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Preoperative embolization is complementary to surgery for large brain arteriovenous malformations (AVMs). From January 2005 to December 2015, 69 patients harboring an AVM were managed in our department by the same surgeon (RG). Forty one were ruptured and 65 were supratentorial. Thirty nine smaller AVMs were treated with surgery stand-alone, whereas, for 30 larger malformations, surgery was combined with adjuvant treatment involving preoperative staged embolization and/or, less frequently, radiosurgery. In all patients treated with surgery alone, complete resection of AVM was achieved. A successful preoperative partial endovascular obliteration of AVM was obtained in 24 out of 27 more complex cases, with a zero mortality rate and a very low morbidity. Here, embolization was of a certain utility in the handling of deeper feeders and nidus excision, also facilitating intraoperative hemostasis. In three cases of residuals, radiosurgery was performed. In those patient treated with a combined approach, a good overall outcome, 0–2 modified Rankin Scale (mRS), was achieved in 25 cases. Preoperative embolization proved to be a reasonable option complementary to high-grade AVMs surgery, reducing the frequency of breakthrough hemorrhages, aiding the elimination of deep feeders, and making the nidus dissection easier.

Supine magnetic resonance imaging (MRI) is routinely used in the assessment of low-back pain and radiculopathy. However, imaging findings often correlate poorly with clinical findings. This is partly related to the positional dependence of spinal stenosis, which reflects dynamic changes in soft-tissue structures. Upright MRI in the flexed, extended, rotated, standing, and bending positions allows patients to reproduce the positions that bring about their symptoms. Assessment of the degree of spinal stability in the degenerate and postoperative lumbar spine is also possible and it offers many diagnostic opportunities. The aim of this chapter is to present the findings concerning the spine instability using conventional and dynamic MRI.

Low back pain has a high lifetime incidence, coming to affect between 80 and 90 % of the general population during their lifetime. For decades, the focus of diagnosis and treatment of low back pain has been the intervertebral disc. However, the only presence of degenerative disc disease identified by imaging, with resultant surgical intervention, is not always rewarding, and nowadays it is well demonstrated that the rich innervation of the articular structures of the facet joints is often the cause of chronic back pain. Several treatments for pain of lumbar facet joints have been proposed, and these are mainly intra-articular steroid injections and radiofrequency denervation of the medial branches, which innervate the zygapophysial joint.