A hundred years after his birth his memory is perpetuated in the Institute he founded and which today bears his name and in the hearts of those who had the privilege of being his disciples. From the beginning, Asenjo imposed a system of work different from that taken in other hospitals. Full dedication to the specialty, full time in the service, that is from 8 am to 6 pm, All clearly stipulated activity, schedule of clinical meetings, surgical ward programming, neuropathology meetings, general visit on Fridays, clinical meeting on Saturdays , Etc., all recorded in a small manual called "Routines", which also stipulated what we now call protocols for the study of each particular neurological pathology. At one time the Institute became "one of the most active in the world" in the words of E.A.Walker.

Objective: We review a description of the surgeries performed at the occipito- Atlanto-Axial segment in order to present the experience of the lesions diagnosed and managed at this level that required anterior decompression. An odontoidectomía was performed due to the irreducible nature of the lesion and/or because the mechanism of compression in the front, which were not susceptible to posterior approach.

Patients and methods: We report six cases in which, was used an trans oral technique to deal with the upper cervical spine segment. The cases were: four cases of rheumatoid arthritis and 2 cases of basilar impression. We described the clinical picture and the surgical technique used. Then we described the techniques used for posterior stabilization in each case.

Results: The first patient operated corresponded to a basilar impression and had dehiscence of the uvula and 1 patient (case 4) died a month after surgery due to nosocomial pneumonia and one pending fixation. The remaining patients were showed clinical improvement of symptoms and good consolidation later.

Conclusions: The trans-oral decompression surgery should be indicated in irreducible injuries and lesions where the compression is above, is recommended in other aetiologies abnormalities of bone, soft tissue or vascular. Transoral decompression - Atlanto axial instability - posterior fixation.

Objective: To analyze the recently reported technical innovations in the reconstruction surgery of brachial plexus injuries.

Patients and methods: A total of 89 articles were analyzed, of which 50 were selected to perform this work. Priority was given to those studies describing technical innovations or large series that include the results of such techniques. The period analyzed was from January 1993 to June 2006. 

Results: Numerous neurometric techniques of the plexus terminal branches have been developed in the last decade, including the use of spinal accessory, phrenic, ulnar, intercostal, C3-C4 cervical roots, contralateral C7 root and hypoglossal nerve. 

Conclusions: Neurotization of the suprascapular and musculocutaneous nerves with the accessory spinal, phrenic and intercostal nerves show good results. In case of incomplete injury, the neuromuscularisation technique of the musculocutaneous with the ulnar (Oberlin) should also be considered. Unlike what happens at the facial level, the hypoglossal is not useful for neurotizing the brachial plexus.

Key words: Brachial plexus lesion, phrenic nerve, intercostal nerves, neuropathy.

A recent extensive review of the results of conventional percutaneous thermo-coagulation indicated that it is the most effective percutaneous technique with the highest residual morbidity.

The present communication is the summary, results and recommendations of our original method, designed to minimize unnecessary morbidity of the procedure. It is based on 31 years of experience in 370 procedures, most of the last 167 performed with our method and technique.

In the treatment of sciatica due to lumbar disc herniation, multiple surgical techniques have been used, from the traditional open surgeries to remove part of the intervertebral disc for decompress and reduce the pressure of this on the root, until its evolution into smaller incisions that allow decompression using the surgical microscope or through the use of endoscopy to access the disc. In some patients, however, even less invasive methods may be used for decompression. These alternatives are varied and are grouped within the percutaneous procedures being used basically in those patients whose pain is originated by a contained hernia.

Myelomeningocele, an open defect of the neural tube, is the most common congenital anomaly of the central nervous system (CNS) and the main cause that determines a number of growth and developmental disabilities in the affected child. It occurs due to a failure of the closure of neurulation in the caudal neural plate during the fourth week of gestation (22 to 26 days of gestation). It is characterized by dorsal protrusion of the meninges through a bony defect at the level of the spinal midline, without a dermal covering, forming a sac containing cerebrospinal fluid (CSF) and neural tissue Dysplastic, and which is usually associated with paralysis of the spinal nerves.