Journal of neurosurgery
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Journal of neurosurgery · Oct 2003
Case ReportsFracture of S1-2 after L4-S1 decompression and fusion. Case report and review of the literature.
The author describes a woman in whom an S1-2 fracture developed after L4-S1 decompression and fusion. Osteoporosis was not present, but the lesion failed to respond to conservative therapy, necessitating surgical extension of the spinal fusion. ⋯ To date, only four cases of sacral stress fracture appear in the literature, all involving female patients and reportedly associated with osteoporosis. Unlike the present case, the fracture resolved satisfactorily in all cases with conservative treatment.
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Journal of neurosurgery · Oct 2003
Case ReportsWriting, calculating, and finger recognition in the region of the angular gyrus: a cortical stimulation study of Gerstmann syndrome.
In an attempt to gain a better understanding of the cerebral functions represented in the angular gyrus and to spare them during surgery, the authors studied patients with brain tumors located close to the angular gyrus and mapped cortical sites by using electrostimulation. ⋯ Symptoms of Gerstmann syndrome can be found during direct brain mapping in the angular gyrus region. In this series of patients, sites producing interferences in writing, calculating, and finger recognition were demonstrated in the angular gyrus, which may or may not have been associated with object-naming, color-naming, or reading sites.
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Journal of neurosurgery · Oct 2003
Case ReportsSpinal intradural extramedullary cavernous angioma. Case report.
The spinal intradural extramedullary cavernous angioma is a rare clinical entity. Only 20 surgically treated cases have been reported. ⋯ Intradural extramedullary cavernous angiomas occur predominantly in males, in the lower thoracolumbar region, exhibit a relatively high association with subarachnoid hemorrhage, and mostly adhere to the nerve root or spinal cord. Because resection is possible without causing morbidity and because outcome depends on the severity of preoperative neurological dysfunction, precise diagnosis and timely treatment are mandatory.
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The purpose of this paper was to analyze outcomes in patients at the Louisiana State University Health Sciences Center (LSUHSC) who presented with contusion-stretch injuries to the axillary nerve. These injuries resulted from shoulder injury either with or without fracture/dislocation. Although recovery of deltoid function can occur spontaneously, this was not always the case. ⋯ Operative exploration of axillary contusion-stretch lesions is worthwhile in carefully selected cases. If indicated by inspection and intraoperative electrical studies, nerve repair can lead to useful function.
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Journal of neurosurgery · Oct 2003
Three-dimensional fluoroscopy-guided percutaneous thoracolumbar pedicle screw placement. Technical note.
The authors sought to evaluate the feasibility and accuracy of three-dimensional (3D) fluoroscopic guidance for percutaneous placement of thoracic and lumbar pedicle screws in three cadaveric specimens. After attaching a percutaneous dynamic reference array to the surgical anatomy, an isocentric C-arm fluoroscope was used to obtain images of the region of interest. Light-emitting diodes attached to the C-arm unit were tracked using an electrooptical camera. ⋯ Two of the violations were less than 2 mm beyond the cortex; the others were between 2 and 3 mm. Coupled with an image guidance system, 3D fluoroscopy allows highly accurate spinal navigation. Results of this study suggest that this technology will facilitate the application of minimally invasive techniques to the field of spine surgery.