World Neurosurg
-
Review Biography Historical Article
Paulus of Aegina and the historical origins of spine surgery.
Paulus of Aegina (625-690 ad) was the last of the prolific Byzantine physicians. His works consolidated and extended the knowledge of his predecessors, with pioneering efforts to improve the surgical management of spinal injuries. ⋯ In particular, we discuss the contributions of Paulus to this corpus and explore his classic 7-book anthology, Epitomoe Medicae Libri Septem (Medical Compendium in Seven Books). In reviewing Paulus' legacy, we show the significant milestones in the early development of anatomic and functional knowledge of the spine.
-
The cervical extensor musculature is important in cases of neck pain and loss of cervical lordosis after laminoplasty. Therefore, various surgical methods have been developed to preserve the muscle during laminoplasty. We have developed a posterior cervical muscle-preserving interspinous process (MIS) approach and decompression method. We have described the operation details and clinical outcomes of selected patients who have undergone this procedure. ⋯ The MIS approach and decompression method was less invasive than both conventional laminoplasty and Shiraishi's selective laminectomy. It is a safe and effective minimally invasive technique for central stenosis caused by cervical spondylotic myelopathy.
-
This study was carried out to analyze the surgical effect of cervical spine sagittal alignment for patients with Hirayama disease (HD). ⋯ Patients with HD have sagittal imbalance of the cervical spine compared with age-matched healthy adolescent subjects, and surgical treatment could correct the sagittal imbalance.
-
Little is known on the impact of the pattern and extent of pneumatization of the sphenoid sinus (SS) on the dimensions of the surgical windows used in extended endoscopic endonasal transsphenoidal approaches. We therefore investigated whether the distances between the 2 optic canals and between the paired paraclival carotid arteries are influenced by the pattern and extent of pneumatization of the SS. ⋯ During the development of the SS, pneumatization progress likely exerts quantitative and direction-specific forces, which gradually increase the interoptic and intercarotid distances.
-
Clinical neurosurgery is a complex specialty with multiple participants, including a variety of providers, patients, family members, and administrators, who interact in complex fashions. Modern-day patient care requires near-constant team communication of vital, detailed clinical information; any breakdown in this process can result in patient harm. Medical communication practices with patients impact mutual rapport as well as the overall physician-patient relationship. ⋯ Neurosurgeons frequently interact with other health care providers and members of the hospital administration on matters relating to billing, compliance, and quality. Communication among the stakeholders is complicated, however, by the fact that the participants may be speaking a variety of different, mutually unintelligible "languages." We discuss the details of the various types of information exchanges in neurosurgery, the key players involved, and the vulnerabilities to breakdowns in the system. In addition, we review the multifaceted, systems-level issues in neurosurgical communication and related weaknesses.