World Neurosurg
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In the setting of a previous proximal fusion, an asymmetric 3-column osteotomy (3CO) can provide tremendous deformity correction. Our goal was to evaluate outcomes and complications of asymmetric 3CO through the proximal fusion mass, for coronal malalignment in patients with previous long thoracic fusion for adolescent idiopathic scoliosis. ⋯ Patients with a history of previous thoracic fusion for adolescent idiopathic scoliosis and coronal malalignment may develop painful degeneration of the segments caudal to the fusion as adults. In this setting, extension of fusion to the sacropelvis alone may worsen the patient's coronal alignment. An asymmetric 3CO may be considered at the proximal fusion mass to achieve realignment objectives, with an acceptable complication rate and an expected improvement in outcomes.
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Bibliometric analysis of scientific publications on spinal cord stimulation in the past two decades.
Spinal cord stimulation (SCS), a common invasive neuromodulation technique, induces pain relief via electrical stimulation of the dorsal column of the spinal cord. To present an overview of research publications on SCS, a bibliometric analysis of scientific publications from 1998 to 2017 was performed. ⋯ This bibliometric analysis first provides a basic overview of research publications on SCS published during the last 2 decades. Considering the expanded indications of SCS, there are a lot of things to do, and various countries should increase support to complete high-quality SCS studies.
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Deep-seated cerebral lesions have fascinated and frustrated countless surgical innovators since the dawn of the microneurosurgical era. To determine the optimal approach, the microneurosurgeon must take into account the characteristics and location of the pathological lesion as well as the operator's range of technical expertise. ⋯ In this article, we highlight 4 innovative surgical corridors and compare their strengths and weaknesses against those of more conventional approaches. Our goal is to use these examples to illustrate the following principles of microneurosurgical innovation: (1) discover more efficient and flexible exposures with superior working angles; (2) ensure maximal early protection of critical neurovascular structures; and (3) effectively handle target pathology with minimal disruption of normal tissues.
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Previous studies have indicated that lobulated aneurysms are more susceptible to rupture than are single-sac aneurysms. We aimed to determine the angiographic characteristics related to the lobulated shape of unruptured intracranial aneurysms (UIAs) and ruptured (RIAs) intracranial aneurysms. ⋯ Bifurcation location, an increased aneurysm size, and a straighter aneurysm inflow angle are independently associated with lobulated aneurysms.
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Cylindrical tubular ports are among the most innovative dynamic tools added to the neurosurgery armamentarium. The rationale behind the use of tubular systems lies in the knowledge that damage to surrounding tissues is minimized with the equal pressure exerted by the walls of the cylinder. A microscope or an endoscope is used for visualization in the tubular ports. ⋯ It costs only the price of a syringe. The efficacy and safety of tubular port systems have been shown in limited studies. The complications associated with the port system have been minimal, and injury to the brain has been reduced by the equal pressure exerted by the walls of the port.