Neurosurgery
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Hemispherotomy techniques have been developed to reduce complication rates and achieve the best possible seizure control. We present the results of our pediatric patients who underwent vertical parasagittal hemispherotomy and evaluate the safety and global long-term outcome of this technique. ⋯ Vertical parasagittal hemispherotomy is an effective surgical technique for hemispheric disconnection. It allows complete disconnection of the hemisphere through a cortical window with good results in terms of seizure outcome and a comparably low complication rate.
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Historical Article
History of spine biomechanics: part I--the pre-Greco-Roman, Greco-Roman, and medieval roots of spine biomechanics.
The roots of spine biomechanics reside in the Antiquity and the Medieval and Renaissance periods. A review of historical treatises reveals detailed information regarding this often historically neglected discipline. ⋯ These documents heavily influenced the portion of the scientific literature that we now regard as "spine biomechanics" up through the Renaissance. The focus of Part I of this two-part series is placed on the ancient and medieval biomechanics-related literature and on associated literature that influenced the development of the field of modern spine biomechanics.
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Case Reports
Surgery after radiosurgery for acoustic neuromas: surgical strategy and histological findings.
To retrospectively review the authors' experience with surgical resections after failed radiosurgery for acoustic neuromas. ⋯ Surgical resection after radiosurgery is indicated in the presence of such symptoms as cerebellar ataxia and increased intracranial pressure. It must be carefully considered because of the natural regression of transient tumor swelling over time. Surgical resection should be limited to subtotal removal for functional preservation. In patients with tumor enlargement several years after radiosurgery, the possibility of chronic intratumoral bleeding resulting from delayed radiation injury must be considered.
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In recent years, percutaneous laser disc decompression (PLDD) has become a routine surgical procedure because it can be performed under local anesthesia and is minimally invasive. However, there is a risk of nerve root and endplate injury owing to heat generated by laser irradiation during PLDD. We recently performed salvage surgery on a patient with heat injury to the L5 nerve root that developed after PLDD. ⋯ When salvage surgery is performed after a PLDD procedure, disc and nerve root injuries owing to laser heat energy must be considered.
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Comparative Study
Novel bipolar forceps with protein repellence using gold-polytetrafluoroethylene composite film.
Advancement in new technology has been necessary for the development of surgical hemostasis. The purpose of this study was to assess novel bipolar forceps plated with gold-polytetrafluoroethylene (PTFE) composite film. ⋯ The concept of promotion of protein repellence is important for achieving reduced adherence of protein to neurosurgical instruments. This protein repellent plating is indispensable to achieve safer and more accurate microneurosurgery.