Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Oct 2011
Case ReportsStereotactic brainstem biopsy in a patient with coagulopathy of unclear etiology: case report.
Parenchymal hemorrhage is one of the most feared risks of stereotactic brain biopsies potentially resulting in neurological deficits or even a fatal outcome. Patients with disorders of the coagulation system are at particular risk, so identifying these is one of the main tasks prior to surgery. Some patients may have a bleeding tendency despite normal laboratory values of the hemostatic system. ⋯ A medication scheme with tranexamic acid and desmopressin effectively decreased the patient's bleeding time in vivo and the procedure was carried out without complications.
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Minim Invasive Neurosurg · Oct 2011
Supraorbital keyhole approach to upper basilar artery aneurysms via the optico-carotid window: a cadaveric anatomic study and preliminary application.
No anatomic data are available addressing the surgical indication for upper BA aneurysms via the supraorbital keyhole approach (SOKA). ⋯ When the width and length of the OCW are > 5 mm and > 7 mm, respectively, the SOKA can meet the requirement of exposure and manipulation of the upper BA. The upper BA aneurysms located < 10 mm higher than the anterior fossa and not more than 5 mm lower than the PCP can be treated via the SOKA. Posterior clinoidectomy and orbitectomy can increase the proximal and the distal exposure of the BA, respectively.
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Minim Invasive Neurosurg · Oct 2011
Case ReportsDecompression procedure using a microendoscopic technique for thoracic myelopathy caused by ossification of the ligamentum flavum.
Microendoscopic discectomy (MED) is one of the minimally invasive endoscopic procedures for treating lumbar disc herniation. The aim of this case report is to describe a patient with thoracic ossification of the ligamentum flavum (OLF) that was completely removed using the microendoscopic technique. ⋯ The authors found that the microendoscopic technique could be applied to decompression surgery for thoracic OLF. The procedure could provide a sufficient decompression with minimum damage to the paraspinal muscles. However, the microendoscopic procedure should be indicated only for select thoracic OLF, such as OLF without fusion at the middle of the spinal canal and OLF without dural ossification, because of its technical difficulties.
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Minim Invasive Neurosurg · Oct 2011
Prevention of development of postoperative dysesthesia in transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation: floating retraction technique.
Transforaminal percutaneous endoscopic lumbar discectomy (PELD) has become a routine surgical procedure because it is minimally invasive. Perioperative complications such as dural injury, infection, nerve root irritation and recurrence can occur not only with PELD, but also with conventional open microsurgery. In contrast, post-operative dysesthesia (POD) due to existing dorsal root ganglion (DRG) injury is a unique complication of PELD. When POD occurs, even if the traversing root has been successfully decompressed, it hinders swift recovery and delays the return to daily routines. Thus, prevention of POD is the key to successful and widespread use of PELD. ⋯ Transforaminal percutaneous endoscopic lumbar discectomy for intracanalicular lumbar disc herniation is a safe and effective procedure. The floating retraction technique is recommended to avoid development of POD.
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Minim Invasive Neurosurg · Oct 2011
A novel percutaneous technique to implant plate-type electrodes.
In spinal cord stimulation (SCS) mainly 2 distinctive implantation techniques can be recognized: the percutaneous and surgical technique. ⋯ We present a novel technique to introduce small profile paddle leads (S-Series™: St. Jude Medical - Neuromodulation Division, Plano, TX) in the epidural space via a percutaneous approach using the Epiducer™ (St. Jude Medical - Neuromodulation Division, Plano, TX) lead delivery system.