Minim Invas Neurosur
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Minim Invas Neurosur · Jun 2007
Case ReportsMinimally invasive endoscopic removal of a herniated nucleus pulposus that had migrated to the S1 nerve root foramen.
In this report, we described an adult case with a lumbar herniated nucleus pulposus that had migrated to the S1 nerve root foramen from L5-S1 disc space. Endoscopically, the migrated mass was successfully removed after laminectomy at the S1 with a small skin incision of 20 mm in length. Unlike the other levels, the intraforaminally migrated mass along the S1 root can be excised without any removal of the facet joints; therefore, additional spinal fusion is not necessary. Thus, an S1 foraminal migrated mass can be a good surgical candidate for minimally invasive endoscopic surgery.
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Minim Invas Neurosur · Apr 2007
Percutaneous endoscopic discectomy for far lateral lumbar disc herniations: prospective study and outcome of 66 patients.
Extraforaminal disc herniations represent up to 11% of all lumbar herniated discs. Numerous surgical approaches have been described. Percutaneous endoscopic discectomy (PED) is one of the minimally invasive techniques; after mastering this procedure it is a practical method that is used for treatment of foraminal or extraforaminal disc herniation. The outcome of PED for treatment of foraminal or extraforaminal disc herniation has been studied. ⋯ Percutaneous endoscopic discectomy is a minimally invasive method and offers many benefits to the patient, but extensive surgical practice is needed to become a capable surgeon. Consequently this technique can only be a treatment option on appropriate patients. This study reconfirmed that the removal of fragmented disc material is achieved and offers a pain-free status.
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Minim Invas Neurosur · Apr 2007
Case ReportsEndovascular stent placement of cervical internal carotid artery dissection related to a seat-belt injury: a case report.
The incidence of carotid artery dissection related to blunt injury is very low, but the mortality rate is high. Rapid diagnosis and proper treatments are discussed. ⋯ Prompt diagnosis without delay and intimate follow-up is the key for the treatment of a carotid injury. Those patients who exhibit cervical bruits and/or seat-belt signs should be examined aggressively. Angioplasty with stents is amenable for patients with traumatic carotid dissections requiring vascular reconstruction in the acute stage.
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Minim Invas Neurosur · Apr 2007
Case ReportsVirtual 3-dimensional preoperative planning with the dextroscope for excision of a 4th ventricular ependymoma.
Advances in computer imaging and technology have facilitated enhancement in surgical planning with a 3-dimensional model of the surgical plan of action utilizing advanced visualization tools in order to plan individual interactive operations with the aid of the dextroscope. This provides a proper 3-dimensional imaging insight to the pathological anatomy and sets a new dimension in collaboration for training and education. ⋯ Virtual reality has brought new proportions in 3-dimensional planning and management of various complex neuroanatomical problems that are faced during various operations. Integration of 3-dimensional imaging with stereoscopic vision makes understanding the complex anatomy easier and helps improve decision making in patient management.
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The aim of this study was to evaluate the clinical results of patients who underwent resection with the aid of microsurgical techniques and stereotactic and image-guided surgery for critically located cavernous malformations which still represent a considerable surgical challenge due to the close proximity of vital and eloquent structures. ⋯ Stereotactic methods together with image-guidance and microsurgical techniques allow the creation of most effective and safe corridors to access the CMs in eloquent regions with a minimization of tissue manipulation and low risk of permanent neurological deficit.