World Neurosurg
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Sacroiliac (SI) joint fusion is considered for the treatment of degenerative sacroiliitis. The procedure has increased in popularity for patients who have exhausted less invasive treatment options since the development of percutaneous SI joint fusion systems. One possible complication of the procedure is a sacral radiculopathy that can result from compression of the S1 nerve by the SI joint fusion implant. Others have described revising the implant by removing it and replacing it with a shorter implant. ⋯ This technical note is for others to consider as a possible minimally invasive solution for the treatment of lumbar radiculopathy after a minimally invasive SI joint fusion procedure.
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Although many studies have investigated functional localization by electrical stimulation, the threshold to identify each area remains controversial. The present study aimed to elucidate the threshold of a cortical stimulation for functional mapping. ⋯ Positive and sensory effects are induced by lower intensities than negative and motor responses, respectively. The present results provide not only a practical guide for functional mapping, but also a hierarchal concept of processing in the brain.
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The incidental dural tear is a common complication in lumbar spine surgery. It has been reported that the incidence of dural tears is much greater in endoscopic procedures. Primary closure via suturing remains challenging in endoscopic procedures. The objective of this study was to conduct a literature review on the surgical technique for dural closure and repair in endoscopic spine surgery. ⋯ An autologous muscle or fat graft in combination with fibrin glue or a fibrin-sealed collagen sponge seems to be a good and safe method for the management of dural tear in lumbar endoscopic spine surgery.
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The bi-needle technique is a new technique for percutaneous endoscopic lumbar discectomy. This technique combines the advantages of Yeung endoscopic spine system (YESS) and transforaminal endoscopic spine system (TESSYS) techniques. The aim of this study was to evaluate effectiveness of the bi-needle technique for percutaneous endoscopic lumbar discectomy and compare it with the TESSYS technique. ⋯ The bi-needle technique is safe and effective for treatment of lumbar disc herniation. Compared with TESSYS technique, operative time is shorter, and recurrence and reoperation rates are lower.
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Because the clinical course of spontaneous aneurysmal subarachnoid hemorrhage (aSAH) can be compromised by pulmonary complications, we sought to review posttreatment outcomes in aSAH patients with and without pulmonary complications. ⋯ Pulmonary problems represent the most common nonneurologic medical complications after aSAH. Despite advances in critical care, pulmonary complications represented predictors of short-term poor outcome only at the 1-year follow-up visit, whereas the medical history of the patient became more relevant for prognosis in long-term follow-up.