Neurosurgical review
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Neurosurgical review · Apr 2012
Translaminar screws of the axis--an alternative technique for rigid screw fixation in upper cervical spine instability.
C2 pedicle screws or transarticular atlantoaxial screws are technically demanding and carry an increased risk of vertebral artery injury. In up to 20% of cases, pedicle and transarticular screw placement is not possible due to a high-riding vertebral artery or very small C2 pedicles in addition to other anatomical variations. Translaminar screws have been reported to rigidly capture posterior elements of C2 and therefore appear to be a suitable alternative. ⋯ Translaminar screws can be used at least as an additional technique for cases of upper cervical spine instability when pedicle screw placement is contraindicated or not possible. The current data suggest comparable biomechanical stability and fusion rates of translaminar screws to other well-known posterior fixation procedures. In addition, translaminar screw placement is technically less demanding and reduces the risk of vertebral artery injury.
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Neurosurgical review · Apr 2012
Post-craniotomy neuronavigation based purely on intraoperative ultrasound imaging without preoperative neuronavigational planning.
Neuronavigation has become an established technology which provides objective data for localization in 3D space and thus decreases uncertainties regarding tumor localization, relation to vasculature, safe trajectories, and craniotomy design during surgery. We have evaluated whether neuronavigation based purely on 3D ultrasound without any preoperative navigational imaging can provide necessary information for navigation and resection control. This application is a new way of utilizing ultrasound-guided neuronavigation. ⋯ The two biopsies yielded representative material. It was possible to use operative neuronavigation based on intraoperative ultrasound without relying on preoperative navigational imaging. Neuronavigation based solely on intraoperative ultrasound was feasible and may increase surgical safety when preoperative neuronavigational image is not feasible or unavailable.