Neurosurgery
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To study the alteration to normal biomechanics after insertion of a lumbar interspinous spacer (ISS) in vitro by nondestructive cadaveric flexibility testing. ⋯ The primary biomechanical effect of the ISS was reduced extension with associated reduced facet loads and smaller decrease in foraminal height. The ISS had little effect on sagittal IAR or on motion or facet loads in other directions.
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En bloc resection, with adequate surgical margins, of primary malignant bone tumors of the sacrum is associated with long term disease control and potential cure. Resection of sacral tumors is difficult due to the proximity of neurovascular and visceral structures, and complete, or even partial, sacrectomy often results in functional loss for the patient. ⋯ This technique for midsacral amputation to remove a sacral tumor en bloc minimizes local recurrence and maximizes neurovascular function.
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Case Reports
Anterior selective amygdalohippocampectomy: technical description and microsurgical anatomy.
We introduce a technique for performing a selective amygdalohippocampectomy (AH) through a minisupraorbital approach. ⋯ The anterior route for selective AH is a logical and straightforward approach to the mesial temporal lobe. Compared with other variations, it is less invasive and destructive, especially in terms of the fibers of the optic pathway, temporal stem, and lateral temporal neocortex.
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Comparative Study
Results after lumbar decompression with and without discectomy: comparison of the transspinous and conventional approaches.
To evaluate the efficacy of the transspinous approach compared with the conventional approach in single-level lumbar laminotomies with and without discectomies. ⋯ Patients who underwent single-level lumbar decompression with or without discectomy had similar outcomes as those who underwent the conventional approach. Although of modest clinical significance, the transspinous approach may afford early mobilization and reduced postoperative pain while providing a satisfactory neurological and functional outcome.