Neurosurgery
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Stereotactic radiosurgery (SRS) of meningiomas is associated with posttreatment peritumoral edema (PTE). The purpose of this study was to evaluate the prevalence and risk factors of post-SRS PTE for intracranial meningiomas. ⋯ Post-SRS PTE is common in patients with meningioma. Tumor-brain contact interface area and preexisting PTE were the most significant risk factors for post-SRS PTE. Tumor volume and tumor-brain contact interface area were significant risk factors for the development of preexisting PTE.
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During the past decade, numerous reports have supported the contribution of awake mapping in surgical removal of brain lesions in eloquent areas, with a significant increase of the extent of resection while minimizing the risk of permanent deficit--and even improving quality of life. ⋯ This review provides new insights into the indications of awake craniotomies for nonlanguage mapping in surgery for lesions in areas not related to language processing.
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En bloc resection, with adequate surgical margins, of primary malignant bone tumors of the sacrum is associated with long term disease control and potential cure. Resection of sacral tumors is difficult due to the proximity of neurovascular and visceral structures, and complete, or even partial, sacrectomy often results in functional loss for the patient. ⋯ This technique for midsacral amputation to remove a sacral tumor en bloc minimizes local recurrence and maximizes neurovascular function.
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Comparative Study
Results after lumbar decompression with and without discectomy: comparison of the transspinous and conventional approaches.
To evaluate the efficacy of the transspinous approach compared with the conventional approach in single-level lumbar laminotomies with and without discectomies. ⋯ Patients who underwent single-level lumbar decompression with or without discectomy had similar outcomes as those who underwent the conventional approach. Although of modest clinical significance, the transspinous approach may afford early mobilization and reduced postoperative pain while providing a satisfactory neurological and functional outcome.