment and pathomorphological signs focusing on the relevant literature and their experience.
Ideggyógyászati Szemle, May 20, 2003
In the past, surgery of the pathologies of cervicothoracic junction carried high risk. Better kno... more In the past, surgery of the pathologies of cervicothoracic junction carried high risk. Better knowledge of the anatomical situation and the increasing experience with anterior approach, corpectomy and spinal stabilization instruments have all made possible to remove the tumours of the cervicothoracic junction in a combined way. The authors present six cases of spinal tumours where removal was done via anterior approach with partial clavicle and sternal resection. In two cases the anterior approach were combined with posterior tumour removal and fixation. Two of the cases were metastatic tumours, one lymphoma, one osteochondroma, one giant cell osteoid tumour and one malignant neurogenic tumour. The ventral approach gave a relatively wide window to explore the tumours and with the help of the operative microscope the tumour removal went fairly well. After total removal of the tumours the cervical spine were stabilized with own clavicle or iliac bone graft, titanium plate and screws. ...
Ideggyógyászati Szemle, Mar 20, 2003
The surgical removal of the cervical intradural pathologies located ventrally carries a high risk... more The surgical removal of the cervical intradural pathologies located ventrally carries a high risk. According to the anatomical situation and the increasing experience with anterior cervical approach and corpectomy revealed the reality to remove the ventral midline pathologies this way. The anterior approach which require corpectomy preferable to cervical intradural lesions located ventrally at the midline. In the literature have described anterior approach for intradural cervical lesions in very limited cases. The authors present five cases of intradural ventral cervical spinal pathologies, where removal was done via anterior cervical approach with corpectomy. Two of the cases were intradural meningeomas, one intramedullary cavernoma, one ventral arachnoid cyst and one malignant neurogenic tumour. The approach was described elsewhere. The corpectomy gave a relatively wide window to explore the pathologies and under operative microscope the local control of removal was fairly well. A...
Neurosurgical Review, Sep 10, 2014
PubMed, 1989
Authors report on their experiences gained in 5 cases with the Halo device. The method of treatme... more Authors report on their experiences gained in 5 cases with the Halo device. The method of treatment is described. On the basis of a literary overview the field of indication, the advantages and the disadvantages of the method are described. In the assessment of the method it is stressed that according to their opinion this is the best conservative method of treatment, and the results compete with that of the operative treatment.
PubMed, 1989
Ventral spondylodesis or ventrofixation is the most important surgical method for the treatment o... more Ventral spondylodesis or ventrofixation is the most important surgical method for the treatment of severe cervical spine injuries accompanied by instability. Its wide indications include fracture-dislocations, compression fractures of the vertebral body, injuries to the disc, luxations, 'tear drop fractures' as well as "hangman's fractures". The essential parts of its technique: previous reduction by traction, anterior cervical approach, removal of the injured parts of vertebral body and disc(s), replacement by corticocancellous bone graft with subsequent plate-screw fixation. The authors performed in their Institute nearly 100 operations of this type, in a 10-year period of which; detailed account is given. Good results of surgery can be expected only by ensuring adequate technical conditions and professional knowledge, performing the operations in centres having sufficient experience.
Journal of Neurosurgery, Nov 1, 2003
Journal of Neurosurgery, 1996
✓ Knowledge of the role and hazards of transoral surgery has expanded rapidly, but the applicatio... more ✓ Knowledge of the role and hazards of transoral surgery has expanded rapidly, but the application of this technique in children has been limited. To assess its usefulness, 27 pediatric patients who underwent transoral surgery between 1985 and 1994 were studied. Transoral surgery was performed for irreducible anterior neuraxial compression at the craniovertebral junction caused by basilar impression, atlantoaxial subluxation with pseudotumor, or chordoma. The patients ranged in age from 3 to 17 years. Symptomatic presentation varied widely, but 89% had significant neurological deficits before surgery. No patient with normal strength deteriorated after surgery. Of the 16 patients with a preoperative motor deficit, nine improved rapidly, three were unchanged, and four significantly worsened in the perioperative period. Those with mobile atlantoaxial subluxation were most vulnerable to surgically related neurological morbidity. Twenty-four patients were alive for long-term follow-up st...
Journal of Neurosurgery, 1996
✓ In this report the authors describe a device that consists of a transportable, radiolucent boar... more ✓ In this report the authors describe a device that consists of a transportable, radiolucent board that couples to a standard halo head ring. The board provides continuous cervical spine immobilization during all phases of acute medical treatment of cervical spine instability, including closed reduction, transport, radiographic imaging, and operative procedures. By combining the advantages of several existing systems, this immobilization device facilitates and improves the safety of comprehensive acute management of cervical spinal instability by eliminating the need for patient transfer from stretcher to radiography machine to operating table. Its radiolucent construction and its compatibility with standard operating tables allow unencumbered surgical access and ample room for biplanar fluoroscopy, thereby also facilitating operative procedures, particularly the placement of internal spinal fixation.
Trauma Case Reports, 2017
One blunt abdominal aortic disruption (BAAD) and one blunt thoracic aortic injury (BTAI) case are... more One blunt abdominal aortic disruption (BAAD) and one blunt thoracic aortic injury (BTAI) case are presented. Both aortic injuries were combined with spinal fractures. In the BAAD case the aortic pseudoaneurysm manifested just above the lumbar fracture while in the BTAI case the aortic injury appeared several vertebras below the thoracal fracture site, suggesting different mechanisms in the aortic wall damage. In both cases the aortic wall first was sealed, successfully, by endovascularly-placed stents, meaning the risks of open aortic reconstructive surgery could be avoided. The adjacent crucial vessel's preservation, despite the stent covering the left subclavian artery and the left common carotid artery in one of the cases was verified by post-operative computed tomography angiography (CTA) examination. In second stage those spinal fractures which were deemed unstable were stabilized by the fixateur interne (a transpedicular screw-rod system). With this treatment sequence we wanted to avoid the unnecessary risk of a possible rupture of the unsealed aortic wall during positioning for the spinal procedure and during the spinal surgery. Both patients recovered from their aortic and spinal injuries.
Ideggyogyaszati Szemle-clinical Neuroscience, 2012
Global Spine Journal, 2015
Orvosi hetilap, Jan 12, 2003
The authors present a case of medically refractory, neurogenic hypertension where the MR examinat... more The authors present a case of medically refractory, neurogenic hypertension where the MR examination revealed an odontoid compression of the anterior medulla as a consequence of a basilar impression. Following transoral odontoidectomy and craniocervical fixation, the blood pressure in the 24-year-old woman returned to normal, and 1 year postoperatively she remains normotensive and off all medication. This reported case provides further support to the theory that there is a subgroup of patients who may have a vascular compression of the medulla with no neurological symptoms other than hypertension.
Recent Advances in Neurotraumatology, 1993
Most of the severe theraco-lumbar spinal injuries need emergency surgery. Operation must be done ... more Most of the severe theraco-lumbar spinal injuries need emergency surgery. Operation must be done by well defined indications. Primary complete neurological lesion is not contraindication for emergency surgery. Reduction, decompression and stabilization have to be performed in the primary neurosurgical treatment. The stabilization method must be chosen with neurorehabilitation aspect. That is why segmental stabilization methods seem to be the best ones. Primary neurosurgical operation is one of the most important first steps of the complex, long-lasting rehabilitation, and has basic role both in neurological and motor-system improvements of the patient.
Journal of Neurosurgery, 2003
Ideggyógyászati Szemle, Nov 30, 2010
Ideggyógyászati Szemle, Jul 30, 2010
It is still challenging to perform the operation for the instability of the C1-C2 junction becaus... more It is still challenging to perform the operation for the instability of the C1-C2 junction because of the limited cases, unique anatomical landmarks, the potential or real injury of the neurological elements, the serious clinical state and the special technical and human background is demanding. With the aim of minimalize the risk the following method provide sufficient stability, successful and simple. The authors used the dorsally implanted screw-rod systems for operating 34 patient with C1-2 instability resulting clinically signs and symptoms. Depending the anatomical landmarks and the technical possibilities, the screw insertion method and the reinforced wire cable use was selected. Meaning the indication of the surgical treatment, the neurological signs, compromise of the spinal canal and pain resisting the conservative treatment was presented. The C1-2 dorsally fixation was performed to 34 patients. Both sided lateral mass screw was inserted in 30 cases (88.3%). Because of the...
Ideggyógyászati Szemle, Nov 30, 2007
The standard surgical procedures used in degenerative thoracic and lumbar spinal canal stenosis a... more The standard surgical procedures used in degenerative thoracic and lumbar spinal canal stenosis allows decompression of the neural structures by unroofing the spinal canal, often resulted in destruction or insufficiency of facet joints, sacrifice the interspinosus/supraspinosus ligament complexes and stripping of the paraspinal muscles altering an already pathologic biomechanical milieu causing segmental instability. Various less invasive techniques exists to save the integrity and prevent the instability of the spine and allow decompression of neural structures located in the spinal canal. The authors discusses the experiences with technique of unilateral laminotomy for bilateral decompression. The unilateral laminotomy for bilateral decompression technique was performed at 60 levels in 51 patients to decompress the symptomatic degenerative stenosis of the thoracic and lumbar spinal canal. The inclusion criteria were used as follows: symptoms of neurogenic claudication and/or radic...
Ideggyógyászati Szemle, Nov 20, 2006
Herniation of the meninges through a defect of the spinal canal is a spinal meningocele, and is u... more Herniation of the meninges through a defect of the spinal canal is a spinal meningocele, and is usually located dorsally in the lumbosacral region. Meningoceles are usually part of a complex developmental disorder, or of a systemic disease, or it can be iatrogenic, as well. We report a very rare case of a true anterior thoracic meningocele.
Ideggyógyászati Szemle, Mar 30, 2008
The conventional dorsal surgical approaches used in removal of intraspinal space-occupying lesion... more The conventional dorsal surgical approaches used in removal of intraspinal space-occupying lesions by unroofing the spinal canal, often result the destruction of dorsal bony structures, sacrifice the interspinosus/supraspinosus ligament complexes and stripping of the paraspinal muscles causing a pathologic biomechanical milieu may lead to spinal deformities, instability. Various less invasive techniques exist to save the integrity and to prevent the instability of the spinal column and allow removal of intraspinally located space-occupying lesions at the same time. The authors discuss the experiences with unilateral partial laminectomy approach in removal of intraspinally, mainly lateral, intra- or extradurally located pathologic lesions. The unilateral partial laminectomy, in which the laminas were preserved (hemi-semi laminectomy) was performed in 86 symptomatic patients to remove space-occupying intra- or extradurally located lesions of the cervical, thoracic and lumbar spinal ca...
Ideggyógyászati Szemle, Jan 20, 2003
Primary glioblastoma multiforme located intramedullary in the spinal cord is a very rare entity. ... more Primary glioblastoma multiforme located intramedullary in the spinal cord is a very rare entity. The authors report eight cases and discuss the clinical features, the possibility of diagnosis, combined treatment and pathomorphological signs focusing on the relevant literature and their experience.
Ideggyógyászati Szemle, May 20, 2003
In the past, surgery of the pathologies of cervicothoracic junction carried high risk. Better kno... more In the past, surgery of the pathologies of cervicothoracic junction carried high risk. Better knowledge of the anatomical situation and the increasing experience with anterior approach, corpectomy and spinal stabilization instruments have all made possible to remove the tumours of the cervicothoracic junction in a combined way. The authors present six cases of spinal tumours where removal was done via anterior approach with partial clavicle and sternal resection. In two cases the anterior approach were combined with posterior tumour removal and fixation. Two of the cases were metastatic tumours, one lymphoma, one osteochondroma, one giant cell osteoid tumour and one malignant neurogenic tumour. The ventral approach gave a relatively wide window to explore the tumours and with the help of the operative microscope the tumour removal went fairly well. After total removal of the tumours the cervical spine were stabilized with own clavicle or iliac bone graft, titanium plate and screws. ...
Ideggyógyászati Szemle, Mar 20, 2003
The surgical removal of the cervical intradural pathologies located ventrally carries a high risk... more The surgical removal of the cervical intradural pathologies located ventrally carries a high risk. According to the anatomical situation and the increasing experience with anterior cervical approach and corpectomy revealed the reality to remove the ventral midline pathologies this way. The anterior approach which require corpectomy preferable to cervical intradural lesions located ventrally at the midline. In the literature have described anterior approach for intradural cervical lesions in very limited cases. The authors present five cases of intradural ventral cervical spinal pathologies, where removal was done via anterior cervical approach with corpectomy. Two of the cases were intradural meningeomas, one intramedullary cavernoma, one ventral arachnoid cyst and one malignant neurogenic tumour. The approach was described elsewhere. The corpectomy gave a relatively wide window to explore the pathologies and under operative microscope the local control of removal was fairly well. A...