Acta neurochirurgica
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Acta neurochirurgica · Dec 2008
Minimally invasive spinal surgery using nucleoplasty: a 1-year follow-up study.
Nucleoplasty is a minimally invasive percutaneous intradiscal coblation therapy option in patients with chronic discogenic low back pain. The purpose of this prospective study was to assess the effectiveness of nucleoplasty in our patients up to 1 year after treatment. ⋯ Nucleoplasty is an effective therapy for chronic, discogenic back pain which results in significant reductions in levels of disability and incapacity for work as well as decreased analgesic consumption.
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Multimodal treatment in the management of giant craniopharyngiomas (>4 cm in diameter) is necessary to obtain optimal results, and includes conservative or palliative treatment and "aggressive" removal. The significance of a new treatment algorithm including direct surgical resection with the intent to avoid radiation therapy and regrowth will be discussed here. ⋯ Special reference is given to direct resection of tumours at an optimal timing within this management. If hypothalamic disturbances are absent or improving due to pre-treatment (medical therapy, symptomatic surgery), giant craniopharyngiomas can be surgically removed in more than two of three patients with low morbidity and only moderate deterioration of endocrine function. The latter has to be accepted when curative surgery is intended, but even then, recurrences cannot be prevented. Contraindication for curative surgery is persisting hypothalamic damage necessitating conservative treatment modalities.
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Acta neurochirurgica · Dec 2008
Long term outcome of anterior cervical discectomy and fusion using coral grafts.
To determine the long term efficacy of coral grafts in anterior cervical discectomy and fusion. ⋯ Despite satisfactory clinical results and a long follow-up period, coral implants yield low fusion rates, particularly in patients with discal hernia of two-level arthrodesis. The use of coral grafts cannot be recommended when fusion is one of the post-operative endpoints.
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Acta neurochirurgica · Dec 2008
A restricted neuroendoscopic approach for pathological diagnosis of intraventricular and paraventricular tumours.
There is increasing interest in the use of neuroendoscopic techniques in neuro-oncology. We report our experience of endoscopic biopsy in patients harbouring intraventricular and paraventricular brain tumours in order to define criteria for the use of this technique. ⋯ In our experience, endoscopic biopsy could provide a pathological diagnosis in 19 of 23 patients. Endoscopic biopsy sampling sufficient tissue should be considered as the first choice in selected lesions that are otherwise difficult to approach.
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Acta neurochirurgica · Dec 2008
Surgical complications secondary to decompressive craniectomy in patients with a head injury: a series of 108 consecutive cases.
Decompressive craniectomy is an important method for managing refractory intracranial hypertension in patients with head injury. We reviewed a large series of patients who underwent this surgical procedure to establish the incidence and type of postoperative complications. ⋯ The potential benefits of decompressive craniectomy can be adversely affected by the occurrence of complications. Each complication secondary to surgical decompression had its own typical time window for occurrence. In addition, the severity of head injury was related to the development of a complication.