Minim Invas Neurosur
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Minim Invas Neurosur · Jun 2005
Three-dimensional computed tomographic anatomy of the abdominal great vessels pertinent to L4-L5 anterior lumbar interbody fusion.
A recent accumulation of surgical and radiological literature has helped spine surgeons to better understand the anatomy and establish surgical trajectories to the anterior L4-L5 disc space. However, the preoperative display of anatomic data in individual subjects in the three-dimensional (3-D) mode has rarely been attempted. The objective of this study was to acquire 3-D images of the abdominal great vessels pertinent to the L4-L5 anterior lumbar interbody fusion (ALIF), and to better define the radiological vascular anatomy. ⋯ The MSA and L4 segmental artery were identified in 79 and 83 subjects, respectively. The 3-D images of the abdominal great vessels together with the lumbar spinal column were reliably depicted. Anatomic data obtained from this study are in accordance with those obtained from conventional 2-D studies, and the 3-D images can serve as a versatile tool for preoperative evaluation for the ALIF candidates and can contribute to the reduction of surgical time and perioperative vascular complications.
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Minim Invas Neurosur · Jun 2005
Indications for neuroendoscopic aqueductoplasty without stenting for obstructive hydrocephalus due to aqueductal stenosis.
Neuroendoscopic aqueductoplasty (EAP) is a curative and radical procedure for obstructive hydrocephalus due to aqueductal stenosis that re-establishes the physiological circulation of cerebrospinal fluid (CSF). We assessed the indications for safe neuroendoscopic aqueductoplasty without stenting to treat aqueductal stenosis. ⋯ EAP can be considered the best surgical procedure for restoring physiological circulation of CSF in patients with obstructive hydrocephalus caused by aqueductal stenosis. However, EAP candidates must be selected very carefully using the following indications: 1) obstructive triventricular hydrocephalus with increased intracranial pressure, 2) translucent membranous stenosis or aqueduct obstruction, and 3) prestenotic dilatation of the aqueduct.