World Neurosurg
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Global neurosurgery is the practice of neurosurgery with the primary purpose of delivering timely, safe, and affordable neurosurgical care to all who need it. The aim of this study is to identify the most frequently cited articles in global neurosurgery through a bibliographic review to characterize articles and trends around this growing topic. ⋯ There is currently a deficit in both the amount of literature surrounding the topic of global neurosurgery and how much that literature is cited. Developing innovative ways to increase academic productivity within, or in collaboration with, low-middle income countries is essential to contribute to global neurosurgery.
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Comparative Study
Comparison of Two Minimally Invasive Techniques with Endoscopy and Microscopy for Extraforaminal Disc Herniations.
Extraforaminal disc herniations are extraordinary herniations because they are located outside the foraminal bony borders and compress the root exiting at the corresponding level, whereas in median or paramedian herniations, the root 1 level below is compressed. Percutaneous endoscopic discectomy (PED) and microscopic extraforaminal discectomy (MEFD) are 2 popular contemporary techniques that have been performed extensively for these herniations since the 1970s. ⋯ PED is more prone to complications because this technique is strictly dependent on the tubular system and the ideal anatomy of the Kambin triangle. Variations in or degeneration of the Kambin triangle can lead to devastating complications in the PED technique, but normal anatomic conditions are feasible in only approximately 20% of patients. The most important feature of this study was that both techniques were performed by the same experienced team, who developed their own concept.
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Hemorrhagic contusion in cervical spinal cord injury (CSCI) is poorly understood. We investigated hemorrhagic expansion in patients with CSCI with an assigned elevated mean arterial pressure (MAP) goal of >85 mm Hg. The change in hemorrhagic area and long-term follow-up data ≥6 months after injury was studied. ⋯ The present study investigated the clinical safety of elevated MAP goals for patients with CSCI and hemorrhagic contusion. Elevated MAPs did not significantly increase the risk of hemorrhagic expansion in those with CSCI. We have also reported the use of hemorrhagic contusion size as a potential radiographic biomarker for neurological outcomes.
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Intracranial recordings are integral to evaluating patients with pharmacoresistant epilepsy whom noninvasive testing fails to localize seizure focus. Although stereo-electroencephalography is the preferred method of intracranial recordings in most centers, subdural electrode (SDE) implantation is necessary in selected cases. ⋯ Hemorrhagic complications after SDE implantation are difficult to detect because of artifact from electrodes, but predictable by prominent midline shift (>4 mm). Risks inherent to SDE implantation may be minimized using conformal grids. With symptomatic EFCs, a single electrode cable exit site allows hematoma evacuation without terminating intracranial recordings.
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To evaluate the surgical technique and accuracy of S2 alar-iliac (SAI) screw placement using intraoperative O-arm-based 3-dimensional navigation (O-arm). ⋯ SAI screw placement can be safely performed using the intraoperative O-arm system and our surgical technique.