Journal of neurosurgery
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Journal of neurosurgery · Jul 2003
Synovial cysts of the lumbar spine: surgery-related results and outcome.
The authors conducted a study to determine the surgery-related results and outcomes in patients with synovial cysts of the lumbar spine. They emphasize several specific characteristics useful in clinical management. ⋯ The findings in this series suggest that synovial cysts can occur at multiple lumbar sites within a short period of time and could be predisposed to developing in certain individuals, predominantly in women older than 40 years of age. Postoperative follow up is recommended and MR imaging mandatory in cases of recurrent sciatica.
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The authors evaluated the efficacy of titanium cage- and anterior cervical plate (ACP)-augmented fusion for reconstruction following decompressive cervical corpectomy in nontraumatic disease. ⋯ Autologous corpectomy bone-filled titanium cages supplemented with ACPs are an effective means of reconstruction after compressive cervical corpectomy. This technique provides a reasonable alternative to procedures involving long solid strut grafts obtained from the bone bank or from the patient.
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Journal of neurosurgery · Jul 2003
Case ReportsEnd-to-side neurorrhaphy as a salvage procedure for irreparable nerve injuries. Technical note.
After a few reports on end-to-side nerve repair at the beginning of the last century, the technique was put aside until its recent reintroduction. The authors present their results in three patients with median nerve defects that were between 15 and 22 cm long and treated using end-to-side median-to-ulnar neurorrhaphy through an epineurial window. The follow-up times were between 32 and 38 months. ⋯ Motor evaluation was completed by assessing the presence of opposition and by palpating the abductor pollicis brevis muscle. Sensory recovery was observed in all patients in the median nerve dermatome, and motor recovery was absent, except in Case 1. End-to-side nerve repair can be a viable alternative to nerve grafting in patients with long gaps between the ends of the injured nerve.
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Journal of neurosurgery · Jul 2003
Case ReportsParamedian transmuscular access to C-3 dumbbell-type neurofibroma without paravertebral muscle dissection from the spinous process or facetectomy. Technical note.
The authors devised a paramedian transmuscular approach to the C2-3 facet joint that enabled total removal of C-3 dumbbell-type neurofibroma; dissection of the paravertebral muscles from the spinous process was not required and the facet joint was preserved. Only splitting or retraction of the paravertebral muscles was necessary. The anatomical features and procedures involved in muscle splitting are described.
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Journal of neurosurgery · Jul 2003
Comparative StudyReduction in the number of repeated operations for the treatment of subacute and chronic subdural hematomas by placement of subdural drains.
The aim of this study was to determine the influence of closed-system subdural drainage on repeated operation rates after burr hole evacuation of subacute and chronic subdural hematomas (SDHs). ⋯ Patients have lower rates of repeated surgeries if subdural drains are placed following evacuation of an SDH via a burr hole. To reach high clinical significance, 12 patients must undergo this simple intervention. If technically feasible, subdural drains should be inserted regardless of any occurrence of brain expansion during surgery.