Neurosurgery
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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.
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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.
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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.
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Balloon compression of the rootlets behind the trigeminal ganglion for the treatment of trigeminal neuralgia has become an increasingly popular method among neurosurgeons. However, the method has recognized complications, including double vision. Although occurring infrequently, diplopia may cause the patient significant disability. To minimize the risk for this complication, we analyzed our patients with respect to the surgical technique. ⋯ By meticulous surgical technique with close attention to the anatomic position and the shape of the inflated balloon, most cases of postcompression diplopia should be avoided.
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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.