Neurosurgery
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To describe the indications and techniques for occipitocervical (OC) fixation. ⋯ OC fixation systems have evolved from wire and cable techniques to plates, rods, and screws. Screw-rod constructs are easy to implant and biomechanically more rigid than wire techniques.
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The arachnoid membrane in the suprasellar region may affect the growth pattern of sellar and suprasellar tumors however, the topographic relationships between the pituitary stalk and the surrounding arachnoid membranes remained unclear. ⋯ The relationship between the pituitary stalk and the surrounding arachnoid membrane is important in evaluating the growth patterns of the sellar and suprasellar tumors, and their topographical relationships.
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Case Reports
Anterior selective amygdalohippocampectomy: technical description and microsurgical anatomy.
We introduce a technique for performing a selective amygdalohippocampectomy (AH) through a minisupraorbital approach. ⋯ The anterior route for selective AH is a logical and straightforward approach to the mesial temporal lobe. Compared with other variations, it is less invasive and destructive, especially in terms of the fibers of the optic pathway, temporal stem, and lateral temporal neocortex.
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We review our experience and technique for C1 lateral mass screw fixation. We compare the results of 3 different constructs incorporating C1 lateral mass screws: occipitocervical (OC) constructs, C1-C2 constructs, and C1 to mid/low cervical constructs. ⋯ Patients treated with C1 lateral mass fixation constructs have a high fusion rate, reduced neck pain, and improved neurologic function. Constructs using C1 lateral mass screws do not need to incorporate C2 pedicle screws. Constructs incorporating C1 lateral mass screws are effective when combined with C2 pars screws, C2 translaminar screws, and C3 lateral mass screws. Constructs using C1 screws are associated with a higher complication rate and a higher pseudoarthrosis rate if extended cranially to the occiput or if extended caudally below C2.
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Comparative Study
Biomechanical comparison of costotransverse process screw fixation and pedicle screw fixation of the upper thoracic spine.
To compare the biomechanics of costotransverse process screw fixation with those of pedicle screw fixation in a cadaveric model of the upper thoracic spine. ⋯ The costotransverse screw technique seems to provide only moderately stiff fixation of the destabilized thoracic spine. Pedicle screw fixation seems to have more favorable biomechanical properties. These data suggest that the costotransverse process construct is better used as a salvage procedure rather than as a primary fixation strategy.