World Neurosurg
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For effective minimally invasive lumbar decompression, we changed the routine of segmental decompression. Using a high-speed drill or an ultrasound knife, we created a working channel, starting at the base of the spinous process of the upper vertebra slightly above the disc level, to target and decompress the contralateral recess, and termed it the translaminar crossover decompression (TCD). We evaluated the feasibility and compared the outcomes of a navigation-guided endoscopic translaminar crossover approach for segmental decompression (eTCD) in elderly patients with microscopic decompression using the same approach (mTCD). ⋯ TCD inherently eliminated central stenosis and facilitated decompression of both recesses via mutual undercutting, with preservation of facet joint integrity.
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To evaluate the results of percutaneous endoscopic transforaminal diskectomy (PETD) in comparison with percutaneous endoscopic interlaminar diskectomy (PEID) for axillar herniation at L5-S1. ⋯ For axillar herniation at L5-S1, PEID can ignore the anatomic obstruction with advantages including a shorter operation time and less intraoperative radiation exposure. PETD has a clinical effect similar to that of PEID, but the process of it is more dangerous and harder than PEID.
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Spinal cord stimulation (SCS) is both relatively safe and reversible. Although SCS is generally regarded as a last resort, some of these patients will undergo additional spinal surgery after the device has been implanted or after its removal. We present a descriptive study of subsequent spinal surgery after SCS implantation. ⋯ To the best of our knowledge, the present study is the first to describe spine surgery in the setting of SCS implantation. Our results have indicated that spine surgery subsequent to, or concurrent with, SCS implantation appears to occur in few patients. Our study results suggest a modest improvement in quality of life outcomes. Therefore, clinicians should remember that patients might require further spine surgery despite the use of SCS implantation and, thus, might require reevaluation by the spine team.
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Observational Study
Feasibility of Staged Bilateral Radiofrequency Vim Thalamotomy for Bilateral Essential Tremor.
Patients with bilateral and/or midline/axial tremor have significant diminution in quality of life (QOL). Various studies report high complication rates with bilateral thalamotomy. However, use of primitive methods in these studies confers questionable validity. We conducted a retrospective observational cohort study in patients with medication-refractory bilateral essential tremor treated with staged bilateral radiofrequency ventral intermediate nucleus thalamotomy to subjectively examine the impact of any adverse effects on QOL and patient satisfaction. ⋯ Adverse effects that are nondisabling and hence acceptable to the patient can be considered acceptable adverse effects. Staged bilateral radiofrequency ventral intermediate nucleus thalamotomy definitely improves QOL in patients with medication-refractory bilateral essential tremor despite occurrence of acceptable adverse effects.
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Depression is a prevalent and disabling condition associated with spinal cord injury (SCI). Such associated negative factor warrants the use of valid and reliable psychological assessment tools among this group. One of the available assessment means is the Patient Health Questionnaire-9 (PHQ-9), a short screening measure that evaluates depression status. Our aim is to test the psychometric properties of the Arabic version of the PHQ-9 including validity and reliability among Lebanese individuals with SCI. ⋯ Our findings suggest that the PHQ-9 has good psychometric properties and is a valid and reliable measure of depression among the Lebanese individuals with SCI.