Neurosurgery
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Historical Article
History of spine biomechanics: part II--from the Renaissance to the 20th century.
Spine biomechanics provide the foundation for the disciplines of spine medicine and spine surgery. Although modern spine biomechanics emerged during the second half of the last century, it has many ancient, medieval, and post-Renaissance roots. In Part I of this series, the ancient and medieval roots of spine biomechanics were reviewed. ⋯ Subsequently, war-related studies performed in the 20th century contributed to the formation of modern biomechanics. The first biomechanics-related organizations and scientific publications did not emerge until the second half of the 20th century. These events provided the final bricks in the foundation that facilitated the emergence of modern spine biomechanics research.
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To evaluate the accuracy of a novel bone-mounted miniature robotic system for percutaneous placement of pedicle and translaminar facet screws. ⋯ These results verify the system's accuracy and support its use for minimally invasive spine surgery in selected patients.
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Comparative Study
The in vivo antitumoral effects of lipopolysaccharide against glioblastoma multiforme are mediated in part by Toll-like receptor 4.
Toll-like receptor 4 (Tlr-4) mediates many biological effects of lipopolysaccharide (LPS), which has antitumoral effects on glioblastoma both in vivo and in vitro. However, the precise role of Tlr-4 in these antitumoral effects remains unknown. ⋯ LPS-induced antitumoral effects on glioblastoma multiforme are mediated, in part, by the Tlr-4 receptor. Further understanding of this process may lead to novel treatment strategies for this uniformly fatal disease.
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The majority of intracranial aneurysms can be treated by either endovascular coiling or microsurgical clipping. A small group of aneurysms may require vascular bypass or reconstruction for their management. A variety of vascular reconstruction techniques are available, including direct suture, patch grafting, local reimplantations, side to side anastomosis, and bypass grafts. ⋯ In this article, the indications and techniques of high-flow bypasses and concurrent aneurysm management are discussed. Troubleshooting of these bypasses is also illustrated. Seven intraoperative videos have been provided to demonstrate the various techniques of radial artery graft harvesting, cervical exposure of carotid vessels, bypasses, and concurrent aneurysm management.
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Case Reports
Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings.
To retrospectively review the authors' experience with surgical resections after failed radiosurgery for acoustic neuromas. ⋯ Surgical resection after radiosurgery is indicated in the presence of such symptoms as cerebellar ataxia and increased intracranial pressure. It must be carefully considered because of the natural regression of transient tumor swelling over time. Surgical resection should be limited to subtotal removal for functional preservation. In patients with tumor enlargement several years after radiosurgery, the possibility of chronic intratumoral bleeding resulting from delayed radiation injury must be considered.