Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Feb 2010
Comparative StudyMinimally invasive approach versus traditional open approach for one level posterior lumbar interbody fusion.
While over the last ten years minimally invasive posterior lumbar interbody fusion (PLIF) has been acknowledged to (i) reduce approach-related morbidity associated with quicker recovery, (ii) require a shorter hospital stay and (iii) deliver similar clinical outcomes when compared to a traditional approach, it is still not the current gold standard. In order to demonstrate the efficacy of the minimally invasive lumbar PLIF approach, a retrospective study was conducted comparing both approaches. ⋯ This study confirmed the results of previous studies which advocated the advantages of less blood loss, less postoperative pain, quicker recovery and shorter duration of hospitalization. However, in the long run, one year after surgery, both groups showed no significant difference with regards to clinical and radiographic outcome. Therefore long-term controlled studies are necessary to validate the role of the minimally invasive PLIF in degenerative lumbar instability.
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Minim Invasive Neurosurg · Feb 2010
The true distal posterior inferior cerebellar artery aneurysm: clinical characteristics and strategy for treatment.
A series of aneurysms located at the 4 (th) or 5 (th) segment of the posterior inferior cerebellar artery (PICA) has not been previously reported in the literature. We report six such cases and analyze their clinical characteristics and outcomes from three different treatment strategies. ⋯ Surgery for the true distal PICA aneurysm results in good clinical outcomes. Clipping or wrapping should be considered as the first choice for treatment, and sacrificing the parent artery of the distal PICA aneurysm is relatively safer than selective coiling. The type of parent artery and particularly the collateralization of its distal part should be considered as an essential factor to take into consideration when choosing a treatment strategy.
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Minim Invasive Neurosurg · Oct 2009
Risk factors for regrowth of intracranial meningiomas after gamma knife radiosurgery: importance of the histopathological grade and MIB-1 index.
The influence of histopathological grade and MIB-1 index of intracranial meningioma on the results of its radiosurgical management is not clear. The objective of the present retrospective study was to make an evaluation of these factors along with an analysis of other variables associated with progression-free survival after gamma knife radiosurgery (GKR). ⋯ Radiosurgery is a highly effective management option for benign intracranial meningiomas, but growth control of non-benign ones is significantly worse. It requires close neuroradiological follow-up and necessitates the search for modified treatment strategies.
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Minim Invasive Neurosurg · Oct 2009
Comparative StudyEffectiveness, security and height restoration on fresh compression fractures--a comparative prospective study of vertebroplasty and kyphoplasty.
Painful fractures of the spine pose a serious clinical problem which gains in importance with the increasing ageing of our population. When conservative treatment of these fractures fails, with vertebroplasty and kyphoplasty we have two percutaneous minimally invasive stabilising procedures at our disposal. ⋯ This study compares vertebroplasty and kyphoplasty with regard to their effectiveness, safety, and restoration of vertebral body height, and complications. There were no differences between the groups with regard to quality of life and pain improvement, but the rate of serious complications was higher after vertebroplasty. Mean vertebral body height restoration at 1 year follow-up was significantly higher (p<0.05) in the kyphoplasty group. It remains to be seen in future long-term studies whether or not restoration of vertebral body height has an effect on the clinical result.
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Minim Invasive Neurosurg · Oct 2009
Microsurgical treatment for typical pituitary apoplexy with 44 patients, according to two pathological stages.
The aim of this study was to explore the pathogenesis of typical pituitary apoplexy in different periods, to help to formulate a reasonable treatment program and to select the correct operation time. ⋯ Typical pituitary apoplexy is mainly caused by hemorrhage secondary to necrosis after infarction. The staging of this disease provides an important guidance value to diagnosis and treatment. The surgical outcomes in the late stage were significantly better than those in the early stage. The patients without significant symptoms can be conservatively treated by hormone substitution therapy.