Minim Invas Neurosur
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Minim Invas Neurosur · Oct 2007
Transmuscular trocar technique - minimal access spine surgery for far lateral lumbar disc herniations.
Minimal access spine surgery (MASS) is gaining increasing importance in microsurgery of the lumbar spine. From a current prospective series we present data on MASS for far lateral lumbar disc herniations (LLDH) via a transmuscular trocar technique (T(2)). The surgical procedure and operative results are demonstrated in detail. In contrast to conventional percutaneous endoscopic techniques, T(2) allows one to operate in the typical microsurgical fashion combined with the advantages of a minimal endoscopic approach with three-dimensional visualization of the surgical target using the operating microscope. ⋯ The T(2) technique represents an auspicious alternative to standard open microsurgery for LLDH, which allows achievement of excellent clinical and cosmetic results, preservation of segmental spine stability, and avoidance of excessive soft tissue trauma.
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Minim Invas Neurosur · Oct 2007
Historical ArticleConcept and treatment of hydrocephalus in the Greco-Roman and early Arabic medicine.
In the ancient medical literature hydrocephalus was not often described although its existence and symptomatology were well known. Most detailed descriptions of hydrocephalus including the surgical treatment are extant in the encyclopaedic works on medicine of the physicians Oreibasios and Aetios from Amida from the 4th and 6th centuries AD, respectively. Because of their broad scientific interests, this type of physicians, typical for the late Roman empire, were known as philosophy-physicians (iota alpha tau rho o sigma o phi iota sigma tau alpha iota). ⋯ Avicenna separated the traumatic haematomas outside the skull from the term hydrocephalus. However Avicenna, as all previous authors, had not linked hydrocephalus with the ventricular system. The autopsy of a child with an exorbitant hydrocephalus performed by the anatomist Vesalius in the 16th century revealed as a single pathology an extremely dilative ventricular system filled with water-like fluid which made it necessary to change completely the ancient concept of hydrocephalus.
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Minim Invas Neurosur · Oct 2007
Neuronavigation and resection of lesions located in eloquent brain areas under local anesthesia and neuropsychological-neurophysiological monitoring.
The aim of this study was to determine the safety and maximal extension of tumor resection achievable with a combination of awake craniotomy under local anesthesia, neuronavigation, and continuous neuropsychological and neurophysiological monitoring in patients with lesions within the eloquent brain. ⋯ The combination of neuronavigation with cortical stimulation and repetitive neurological and language examinations allows a more radical resection of tumors in eloquent brain areas, otherwise considered as inoperable.
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Minim Invas Neurosur · Oct 2007
A simple technique for bridging small cranial dural defects without the use of grafts: technical note.
A watertight closure of the dura is important in preventing post-operative complications. Various techniques are described to close small dura defects. We present a simple technique that uses on site homologues dura tissue to bridge small dura defects by separating the periosteum from the inner meningeal layer. This provides a low-cost, tension-free repair without the use of synthetic materials or need to harvest autologous materials.