Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Jun 2009
Comparative StudyPosterior lumbar interbody fusion: comparison of single intervertebral cage and single side pedicle screw fixation versus bilateral cages and screw fixation.
The efficacy and economy of an alternative sparing method for posterior lumbar interbody fusion (PLIF) using a single cage fixed with pedicle screws placed on a single side (SS group, n=22) was compared to that of a standard bilateral protocol using two cages and pedicle screws placed bilaterally (BL group, n=15). ⋯ In conclusion, the results of this retrospective comparative level III study warrant further studies on the SS protocol which may lead to the adoption of this minimally invasive protocol in the standard practice of PLIF in selected cases.
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Different approaches to the skull base have been developed through the sphenoidal sinus. Traditional boundaries of the trans-sphenoidal approach can be extended in antero-posterior and lateral planes. We review our experience with the extended endoscopic endonasal approach in the first 12 cases. ⋯ The extended endoscopic endonasal approach is a promising minimally invasive alternative for selected cases with sellar, parasellar or clivus lesions. As techniques and technology advance, this approach may become the procedure of choice for most lesions and should be considered an option in the management of the patients with these complex pathologies by skull base surgeons.
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Minim Invasive Neurosurg · Jun 2009
Surgical management of bilateral middle cerebral artery aneurysms via a unilateral supraorbital key-hole craniotomy.
Surgical management of multiple intracranial aneurysms may be difficult if located bilaterally. In the case of bilateral middle cerebral artery (MCA) aneurysms, surgical treatment through a unilateral approach is generally not recommended. In this study we describe the surgical technique and important factors that enable treatment of bilateral MCA aneurysms via a unilateral key-hole approach. ⋯ Bilateral aneurysms of the MCA may be treated sufficiently through a unilateral supraorbital key-hole approach in selected patients. This is also possible in patients presenting with SAH. Factors necessitating bilateral craniotomies were brain swelling and complex configuration of the contralateral aneurysm.
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Minim Invasive Neurosurg · Jun 2009
Case ReportsMinimally invasive thoracic corpectomy and anterior fusion in a patient with metastatic disease: case report and review of the literature.
For patients with metastatic disease to the spine there are numerous surgical approaches for decompression of neural elements and maintenance of mechanical stability. The challenge is to accomplish this while minimizing patient morbidity. Here we report on the feasibility and utility of a minimally invasive extreme lateral approach to the mid to high thoracic spine for anterior decompression and fusion.
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Minim Invasive Neurosurg · Jun 2009
Endoscopic suboccipital decompression on pediatric Chiari type I.
To minimize the invasiveness and maximize the adequacy of Chiari decompression on pediatric patients, 0 degrees and 30 degrees endoscopes were adapted to perform the procedure of suboccipital craniectomy and upper cervical laminectomies. ⋯ The use of the endoscope through a suboccipital craniectomy and upper cervical laminectomies has made Chiari decompression in pediatric population comparable with the conventional procedure in terms of minimal surgical invasiveness, recovery time, and complexity of the procedure.