Neurosurgery
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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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We have developed scaled suction to facilitate the measurement of aneurysm neck width and tumor size during operations. ⋯ Our scaled suction device is a simple and useful navigator for continuously measuring intraoperative variables such as lesion size and distance between the lesion and the surrounding vital structures.
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The mini-open approach for transforaminal lumbar interbody fusion is described in detail. Operating room setup and surgical positioning are demonstrated. ⋯ The surgical technique used for decompression and fusion is presented in detail. The surgical pearls and pitfalls of the mini-open TLIF are described and illustrated.