Minim Invas Neurosur
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Minim Invas Neurosur · Apr 2008
Comparative StudyComparison of techniques for decompressive lumbar laminectomy: the minimally invasive versus the "classic" open approach.
Decompressive laminectomy offers an effective surgical treatment of lumbar spinal stenosis. The purpose of this study was to compare the elements of treatment commonly associated with successful outcomes in the assessment of laminectomies - operating room times, estimated blood loss, length of stay, and complications - of the minimally invasive and open approach laminectomies. ⋯ Bilateral decompression of lumbar spinal stenosis via a unilateral approach involves shorter operating times and less blood loss, less muscle dissection, fewer and less severe complications, and better mobility in the immediate postoperative period than open decompressive techniques. In addition, this technique is very similar to the commonly performed microendoscopic discectomy and is easily mastered over time.
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Minim Invas Neurosur · Feb 2008
Automated registration of intraoperative CT image data for navigated skull base surgery.
With a new intraoperative computed tomography (CT) imaging system, patient-to-image registration without any invasive registration markers is possible. Furthermore, registration can be performed fully automatically. The accuracy of this method for skull base surgery was investigated in this study. ⋯ Fully automated registration based on a tracked CT gantry is a robust and accurate registration method for skull base surgery.
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Minim Invas Neurosur · Feb 2008
Case ReportsExclusive endoscopic removal of a planum sphenoidale meningioma: a case report.
Midline suprasellar meningiomas have traditionally been removed through transcranial approaches. Endoscopic endonasal approaches have already been described for the removal of tuberculum sellae meningiomas (Cook), but their exclusive use for planum sphenoidale meningiomas has never been reported. ⋯ The anterior skull base defect has been reconstructed with a pedicled mucosa flap from nasal septum (Hadad-Bassagasteguy flap). The postoperative course was uneventful, and no sign of recurrence was noticed at the MRI control performed after 3 months.
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Minim Invas Neurosur · Feb 2008
Case ReportsMinimally invasive excision of lumbar epidural lipomatosis using a spinal endoscope.
In this report, we describe the case of a patient with a long-term radiculopathy due to epidural lipomatosis at the L3-4 intervertebral disc level. The fatty tissue was located on the dorsal side of the dural sac in the spinal canal and compressed the dural sac. ⋯ After surgery, the symptoms disappeared, and neurological deficits normalized. We would like to state that epidural lipomatosis is a good candidate for minimally invasive endoscopic surgery because of its anatomic location.
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Minim Invas Neurosur · Feb 2008
Treatment strategies and outcome in patients with non-tuberculous spinal epidural abscess--a review of 46 cases.
Spinal epidural abscess (SEA) is a rare disease and its early detection and appropriate treatment is essential to prevent high morbidity and mortality. There are only few single-institution series who report their experiences with the microsurgical management of SEA and treatment strategies are discussed controversially. Within the last 15 years the authors have treated 46 patients with SEA. This comparatively high number of cases encouraged us to review our experiences with SEA focussing on the clinical presentation, microsurgical management and outcome. ⋯ Early diagnosis, microsurgical therapy with appropriate antibiotic therapy and careful observation of patients are the keys to successful management of SEA. The goal of surgical treatment is to isolate the causative organism and to perform a decompression at the site of maximal cord compression in cases of neurological deterioration or severe pain. Instrumentation with primary fixation does not seem to be imperative. In cases of post-operative worsening, a fracture of additionally infected bony elements has to be considered and a stabilisation should be discussed on an individual basis.