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1 Expanding neurosurgeryThe history of medicine is replete with innovations in neurosurgery that have spurred further developments across the medical spectrum. Surgeons treating pathologies in the head and spine have broken ground with new approaches, techniques, and technologies since ancient times. Neurosurgeons occupy a...2014-01-01
2 Transtemporal approach to the removal of a lateral pontine tumorThis video demonstrates a very useful trajectory to a pontine lesion. A 68-year-old man presented with tongue numbness and weakness. The approach used was a transtemporal presigmoid retrolabyrinthine approach to enable an orthogonal trajectory to the lateral pons. Following the transtemporal opening...2014-01-01
3 Intracranial hypotension as a complication of lumbar puncture prior to elective aneurysm clippingBackground: Lumbar dural defects are an uncommon but important cause of persistent intracranial hypotension in the neurosurgical population. We present a case of intracranial hypotension after elective craniotomy due to a lumbar puncture performed 3 weeks earlier. Case Description: A 55‑year‑old...2014-01-01
4 Response to Craniopharyngioma adherence to the hypothalamusTo The Editor: We have viewed with great interest the special supplement published by Neurosurgical Focus in January 2013 (Neurosurgical Focus, Video Atlas of Operative Surgery: Intraventricular Lesions: Microscopic and Endoscopic Approaches, Vol 34: January 2013) in which a compilation of videos de...2014-01-01
5 Management of meningiomas involving the transverse or sigmoid sinusMeningiomas that invade the transverse or sigmoid sinuses are uncommon tumors that are challenging to treat surgically. Although the risk of recurrence is associated with the extent of resection, complete removal of meningiomas in these locations must be balanced with avoidance of venous outflow obs...2013-01-01
6 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 3: Assessment of economic outcomeA comprehensive economic analysis generally involves the calculation of indirect and direct health costs from a societal perspective as opposed to simply reporting costs from a hospital or payer perspective. Hospital charges for a surgical procedure must be converted to cost data when performing a c...2014-01-01
7 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 4: Radiographic assessment of fusion statusThe ability to identify a successful arthrodesis is an essential element in the management of patients undergoing lumbar fusion procedures. The hypothetical gold standard of intraoperative exploration to identify, under direct observation, a solid arthrodesis is an impractical alternative. Therefore...2014-01-01
8 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 9: Lumbar fusion for stenosis with spondylolisthesisPatients presenting with stenosis associated with a spondylolisthesis will often describe signs and symptoms consistent with neurogenic claudication, radiculopathy, and/or low-back pain. The primary objective of surgery, when deemed appropriate, is to decompress the neural elements. As a result of t...2014-01-01
9 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 7: Lumbar fusion for intractable low-back pain without stenosis or spondylolisthesisEstablishing an appropriate treatment strategy for patients presenting with low-back pain, in the absence of stenosis or spondylolisthesis, remains a controversial subject. Inherent to this situation is often an inability to adequately identify the source of low-back pain to justify various treatmen...2014-01-01
10 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: Assessment of functional outcome following lumbar fusionAssessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with l...2014-01-01
11 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 8: Lumbar fusion for disc herniation and radiculopathyPatients suffering from a lumbar herniated disc will typically present with signs and symptoms consistent with radiculopathy. They may also have low-back pain, however, and the source of this pain is less certain, as it may be from the degenerative process that led to the herniation. The surgical al...2014-01-01
12 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 6: Discography for patient selectionIdentifying the etiology of pain for patients suffering from chronic low-back pain remains problematic. Noninvasive imaging modalities, used in isolation, have not consistently provided sufficient evidence to support performance of a lumbar fusion. Provocative testing has been used as an adjunct in ...2014-01-01
13 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 16: Bone graft extenders and substitutes as an adjunct for lumbar fusionIn an attempt to enhance the potential to achieve a solid arthrodesis and avoid the morbidity of harvesting autologous iliac crest bone (AICB) for a lumbar fusion, numerous alternatives have been investigated. The use of these fusion adjuncts has become routine despite a lack of convincing evidence ...2014-01-01
14 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 13: Injection therapies, low-back pain, and lumbar fusionThe medical literature continues to fail to support the use of lumbar epidural injections for long-term relief of chronic back pain without radiculopathy. There is limited support for the use of lumbar epidural injections for short-term relief in selected patients with chronic back pain. Lumbar intr...2014-01-01
15 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 14: Brace therapy as an adjunct to or substitute for lumbar fusionThe utilization of orthotic devices for lumbar degenerative disease has been justified from both a prognostic and therapeutic perspective. As a prognostic tool, bracing is applied prior to surgery to determine if immobilization of the spine leads to symptomatic relief and thus justify the performanc...2014-01-01
16 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 17: Bone growth stimulators as an adjunct for lumbar fusionThe relationship between the formation of a solid arthrodesis and electrical and electromagnetic energy is well established; most of the information on the topic, however, pertains to the healing of long bone fractures. The use of both invasive and noninvasive means to supply this energy and supplem...2014-01-01
17 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 11: Interbody techniques for lumbar fusionInterbody fusion techniques have been promoted as an adjunct to lumbar fusion procedures in an effort to enhance fusion rates and potentially improve clinical outcome. The medical evidence continues to suggest that interbody techniques are associated with higher fusion rates compared with posterolat...2014-01-01
18 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 12: Pedicle screw fixation as an adjunct to posterolateral fusionThe utilization of pedicle screw fixation as an adjunct to posterolateral lumbar fusion (PLF) has become routine, but demonstration of a definitive benefit remains problematic. The medical evidence indicates that the addition of pedicle screw fixation to PLF increases fusion rates when assessed with...2014-01-01
19 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 10: Lumbar fusion for stenosis without spondylolisthesisLumbar stenosis is one of the more common radiographic manifestations of the aging process, leading to narrowing of the spinal canal and foramen. When stenosis is clinically relevant, patients often describe activity-related low-back or lower-extremity pain, known as neurogenic claudication. For tho...2014-01-01
20 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 1: Introduction and methodologyFusion procedures are an accepted and successful management strategy to alleviate pain and/or neurological symptoms associated with degenerative disease of the lumbar spine. In 2005, the first version of the "Guidelines for the performance of fusion procedures for degenerative disease of the lumbar ...2014-01-01
21 Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 15: Electrophysiological monitoring and lumbar fusionIntraoperative monitoring (IOM) is commonly used during lumbar fusion surgery for the prevention of nerve root injury. Justification for its use stems from the belief that IOM can prevent nerve root injury during the placement of pedicle screws. A thorough literature review was conducted to determin...2014-01-01
22 The frontotemporal (Pterional) approach: an historical perspectiveThe frontotemporal, so-called "pterional" approach has evolved with the contribution of many neurosurgeons over the past century. It has stood the test of time and been the most commonly used transcranial approach in neurosurgery. In its current form, drilling the sphenoid wing as far down as the su...2012-01-01
23 Lateral mass screw fixation in the cervical spineTo The Editor: We read with interest the article by Kawabata et al.15 (Kawabata S, Watanabe K, Hosogane N, et al: Surgical correction of severe cervical kyphosis in patients with neurofibromatosis Type 1. Report of 3 cases. J Neurosurg Spine 18:274-279, March 2013). Reconstructive spinal surgery has...2014-01-01
24 Submandibular high-flow bypass in the treatment of skull base lesions: an analysis of long-term outcomeBackground: Cerebral bypass surgery remains an integral part of the treatment of complex skull base tumors and unclippable aneurysms. Objective: The authors retrospectively analyzed a single-surgeon experience using a high-flow submandibular-infratemporal saphenous vein graft bypass technique after ...2012-01-01
25 Intraoperative aneurysmal subarachnoid hemorrhage after rupture of a previously undiagnosed intracranial aneurysm during Chiari decompression: case report and literature reviewType 1 Chiari malformation occurs when caudal displacement of cerebellar tonsils below the level of foramen magnum obstructs the normal flow of cerebrospinal fluid (CSF) between the cranial and spinal spaces, a condition that often needs surgical decompression to restore normal CSF circulation. Abru...2014-01-01
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