Neurosurgery
-
Detecting patients at risk for secondary neurological deterioration (SND) after mild to moderate traumatic brain injury is challenging. ⋯ In patients with no severe brain lesions on CT after mild to moderate traumatic brain injury, TCD on admission, in complement with brain CT scan, could accurately screen patients at risk for SND.
-
Clinical Trial
Long-term outcome after microendoscopic diskectomy for lumbar disk herniation: a prospective clinical study with a 5-year follow-up.
Several authors have reported results obtained with the microendoscopic diskectomy (MED) technique, but the long-term outcome has not been described. This report summarizes our clinical experience with the lumbar MED technique with a long-term follow-up period. ⋯ MED not only reduces the incision, tissue damage, and postoperative period of incapacity but also offers long-term results comparable to those of conventional techniques.
-
Clinical Trial
O-arm-guided balloon kyphoplasty: prospective single-center case series of 54 consecutive patients.
Balloon kyphoplasty is widely used to treat vertebral compression fractures. Procedure outcome and safety are directly linked to precise radiological imaging requiring 1 or 2 C arms to allow correct visualization throughout the procedure. This minimally invasive spinal surgery is associated with radiation exposure for both patient and surgeon. In our center, we switched from using a C-arm to an O-arm image guidance system to perform balloon kyphoplasty. Our preliminary experience is reported in Acta Neurochirurgica, and the encouraging results led us to study this subject more extensively. This article presents our complete results. To the best of our knowledge, there is no comparable clinical series describing O-arm use in kyphoplasty procedures published in the literature. ⋯ With this new intraoperative system, the overall surgical and fluoroscopy times can be further reduced in the near future.
-
Clinical Trial
Cranioplasty with adipose-derived stem cells and biomaterial: a novel method for cranial reconstruction.
There is no optimal method for reconstruction of large calvarial defects. Because of the limitations of autologous bone grafts and alloplastic materials, new methods for performing cranioplasties are needed. ⋯ The combination of scaffold material such as beta-tricalcium phosphate and autologous adipose-derived stem cells constitutes a promising model for reconstruction of human large cranial defects. The success of these clinical cases paves way for further studies and clinical applications to turn this method into a reliable treatment regimen.
-
Neurovascular surgeons have been trying to find a solution to the problem of surgical invasiveness by applying minimally invasive keyhole approaches. ⋯ A superciliary approach can be a reasonable alternative to a pterional approach for small (<15 mm) UIAs arising at the supraclinoid ICA, A1, ACoA, and M1 segment including the MCA bifurcation.