Journal of neurosurgery
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Journal of neurosurgery · Jul 2001
Effect of frameless stereotaxy on the accuracy of C1-2 transarticular screw placement.
In recent studies some authors have indicated that 20% of patients have at least one ectatic vertebral artery (VA) that, based on previous criteria in which preoperative computerized tomography (CT) and standard intraoperative fluoroscopic techniques were used. may prevent the safe placement of C1-2 transarticular screws. The authors conducted this study to determine whether frameless stereotaxy would improve the accuracy of C1-2 transarticular screw placement in healthy patients, particularly those whom previous criteria would have excluded. ⋯ Frameless stereotaxy provides precise image guidance that improves the safety of C1-2 transarticular screw placement and potentially allows this procedure to be performed in patients previously excluded because of the inaccuracy of nonimage-guided techniques.
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Journal of neurosurgery · Jul 2001
Combined surgical and endovascular techniques of flow alteration to treat fusiform and complex wide-necked intracranial aneurysms that are unsuitable for clipping or coil embolization.
Certain intracranial aneurysms, because of their fusiform or complex wide-necked structure, giant size, or involvement with critical perforating or branch vessels. are unamenable to direct surgical clipping or endovascular coil treatment. Management of such lesions requires alternative or novel treatment strategies. Proximal and distal occlusion (trapping) is the most effective strategy. In lesions that cannot be trapped, alteration in blood flow to the "inflow zone," the site most vulnerable to aneurysm growth and rupture, is used. ⋯ Despite a high incidence of transient complications, intracranial aneurysms that cannot be clipped or occluded require alternative surgical and endovascular treatment strategies. In those aneurysms that cannot safely be trapped or occluded, one approach is the treatment strategy of flow alteration.
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Journal of neurosurgery · Jul 2001
Associated change in plantar temperature and sweating after transthoracic endoscopic T2-3 sympathectomy for palmar hyperhidrosis.
Transthoracic endoscopic T2-3 sympathectomy is currently the treatment of choice for palmar hyperhidrosis. Compensatory sweating of the face, trunk, thigh, and sole of the foot was found in more than 50% of patients who underwent this procedure. The authors conducted this study to investigate the associated intraoperative changes in plantar skin temperature and postoperative plantar sweating. ⋯ In contrast to compensatory sweating in other parts of the body after T2-3 sympathetomy, improvement: in plantar sweating was shown in 72% and worsened symptoms in 6% of patients. The intraoperative plantar skin temperature change and perioperative SSR demonstrated a correlation between these changes.
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Journal of neurosurgery · Jul 2001
Sensory ganglionectomy: theory, technical aspects, and clinical experience.
Sensory ganglionectomy offers theoretical advantages over rhizotomy but remains controversial because reported success rates vary widely. The authors sought to add to the available data on this subject and to review technical aspects of the surgery. ⋯ Dorsal root ganglionectomy has a useful role in the treatment of a variety of refractory pain states, especially those involving radicular pain.
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Journal of neurosurgery · Jul 2001
Microendoscopic posterior cervical laminoforaminotomy for unilateral radiculopathy: results of a new technique in 100 cases.
In this report the author presents surgery-related outcomes after application of a new technique. A posterior microendoscopic laminoforaminotomy was used for the surgical treatment of unilateral cervical radiculopathy secondary to intervertebral disc herniations and/or spondylotic foraminal stenosis. The results of this procedure are compared with those achieved using traditional laminoforaminotomy and anterior cervical discectomy with or without fusion. ⋯ The microendoscopic posterior laminoforaminotomy is an effective alternative for the treatment of unilateral cervical radiculopathy secondary to lateral or foraminal disc herniations or spondylosis. In this group of patients, it is preferable because it does not require the sacrifice of a cervical motion segment, has a low incidence of complications, and is associated with a much quicker return to unrestricted full activity than that obtained with other techniques.