Minim Invas Neurosur
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Having the experience of more than 4,000 hypophysectomy operations (150 cases per year on the average) by the senior author, initially performed via an intracranial, then a transseptal approach, now a direct endonasal approach, as a minimal invasive technique, is introduced to reduce the complications and for better comfort of the patient. It is the least traumatic route to the sella turcica, it avoids brain retraction, and it provides excellent visualization of the pituitary gland and lesions related to that structure. The brilliant increased vision of the surgical target offered by the endoscope can enable a more effective removal of the lesion, followed by superior clinical results and a reduction in the incidence of complications.
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Minim Invas Neurosur · Aug 2008
ReviewDay surgery awake craniotomy for removing brain tumours: technical note describing a simple protocol.
Day surgery awake craniotomy has been recently proposed for patients harbouring supratentorial brain tumours. This technique has been demonstrated to be safe and effective in a large cohort of patients operated by one neurosurgeon at the University of Toronto. ⋯ In particular, patient eligibility criteria are briefly discussed and intra- and post-operative management are presented. Key messages for those who are going to start to perform day surgery awake craniotomies include the preparation of a fast, simple and standardized protocol for the treatment of these patients and cooperation among patients and their care-givers (surgeon, anesthetist, nurses, family members).
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Minim Invas Neurosur · Aug 2008
Treatment of degenerative cervical disc disease with uncoforaminotomy--intermediate clinical outcome.
Anterior cervical uncoforaminotomy (uncoforaminotomy) is an operative method intended to preserve the functional motion segment of the cervical spine while removing the underlying pathology. Controversy exists concerning the patients best suited for this treatment modality. Furthermore, no long-term outcome analyses have been published. ⋯ Uncoforaminotomy, especially in patients with soft-disc pathologies, is a good operative method for the treatment of radicular pain.
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Minim Invas Neurosur · Aug 2008
Multicenter StudyPercutaneous axial lumbar interbody fusion (AxiaLIF) of the L5-S1 segment: initial clinical and radiographic experience.
Anterior access to the L5-S1 disc space for interbody fusion can be technically challenging, frequently requiring the use of an approach surgeon for adequate exposure. We reviewed our experience with a novel minimally invasive technique for L5-S1 interbody fusion that exploits the presacral space and its relative dearth of critical structures. ⋯ The percutaneous paracoccygeal approach to the L5-S1 interspace provides a minimally invasive corridor through which discectomy and interbody fusion can safely be performed. It can be used alone or in combination with minimally invasive or traditional open fusion procedures. It may provide an alternative route of access to the L5-S1 interspace in those patients who may have unfavorable anatomy for or contraindications to the traditional open anterior approach to this level.