Journal of neurological surgery. Part A, Central European neurosurgery
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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.
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J Neurol Surg A Cent Eur Neurosurg · Sep 2013
Case ReportsGlossopharyngeal neuralgia treated with an endoscopic assisted midline suboccipital subtonsillar approach: technical note.
Glossopharyngeal nerve neuralgia (GPN) is an exceptionally rare skull-based disorder. It is treated similar to other neurovascular conflicts. The approach, however, is debatable, as the caudal cranial nerves and especially the exit zones at the brainstem are barely visible via the retrosigmoid approach. ⋯ A midline subtonsillar approach with endoscopic assistance to the lateral brainstem is a straightforward time- and morbidity-sparing procedure.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2013
Neuronavigation-assisted endoscopic unilateral cyst fenestration for treatment of symptomatic septum pellucidum cysts.
Traditional surgical treatments for this rare disease include open surgical procedures and ventriculoperitoneal shunting. In 1995, endoscopic fenestration was first applied to treatment of cysts of the septum pellucidum (CSP). However, cyst fenestration generally takes a bilateral approach by making two burr holes leading to two fenestrations in the lateral walls of the cyst. Some disadvantages are related to bilateral fenestration. So far, there is no consensus on the surgical indications, the endoscopic approaches, and techniques for CSPs. Based on our experience with 14 cases of symptomatic CSP treated with neuronavigation-assisted endoscopic unilateral cyst fenestration via a single burr hole, we discuss the operative indications and the utility of endoscope-assisted techniques in combination with neuronavigation. ⋯ The results after uni- and bilateral CSP fenestration show no significant difference. Avoiding damage of contralateral tissue, the surgical trauma in unilateral fenestration is less than in bilateral fenestration. Furthermore, the unilateral approach shortens the operation time. We believe that unilateral cyst fenestration is a better therapeutic option in symptomatic CSP.
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J Neurol Surg A Cent Eur Neurosurg · Jul 2013
Case ReportsMinimally invasive, robot-assisted, anterior lumbar interbody fusion: a technical note.
Minimally invasive techniques in spine surgery have gained significant popularity due to decreased tissue dissection and destruction, postoperative pain, and hospital stay. The laparoscopic anterior lumbar interbody fusion (ALIF), an innovation in minimally invasive spine surgery, is rarely done because it has marginal benefit over the mini-open ALIF technique in rates of retrograde ejaculation and vascular complications. We propose these outcomes can be improved with enhanced robotic-assisted dissection and exposure for ALIF. ⋯ Use of the robotic assistance in the performance of ALIF is possible without significant operative complications. This technique may provide added benefit over conventional laparoscopic approaches to the spine.