British journal of neurosurgery
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Microdiscectomy for lumbar disc prolapse on a day-patient basis was introduced by our department in 1985 and first reported in 1987, but has not been generally adopted in the United Kingdom. We now report our experience of the first 100 patients with lumbar disc prolapse treated by day-case microdiscectomy. Post-operative assessment was in the out-patient clinic and by subsequent postal questionnaire (average follow-up 37 months, range 3-64 months). ⋯ Only three patients developed a recurrent disc prolapse. Patient feedback was favourable and the majority (85%) said that, if necessary, they would be prepared to have the operation again on a day-case basis. For selected patients, lumbar microdiscectomy is a suitable procedure for day-case surgery.
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Review Case Reports
Lateral parascapular extrapleural approach for single-stage excision of dumb-bell neurofibroma.
An excision of a T1 dumb-bell neurofibroma via a single-stage lateral parascapular extrapleural approach is described. The different surgical approaches that can be used to approach dumb-bell tumours are reviewed, together with the relevant literature.
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In an attempt to prevent tethering following intradural procedures in the spine or at the foramen magnum silastic film has been inserted as a dural substitute. Magnetic resonance imaging has enabled us to judge the effectiveness of this material in preventing tethering at the operative site. Our experience of Silastic dura substitute in 43 paediatric and adult cases is discussed, and illustrated together with a description of the technique of insertion and an analysis of the complications associated with its use.
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A new approach to anterior circulation aneurysms is described in which the position of the surgeon is radically different from usual, allowing an enhanced view along the plane of the parent artery with minimal retraction and proximal control. The position of the surgeon and assistant are comfortable, and the scrub nurse's access to the surgeon's hands is greatly enhanced.
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Progressive Systemic Scleroderma (PSS) is a generalized disease of connective tissue involving the skin, as well as other internal organs. The cutaneous signs are characterized by a progressive sclerosis and loss of function or dexterity in the hands. ⋯ The study confirms that SCS is an effective therapy in patients with PSS and Raynaud's phenomenon because of its beneficial effects on the Raynaud episodes, ulcers, pain, vascular sclerosis and hand function. This method may have a primary role in the treatment of this chronic disorder because of the high probability of failure of other medical or surgical therapy.