Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Oct 2011
A haemostatic agent delivery system for endoscopic neurosurgical procedures.
In endoscopic neurosurgery problems with haemostasis due to poor access exist. We have developed a system which allows the delivery of a variety of haemostatic agents in a more efficacious manner. The system has been used successfully in endoscopic skull base surgery and endoscopic surgery within the parenchyma of the brain using tube systems.
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Minim Invasive Neurosurg · Oct 2011
Evaluation of indirect decompression of the lumbar spinal canal following minimally invasive lateral transpsoas interbody fusion: radiographic and outcome analysis.
The surgical treatment of lumbar stenosis traditionally includes laminectomy for direct decompression of the spinal canal. Selected patients with spinal stenosis may also require lumbar fusion. Minimally invasive lateral transpsoas interbody fusion has the ability of placing a large interbody cage that can increase disc height and distract the spinal level. The purpose of this study was to examine the concept of indirect decompression of the spinal canal in patients with co-existing lumbar spinal stenosis undergoing lateral transpsoas interbody fusion. ⋯ Indirect decompression of spinal stenosis can be achieved with lateral transpsoas interbody fusion with improved clinical outcomes. Pre-op and post-op MRI scans showed a significant increase in dural sac dimensions. The mechanism for this indirect decompression may relate to stretching and unbuckling of the spinal ligaments and a decrease in intervertebral disc bulging. Further studies are needed to determine which stenosis patients undergoing this surgery are most appropriate for indirect decompression alone over laminectomy.
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Minim Invasive Neurosurg · Oct 2011
Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique.
Transforaminal percutaneous endoscopic lumbar discectomy (PELD) has become a routine surgical procedure because it is minimally invasive. Perioperative complications such as dural injury, infection, nerve root irritation and recurrence can occur not only with PELD, but also with conventional open microsurgery. In contrast, post-operative dysesthesia (POD) due to existing dorsal root ganglion (DRG) injury is a unique complication of PELD. When POD occurs, even if the traversing root has been successfully decompressed, it hinders swift recovery and delays the return to daily routines. Thus, prevention of POD is the key to successful and widespread use of PELD. ⋯ Transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation is a safe and effective procedure. The floating retraction technique is recommended to avoid development of POD.
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Minim Invasive Neurosurg · Oct 2011
A novel percutaneous technique to implant plate-type electrodes.
In spinal cord stimulation (SCS) mainly 2 distinctive implantation techniques can be recognized: the percutaneous and surgical technique. ⋯ We present a novel technique to introduce small profile paddle leads (S-Series™: St. Jude Medical - Neuromodulation Division, Plano, TX) in the epidural space via a percutaneous approach using the Epiducer™ (St. Jude Medical - Neuromodulation Division, Plano, TX) lead delivery system.
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Minim Invasive Neurosurg · Oct 2011
Supraorbital keyhole approach to upper basilar artery aneurysms via the optico-carotid window: a cadaveric anatomic study and preliminary application.
No anatomic data are available addressing the surgical indication for upper BA aneurysms via the supraorbital keyhole approach (SOKA). ⋯ When the width and length of the OCW are > 5 mm and > 7 mm, respectively, the SOKA can meet the requirement of exposure and manipulation of the upper BA. The upper BA aneurysms located < 10 mm higher than the anterior fossa and not more than 5 mm lower than the PCP can be treated via the SOKA. Posterior clinoidectomy and orbitectomy can increase the proximal and the distal exposure of the BA, respectively.