Neurosurgery
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Comparative Study
National trends in surgical procedures for degenerative cervical spine disease: 1990-2000.
Degenerative cervical spine disease is one of the most common indications for spinal surgical intervention. The impact of the unprecedented changes in healthcare technology and delivery over the past decade is unknown. We examined this issue using the Nationwide Inpatient Sample database, a representative sample of all United States inpatient hospitalizations. ⋯ Compared with one decade ago, the surgical treatment of degenerative cervical spine disease has evolved to include a higher percentage of anterior and fusion procedures performed on a more diverse, older, and comorbid patient population, with shortened hospital stay and improved morbidity and mortality, although at substantially increased cost.
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This study examined the relationship of the optic radiation to the landmarks important in temporal lobe surgery. ⋯ The optic radiation reached the anterior tip of the temporal horn. Resections that extend through the roof of the temporal horn more than 3 cm behind the temporal pole cross the anterior loop of the optic radiation.
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Case Reports
Image-guided transsacral approach to presacral lesions of nerve root origin: technical note.
The utility of image guidance in fashioning a posterior transsacral operative corridor for approaching small presacral neural lesions has not previously been reported. ⋯ An image-guided transsacral approach is a viable option for accessing small to moderately sized lesions of nerve root origin located within the presacral space.
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The far-lateral approach is an extension of the standard suboccipital approach, designed to maximize exposure of the lateroventral craniocervical junction. Following a basic principle of cranial base surgery, the angle of view is increased by bone removal. Bone removal involves the most lateral part of the inferior occipital squama and the posterior arch of C1. ⋯ Transposition of the vertebral artery is seldom required. The far-lateral approach allows a tangential, unobstructed view of the lateroventral cervicomedullary area and can be applied effectively to manage with a heterogeneous spectrum of pathological lesions involving this area. The technical aspects of the procedure are briefly illustrated in this report.
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Biography Historical Article
Neurosurgery 100 years ago: the Queen Square letters of Foster Kennedy.
The prominent New York City neurologist Foster Kennedy (1884-1952) trained at London's Queen Square from 1906 to 1910. He was exposed to a number of eminent neurologists including, Sir Victor Horsley and other surgeons. ⋯ Descriptions of the personalities involved give rare insight to this era. The Foster Kennedy syndrome--homolateral optic atrophy and contralateral papilledema with an inferior frontal tumor--was characterized under the stimulating support of Gowers and Horsley.