Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Mar 2013
ReviewCranial base repair with combined vascularized nasal septal flap and autologous tissue graft following expanded endonasal endoscopic neurosurgery.
The expanded endonasal endoscopic approach provides excellent visualization and access to midline skull base lesions, albeit with a relatively high risk of postoperative cerebrospinal fluid (CSF) leakage. We present our experience with the expanded endonasal endoscopic approach to the skull base in an institution where, previously, a traditional transsphenoidal approach with a surgical microscope had been used. ⋯ The repair of skull base defects created during expanded endonasal endoscopic surgery is improved by use of a mucoperichondrial nasal septal flap combined with a layered autologous tissue graft. When CSF leakage occurs despite nasal septal flap closure, the site of the leakage may be easier to localize and repair.
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J Neurol Surg A Cent Eur Neurosurg · Mar 2013
Endoscopic interlaminar management of lumbar disc disease.
The role of surgery by minimally invasive techniques for lumbar disc disease remains unclear in the Cochrane review. There are reports of significant advantages of endoscopy over open or microdiscectomy techniques, such as better visualization of the lesion, smaller incision sizes with lower short-term morbidity, reduced hospital stay, and better education. ⋯ Endoscopic interlaminar technique (ILT) was a safe and effective alternative procedure for lumber disc disease. This was associated with some complications, especially in the initial learning curve. Once the practitioner is over the learning curve and has acquired expertise, this procedure was safe and effective.
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J Neurol Surg A Cent Eur Neurosurg · Jan 2013
Case ReportsPurely neuroendoscopic resection of an intraventricular cavernous angioma: case report.
Intraventricular cavernomas are rare and generally treated by microsurgical approach. With the advances in neuroendoscopy, intraventricular lesions have been managed by this technique. However, tumor size and vascular nature are considered restrictive factors. As far as we are concerned, there are two cases in the literature of intraventricular cavernoma resection done by neuroendoscopy. ⋯ As neuroendoscopy evolves, we see that lesions considered impossible to be managed by neuroendoscopy before today are being treated with the advantages that the minimally invasive surgery offers.
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J Neurol Surg A Cent Eur Neurosurg · Jan 2013
Case ReportsTransdural imaging of meningiomas by indocyanine green videography: the eclipse sign.
Indocyanine green videography has been introduced into neurosurgical fields for minimally invasive neurosurgery. To establish a new intraoperative imaging modality, we performed transdural indocyanine green videography during the surgery of meningiomas. ⋯ Transdural observation of the cortical arteries and veins and the venous sinus was successfully performed followed by the visualization of the projection of meningiomas as the shadow. We propose this sign as "the Eclipse sign." This transdural imaging method was of value in terms of precise and minimal dural incision.
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J Neurol Surg A Cent Eur Neurosurg · Jan 2013
Temporary percutaneous pedicle screw fixation for treatment of thoracolumbar injuries in young adults.
Bone-only injuries of the spine, including Chance fractures, are commonly managed nonoperatively. However, selected patients may benefit from surgical stabilization. In this report, the authors describe a method of temporary internal fixation with percutaneous pedicle screws for patients with intractable pain and thoracolumbar fractures. ⋯ Temporary internal bracing of bone-only thoracolumbar fractures in young adults is a safe and effective treatment strategy in selected patients. This procedure provides rapid pain control and early mobilization without sacrificing any spinal motion segments.