Journal of neurosurgery
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Journal of neurosurgery · Jul 2003
Case ReportsCategory-specific naming deficit identified by intraoperative stimulation mapping and postoperative neuropsychological testing. Case report.
Category-specific naming deficits and differential brain activation patterns have been reported in patients naming living as opposed to nonliving objects. The authors report on a case in which they used preoperative functional magnetic resonance (fMR) imaging, intraoperative electrocortical stimulation mapping (ESM), and postoperative neuropsychological testing to map language function. ⋯ These authors are the first to identify a specific and well-localized area of category-specific naming in the inferior temporal lobe and to demonstrate congruence of intraoperative and postoperative category-specific naming deficits. They also emphasize the roles of preoperative and intraoperative testing in predicting clinical outcomes.
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Journal of neurosurgery · Jul 2003
Transarticular screw fixation in the middle and lower cervical spine. Technical note.
Although atlantoaxial transarticular screw fixation is technically demanding and there is a significant risk of vertebral artery (VA) injury, transarticular screw insertion in the middle and lower cervical spine is simple and can be performed safely with the aid of lateral fluoroscopic guidance. The authors describe the surgical techniques and outcome of transarticular screw fixation in the middle and lower cervical spine. Transarticular screw insertion into C2-3 or caudal cervical joints was performed from the articular pillar, directing the screw anterocaudally to penetrate the facet joint and the anterior cortex of the articular pillar, parallel to the sagittal plane. ⋯ No instance of screw backout or loosening was identified radiographically; fusion was achieved in all patients. Biomechanical strength is maintained by penetrating four cortical layers. When performed appropriately, this method is safe and reliable and deserves more widespread use.
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Journal of neurosurgery · Jul 2003
Comparative StudyIn vitro biomechanical comparison of pedicle screws, sublaminar hooks, and sublaminar cables.
Three types of posterior thoracolumbar implants are in use today: pedicle screws, sublaminar titaniumcables, and sublaminar hooks. The authors conducted a biomechanical comparison of these three implants in human cadaveric spines. ⋯ These findings suggest that screws possess the greatest pullout strength of the three fixation systems. Sublaminar cables are the least rigid of the three. When screw failure occurred, the mechanism was generally screw back-out, without vertebral fractures.
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Journal of neurosurgery · Jul 2003
Kyphoplasty for vertebral compression fractures: 1-year clinical outcomes from a prospective study.
Over the past 15 years, vertebroplasty has emerged as a treatment for vertebral compression fractures. This technique, however, does not restore vertebral height and is associated with a high rate of cement leakage. Recently, kyphoplasty was developed in an effort to circumvent this problem. Although its immediate results have been reported, it is unclear whether the benefits endure. ⋯ Kyphoplasty is an effective treatment for vertebral compression fractures. The benefits presented in the early postoperative period and persisted at 1 year posttreatment.
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Journal of neurosurgery · Jul 2003
Comparative StudyBiomechanical analysis of multilevel cervical corpectomy and plate constructs.
The authors compared the biomechanical stability of two multilevel cervical constructs involving the placement of equal size anterior cervical plates (ACPs) after decompressive surgery: the first is placed after three-level corpectomy with strut graft and the second after two-level corpectomy and aggressive discectomy with strut graft. In addition, both constructs were evaluated with and without the application of a screw attaching the ACP to the strut graft to determine whether the additional screw enhanced stability in any mode of loading. ⋯ The construct associated with the two-level corpectomy/discectomy provided better immediate postoperative stability than that associated with the three-level corpectomy. The addition of a screw to the strut graft conferred stability on the three-level construct but not the two-level construct.