Journal of neurosurgery
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Journal of neurosurgery · Jul 2003
Image-guided resection for thoracic ossification of the ligamentum flavum.
The purpose of this study was to evaluate the advantages of using an image guidance system to aid in the resection of ossified of the ligamentum flavum (OLF) in the thoracic spine. The procedure and surgery-related outcome are discussed. ⋯ The image guidance system allows accurate resection of the OLF while preserving as much as possible the facet joints and posterior elements of the thoracic spine.
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Journal of neurosurgery · Jul 2003
Diagnostic accuracy of magnetic resonance imaging for detecting posterior ligamentous complex injury associated with thoracic and lumbar fractures.
The posterior ligamentous complex (PLC) in the thoracic and lumbar spine is one of the region's important stabilizers. The precise diagnosis of PLC injury is required to evaluate the instability of the injured spine; however, the accuracy of magnetic resonance (MR) imaging for diagnosing PLC injury has remained unclear. In this study, the authors compared preoperative MR imaging findings with direct intraoperative observation of PLC injury, clarifying the former's diagnostic accuracy regarding detection of PLC injury associated with the thoracic and lumbar fractures. ⋯ This study clarified a high diagnostic accuracy and interobserver reliability of MR imaging for PLC injury. The precise diagnosis of PLC injury is essential to determine the mechanical instability of the injured thoracic and lumbar spine, especially in differentiating unstable (three-column) burst fractures from the relatively stable (two-column) type. The authors conclude that MR imaging is a powerful diagnostic tool to evaluate PLC injury associated with thoracic and lumbar fractures.
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Journal of neurosurgery · Jul 2003
Biography Historical ArticleOsler and the "medico-chirurgical neurologists": Horsley, Cushing, and Penfield.
Sir Victor Horsley's lecture "On the Technique of Operations on the Central Nervous System," delivered in Toronto in 1906, set the stage for an appraisal of Sir William Osler as a protagonist for the emerging specialty of neurosurgery. During his time at McGill University from 1871 to 1884, Osler performed more than 1000 autopsies. Hispathological reports covered the topics of cerebral aneurysm, apoplectic hemorrhage, vascular infarction, subdural hematoma, meningitis, multiple sclerosis, cerebral abscess, and brain tumor. ⋯ Regarding neurosurgery, Osler commended the pioneer operation for a brain tumor in 1884 by Rickman Godlee and the surgery for epilepsy in 1886 by Horsley. In 1907, in discussing the state of brain surgery as reviewed by Horsley, William Macewen, and others, Osler made a plea for "medico-chirurgical neurologists, properly trained in the anatomical, physiological, clinical and surgical aspects of the subject." He played a significant role as a referring physician, mentor, and friend to his young colleague Harvey Cushing (later to become Osler's Boswell), who was breaking new ground in neurosurgery at Johns Hopkins Hospital. Beyond that Osler became an inspiring hero figure for his Oxford student Wilder Penfield, who a few decades later would establish a neurological institute at McGill University where medico-chirurgical neurology would flourish.
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Journal of neurosurgery · Jul 2003
Relationship between alignment of upper and lower cervical spine in asymptomatic individuals.
The aim of this study was to establish standard values for the normal alignment of the upper cervical spine and to clarify its relationship with the lower cervical spine in terms of alignment ⋯ Such relationships between alignment of the upper and lower cervical spines should be taken into consideration when performing occipitocervical fusion.
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The authors evaluated the efficacy of titanium cage- and anterior cervical plate (ACP)-augmented fusion for reconstruction following decompressive cervical corpectomy in nontraumatic disease. ⋯ Autologous corpectomy bone-filled titanium cages supplemented with ACPs are an effective means of reconstruction after compressive cervical corpectomy. This technique provides a reasonable alternative to procedures involving long solid strut grafts obtained from the bone bank or from the patient.