Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Feb 2010
Comparative StudyMinimally invasive approach versus traditional open approach for one level posterior lumbar interbody fusion.
While over the last ten years minimally invasive posterior lumbar interbody fusion (PLIF) has been acknowledged to (i) reduce approach-related morbidity associated with quicker recovery, (ii) require a shorter hospital stay and (iii) deliver similar clinical outcomes when compared to a traditional approach, it is still not the current gold standard. In order to demonstrate the efficacy of the minimally invasive lumbar PLIF approach, a retrospective study was conducted comparing both approaches. ⋯ This study confirmed the results of previous studies which advocated the advantages of less blood loss, less postoperative pain, quicker recovery and shorter duration of hospitalization. However, in the long run, one year after surgery, both groups showed no significant difference with regards to clinical and radiographic outcome. Therefore long-term controlled studies are necessary to validate the role of the minimally invasive PLIF in degenerative lumbar instability.
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Minim Invasive Neurosurg · Feb 2010
The supraorbital craniotomy for access to the skull base and intraaxial lesions: a technique in evolution.
The supraorbital craniotomy was initially described as a minimally invasive means to target extra-axial lesions in the anterior cranial fossa and sellar/parasellar region. Since its initial description, various modifications have been described. We report our recent experience with this approach (and its modifications) for not only extra-axial but also intra-axial neoplastic pathology. ⋯ The supraorbital craniotomy and its modifications provide an ideal anterior subfrontal approach through which a wide variety of pathology can be approached. This technique has particular considerations in comparison to traditional cranial base approaches that must be taken into account before it is utilized.
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Minim Invasive Neurosurg · Feb 2010
Case ReportsStaged use of the transsphenoidal approach to resect superior third ventricular craniopharyngiomas.
Craniopharyngiomas are benign tumors, usually originating from the infundibulum or tuber cinereum. Their surgical treatment is challenging because of their relationship to neural and vascular structures. Large craniopharyngiomas that invade the upper third of the third ventricle are a common reason for patients to need a second operation to accomplish a gross total resection. Transsphenoidal approaches are being increasingly used in the treatment of craniopharyngiomas. Large craniopharyngiomas involving the superior third ventricle are most commonly resected through a staged approach, often involving a transcortical or interhemispheric route. ⋯ The authors find this to be an excellent indication for an endoscopic extended transsphenoidal approach in selected cases.
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Minim Invasive Neurosurg · Feb 2010
The true distal posterior inferior cerebellar artery aneurysm: clinical characteristics and strategy for treatment.
A series of aneurysms located at the 4 (th) or 5 (th) segment of the posterior inferior cerebellar artery (PICA) has not been previously reported in the literature. We report six such cases and analyze their clinical characteristics and outcomes from three different treatment strategies. ⋯ Surgery for the true distal PICA aneurysm results in good clinical outcomes. Clipping or wrapping should be considered as the first choice for treatment, and sacrificing the parent artery of the distal PICA aneurysm is relatively safer than selective coiling. The type of parent artery and particularly the collateralization of its distal part should be considered as an essential factor to take into consideration when choosing a treatment strategy.