Neurosurgery
-
The idea of surgical treatment for epilepsy is not new. However, widespread use and general acceptance of this treatment has only been achieved during the past three decades. A crucial step in this direction was the development of video electroencephalographic monitoring. ⋯ Today, epilepsy surgery is more effective and conveys a better seizure control rate. It has become safer and less invasive, with lower morbidity and mortality rates. This article summarizes the various developments of the past three decades and describes the present tools for presurgical evaluation and surgical strategy, as well as ideas and future perspectives for epilepsy surgery.
-
To study the influence of the anatomy of neurovascular compression (NVC) on pain outcome in patients with classic trigeminal neuralgia treated by radiosurgery. ⋯ The visualization of NVC, nerve atrophy, and nerve dislocation on magnetic resonance imaging scans was not associated with pain outcome. A large vessel compressing the nerve and deforming the brainstem and proximal NVC were associated with a lesser pain control.
-
There is little information about in-hospital complication rates, adverse outcomes, and mortality after spinal fusion for cervical spondylotic myelopathy (CSM). The aim of this study was to report inpatient mortality, complications, and outcomes on a national level. ⋯ We provide a national estimate of inpatient complications and outcomes after spinal fusion for CSM patients in the United States. We demonstrate the impacts of age, complications, and medical comorbidities on the outcome of surgery for patients with this common disorder. We provide complication rates stratified by age and medical comorbidities for elderly patients who present with CSM who need spinal fusion.
-
Device-related infection is a common complication of deep brain stimulator (DBS) implantation. We reviewed the incidence and management of early hardware-related infections in a large series. ⋯ In a large series of new DBS hardware implantations, the incidence of postoperative hardware-related infection requiring further surgery was 4.5%. When only one device component was involved, partial hardware removal was often successful.
-
The past decade has witnessed the increasing application of robotics in surgery, yet there is no existing system that combines stereotaxy and microsurgery in an imaging environment. To fulfill this niche, we have designed and manufactured an image-guided robotic system that is compatible with magnetic resonance imaging. ⋯ We are providing technology to advance and transform surgery with the potential to improve patient outcome.