Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Oct 2016
Options in treating trigeminal neuralgia: Experience with 195 patients.
For patients with medically unresponsive trigeminal neuralgia (TN), surgical options include microvascular decompression (MVD), radiofrequency rhizotomy (RF), and stereotactic radiosurgery (SRS). In an attempt to identify the risks and benefits and cost inherent with each of the three modalities, we performed a retrospective review of our experience with 195 cases of TN treated over the past 15 years. ⋯ MVD for TN is the treatment least likely to fail or require additional treatment. Patients who underwent MVD were younger than those undergoing RF or SRS. The highest rate of recurrence of TN was encountered in patients undergoing RF (64%). Facial numbness was least likely to occur with MVD (16%) compared to RF and SRS (50% and 36% respectively).
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Clin Neurol Neurosurg · Oct 2016
Influence of the T1-slope on sagittal alignment of the subaxial cervical spine after posterior atlantoaxial fusion in os odontoideum.
To analyze the effect of T1-slope (T1S) on sagittal alignment of the subaxial cervical spine after posterior C1-C2 fusion. ⋯ T1S was a useful parameter to evaluate postoperative alignment of the subaxial cervical spine after posterior C1-C2 fusion. To avoid postoperative misalignment of the subaxial cervical spine, C1-C2 should be fixed in less lordosis, especially in patients with high preoperative T1S.
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Clin Neurol Neurosurg · Sep 2016
Review Meta AnalysisTransoral and transnasal odontoidectomy complications: A systematic review and meta-analysis.
The craniovertebral junction (CVJ) is a complex region of the spine with unique anatomical and functional relationships. To alleviate symptoms associated with pathological processes involving the odontoid process, decompression is often required, including odontoidectomy. Accurate knowledge of the complication rates following the transoral and transnasal techniques is essential for both patients and surgeons. ⋯ This work presents a systematic review of complications reported for transoral or transnasal odontoidectomy across a heterogeneous group of surgeons and patients. Due to inconsistent reporting, statistical significance was only achieved for postoperative tracheostomy, which was significantly higher in the transoral group. This investigation sets the framework for further discussions regarding odontoidectomy approach options and their associated complications during the informed consent process.
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Clin Neurol Neurosurg · Sep 2016
An investigation on the effect of improved X-rays-guided radiofrequency thermocoagulation denervation on lumbar facet joint syndrome.
This study aims to observe the clinical efficacy and feasibility of improved X-rays-guided radiofrequency thermocoagulation denervation for treating low back pain secondary to lumbar facet joint syndrome (LFJS). ⋯ Improved X-rays-guided radiofrequency thermocoagulation denervation is an effective, minimally invasive and convenient method for treating low back pain secondary to lumbar facet syndrome.
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Clin Neurol Neurosurg · Aug 2016
Transforaminal percutaneous endoscopic lumbar discectomy for very high-grade migrated disc herniation.
Transforaminal percutaneous endoscopic lumbar discectomy (PELD) for high-grade migrated disc herniation has been regarded as a challenging task, but because of the remarkable improvement in navigable instruments and advanced epiduroscopic technique, it can be used for the treatment of high- or very high-grade migrated disc herniation. The purpose of this study was to describe in detail the standardized technique of transforaminal PELD for very high-grade migrated disc herniation and demonstrate the clinical results. ⋯ Transforaminal PELD can be effective for very high-grade migrated lumbar disc herniation, and a standardized technique may provide a reliable and reproducible result.