Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Aug 2009
Case ReportsNeuronavigation in the minimally invasive presacral approach for lumbosacral fusion.
Intraoperative 3D navigation (3D NAV) is gaining importance in spinal surgery, especially with the advancement of minimally invasive techniques in this field. We hypothesized that 3D NAV may be of benefit in the recently described minimally invasive presacral approach for L4-S1 fusion (AxiaLIF). ⋯ The minimally invasive presacral approach to L4-L5-S1 fusion can be performed safely and accurately with intraoperative 3D NAV. This is especially the case in two-level AxiaLIF procedures, where computer guidance can provide better planning possibilities for optimal screw trajectory.
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Minim Invasive Neurosurg · Aug 2009
Minimally invasive awake craniotomy using Steiner-Lindquist stereotactic laser guidance.
Awake craniotomy permits the continuous assessment of intraoperative neurological functions. In addition, stereotactic laser guidance aids in performing minimally invasive procedures related to the radical resection of lesions located in eloquent and non-eloquent brain regions. ⋯ Awake craniotomy with the aid of stereotactic laser guidance is a safe procedure that assists in performing minimally invasive resection of lesions in eloquent and non-eloquent brain regions. Although direct intraoperative stimulation was not performed, detection of the functioning areas of the brain with fMRI decreased additional postoperative neurological deficits. Overall, this method decreased the operation time and hospital stay.
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Minim Invasive Neurosurg · Aug 2009
Technique for shaping microcatheter tips in coil embolization of paraclinoid aneurysms using full-scale volume rendering images of 3D rotational angiography.
In coil embolization of paraclinoid aneurysms, it is sometimes difficult to introduce and stabilize microcatheter tips in the aneurysms. We report a new technique for shaping microcatheter tips in the coil embolization of paraclinoid aneurysms. ⋯ This technique is feasible for shaping microcatheter tips precisely for coil embolization of paraclinoid aneurysms.
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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.