Acta neurochirurgica
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This was a retrospective study of clinical and radiological results of cervical arthroplasty using the Bryan cervical disc prosthesis to evaluate the efficacy of arthroplasty in clinical applications. ⋯ Arthroplasty using the Bryan disc appears to be safe and provided a favorable preliminary clinical and radiological outcome. Postoperative kyphosis can be prevented by understanding the biomechanical properties of the Bryan disc. Future studies will need to address the association between postoperative kyphosis, clinical outcome and adjacent segment disease.
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Acta neurochirurgica · Sep 2006
Review Case ReportsThe midline suboccipital subtonsillar approach to the hypoglossal canal: surgical anatomy and clinical application.
Primary lesions of the hypoglossal canal, such as hypoglossal schwannomas, are rare. No consensus exists with regard to the surgical approach of choice for treatment of these lesions. Usually, lateral transcondylar approaches have been used. ⋯ The midline subtonsillar approach permits a straight primary intradural view to the hypoglossal canal. There is no necessity of condylar resections. The surgical anatomy of the subtonsillar approach is described and illustrated by an example of a case.
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Acta neurochirurgica · Sep 2006
Case ReportsThoracic radiculopathy from a paravertebral mesothelial cyst.
We report on an extremely rare case of a paravertebral thoracic mesothelial cyst in a young woman who presented with dorsal radiculopathy affecting the T5 dermatome. The patient underwent a standard transthoracic intercostal approach with removal of the cyst. ⋯ To our knowledge, this is the first report of radiculopathy due to a paravertebral mesothelial cyst. Although highly unusual, paravertebral mesothelial cyst should be considered in the differential diagnosis for lesions inducing dorsal radicular pain.
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Acta neurochirurgica · Sep 2006
Case ReportsSmall keyhole transuncal foraminotomy for unilateral cervical radiculopathy.
Interbody fusion after anterior discectomy may lead to acceleration of degenerative changes at adjacent levels. Although the posterior approach preserves the motion segment, decompression of the nerve root is indirect if "hard disc prolaps" is the main cause. Recently, a technique of microsurgical anterior cervical foraminotomy for the treatment of radiculopathy with preservation of the segment mobility was published. ⋯ No instability of the cervical spine was seen. The microsurgical anterior foraminotomy via a small keyhole transuncal approach is safe, minimally invasive, and represents an effective method to treat unilateral cervical radiculopathy caused by disc prolaps and/or uncovertebral osteophytes. Additionally, the segment mobility is preserved and prevents the acceleration of degenerative changes at adjacent levels.
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Acta neurochirurgica · Sep 2006
Brainstem hypoperfusion in severe symptomatic vasospasm following aneurysmal subarachnoid hemorrhage: role of basilar artery vasospasm.
The hemodynamic effects of vertebrobasilar vasospasm are ill defined. The purpose of this study was to determine the effects of basilar artery (BA) vasospasm on brainstem (BS) perfusion. ⋯ These findings suggest that the incidence of BA vasospasm in patients with severe symptomatic vasospasm is high and patients with significant BA vasospasm are at higher risk to experience BS ischemia. Further studies should be done to evaluate the effects of endovascular therapy on BS perfusion and the impact of BS ischemia on morbidity and mortality of patients with severe symptomatic vasospasm.