Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Nov 2013
Single-Incision laparoscopic surgery (SILS) for ventriculoperitoneal shunt placement.
Single-incision laparoscopic surgery (SILS) may facilitate safer shunt placement and lower distal obstruction rate than is seen in conventional surgery. ⋯ SILS is a safe and effective technique for ventriculoperitoneal shunt placement and can be accomplished with no higher risk of shunt infection and distal malfunction. Without an additional port, SILS allows good visualization of the peritoneal cavity to avoid major intra-abdominal complications. Only one 6-mm incision at the umbilicus area is required and is almost invisible after wound healing.
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J Neurol Surg A Cent Eur Neurosurg · Nov 2013
Comparative StudyThree-dimensional high-definition neuroendoscopic surgery: a controlled comparative laboratory study with two-dimensional endoscopy and clinical application.
The purpose of this research was to investigate the usefulness of three-dimensional (3D) endoscopy compared with two-dimensional (2D) endoscopy in neuroendoscopic surgeries in a comparative study and to test the clinical applications. ⋯ The use of a 3D neuroendoscope improved depth perception and task performance. Our results suggest that 3D endoscopes could shorten the learning curve of young neurosurgeons and play an important role in both general surgery and neurosurgery.
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J Neurol Surg A Cent Eur Neurosurg · Nov 2013
The modified pterional keyhole craniotomy for open cerebrovascular surgery: a new workhorse?
The frontotemporal craniotomy is the most commonly used approach for vascular neurosurgery. However, this approach requires significant mobilization of overlying soft tissues, resulting in muscle atrophy and temporomandibular joint pain. We describe a modified pterional keyhole approach and its use in our initial clinical experience. ⋯ In carefully selected patients, a minimally invasive keyhole approach may be a safe and effective alternative to traditional pterional craniotomy for certain anterior circulation aneurysms.
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J Neurol Surg A Cent Eur Neurosurg · Nov 2013
Lumbar ligamentum flavum: spatial relationships to surrounding anatomical structures and technical description of en bloc resection.
One structure, the ligamentum flavum, nearly always encountered in lumbar spinal operations, has not been examined as an important anatomical landmark. In this context, we describe its relevance in corridors of small surgical exposures created by minimally invasive spinal approaches. ⋯ Our cadaveric and microscopic surgical dissections show the ligamentum flavum as seen in the new corridors of small surgical exposures during minimally invasive surgeries of the lumbar spine. Identifying this landmark, surgeons can envision the location of the nerve roots to help prevent their injury.
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J Neurol Surg A Cent Eur Neurosurg · Sep 2013
Comparative StudyCost savings associated with prevention of recurrent lumbar disc herniation with a novel annular closure device: a multicenter prospective cohort study.
Same-level recurrent disc herniation is a well-defined complication following lumbar discectomy. Reherniation results in increased morbidity and health care costs. Techniques to reduce these consequences may improve outcomes and reduce cost after lumbar discectomy. In a prospective cohort study, we set out to evaluate the cost associated with surgical management of recurrent, same-level lumbar disc herniation following primary discectomy. ⋯ Recurrent disc herniation did not occur in any patients after annular closure within the 12-month follow-up. The reduction in the incidence of reherniation was associated with potentially significant cost savings. Development of novel techniques to prevent recurrent lumbar disc herniation is warranted to decrease the associated morbidity and health care costs associated with this complication.