Acta neurochirurgica
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Long-term survival of patients with recurrent gliomas depends on the extent of resection. Thus, the desirability of an intra-operative imaging modality that can augment the resection extension without affecting vital surrounding structures is more than obvious. It was the aim of the present study to evaluate a possible benefit of image-guided intra-operative ultrasonography for the surgery of recurrent gliomas. ⋯ Neurosonography is a time- and cost-effective technology offering intra-operative imaging. The improved orientation and visualization of tumour remnants, adjacent ventricles, and the enhanced intra- and peri-tumoural vasculature is one of the main advantages of ultrasonography-assisted image-guided surgery, which is most obvious during surgery for cystic gliomas.
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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.