Articles: neuronavigation.
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Review
Improving safety in spinal deformity surgery: advances in navigation and neurologic monitoring.
The treatment of spinal deformities has rapidly changed during the past decade. The advent of new surgical techniques, particularly thoracic pedicle screws and spinal osteotomies, allow more aggressive deformity correction, and require an increased focus on safety. ⋯ Navigation systems today are where intraoperative neuromonitoring was 20 years ago: new, under investigation, not widely accepted, with concerns for cost, safety and efficiency. Navigation enhances the accuracy of pedicle screws placement in deformed spines, reducing the rate of misplaced screws and potential complications. With further use and investigation, navigation, like neuromonitoring, will soon become standard at major spine centers throughout the world.
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Review Case Reports
Safe resection of arteriovenous malformations in eloquent motor areas aided by functional imaging and intraoperative monitoring.
Arteriovenous malformations (AVMs) proximal to motor cortical areas or motor projection systems are challenging to manage because of the risk of severe sensory and motor impairment. Surgical indication in these cases therefore remains controversial. ⋯ Surgical resection of AVMs in eloquent motor areas can be considered a safe option for selected cases when performed in conjunction with a detailed functional assessment. Possible selection criteria for surgical treatment are discussed in light of the presented clinical data.
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Review Case Reports
The use of intraoperative navigation for percutaneous procedures at the skull base including a difficult-to-access foramen ovale.
We describe the use of an intraoperative CT scan obtained using the Medtronic O-arm (Littleton, Massachusetts) for image-guided cannulation of the foramen ovale not previously accessible with the use of fluoroscopy alone. Unlike previously described procedures, this technique does not require placement of an invasive head clamp and may be used with an awake patient. ⋯ Based on our experience, neuronavigation with the use of intraoperative O-arm CT imaging is useful during these cases.
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Review
Frameless stereotactic targeting devices: technical features, targeting errors and clinical results.
Brain biopsies (BB) and depth electrode placements (DEP) are increasingly performed using frameless stereotactic targeting devices. This paper is intended to provide a comprehensive review of the technical features, targeting errors and clinical results. ⋯ Frameless stereotactic targeting devices may reach targeting errors and clinical results comparable with standard frame-based stereotaxy. Advantages and disadvantages of different devices should be acknowledged to ensure optimal technical performance.
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Review article. ⋯ Pedicle screw provides excellent 3-dimensional fixations and is a useful procedure for reconstruction of the cervical spine in various kinds of disorders. Possible neurovascular complication can be minimized by sufficient preoperative imaging studies and strict control of screw placement during surgery.