Acta neurochirurgica
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Acta neurochirurgica · Oct 2019
Gradual expansion of stent retriever in mechanical thrombectomy for curved middle cerebral artery: structural findings of the stent for predictable recanalization results.
Trevo Provue stent retriever with visible struts under fluoroscopy may be useful in identifying the optimal position and expansion of the stent during the procedure. This study aimed to demonstrate and analyze changes in the segmental diameter of a radio-opaque stent retriever after deployment according to recanalization results, and its relationship with the angle of the occluded segment of the middle cerebral artery (MCA). ⋯ The diameter of the stent retriever after deployment was associated with the recanalization results in mechanical thrombectomy following MCA occlusion.
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Acta neurochirurgica · Oct 2019
How I do it: total uncinatectomy during anterior diskectomy and fusion for cervical radiculopathy caused by uncovertebral joint hypertrophy.
Cervical radiculopathy from uncovertebral joint hypertrophy and foraminal stenosis is a common indication for anterior cervical diskectomy and fusion (ACDF). Often, the uncinate hypertrophy extends lateral to the foramen and impinges on the nerve close to the vertebral artery as it travels in between the transverse foramina. ⋯ Total uncinatectomy is a useful adjunct during ACDF for complete foraminal decompression in cases of uncovertebral joint hypertrophy.
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Acta neurochirurgica · Oct 2019
Early decompressive surgery in patients with traumatic spinal cord injury improves neurological outcome.
The role and timing of a decompressive surgical intervention in patients with traumatic spinal cord injury (SCI) remain controversial. Given the impact of SCI on the individual and society, decompressive surgery to reduce the extent of tissue destruction and improving neurological outcome after initial spinal cord trauma are needed. ⋯ The present study reports a beneficial effect of early decompression surgery, especially for incomplete SCI patients; however, surgical decision-making is complex, and all cases of acute spinal cord injury should be cautiously interpreted and handled on an individual basis.
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Acta neurochirurgica · Oct 2019
The long-term effects of microvascular decompression on social phobia and health-related quality of life in patients with hemifacial spasm: a 3-year prospective study.
Although not a life-threatening condition, hemifacial spasm (HFS) frequently leads to social phobia because it causes significant facial disfigurement and consequently reduces health-related quality of life (HRQoL). The purpose of the current study was to examine the long-term effects of MVD on psychological aspects and HRQoL in HFS patients with social anxiety over a 36-month follow-up. ⋯ The improvements previously observed in psychological aspects and HRQoL over a short-term follow-up after MVD in HFS patients with social phobia were maintained for at least 36 months after MVD.
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Microscope-based augmented reality (AR) is commonly used in cranial surgery; however, until recently, this technique was not implemented for spinal surgery. We prospectively investigated, how AR can be applied for intradural spinal tumor surgery. ⋯ Microscope-based AR can be reliably applied to intradural spinal tumor surgery. Automatic AR registration ensures high precision and provides an intuitive visualization of the extent of the tumor and surrounding structures. Given this setting, all advanced multi-modality options of cranial AR can also be applied to spinal surgery.