Neurosurgery
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Multicenter Study Comparative Study Controlled Clinical Trial
Comparative effectiveness of ventral vs dorsal surgery for cervical spondylotic myelopathy.
Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction. ⋯ Surgery for treating CSM was followed by significant improvement in disease-specific symptoms and in HR-QOL. Greater improvement in HR-QOL was observed after ventral surgery. Dorsal fusion surgery was associated with longer length of hospital stay and higher hospital costs. The pilot study demonstrated feasibility for a larger randomized clinical trial.
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Multicenter Study
Fundamental skills for entering neurosurgery residents: report of a Pacific region "boot camp" pilot course, 2009.
Incorporation of the first postgraduate year of training into neurological surgery residencies in 2009 posed new challenges to neurosurgical educators. A "boot camp" course was held in August 2009 to introduce first year neurosurgical trainees to various fundamental cognitive and practical skills. ⋯ A fundamental skills boot camp course for first year neurosurgical trainees seems valuable.
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Catheter, needle, and electrode misplacement in navigated neurosurgery can result in ineffective treatment and severe complications. ⋯ The catheter localization errors have significant variations at the target and along the insertion trajectory. Trajectory errors may differ significantly from the errors at the target. Moreover, the single registration error number reported by the navigation system does not appropriately reflect the trajectory and target errors and thus should be used with caution to assess the procedure risk.
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A standard pterional approach with a free bone flap to treat brain aneurysms was first introduced and popularized by Yaşargil. ⋯ With the use of this muscle-preserving and bone-sparing pterional approach and with little additional labor, temporalis muscle function is preserved and improved cosmesis is obtained.
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The efficacy of deep brain stimulation (DBS) is highly dependent on the accuracy of lead placement. ⋯ iCT can be easily incorporated into standard DBS surgery, replaces the need for C-arm fluoroscopy, and provides accurate intraoperative 3-dimensional confirmation of electrode tip locations relative to preoperative images and surgical plans. iCT fused to preoperative MRI may obviate the need for routine postoperative MRI in DBS surgery. Technical nuances that must be mastered for the efficient use of iCT during DBS implantation are described.