Journal of neurosurgery
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Journal of neurosurgery · Oct 2003
Comparative StudyOne-level one-sided lumbar disc surgery with and without microscopic assistance: 1-year outcome in 114 consecutive patients.
The aim of this study was to compare the outcomes following macrodiscectomy and microsurgery for one-level one-sided lumbar disc excision. ⋯ Microdiscectomy allows the surgeon good visualization and is less traumatic to the involved tissues. Interestingly, the results of this study indicated that microsurgery does not reduce hospitalization time, nor does it improve the overall surgery-related outcome. The main differences between the two procedures were length of the incision and operative time. The author found that lumbar microdiscectomy allows patients earlier return to work and/or normal life with less reliance on postoperative narcotic analgesic agents.
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Journal of neurosurgery · Oct 2003
Posterolateral percutaneous endoscopic lumbar foraminotomy for L5-S1 foraminal or lateral exit zone stenosis. Technical note.
The purpose of this study was to determine the efficacy and feasibility of posterolateral percutaneous endoscopic lumbar foraminotomy (PELF) for foraminal or lateral exit zone stenosis of the L5-S1 level in the awake patient. Twelve consecutive patients with L5-S1 foraminal stenosis and associated leg pain underwent PELF between May 2001 and July 2002. Under fluoroscopic guidance, posterolateral endoscopic foraminal decompression was performed using a bone reamer, endoscopic forceps, and a laser. ⋯ There was no complication. The PELF procedure provides a simple alternative for treating lumbar foraminal or lateral exit zone stenosis in selected cases. The authors found that the posterolateral endoscopic approach to the L5-S1 foramen was usually possible and that using a bone reamer to undercut the superior facet was effective.
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Journal of neurosurgery · Oct 2003
Changes in nerve root motion and intraradicular blood flow during intraoperative femoral nerve stretch test. Report of four cases.
It is not known whether changes in intraradicular blood flow (IRBF) occur during the femoral nerve stretch test (FNST) in patients with lumbar disc herniation. An FNST was conducted in patients with lumbar disc herniation to observe the changes in IRBF, and results were then compared with clinical features. ⋯ The intraoperative FNST showed that the hernia compressd the nerve roots and there was marked disturbance of gliding, which was reduced to only a few millimeters. During the test, IRBF decreased by 92.8 to 100% (96.9 +/- 3.7% [mean +/- standard error of the mean]).
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Journal of neurosurgery · Oct 2003
Multicenter Study Clinical TrialClinical and radiological evaluation of the Codman semiconstrained load-sharing anterior cervical plate: prospective multicenter trial and independent blinded evaluation of outcome.
Semiconstrained load-sharing implants for spinal fixation accommodate change in the screw-plate interface as bone grafts shrink. The authors evaluated the clinical and radiological outcome in patients after placement of the Codman anterior cervical plate (ACP) system, which allows change in the screw-plate angle. ⋯ Based on an independent blinded evaluation, the Codman ACP provides effective fixation with load sharing and is effective in achieving fusion with a 94% success rate. Direct comparison with rigidly locked devices is required to establish definitively the optimal method for anterior cervical fixation.