Journal of neurosurgery
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Journal of neurosurgery · Oct 2003
Posterolateral percutaneous endoscopic lumbar foraminotomy for L5-S1 foraminal or lateral exit zone stenosis. Technical note.
The purpose of this study was to determine the efficacy and feasibility of posterolateral percutaneous endoscopic lumbar foraminotomy (PELF) for foraminal or lateral exit zone stenosis of the L5-S1 level in the awake patient. Twelve consecutive patients with L5-S1 foraminal stenosis and associated leg pain underwent PELF between May 2001 and July 2002. Under fluoroscopic guidance, posterolateral endoscopic foraminal decompression was performed using a bone reamer, endoscopic forceps, and a laser. ⋯ There was no complication. The PELF procedure provides a simple alternative for treating lumbar foraminal or lateral exit zone stenosis in selected cases. The authors found that the posterolateral endoscopic approach to the L5-S1 foramen was usually possible and that using a bone reamer to undercut the superior facet was effective.
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Journal of neurosurgery · Oct 2003
Mechanism of the spinal cord injury and the cervical spondylotic myelopathy: new approach based on the mechanical features of the spinal cord white and gray matter.
The authors have previously investigated the mechanical properties of the white and gray matter in the bovine cervical spinal cord, demonstrating that the gray matter is more rigid, although more fragile, than the white matter. In the present study they conducted additional tensile tests on the bovine cervical spinal cord by changing strain levels and strain rates applied to the white and gray matter. ⋯ These differences in mechanical properties between the white and gray matter constitute different mechanisms contributing to the development of tissue damage and clinical symptoms.
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Journal of neurosurgery · Oct 2003
Randomized Controlled Trial Clinical TrialFactors associated with the development of vasospasm after planned surgical treatment of aneurysmal subarachnoid hemorrhage.
The goal of this study was to determine factors associated with the development of symptomatic vasospasm among patients with aneurysmal subarachnoid hemorrhage (SAH) who participated in the randomized, double-blind, placebo-controlled trials of tirilazad between 1991 and 1997. ⋯ Symptomatic vasospasm was associated with the amount of SAH on the CT scan, the presence of IVH, and the patient's neurological grade. The association with patient age may reflect alterations in vessel reactivity associated with age. A history of hypertension may render the brain more susceptible to symptoms from vasospasm. The explanation for the relationships with aneurysm size, use of prophylactic induced hypertension, and the particular study is unclear.