Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Jun 2011
Minimally invasive technique for decompression of lumbar foraminal stenosis using a spinal microendoscope: technical note.
Lumbar foraminal stenosis is a troublesome disease. Decompression of the whole length of the nerve root from the spinal canal to extraforaminal zone is often a surgical requirement due to the difficulty in identifying the nerve compression site before surgery, making preservation of the posterior elements difficult. The authors report a minimally invasive microendoscopic technique for lumbar foraminal stenosis to decompress the entire length of the nerve root from the spinal canal to the extraforaminal zone while preserving the posterior elements. ⋯ This microendoscopic technique proved to be useful for the treatment of lumbar foraminal stenosis.
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Since the first reported endoscopic treatment of colloid cysts of the third ventricle by Powel et al. in 1983, several endoscopic techniques have been described. Therefore, the authors describe their technique of neuroendoscopic colloid cyst removal, developed during the last 16 years. ⋯ With the described endoscopic technique, complete removal of colloid cysts is possible in almost 90 % of cases.
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Minim Invasive Neurosurg · Apr 2011
Randomized Controlled TrialTopical anesthetic EMLA for postoperative wound pain in stereotactic gamma knife radiosurgery: a perspective, randomized, placebo-controlled study.
Patients who undergo stereotactic gamma knife radiosurgery (GKRS) need a rigid frame fixation for the stereotactic procedures. Many patients suffered from postoperative wound pain after frame removal. The present study investigated whether an additional application of a topical anesthetic prior to frame removal could reduce this discomfort. ⋯ EMLA when applied 60 min before frame removal has an anesthetic effect of reducing the postoperative wound pain in patients who undergo GKRS.
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Minim Invasive Neurosurg · Feb 2011
A laparoscopic approach to ventriculoperitoneal shunt placement with a novel fixation method for distal shunt catheter in the treatment of hydrocephalus.
The laparoscopically assisted ventriculoperitoneal (VP) shunt has been widely used in the clinical treatment of hydrocephalus for its simplicity and reliability. Despite significant improvements in shunt procedures, shunt complications remain common. Our clinical experiences suggest that the fixation of the distal (peritoneal) shunt catheter using threads and hemoclips may partially contribute to complications of the distal shunt including obstruction of the shunt and infection. In this study, we explored a novel fixation method in the laparoscopically assisted VP shunt with use of the liver falciform ligament as a natural support for fixation of the distal shunt catheter. ⋯ The modified laparoscopically assisted VP shunt in the treatment of hydrocephalus with fixation of the distal shunt catheter to a natural anatomic structure could potentially reduce the necessity of repeat surgery for addressing the complications caused by catheter obstruction and infections, reduce the chance of adhesions, and would be of benefit to those patients who need future revisions.
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Minim Invasive Neurosurg · Feb 2011
Review Comparative StudyPost-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis.
Surgical site infection (SSI) in the setting of lumbar fusion is associated with significant morbidity and medical resource utilization. To date, there have been no studies conducted with sufficient power to directly compare the incidence of SSI following minimally invasive (MIS) vs. open TLIF procedures. Furthermore, studies are lacking that quantify the direct medical cost of SSI following fusion procedures. We set out to determine the incidence of SSI in patients undergoing MIS vs. open TLIF reported in the literature and to determine the direct hospital cost associated with the treatment of SSI following TLIF at our institution. ⋯ Post-operative wound infections following TLIF are costly complications. MIS vs. open TLIF is associated with a decreased reported incidence of SSI in the literature and may be a valuable tool in reducing hospital costs associated with spine care.