Journal of neurosurgery
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Journal of neurosurgery · Jul 2003
Comparative StudyBiomechanical comparison of expandable cages for vertebral body replacement in the cervical spine.
Recently, expandable cages for vertebral body replacement in the cervical spine have been developed. The purpose of this study was to compare the biomechanical properties of expandable cages with those of a tricortical iliac crest graft and a nonexpandable cage. ⋯ In comparison to a tricortical iliac crest bone graft and a nonexpandable cage, expandable cages have no biomechanical advantages. Due to the low extension and rotational stiffness, none of the implants can be recommended as a stand-alone device. Additional anterior plating increased biomechanical stability adequately. Therefore, additional posterior stabilization should only be considered in cases of severe rotational instability of the cervical spine.
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Journal of neurosurgery · Jul 2003
Clinical TrialThoracoscopic limited T-3 sympathicotomy for primary hyperhidrosis: prevention for compensatory hyperhidrosis.
Compensatory hyperhidrosis is a major and troublesome complication of thoracoscopic sympathectomy for primary hyperhidrosis. The incidence of compensatory hyperhidrosis has been reported to be as high as 50 to 97% in the patients who underwent sympathetic ganglia resection. In this study the authors evaluate the role of thoracoscopic T-3 sympathicotomy for primary hyperhidrosis and the prevention of compensatory hyperhidrosis. ⋯ Thoracoscopic limited T-3 sympathicotomy is an effective method to treat primary hyperhidrosis, its rate of compensatory hyperhidrosis is low, and its rate of long-term patient satisfaction is high.
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The goal of this study was to provide epidemiological and clinical data on the management of cavernomas of the basal ganglia and brainstem from a long-term series at one institution. ⋯ Over the long term, outcomes were worse following conservative treatment or shunt insertion surgery than after microsurgery of symptomatic cavernomas. Incidental cavernomas carried a low risk of neurological deterioration. Surgery should follow generally accepted indications, but only with the confidence that total removal can be safely achieved. Surgery that is performed within 10 to 30 days following ictus may be preferable to delayed surgery.
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Journal of neurosurgery · Jul 2003
Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae.
The goal of this study was to quantify volumetrically cement fill and leakage in patients with osteoporotic and metastatic vertebral lesions undergoing percutaneous vertebroplasty and to establish whether these factors have any clinical significance at follow up. ⋯ Although there was no correlation between cement fill or cement leakage and pain relief, there exists a risk of serious complications due to cement leakage.
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Journal of neurosurgery · Jul 2003
Biography Historical ArticleOsler and the "medico-chirurgical neurologists": Horsley, Cushing, and Penfield.
Sir Victor Horsley's lecture "On the Technique of Operations on the Central Nervous System," delivered in Toronto in 1906, set the stage for an appraisal of Sir William Osler as a protagonist for the emerging specialty of neurosurgery. During his time at McGill University from 1871 to 1884, Osler performed more than 1000 autopsies. Hispathological reports covered the topics of cerebral aneurysm, apoplectic hemorrhage, vascular infarction, subdural hematoma, meningitis, multiple sclerosis, cerebral abscess, and brain tumor. ⋯ Regarding neurosurgery, Osler commended the pioneer operation for a brain tumor in 1884 by Rickman Godlee and the surgery for epilepsy in 1886 by Horsley. In 1907, in discussing the state of brain surgery as reviewed by Horsley, William Macewen, and others, Osler made a plea for "medico-chirurgical neurologists, properly trained in the anatomical, physiological, clinical and surgical aspects of the subject." He played a significant role as a referring physician, mentor, and friend to his young colleague Harvey Cushing (later to become Osler's Boswell), who was breaking new ground in neurosurgery at Johns Hopkins Hospital. Beyond that Osler became an inspiring hero figure for his Oxford student Wilder Penfield, who a few decades later would establish a neurological institute at McGill University where medico-chirurgical neurology would flourish.