The VII International Symposium: New technologies in neurosurgery

The VII International Symposium with the theme New Technologies in Neurosurgery was held in the Kirov Medicomilitary Academy (Saint Petersburg) on May 27-29, 2004. It was organized by the Medicomilitary Academy under the auspices of the Association of Russian Neurosurgeons, the Committee on Public Health of the Saint Petersburg Government, the Burdenko Research Neurosurgical Institute, the Sklifosovsky Research Institute of Emergency Care, the Moscow State Medical-Stomatologic University, the Federation of Russian Anesthesiologists and Resuscitators and the Human Health Public Organization.

The Symposium President: Chief of the of the Medicomilitary Academy, Honored Science Worker of the Russian Federation, Writing Member of the Russian Academy of Medical Science, Professor B.V.Gaidar.

The Organizing Committee: V.E.Parfenov (Chairman), D.V.Svistov and V.B.Semenyutin (Deputy Chairmen), Yu.V.Dikarev, E.N.Kondakov, A.N.Konovalov, V.V.Krylov, B.D.Kustov, Yu.V.Lobzin, A.V.Ostrovsky, A.V.Polezhaev, Yu.S.Polushin, A.A.Potapov, Yu.A.Shcherbuk.

The General Sponsor: SIEMENS.

Sponsors: DBU company, SOERING.

A total number of participants: 537 men.

There were 2 plenary and 16 section meetings. The scientific program included 170 reports on practically all aspects of neurosurgery:

The Symposium participants had a chance to hear reports, made on May 27 by such leading Russian specialists in the field of neuroscience as B.V.Gaidar, V.E.Parfenov, V.E.Olyushin, A.K.Dulaev, A.A.Lutsik, V.A.Khilko, V.V.Krylov, D.V.Svistov, G.E.Trufanov, Yu.A.Shcherbuk, V.B.Semenyutin, S.V.Tsarenko, A.V.Shchegolev, L.B.Likhterman.

Despite a short duration of the Symposium, there was a big number of interesting reports on diagnosis and treatment of neurosurgical pathology of the brain, spinal cord, spine and peripheral nerves.

Great attention was paid to development and wider use of minimum invasive surgical methods, based on endoscopic videomonitoring, which makes an approach and intervention proper less traumatic, but no less radical. Owing to this technique, it becomes possible to reduce an access volume, to examine and to perform manipulations on structures, which cannot be seen directly through an operative wound, as well as to obtain their magnified image with preserved microanatomy and microtopography.

The reports, made at section meetings on neurooncology, were devoted to such modern modalities, as stereotaxis, ultrasonic navigation, neuronavigation systems (Stealth Station, TREON, etc.), laser technologies in brain surgery. The problem of treatment of malignant tumors aroused great interest and caused heated discussion. The reporters presented information on up-to-date views on combined treatment of such diseases, drugs and dosage schemes for chemotherapy (Temodal, Fotemustin, BCNU, PCV, etc.), initial experience in the field of photodynamic and vaccine therapy.

One should mention a problem of preoperative embolization of hypervascularized cerebral tumors, which was of great interest for the participants. It was proved, that this method reduced intraoperative bleeding to a considerable extent and could be used as an independent means of treatment in some cases with difficult-of-access neoplasms.

As for sectional meetings on vascular neurosurgery, the main problem under discussion was intravascular and minimum invasive methods of treatment. Reports, which attracted peculiar attention, were devoted to intraoperative use of MRI in treatment of non-traumatic intracerebral hemorrhages, ultrasonic diagnosis of aneurysms at various stages of intervention, transvenous approach in intravascular operations for vascular diseases, results of stenting in atherosclerotic lesions of a carotid region, embolization of intracranial aneurysms with microspirals, etc.

Subsection meetings on craniocerebral trauma dealt with tactics of its conservative and surgical treatment. A structure of isolated and associated craniocerebral trauma, choice of a method of trephination in various injuries of the brain, extracranial closure of liquor fistulas, new approaches to treatment of acute traumatic subdural hydromas were discussed. Determining indications for conservative treatment of casualties with small intracranial hematomas was a traditional problem of discussion; intensive care with dynamic CT-control was acknowledged to be expedient in hematoma of up to 50 ml. Information on morphologic substantiation of neurotransplantation in severe craniocerebral trauma was presented; methods of prevention and treatment of infectious complications in craniocerebral wounds were proposed.

The reports, made at section meetings on spinal surgery, concerned modern approaches to treatment of traumas and degenerative-dystrophic diseases of the spine and spinal cord. Optimum treatment-and-diagnosis algorithms in traumas of the cervical spine, versions of anterior decompression of the spinal cord and interbody spondylodesis in operations with a posterior access, tactics of treatment of multiple and multilevel injuries of the spine were discussed. Information on new methods of neurotransplantation in surgery of severe spinal trauma was given. As usual, reports on systems for internal fixation of the spine (Medtronic, Sofamor Danek, Striker, Aesculapius, Johnson & Johnson, etc.) and their use were of particular interest.

Many interesting reports were heard at section meetings on radiation diagnosis in neurosurgery. The problems under discussion were as follows: results of combined use of PET and CT in neurooncology, potentialities of SPECT with 99MTC-technetril in estimating malignancy of brain tumors, use of diffusion- and perfusion-weighted MRI in disorders of cerebral circulation, MRI results and their use in preoperative planning of microvascular decompression in patients with trigeminal neuralgia, 3D-CT-angiography in diagnosis of cerebral aneurysms, etc.

Leading foreign specialists from such countries as Byelorussia, the Ukraine, Kazakhstan, Moldova, the USA, Germany, Switzerland, Slovakia took part in plenary and section meetings. Among the participants one could mention representatives of all leading neurosurgical research Institutes and clinics of Russia, located in Moscow, Saint Petersburg, Chelyabinsk, Khabarovsk, Ekaterinburg, Novosibirsk, Samara, Rostov-on-Don, Kemerovo, Novokuznetsk, Omsk, Tomsk, etc.

A meeting of neuroanesthesiologists and neuroresuscitators (members of the Russian Federation of Anesthesiologists and Resuscitators) became a constituent part of the Symposium. A memorandum with recommendations on rendering prehospital medical care in severe craniocerebral trauma was adopted. All reports were characterized by a high scientific level; they depicted modern approaches to general anesthesia and intensive care in neurosurgical patients.

Chief Neurosurgeons of military districts and navies of the Russian Armed Forces took part in the Symposium as well. They made reports on activity of neurosurgical service and its results. A seminar Neurosurgical Service of the Russian Railways Open Joint-Stock Company was held.

Medical equipment, manufactured by 40 companies, was exhibited in the foyer of the Academy's club-house during May 27-29. All big medical companies, producing neurosurgical devices for the internal and external markets, took part in this exhibition. Transactions of the Symposium, containing more than 400 abstracts, were published. It has become a good tradition of such forums.