Minim Invas Neurosur
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Minim Invas Neurosur · Aug 2006
Application of intraoperative 3D ultrasound during navigated tumor resection.
Intraoperative 3D ultrasound (3D-iUS) may enhance the quality of neuronavigation by adding information about brain shift and tumor remnants. The aim of our study was to prove the concept of 3D ultrasound on the basis of technical and human effects. A 3D-ultrasound navigation system consisting of a standard personal computer containing a video grabber card in combination with an optical tracking system (NDI Polaris) and a standard ultrasound device (Siemens Omnia) with a 7.5 MHz probe was used. 3D-iUS datasets were acquired after craniotomy, at different subsequent times of the procedure and overlaid with preoperative MRI. ⋯ The introduction of 3D ultrasound has increased the value of neuronavigation substantially, making it possible to update several times during surgery and minimize the problem of brain shift. Configuration of both the 3D iUS based on a standard ultrasound system and the MR navigation system is time- and especially cost-effective. Faster navigational datasets and more intuitive image-guided surgery enable novel and user-friendly display techniques.
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Minim Invas Neurosur · Aug 2006
Application of neuronavigation system to brain tumor surgery with clinical experience of 420 cases.
A new era of neurosurgery has recently been unveiled with the advent of image-guided surgery. The use of neuronavigation is beginning to have a significant impact on a variety of intracranial procedures. Herein, we report our clinical experience using a neuronavigation system with different surgical applications and techniques for a variety of brain tumors. ⋯ We utilized this system to effectively make bone flaps, to detect critically located, deep-seated, subcortical, skull-base and skull bone tumors, and to operate on intraparenchymal lesions with grossly unclear margins, such as gliomas. We also performed tumor biopsy using the combination of a conventional stereotactic biopsy instrument and an endoscope. The application of the neuronavigation system not only revealed benefits for operative planning, appreciation of anatomy, lesion location and the safety of surgery, but also greatly enhanced surgical confidence.
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Minim Invas Neurosur · Jun 2006
Pulsed radiofrequency in the treatment of patients with chronic neuropathic spinal pain.
In recent years there has been debate among spinal surgeons, neurosurgeons and pain physicians regarding the efficacy of radiofrequency (RF) ablation when treating patients with a neuropathic pain source. It is usually considered as a treatment option after conservative treatment has failed. Twenty-eight patients with a minimal follow-up of 1 year were examined in our institution after they had undergone pulsed radiofrequency (PRF) procedures due to neuropathic spinal pain. ⋯ No complications were found in this study except for mild discomfort in the treated area which spontaneously resolved up to 3 weeks after the procedure. We concluded that PRF is a safe and an effective procedure for patients who suffer from chronic neuropathic pain from spinal origin. It should be tried after conservative treatment has failed.
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Minim Invas Neurosur · Apr 2006
A New full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients.
Even with good results, conventional disc operations may result in consecutive damage due to traumatisation. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation. The transforaminal operation is the most common full-endoscopic procedure in surgery of the lumbar spine. ⋯ The authors view the technique described, which offers the advantage of a truly minimally invasive procedure, as a sufficient and safe alternative to conventional procedures, when the appropriate indication criteria are heeded. There are technical problems because of the small instruments. In conjunction with the transforaminal procedure, this is an expansion of the spectrum for full-endoscopic surgery of lumbar disc herniations.
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Minim Invas Neurosur · Apr 2006
Case ReportsModified surgical technique for the treatment of idiopathic spinal cord herniation.
Spinal cord herniation is not a common disease and only 80 cases have been reported to the best of our knowledge. The treatment of this lesion is thought to be difficult and a better surgical technique has not been established. ⋯ The direct widening of the dural defect has been reported to be the only treatment providing a good outcome. We suggest that our modified technique for its closure can be as safe and effective as the direct widening method.