Neurosurgery
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Cervical arthroplasty is a promising nonfusion alternative for the treatment of degenerative disc disease. After anterior cervical discectomy for neurological decompression, the intervertebral space is reconstructed by use of a metal and polymer prosthesis, allowing semiconstrained motion in multiple planes. This approach allows for preservation of cervical motion, potentially reducing the risk of transitional-level disease.
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Comparative Study
Ideal suture diameter is critical for consistent middle cerebral artery occlusion in mice.
The use of transgenic and knockout mice has led to a need for a consistent model of mouse transient focal cerebral ischemia. In a great majority of the published mouse middle cerebral artery (MCA) occlusion studies, the methods indicated the type of intraluminal suture used without indicating the actual suture diameter after modification. We attempted to determine the ideal suture diameter to produce consistent occlusion in the MCA of adult male C57BL/6 mice. ⋯ Small changes in the diameter of the occlusion suture tip affect consistency in the mouse MCA occlusion model.
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2-Octylcyanoacrylate (Dermabond; Ethicon, Inc., Somerville, NJ) is a liquid adhesive being used with increasing frequency for the closure of lacerations and surgical incisions. Dermabond provides excellent cosmetic closure, and recent studies have demonstrated very low infection risks when it is properly applied. There are no published studies using Dermabond on lumbar or cervical procedures. This study was undertaken to determine whether Dermabond is safe and efficacious to use in these common neurosurgical procedures. ⋯ This study demonstrates that Dermabond is safe to use in neurosurgery patients undergoing lumbar or cervical procedures, with only 1 patient of 200 having a proven infection. Patients are able to shower and do not have sutures or staples to remove. Patient responses are overwhelmingly positive.
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Traumatic spondylolisthesis of the axis may be treated by external immobilization or surgical fixation. ⋯ Although this technique has been reported previously, it is more commonly used in multilevel cervical fusions than for stand-alone repair of C2. Management options, anatomy, and technical considerations for the treatment of traumatic spondylolisthesis are reviewed.
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Basilar apex region aneurysms are among the most complex cerebral aneurysms. They are not, however, among the most common aneurysms, and increased use of endovascular treatment has further decreased the number of patients with these lesions who undergo surgery. ⋯ We prefer an orbitozygomatic craniotomy and transsylvian approach. Meticulous exercise of the basic tenets of aneurysm surgery (proximal vascular control, sharp dissection, and preservation of perforating vessels) is crucial to optimal patient outcomes.