Neurosurgery
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Randomized Controlled Trial Clinical Trial
Long-term follow-up of patients treated with cervical radiofrequency neurotomy for chronic neck pain.
To determine the long-term efficacy of percutaneous radiofrequency medial branch neurotomy in the treatment of chronic neck pain. ⋯ Radiofrequency neurotomy provides clinically significant and satisfying periods of freedom from pain, and its effects can be reinstated if pain recurs.
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Comparative Study
Direct and combined revascularization in pediatric moyamoya disease.
Surgical revascularization of moyamoya disease can improve neurological outcomes, compared with the natural history of the disease or the results of medical treatment. Controversy exists regarding whether direct or indirect revascularization yields better outcomes. This study involves a single-center experience with direct anastomosis and is the first North American series using direct revascularization for pediatric patients with moyamoya disease. ⋯ Surgical revascularization by direct anastomosis in pediatric patients is technically feasible, is well tolerated, and can improve the progressive natural history, the angiographic appearance, and the cerebral blood flow abnormalities associated with the disease. Direct revascularization has the advantage of providing immediate and high-flow revascularization and is particularly useful for patients who have experienced failure of previous indirect revascularization procedures.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative study of propofol and midazolam effects on somatosensory evoked potentials during surgical treatment of scoliosis.
Studies of the effects on lower-limb cortical somatosensory evoked potentials (CSEP) during total intravenous anesthesia are sparse for propofol and are lacking for midazolam. This study was designed to compare the effects of propofol and midazolam on CSEP under total intravenous anesthesia during intraoperative monitoring for surgical treatment of scoliosis. ⋯ This study demonstrates the appropriate use of either propofol or midazolam in scoliosis monitoring. Preoperative small-amplitude CSEPs might favor the use of propofol anesthesia.
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Randomized Controlled Trial Clinical Trial
Angles between A1 and A2 segments of the anterior cerebral artery visualized by three-dimensional computed tomographic angiography and association of anterior communicating artery aneurysms.
The angle of arteries at bifurcations, as well as the blood flow, are factors of hemodynamic stress on the apical region, where aneurysms often develop. Using images obtained with three-dimensional computed tomographic angiography, we sought to determine the angles between the A1 and A2 segments of the anterior cerebral artery of the anterior communicating artery (ACoA) complex associated with aneurysms. These angles cannot be detected by conventional cerebral angiography. ⋯ ACoA aneurysms are associated with the smaller A1-A2 angle junction of the ACoA complex, where higher hemodynamic stress may occur in patients with normoplastic A1 segments.