The “headache”: a widespread disorder to learn about

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The “headache” is one of the most common chronic diseases in the world such that the World Health Organization (WHO) places it 19th among the disabling pathologies.

The social impact of this disorder is high both for the direct costs of necessary treatments, and for the indirect ones in terms of decreased productivity.

The “headache” indeed, as commonly referred, is a disabling disease that may adverserly affect the quality of life of affected individuals.

The headaches can be classified into primary and secondary: in the first case, are included those forms of which it is not possible to identify a real organic cause. They are the most common, and affect in an episodic way about  ten million Italians with a greater incidence on women. In most cases they can be solved or improved with an appropriate therapy. Generally, we can consider them as a mode of abnormal reaction of nervous system to certain environmental factors.

The primary headaches are classified into three categories: the migraine is the most known. It manifests itself mainly in adult age, between 35 and 45 years of age, interval in which affects the female population most. It may involve different areas of head and arise at any time of the day. It causes severe and pulsating pain, aggravated by movements or light and sensory stimuli.

The tension headaches identify the most common “headache” that anyone, at least occasionally, has experienced. They cause less intense pain, not necessarily affecting the performance of daily activities. The real difficulty arises when they tend to become chronic, causing a prolonged or repeated malaise.

Finally, the cluster headache, rarer but more disabling, causes intense pains, only rarely chronic. It is called “cluster” because individual attacks tend to concentrate in periods of few months and then disappear and reappear at a distance of time.

But the secondary headaches are less frequent but may depend on different pathologic conditions. The physician will prescribe more investigations for a correct diagnosis and assessment of appropriate therapy, based on the etiology of headache.

The Netherlands visits Clinica San Francesco

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The Clinica San Francesco continues to be an European reference point for the robotic orthopaedic surgery.

On Wednesday 14th December 2021 the Clinic opened its doors to a team of Dutch surgeons, arrived to attend the training “Surgical observation – Mako Robotics Assisted Surgery” led by Dr Piergiuseppe Perazzini, Director of Orthopaedic and Traumatology Functional Unit. Drs Matthijis Somford (Rijnstate Hospital), Lucas Taminiau (Bergman Clinics, Haaglanden MC), Pieter Geervliet (NWZ Ziekenhuis Groep), Guido van Solinge (Isala Hospital) e Daniël Hoornenborg (Xpert Clinic) attended the event. Dr Perazzini allowed Dutch colleagues to attend different Mako robot assisted surgery cases both on knee and hip.

Here are the guests’ testimonies.

Dr Somford “Today we have had an extraordinary experience. We have seen different cases, primary simple cases, but also complex; we were shown all the aspects on how to use the robotic surgery. I think there are many advantages, but for me, for what I’ve seen today, in complex cases where there are anatomy changes the robot may lead to arrange the component precisely and make it more reproducible. It is the future of orthopaedic surgery and articular prostheses. At the moment there are only three Mako systems in the Netherlands, but I hope that the Mako technology will spread and we will be able to use the robotic also in our hospital”.

Dr Taminiau “Before today I had never seen this procedure, the today’s experience has allowed us to see different cases of knee and hip robotic surgery. It’s been very nice to be here, we have seen many positive aspects on robotic knee and hip replacement. The advantage for the surgeon is that robot guides you in right arrangement of prosthesis during the placement and the patient’s benefit is that the prosthesis is placed in the best possible way. I believe that this leads to a greater patient satisfaction in the long term. I don’t know when this future starts, in a year, ten or twenty years, I think surgery is going to be more robotic”.

Dr Geervielt “Before today I had never experience with robotic surgery and I have seen an unique prosthesis procedure and completely new. It has been very interesting to see how it works and what are the outcomes for patient. I believe that thanks to the robotic surgery we reached an optimal positioning of component and I think it is the best advantage for patient in long term. It is the future, probably in a couple of years we will find it in every Dutch hospital”.

Dr Von Solinge “Today it’s been an extraordinary day, I would like to thank Dr Perazzini and his team for showing us the robotic surgery. It has been fantastic, we have carried out two hip primary arthroplasty and it has been really stimulating and interesting to see how robotic surgery works. I think that this procedure can be very useful both in hip simple primary osteoarthrosis cases and in complex ones and I can’t wait to use it in my country too, the Netherlands. I believe it is the future and it will help us. We don’t yet use it, but we are considering it and I hope that in next years we will try to work with robotic surgery”.

Dottor Hoornenborg “I had never experience with robotic surgery so this has been my first contact with the Mako robotic arm and has been really interesting to see how the knee replacement has been performed, without looking at the patient, but watching the computer display. I think that the advantages for surgeon and patient, in particular for surgeon, are the reproducibility of phases and repairing of knee ligaments especially in the partially new replacements- I think that robotic surgery will have a great future in the orthopaedic surgery, not in next years, maybe, but soon. It will be a great thing”.

The Clinic orthopaedic staff represents the real European and ‘outside the USA’ forerunner of this innovative procedure, having introduced it in 2011 for the partial knee replacement and in 2012 for the total hip replacement (it was also the first in Italy to introduce the robotic total knee replacement) holding the wildest and most long-running records. The Clinica San Francesco is Veneto Region reference centre for robotic orthopaedic surgery as well as European Robotic Orthopaedic Centre (CORE) with an intense training activity for surgeons from all over the Europe.