Neurosurgery
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The incidence of spinal instability after penetrating gunshot wounds to the spine in adolescents is unknown. We describe our experience over a 15-year period. ⋯ After penetrating gunshot wounds to the spine, patients at 1-year follow-up examinations have evidence of significant, but nonfunctional, improvement. No evidence of spinal instability was noted in this study, and no surgical intervention was required.
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Comparative Study Clinical Trial
Tumors of the lateral and third ventricle: removal under endoscope-assisted keyhole conditions.
Intraventricular tumors usually are managed by approaches and microsurgical techniques that need retraction and dissection of important brain structures. Minimally invasive endoscopic procedures achieve a remarkable alternative to conventional microneurosurgical techniques. Endoscope-assisted microneurosurgery may be a minimally invasive technique with maximally effective treatment. Using the keyhole concept for planning the surgical strategy, the reduction of the brain retraction is achieved, which is one of the main benefits of this technique. ⋯ Endoscope-assisted keyhole neurosurgery seems to be a safe method of removing tumors in all regions inside the ventricular system with a low risk of permanent neurological deficits. The exact surgical corridor planning on the basis of the keyhole strategy offers less traumatic exposure of even deep-seated endoventricular tumors.
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Comparative Study Clinical Trial
Microendoscopic discectomy compared with standard microsurgical discectomy for treatment of uncontained or large contained disc herniations.
Minimally invasive spinal techniques have been developed for years in an attempt to minimize trauma. However, most endoscopic techniques have been unable to address uncontained or large contained disc herniations. The aim of this prospective study was to compare the results of microendoscopic discectomy (MED) and microsurgical discectomy in the treatment of patients with uncontained or large contained disc herniations. ⋯ MED is at least as effective as microsurgical discectomy for treatment of uncontained or large contained disc herniations, although the advantages over the open technique are short lived and did not reach significance. Nonetheless, for the surgeon accustomed to endoscopic techniques, MED seems to be a safe procedure.
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Comparative Study Clinical Trial
Piezoelectric bone surgery: a revolutionary technique for minimally invasive surgery in cranial base and spinal surgery? Technical note.
Piezoelectric surgery represents an innovative, ultrasonic surgery technique for performing a safe and effective osteotomy or osteoplasty that contrasts with the traditional hard and soft tissue management methods with rotating instruments. ⋯ The present preliminary report (comprising illustrative case reports) demonstrates and introduces for the first time the utility of piezoelectric bone surgery in cranial base and spinal surgery in children. Until now, there has been no documented neurosurgical experience of this technique even in adults.
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The present article describes a rare presentation of Type I neurofibromatosis (NFI) involving adjoining intercostal plexiform neurofibromas, as well as the novel use of thoracoscopy to guide surgical resection. This presentation highlights the manner in which NFI may affect selective regions of the body disproportionately through genetic mosaicism. ⋯ Isolated adjoining intercostal plexiform neurofibroma is a unique presentation of mosaic NFI. Because of its limited penetrance, this variant may present as a regional pain syndrome. Thoracoscopy can be used effectively to guide intercostal nerve sheath tumor resection.