World Neurosurg
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Trigeminal ganglion stimulation can be effective for trigeminal neuralgia. For patients who respond well to neurostimulation delivered percutaneously through the foramen ovale but require extensive revision and removal of instrumentation, a subtemporal approach for stimulation of the trigeminal ganglion is an alternative option as a salvage procedure. ⋯ The subtemporal approach for salvage placement of the trigeminal ganglion stimulating electrode was effective in this patient and minimized risks given her history of erosion and multiple operations. This suggests that the subtemporal approach is a viable salvage operation for trigeminal ganglion stimulation for trigeminal neuropathic pain.
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Endoscopic resection of colloid cysts is a widely accepted treatment option instead of microsurgery. However, there is still a debate about a potentially higher rate of incomplete resections and recurrence. ⋯ Our results indicate that endoscopic treatment of colloid cysts is a safe and effective treatment option that provides excellent long-term results. However, we determined that a significant risk for recurrence exists when even small parts of the cyst capsule were left behind. Therefore, we advocate an attempt at total endoscopic cyst resection.
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With the aging population in the United States, it can be anticipated that the prevalence of spinal cord injuries (SCIs) and cancer will increase. Primary or metastatic spine tumors sit at a unique intersection of these 2 realms. Our objective was to evaluate the prevalence, outcomes, and complications after the management of SCI arising from spinal tumors. ⋯ SCI associated with spinal tumor is often managed surgically and associated with high rates of complications. The present study has demonstrated longer survival rates compared with the existing data.
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First carpometacarpal (CMC) joint osteoarthritis (OA) is commonly encountered in clinical practice. The preferred surgical option when conservative therapy fails varies with the stage and nature of the disease. Denervation of the first CMC joint is a relatively new procedure for managing stable thumb CMC joint OA. Our objective was to review our experience and surgical technique with first CMC joint denervation surgery. ⋯ First CMC joint denervation provided good pain relief and improvement in grip strength in patients with thumb CMC joint OA. This minimally invasive technique proved to be a good option for providing optimal pain control and improvement in strength with minimal and mild complications.
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The lateral supraorbital (LS) and minipterional (MP) approaches have been reported for treating intracranial aneurysms as alternative to the pterional approach. We describe our decision making for selecting the minicraniotomy, LS versus MP, for managing noncomplex aneurysms of the middle cerebral artery (MCA), based on the depth of the aneurysm within the Sylvian fissure. ⋯ Our strategy for selecting the keyhole approach based on the depth of the aneurysm within the Sylvian fissure is efficient and safe. We suggest the use of the LS approach when the aneurysm is <15 mm from the M1 origin and the MP approach when the aneurysm is ≥15 mm from the M1 origin.