Journal of neurosurgery
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Journal of neurosurgery · Jan 1999
Long-term follow up of patients surgically treated by the far-lateral approach for foraminal and extraforaminal lumbar disc herniations.
This study was undertaken to evaluate the long-term benefit in 202 patients who were surgically treated via a microsurgical far-lateral approach for foraminal or extraforaminal lumbar disc herniations. ⋯ The far-lateral approach is a safe, effective procedure that avoids the risk of secondary spinal instability.
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Journal of neurosurgery · Jan 1999
Cavernous malformations of the brainstem: experience with 100 patients.
In this study the authors review surgical experience with cavernous malformations of the brainstem (CMBs) in an attempt to define more clearly the natural history, indications, and risks of surgical management of these lesions. ⋯ The natural history of CMBs is worse than that of cavernous malformations in other locations. These CMBs can be resected using skull base approaches, which should be considered in patients with symptomatic hemorrhage who harbor lesions that approach the pial surface. Venous anomalies are always associated with CMBs and must be preserved.
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Journal of neurosurgery · Jan 1999
Case ReportsFatal subarachnoid hemorrhage after endoscopic third ventriculostomy. Case report.
In recent years, endoscopic third ventriculostomy has become a well-established procedure for the treatment of various forms of noncommunicating hydrocephalus. Endoscopic third ventriculostomy is considered to be an easy and safe procedure. Complications have rarely been reported in the literature. ⋯ Despite emergency external ventricular drainage, the patient died a few hours later. Although endoscopic third ventriculostomy is considered to be a simple and safe procedure, one should be aware that severe and sometimes fatal complications may occur. To avoid vascular injury, perforation of the floor of the third ventricle should be performed in the midline, halfway between the infundibular recess and the mammillary bodies, just behind the dorsum sellae.
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Journal of neurosurgery · Jan 1999
Case ReportsComplex cervical spine neoplastic disease: reconstruction after surgery by using a vascularized fibular strut graft. Case report.
The authors report a case of an aggressive chordoma in the cervical spine of a 15-year-old girl who underwent radical resection followed by reconstruction using an anterior vascularized fibular strut graft and posterior arthrodesis prior to receiving immediate postoperative radiation therapy. The patient had successful graft incorporation 4 months postoperatively. The authors review the advantages of using vascularized fibular strut grafts for the treatment of multilevel cervical spine neoplastic disease and discuss the theoretical advantages of using vascularized grafts that tolerate therapeutic levels of radiation.
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Journal of neurosurgery · Jan 1999
One-stage posterior decompression and reconstruction of the cervical spine by using pedicle screw fixation systems.
This retrospective study was conducted to analyze the results of one-stage posterior decompression and reconstruction of the cervical spine by using pedicle screw fixation systems in 46 patients. ⋯ The pedicle screw fixation procedure, which does not require the lamina to be used as a stabilizing anchor, has proven to be valuable when performing one-stage posterior decompressive and reconstructive surgery in the cervical spine. The risk to neurovascular structures in this procedure, however, cannot be completely eliminated. Thorough knowledge of local anatomy and application of established surgical techniques are essential for this procedure.