Journal of neurosurgery
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Journal of neurosurgery · Oct 2003
Comparative Study Clinical TrialImproved accuracy of computer-assisted cervical pedicle screw insertion.
The authors introduce a unique computer-assisted cervical pedicle screw (CPS) insertion technique used in conjunction with specially modified original pedicle screw insertion instruments. The accuracy of screw placement as well as surgery-related outcome and complication rates were compared between two groups of patients: those in whom a computer-assisted and those in whom a conventional manual insertion technique was used. ⋯ In contrast to the previously reported computer-assisted technique, our CPS insertion technique provides real-time three-dimensional instrument/screw tip information. This serves as a powerful tool for safe and accurate pedicle screw placement in the cervical spine.
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Journal of neurosurgery · Oct 2003
Factors related to long-term outcome after decompressive surgery for ossification of the ligamentum flavum of the thoracic spine.
Factors related to long-term surgical outcome of thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) have not been fully investigated. To evaluate these factors, the authors reviewed medical records obtained in patients who had undergone decompressive surgery for thoracic OLF. ⋯ Duration of preoperative symptoms represents the most important predictor of long-term surgery-related outcome in patients treated for thoracic OLF. The type of ossified ligamentum flavum, dural adhesion, and simultaneous surgery for coexistent cervical or lumbar lesions do not appear to influence the long-term postoperative prognosis.
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Journal of neurosurgery · Oct 2003
Case ReportsWriting, calculating, and finger recognition in the region of the angular gyrus: a cortical stimulation study of Gerstmann syndrome.
In an attempt to gain a better understanding of the cerebral functions represented in the angular gyrus and to spare them during surgery, the authors studied patients with brain tumors located close to the angular gyrus and mapped cortical sites by using electrostimulation. ⋯ Symptoms of Gerstmann syndrome can be found during direct brain mapping in the angular gyrus region. In this series of patients, sites producing interferences in writing, calculating, and finger recognition were demonstrated in the angular gyrus, which may or may not have been associated with object-naming, color-naming, or reading sites.
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Journal of neurosurgery · Oct 2003
Case ReportsFracture of S1-2 after L4-S1 decompression and fusion. Case report and review of the literature.
The author describes a woman in whom an S1-2 fracture developed after L4-S1 decompression and fusion. Osteoporosis was not present, but the lesion failed to respond to conservative therapy, necessitating surgical extension of the spinal fusion. ⋯ To date, only four cases of sacral stress fracture appear in the literature, all involving female patients and reportedly associated with osteoporosis. Unlike the present case, the fracture resolved satisfactorily in all cases with conservative treatment.
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Journal of neurosurgery · Oct 2003
Case ReportsUpper thoracic spinal cord herniation after traumatic nerve root avulsion. Case report and review of the literature.
Transdural herniation of the spinal cord, a rare but well-documented entity, has been reported sporadically for more than 25 years as a possible cause for various neurological signs and symptoms ranging from isolated sensory or motor findings to myelopathy and Brown-Séquard syndrome. The authors report, to the best of their knowledge, the first case of upper thoracic spinal cord herniation occurring after traumatic nerve root avulsion.