Neurosurgery clinics of North America
-
Neurosurg. Clin. N. Am. · Jul 2014
ReviewPitfalls and complications management in the endovascular treatment of aneurysms.
This article reviews complications associated with the endovascular management of intracranial aneurysms, focusing on risk factors, avoidance, recognition, and management. Such complications can be devastating. Both neurologic and nonneurologic complications can occur. ⋯ Reduction of complication rates can be achieved by careful patient selection, meticulous planning and preparation for the procedure, anticipating potential complications, and preparing for their management. Tracking outcomes and a robust case conference can further enhance outcomes. Education of the care team and a collaborative environment can foster greater focus on avoidance of complications.
-
Neurosurg. Clin. N. Am. · Apr 2014
ReviewMinimally invasive extracavitary transpedicular corpectomy for the management of spinal tumors.
Management of spinal metastasis is a large and challenging clinical problem. For metastatic epidural spinal cord compression, a prospective, randomized, controlled trial showed the utility of circumferential surgical decompression followed by adjuvant radiotherapy. ⋯ The transpedicular approach has recently been modernized with minimally invasive and mini-open techniques. This article presents the relevant clinical background on spinal metastasis, reviews the surgical technique for minimally invasive transpedicular corpectomy, and finally reviews relevant results in the literature.
-
Neurosurg. Clin. N. Am. · Apr 2014
Review Comparative StudyMinimally invasive transforaminal lumbar interbody fusion (MI-TLIF): surgical technique, long-term 4-year prospective outcomes, and complications compared with an open TLIF cohort.
Transforaminal lumbar interbody fusion (TLIF) is an important surgical option for the treatment of back pain and radiculopathy. The minimally invasive TLIF (MI-TLIF) technique is increasingly used to achieve neural element decompression, restoration of segmental alignment and lordosis, and bony fusion. This article reviews the surgical technique, outcomes, and complications in a series of 144 consecutive 1- and 2-level MI-TLIFs in comparison with an institutional control group of 54 open traditional TLIF procedures with a mean of 46 months' follow-up. The evidence base suggests that MI-TLIF can be performed safely with excellent long-term outcomes.
-
Neurosurg. Clin. N. Am. · Apr 2014
ReviewLateral transpsoas lumbar interbody fusion: outcomes and deformity correction.
The lateral transpsoas approach for interbody fusion is a minimally invasive technique that has been gaining increasing popularity in the management of a variety of spinal degenerative disorders. Recently, there has been increasing utilization of this technique in the management of adult deformity. The authors present a review of the current evidence of using the lateral lumbar transpsoas approach in the correction of adult degenerative scoliosis.
-
Neurosurg. Clin. N. Am. · Apr 2014
ReviewMinimally invasive lateral transpsoas approach to the lumbar spine: pitfalls and complication avoidance.
The lateral transpsoas approach to the lumbar spine has become an increasingly popular method to achieve fusion. Although this approach requires less tissue dissection, a smaller incision, decreased operative time, reduced blood loss and postoperative pain, and shorter hospital stay, it carries the potential for serious neurologic and visceral complications. This article reviews these complications in detail and proposes mechanisms for their avoidance.