Neurosurgery
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Multicenter Study Comparative Study
Correlation between withdrawal symptoms and medication pump residual volume in patients with implantable SynchroMed pumps.
To investigate whether patients with implantable SynchroMed pumps (Medtronic, Inc., Minneapolis, MN) develop symptoms of drug withdrawal at residual medication volumes that exceed 2 ml (the alarm residual volume recommended by the manufacturer). ⋯ Some patients develop symptoms of drug withdrawal at residual volumes that exceed 2 ml. We could not identify factors that predict this occurrence. Withdrawal symptoms did not recur when the alarm volume was increased to 4 ml.
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Comparative Study
The unique characteristics of "upper" lumbar disc herniations.
To compare the characteristics, presentation, and surgical outcome of patients with microdiscectomies at L1-L2 and L2-L3 with those we treated at L3-L4. We further sought to compare these results with those reported in the literature for discectomies at the L4-L5 and L5-S1 levels. ⋯ Herniated discs at the L1-L2 or L2-L3 level are different entities from those at lower levels of the lumbar spine. The surgical outcome in terms of postoperative back and radicular pain is worse for herniated discs at L1-L2 and L2-L3 compared with those treated at L3-L4. Our patients with L1-L2 or L2-L3 surgically treated herniated discs were more likely to have had previous lumbar surgery and required a fusion more often than their counterparts with L3-L4 herniated discs.
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To investigate the contribution of high-field intraoperative magnetic resonance imaging (iMRI) for further reduction of tumor volume in glioma surgery. ⋯ Despite extended resections, introduction of high-field iMRI in conjunction with functional navigation did not translate into an increased risk of postoperative deficits. The use of high-field iMRI increased radicality in glioma surgery without additional morbidity.