Neurosurgery
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Comparative Study
Biomechanical comparison of costotransverse process screw fixation and pedicle screw fixation of the upper thoracic spine.
To compare the biomechanics of costotransverse process screw fixation with those of pedicle screw fixation in a cadaveric model of the upper thoracic spine. ⋯ The costotransverse screw technique seems to provide only moderately stiff fixation of the destabilized thoracic spine. Pedicle screw fixation seems to have more favorable biomechanical properties. These data suggest that the costotransverse process construct is better used as a salvage procedure rather than as a primary fixation strategy.
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Local delivery of temozolomide (TMZ) through polymers is superior to oral administration in a rodent glioma model. ⋯ The survival of tumor-bearing animals in the 9L and F98 glioma models was improved with the local delivery of BCNU and TMZ combined with XRT when compared with either treatment alone or oral TMZ, local BCNU, and XRT.
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To analyze the 3-dimensional relationships of the inferior fronto-occipital fasciculus (IFOF) within the temporal stem using anatomic dissection and to study the surgical application. ⋯ In the transsylvian approach to the mesiotemporal structures in the left dominant hemisphere, an incision within the posterior 8 mm from the limen insulae is less likely to damage the IFOF than more posterior incisions along the inferior limiting sulcus. In the temporal transopercular approach to left temporo-insular gliomas, the IFOF constitutes the deep functional limit of the resection within the temporal stem.
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Patients who undergo posterior cervical spinal fusion procedures frequently experience significant postoperative pain. Use of a local anesthetic continuous infusion pump after surgery may improve these outcome variables. ⋯ Patients with the local anesthetic continuous infusion device required less narcotics and reported lower pain scores than control patients on each of the first 4 PODs. These results suggest that continuous infusion of local anesthetic into the paravertebral tissue during the immediate postoperative period is a safe and effective technique that achieves lower pain scores and narcotic use and improves multiple postoperative outcome variables.