Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2017
Does Navigation Improve Pedicle Screw Placement Accuracy? Comparison Between Navigated and Non-navigated Percutaneous and Open Fixations.
The aim of our study was to assess how a preoperative computed tomography (CT)-based navigation system affected the correctness and safety of transpedicular screw insertion, compared with standard techniques. ⋯ Our results confirm the advantages of the navigation technique, which ensures greater accuracy, in open as well as percutaneous procedures.
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Acta Neurochir. Suppl. · Jan 2017
Clinical and Neuropsychological Outcome After Microsurgical and Endovascular Treatment of Ruptured and Unruptured Anterior Communicating Artery Aneurysms: A Single-Enter Experience.
Anterior communicating artery (ACoA) aneurysms have a high risk of rupture. Morbidity and mortality following rupture are higher than at other sites. The aim of this study was to evaluate the long-term clinical and neuropsychological outcomes of patients treated for ruptured and unruptured ACoA aneurysms: a comparison between surgical and endovascular treatment was performed. ⋯ The presence of subarachnoid hemorrhage is more important than the type of treatment in determining the clinical and neuropsychological outcomes of ACoA treatment; these outcomes can be improved by adequate rehabilitation protocols.
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Acta Neurochir. Suppl. · Jan 2017
Functional Reconstruction of Motor and Language Pathways Based on Navigated Transcranial Magnetic Stimulation and DTI Fiber Tracking for the Preoperative Planning of Low Grade Glioma Surgery: A New Tool for Preservation and Restoration of Eloquent Networks.
Surgery of low-grade gliomas (LGGs) in eloquent areas still presents a challenge. New technologies have been introduced to enable the performance of "functional", customized preoperative planning aimed at maximal resection, while reducing the risk of postoperative deficits. We describe our experience in the surgery of LGGs in eloquent areas using preoperative planning based on navigated transcranial magnetic stimulation (nTMS) and diffusion tensor imaging (DTI) tractography. ⋯ The functional preoperative mapping of speech and motor pathways based on nTMS and DTI tractography provided useful information, allowing us to plan the best surgical strategy for radical resection; this resulted in improved postoperative neurological results.
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Acta Neurochir. Suppl. · Jan 2017
Functional Magnetic Resonance Imaging (fMRI), Pre-intraoperative Tractography in Neurosurgery: The Experience of Sant' Andrea Rome University Hospital.
The goal of neurosurgery for cerebral intraparenchymal neoplasms of the eloquent areas is maximal resection with the preservation of normal functions, and minimizing operative risk and postoperative morbidity. Currently, modern technological advances in neuroradiological tools, neuronavigation, and intraoperative magnetic resonance imaging (MRI) have produced great improvements in postoperative morbidity after the surgery of cerebral eloquent areas. The integration of preoperative functional MRI (fMRI), intraoperative MRI (volumetric and diffusion tensor imaging [DTI]), and neuronavigation, defined as "functional neuronavigation" has improved the intraoperative detection of the eloquent areas. ⋯ We found a high concordance between fMRI/DTI and intraoperative brain mapping; their combination improves the sensitivity of each technique, reducing pitfalls and so defining "functional neuronavigation", increasing the definition of eloquent areas and also reducing the time of surgery.
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Acta Neurochir. Suppl. · Jan 2017
Restoration of Thoracolumbar Spine Stability and Alignment in Elderly Patients Using Minimally Invasive Spine Surgery (MISS). A Safe and Feasible Option in Degenerative and Traumatic Spine Diseases.
Minimally invasive spine surgery (MISS), including percutaneous pedicle-screw fixation (PPSF), mini-open transforaminal lumbar interbody fusion (m-open TLIF), vertebroplasty, and stentoplasty, allows the preservation of neurological function and the restoration of spine stability, while reducing associated risks and complications. This study aimed to analyze the safety and efficacy of MISS in elderly patients suffering from degenerative or traumatic thoracolumbar diseases. Forty-five patients (28 females), with a mean age of 73 years (range 65-89), suffering from osteoporotic vertebral fractures (24), degenerative spondylolisthesis (15), and lumbar canal stenosis with instability and/or de novo scoliosis (6) were included. ⋯ Only three patients developed postoperative complications. No patients showed neurological deficits. Minimally invasive spine surgery for degenerative and traumatic spinal diseases is a safe and effective treatment also in elderly patients.