Articles: neuronavigation.
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Case Reports
Endoscopic aqueductal stenting via the fourth ventricle under navigating system guidance: technical note.
We report three patients with symptomatic isolated fourth ventricle after ventriculoperitoneal shunt placement for hydrocephalus associated with ventricular hemorrhage. All three patients were treated successfully with our new method of endoscopic aqueductal stenting under navigating system guidance. ⋯ Our method of aqueductal stenting is a reasonable choice for initial treatment of patients with isolated fourth ventricle, and it entails less invasive neurosurgery.
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Stereotact Funct Neurosurg · Jan 2005
Clinical TrialFrameless stereotactic ventricular shunt placement for idiopathic intracranial hypertension.
Cerebrospinal fluid (CSF) shunting effectively reverses symptoms of idiopathic intracranial hypertension (IIH). Lumboperitoneal (LP) shunts have traditionally been used in patients with IIH due to a frequently undersized ventricular system. However, the advent of image-guided stereotaxis has enabled effective ventricular catheter placement in patients with IIH. We describe the first large series of frameless stereotactic ventriculoperitoneal (VP) shunting for patients with slit ventricles and IIH. ⋯ In our experience treating patients with IIH, frameless stereotactic ventricular CSF shunts were extremely effective at treating IIH-associated intractable headache, and continued to provide relief in nearly half of patients 2 years after shunting without many of the shunt-related complications that are seen with LP shunts. Placing ventricular shunts using image-guided stereotaxis in patients with IIH despite the absence of ventriculomegaly is an effective, safe treatment option.
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With the advent of frameless stereotaxy and its application to the spine, more precise and less invasive spinal procedures are possible. In addition to being less invasive, these techniques may increase surgeon confidence and allow shorter operating times. Described here is a case of Pott's disease of the thoracolumbar spine and how intraoperative image guidance can facilitate operative progress and accuracy in a patient in whom the underlying disease has severely deformed the normal anatomy of the spine. ⋯ Facilitation with image-guided placement of bicortical vertebral body screws and an interbody device is demonstrated. A diagram of the recommended positioning of the equipment in the operating room is provided along with "pearls" learned from our experience with this application. We believe that even the most experienced and skilled surgeon will find facilitation of anterior thoracolumbar surgery with image guidance to be of considerable benefit.
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Clinical Trial
Intraoperative Iso-C C-arm navigation in cervical spinal surgery: review of the first 52 cases.
Fifty-two study participants underwent cervical spine surgery using intraoperative Iso-C imaging with or without spinal navigation. ⋯ Iso-C intraoperative fluoroscopy is an accurate and rapid way to perform CT-quality image-guided navigation in cervical spinal surgery. In most cases, it obviates the need for postoperative imaging.