Biportal endoscopic cervical open‑door laminoplasty to treat cervical spondylotic myelopathy
Neurosurgery Blog
by cba
2d ago
Acta Neurochirurgica (2024) 166:182 Although cervical laminoplasty is a frequently utilized surgical intervention for cervical spondylotic myelopathy, it is primarily performed using conventional open surgical techniques. We attempted the minimally invasive cervical laminoplasty using biportal endoscopic approach. Methods Contralateral lamina access is facilitated by creating space through spinous process drilling, followed by lamina hinge formation. Subsequently, the incised lamina is elevated from ipsilateral aspect, and secure metal plate fixation is performed. Conclusion We successfully p ..read more
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Postoperative complications after surgery for lumbar spinal stenosis, assessment using two different data sources
Neurosurgery Blog
by cba
4d ago
Acta Neurochirurgica (2024) 166:189 Lumbar spinal stenosis (LSS) is a prevalent disorder, and surgery for LSS is a common procedure. Postoperative complications occur after any surgery and impose costs for society and costs and additional morbidity for patients. Since complications are relatively rare, medical registries of large populations may provide valuable knowledge. However, recording of complications in registries can be incomplete. To better estimate the true prevalence of complications after LSS surgery, we reviewed two different sources of data and recorded complications for a samp ..read more
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Predictors of pelvic tilt normalization: a multicenter study on the impact of regional and lower-extremity compensation on pelvic alignment after complex adult spinal deformity surgery
Neurosurgery Blog
by cba
6d ago
J Neurosurg Spine 40:505–512, 2024 OBJECTIVE The objective was to determine the degree of regional decompensation to pelvic tilt (PT) normalization after complex adult spinal deformity (ASD) surgery. METHODS Operative ASD patients with 1 year of PT measurements were included. Patients with normalized PT at baseline were excluded. Predicted PT was compared to actual PT, tested for change from baseline, and then compared against age-adjusted, Scoliosis Research Society–Schwab, and global alignment and proportion (GAP) scores. Lowerextremity (LE) parameters included the cranial-hip-sacrum angle ..read more
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Focused Ultrasound Central Lateral Thalamotomy for the Treatment of Refractory Neuropathic Pain
Neurosurgery Blog
by cba
1w ago
Neurosurgery 94:690–699, 2024 Magnetic resonance–guided focused ultrasound (MRgFUS) central lateral thalamotomy (CLT) has not yet been validated for treating refractory neuropathic pain (NP). Our aim was to assess the safety and potential efficacy of MRgFUS CLT for refractory NP. METHODS: In this prospective, nonrandomized, single-arm, investigator-initiated phase I trial, patients with NP for more than 6 months related to phantom limb pain, spinal cord injury, or radiculopathy/radicular injury and who had undergone at least one previous failed intervention were eligible. The main outcomes wer ..read more
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Risk of Bone Wax Migration During Retrosigmoid Craniotomy for Microvascular Decompression
Neurosurgery Blog
by cba
1w ago
Operative Neurosurgery 26:406–412, 2024 Bone wax is a flexible hemostatic agent commonly used for surgery in the posterior cranial fossa to control bleeding from the mastoid emissary vein. A large amount of bone wax can migrate into the sigmoid sinus through the mastoid emissary canal (MEC). We aimed to identify clinical factors related to intraoperative bone wax migration through the MEC during microvascular decompression (MVD) surgery, which may result in sigmoid sinus thrombosis. METHODS: We retrospectively collected the clinical data of patients with trigeminal neuralgia, hemifacial spasm ..read more
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Pain alleviation and functional improvement: ultra-early patient-reported outcome measures after full endoscopic spine surgery
Neurosurgery Blog
by cba
1w ago
J Neurosurg Spine 40:465–474, 2024 Questions regarding anticipated pain improvement and functional recovery postsurgery are frequently posed in preoperative consultations. However, a lack of data characterizing outcomes for the first postoperative days only allows for anecdotal answers. Hence, the assessment of ultra-early patient-reported outcome measures (PROMs) is essential for patient-provider communication and patient satisfaction. The aim of this study was to elucidate this research gap by assessing and characterizing PROMs for the first days after full endoscopic spine surgery (FESS ..read more
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Use of 5-ALA fluorescence–guided surgery versus white-light conventional microsurgery for the resection of newly diagnosed glioblastomas (RESECT study): a French multicenter randomized phase III study
Neurosurgery Blog
by cba
1w ago
J Neurosurg 140:987–1000, 2024 Only one phase III prospective randomized study, published in 2006, has assessed the performance of 5-aminolevulinic acid (5-ALA) fluorescence–guided surgery (FGS) for glioblastoma resection. The aim of the RESECT study was to compare the onco-functional results associated with 5-ALA fluorescence and with white-light conventional microsurgery in patients with glioblastoma managed according to the current standards of care. METHODS This was a phase III prospective randomized single-blinded study, involving 21 French neurosurgical centers, comparing 5-ALA FGS with ..read more
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Asleep triple-modality motor mapping for perirolandic gliomas: an update on outcomes
Neurosurgery Blog
by cba
1w ago
J Neurosurg 140:1029–1037, 2024 Maximal safe resection of gliomas near motor pathways is facilitated by intraoperative mapping. Here, the authors review their results with triple-modality asleep motor mapping with motor evoked potentials and bipolar and monopolar stimulation for cortical and subcortical mapping during glioma surgery in an expanded cohort. METHODS This was a retrospective analysis of patients who underwent resection of a perirolandic glioma near motor pathways. Clinical and neuromonitoring data were extracted from the electronic medical records for review. All patients with ne ..read more
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Evaluating the safe zone for lumbar pedicle screws: are midline crossing screws indicative of pedicle breach?
Neurosurgery Blog
by cba
2w ago
The Spine Journal 24 (2024) 617−624 Pedicle screw breach (PSB) is not uncommon following lumbar instrumentation, and in some instances, it may lead to vascular and/or neurologic complications. Previous literature suggested that screws crossing the vertebral midline on an anterior-posterior (AP) radiograph (or midsagittal on CT) are concerning for medial pedicle breach. OBJECTIVE: Our primary aim was to map out the safe zones (SZ) of bilateral pedicle instrumentation and their relationship at each lumbar vertebral level. Our secondary aim was to evaluate the presence of SZs’ intersection at ea ..read more
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Stenting for Venous Sinus Stenosis in Patients With Idiopathic Intracranial Hypertension
Neurosurgery Blog
by cba
2w ago
Neurosurgery 94:648–656, 2024 Although venous sinus stenting (VSS) improves cerebrospinal fluid reabsorption and decreases intracranial pressure in patients with idiopathic intracranial hypertension (IIH), the underlying pathophysiology of IIH is not well understood. We present a review and meta-analysis of the literature on VSS for IIH treatment, focusing on the rates of restenosis and symptom recurrence. METHODS: We performed a systematic review of PubMed and Embase databases between January 1, 2011, and December 31, 2021. Articles including ≥5 patients with IIH and venous sinus stenosis tre ..read more
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