World Neurosurg
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We sought to explore whether additional bone grafting of the atlantoaxial joint increases the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. ⋯ Additional bone grafting of the atlantoaxial joint could increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion.
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To evaluate the results of percutaneous endoscopic transforaminal diskectomy (PETD) in comparison with percutaneous endoscopic interlaminar diskectomy (PEID) for axillar herniation at L5-S1. ⋯ For axillar herniation at L5-S1, PEID can ignore the anatomic obstruction with advantages including a shorter operation time and less intraoperative radiation exposure. PETD has a clinical effect similar to that of PEID, but the process of it is more dangerous and harder than PEID.
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Comparative Study
Comparing Microvascular Decompression with Gamma Knife Radiosurgery for Trigeminal Neuralgia A Cost-effectiveness Analysis.
Both microvascular decompression (MVD) and Gamma Knife radiosurgery (GKRS) are time-tested treatment modalities for trigeminal neuralgia (TN). There is little evidence in the literature studying these modalities head to head in a cost-effectiveness comparison. ⋯ In patients medically eligible for either procedure, we found MVD to be the most cost-effective modality to treat TN, primarily because of its reported greater durability. MVD remained the most cost-effective strategy across a broad range of model input values in sensitivity analyses.
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For effective minimally invasive lumbar decompression, we changed the routine of segmental decompression. Using a high-speed drill or an ultrasound knife, we created a working channel, starting at the base of the spinous process of the upper vertebra slightly above the disc level, to target and decompress the contralateral recess, and termed it the translaminar crossover decompression (TCD). We evaluated the feasibility and compared the outcomes of a navigation-guided endoscopic translaminar crossover approach for segmental decompression (eTCD) in elderly patients with microscopic decompression using the same approach (mTCD). ⋯ TCD inherently eliminated central stenosis and facilitated decompression of both recesses via mutual undercutting, with preservation of facet joint integrity.
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Selective dorsal rhizotomy (SDR) is used to improve spasticity, gait, and pain in children with spastic diplegia. There is growing evidence supporting its long-term benefits in terms of functional outcomes, independence, and quality of life. There is, however, little contemporary work describing the surgical morbidity of this irreversible procedure. The purpose of this study is to evaluate the surgical outcomes and complications of SDR at a single United Kingdom center. ⋯ SDR using a single-level approach is a safe procedure with low surgical morbidity. This study complements the growing evidence base in support of SDR for spastic diplegia and should help inform decisions when considering treatment options.