Neurosurgery
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Peripheral nerve stimulation is a form of neuromodulation that applies electric current to peripheral nerves to induce stimulation paresthesias within the painful areas. ⋯ We describe a method of ultrasound-guided peripheral nerve stimulation that avoids the invasiveness of electrode placement via an open procedure while providing excellent pain relief. We further describe limitations of the percutaneous approach when navigating close to large blood vessels, a situation more appropriately managed with open peripheral nerve stimulator placement. Ultrasound-guided placement may be considered for patients receiving peripheral nerve stimulators placed within the deep tissues, and not easily placed in a blind fashion.
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Although anterior fixation of the axis is not commonly performed, plate fixation of C2 is an important technique for treating select upper cervical traumatic injuries and is also useful in the surgical management of spondylosis. ⋯ Anterior plate fixation of the axis for degenerative disease can be accomplished with acceptable morbidity employing an extension of the standard anterolateral route.
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Review Historical Article
The development of neurosurgery at the University of Utah, 1955-2009.
Located in the geographic Intermountain West, the Department of Neurosurgery at the University of Utah has undergone remarkable growth and transformation since the appointment of the first full-time clinical faculty member in 1955. The Department has provided broad neurosurgical services to an expanding community while fulfilling its academic mission of pushing the frontiers within neurosurgical subspecialties. The history of neurosurgery in the Salt Lake Valley and the achievements of the Department of Neurosurgery, including the seminal development of early cranial stereotactic devices, are reviewed in this article.
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Comparative Study
A comparative analysis of the results of vertebroplasty and kyphoplasty in osteoporotic vertebral compression fractures.
The most common complication of osteoporosis is vertebral fractures, which occur more frequently than all other fractures (hip, wrist, and ankle). ⋯ Both vertebroplasty and kyphoplasty are effective at improving pain, functional disability, and quality of life; however, kyphoplasty provides better results, which are maintained over long-term follow-up.
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Previous studies have shown that subthalamic nucleus (STN) deep brain stimulation (DBS) improves tremor in Parkinson disease (PD). However, the patients included in those studies were unselected for tremor severity. ⋯ STN DBS is effective for severe off- and on-medication tremor and off-medication action tremor in PD. Our findings suggest that STN DBS reduces PD tremor through, at least in part, its effect on the tremor-generating mechanism independent of dopaminergic transmission and that long-term electrical stimulation of STN might induce a structural or neurochemical change leading to the improvement of tremor.