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Operative Neurosurgery (Hagerstown, Md.)

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September 13, 2018: Operative Neurosurgery (Hagerstown, Md.)
Ashok Pillai, Ayyadurai Ratnathankom, Sreehari N Ramachandran, Suhas Udayakumaran, Pramod Subhash, Arjun Krishnadas
BACKGROUND: Robotic automation and haptic guidance have multiple applications in neurosurgery. OBJECTIVE: To define the spectrum of cranial procedures potentially benefiting from robotic assistance in a university hospital neurosurgical practice setting. METHODS: Procedures utilizing robotic assistance during a 24-mo period were retrospectively analyzed and classified as stereotactic or endoscopic based on the mode utilized in the ROSA system (Zimmer Biomet, Warsaw, Indiana)...
September 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Gila R Weinstein, Daniel Komlos, Neil Haranhalli, John K Houten
BACKGROUND: Poor cosmetic results following cervical laminectomy and fusion (CLF) are rarely considered in assessing surgical complications. Atrophy from muscle denervation and posterior bone loss may result in a sunken appearance; relative tension may lead to wide, unsightly scars. Paraspinal muscle flaps are routinely employed by plastic surgeons for closure of wound infection and dehiscence. OBJECTIVE: To assess clinical and cosmetic results of CLF with/without a paraspinal muscle flap closure technique...
September 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Daniel G Eichberg, Simon S Buttrick, Jake M Sharaf, Brian M Snelling, Ashish H Shah, Michael E Ivan, Ricardo J Komotar
BACKGROUND: Colloid cysts are challenging lesions to access. Various surgical approaches are utilized which all require brain retraction, creating focal pressure, local trauma, and potentially surgical morbidity. Recently, tubular retractors have been developed that reduce retraction pressure by distributing it radially. Such retractors may be beneficial in colloid cyst resection. OBJECTIVE: To retrospectively review a single neurosurgeon's case series, as well as the literature, to determine the efficacy and safety profile of transtubular colloid cyst resections...
September 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Mithun G Sattur, Karl R Abi-Aad, Fucheng Tian, Matthew E Welz, Barrett Anderies, Bernard R Bendok
We present the case of a 56-yr-old right-handed male, after informed consent was obtained, who presented with acute confusion and agitation, on the background of a remote history of an uncomplicated resection of a left parietal grade 2 glioma. Imaging revealed a large, acute right temporal intracerebral hemorrhage (ICH). Standard vascular workup for the cause of the ICH included catheter angiography. No direct cause of the hemorrhage was revealed; however, a high grade parasagittal dural arteriovenous fistula (DAVF) with cortical venous reflux was noted close to the prior craniotomy site...
September 6, 2018: Operative Neurosurgery (Hagerstown, Md.)
(no author information available yet)
No abstract text is available yet for this article.
September 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Zhimin Pan, Junlong Zhong, Shiming Xie, Limin Yu, Chunyang Wu, Yoon Ha, Keung Nyun Kim, Youshan Zhang, Kai Cao
BACKGROUND: Biomechanical studies revealed that pedicle screw instrumentation has a superior stabilizing effect compared with other internal fixations in reconstructing the subaxial cervical spine. However, severe neurovascular risks preclude surgeons from routinely conducting pedicle screw manipulation in cervical spine. OBJECTIVE: To evaluate the accuracy and safety of the lateral vertebral notch (LVN)-referred technique used in subaxial cervical pedicle screw (CPS) placement...
September 4, 2018: Operative Neurosurgery (Hagerstown, Md.)
Philippe Lavigne, Eric W Wang, Juan C Fernandez-Miranda
The optimal treatment for skull base chordomas is gross total resection followed by radiotherapy and not radiation of partially resected tumors. Supratotal resection, defined as removal beyond all involved bone and dura, is ideal but difficult to achieve. In this video, we present the case of a 37-yr-old man with new onset of progressive cranial nerve sixth palsy and a skull base lesion compatible with clival chordoma. He underwent partial surgical resection at an outside institution via transcranial approach, with significant tumor residual at the clivus, dorsum sella, posterior clinoids, and petrous apex, extensive dural invasion, and intradural extension with attachment to the basilar artery and its long perforating branches...
September 4, 2018: Operative Neurosurgery (Hagerstown, Md.)
Nicole Chwee Har Keong
No abstract text is available yet for this article.
September 4, 2018: Operative Neurosurgery (Hagerstown, Md.)
Charles J Prestigiacomo
No abstract text is available yet for this article.
September 4, 2018: Operative Neurosurgery (Hagerstown, Md.)
Jacob Archer, Andrew Jea
Tethered cord syndrome is a constellation of signs and symptoms involving sensory and motor dysfunction of the lower extremities, bladder, and bowel. The pathophysiology may be from a mechanical stretch of the distal spinal cord causing deleterious changes in blood supply and metabolism. The standard of care for tethered cord syndrome has been tethered cord release. However, drawbacks of traditional tethered cord release include neurological injury, cerebrospinal fluid leak, and intradural scarring and retethering of the spinal cord (secondary tethering)...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Simone E Dekker, Chad A Glenn, Thomas A Ostergard, Mickey L Smith, Brian D Rothstein, Abhishek Ray, Nicholas C Bambakidis
This 3-dimensional operative video illustrates resection of a lumbar schwannoma in a 57-yr-old female who presented with right lower extremity numbness, paresthesias, as well as a long history of lower back pain with rest. On magnetic resonance imaging (MRI), there was evidence of an intradural extramedullary enhancing lesion at L5, nearly completely encompassing the spinal canal. This video demonstrates the natural history, treatment options, surgical procedure, risks, and complications of treatment of these types of tumors...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Corey T Walker, Jakub Godzik, David S Xu, Nicholas Theodore, Juan S Uribe, Steve W Chang
Lateral interbody fusion has distinct advantages over traditional posterior approaches. When adjunctive percutaneous pedicle screw fixation is required, placement from the lateral decubitus position theoretically increases safety and improves operative efficiency by obviating the need for repositioning. However, safe cannulation of the contralateral, down-side pedicles remains technically challenging and often prohibitive. In this video, we present the case of a 59-yr-old man with refractory back pain and bilateral lower extremity radiculopathy that was worse on the left than right side...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Shigeki Yamada, Masatsune Ishikawa, Kazuo Yamamoto
BACKGROUND: Freehand ventricular catheter placement has been reported to have poor accuracy. OBJECTIVE: To investigate whether preoperative computational simulation using diagnostic images improves the accuracy of ventricular catheter placement. METHODS: This study included 113 consecutive patients with normal-pressure hydrocephalus (NPH), who underwent ventriculoperitoneal shunting via a parieto-occipital approach. The locations of the ventricular catheter placement in the last 48 patients with preoperative virtual simulation on the 3-dimensional workstation were compared with those in the initial 65 patients without simulation...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Thomas A Ostergard, Chad A Glenn, Simone E Dekker, Nicholas C Bambakidis
BACKGROUND: When performing a craniotomy involving the orbital bar, the supraorbital notch is a potential landmark to localize the lateral extent of the frontal sinus. Avoidance of the frontal sinus is important to reduce the risk of postoperative surgical site infection, epidural abscess formation, and mucocele development. OBJECTIVE: To determine the reliability of the supraorbital notch as a marker of the lateral location of the frontal sinus. METHODS: Cadaveric dissections were used with image guidance software to define the relationship between the frontal sinus and supraorbital foramen...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Simon Schieferdecker, Clemens Neudorfer, Faycal El Majdoub, Mohammad Maarouf
BACKGROUND: Current treatment options for bladder disorders of neurogenic etiology often leave unsatisfactory results. Therefore, new and effective treatments must be investigated. High-frequency spinal cord stimulation (HF-SCS) at 10 kHz has proven to be effective in the treatment of refractory chronic back and leg pain. OBJECTIVE: To evaluate the efficacy of HF-SCS at 10 kHz in alleviating lower urinary tract dysfunction and bladder incontinence in 5 patients with underlying neurological disease or spinal cord injury, through retrospective study...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Peter A Chiarelli, Anoop P Patel, Amy Lee, Srinivasa R Chandra, Laligam N Sekhar
BACKGROUND AND IMPORTANCE: Refractory ischemic symptoms in moyamoya disease are a challenging problem, particularly in situations in which multiple direct and indirect revascularization techniques have already been employed. In addition, revascularization of the parietal lobes is difficult, as this area is a watershed between the middle cerebral artery and posterior cerebral artery distributions. CLINICAL PRESENTATION: This is the case of a 50-yr-old woman with hemibody sensorimotor deficits, who had previously undergone bilateral arterial bypass and temporalis myosynangiosis...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Justin R Mascitelli, Sirin Gandhi, Claudio Cavallo, Michael J Nanaszko, Ernest J Wright, Michael T Lawton
Brainstem cavernous malformations (CMs) account for 15% to 18% of all intracranial CMs1 and 13% of all cerebrovascular pathology in the posterior fossa.1,2 This video demonstrates the resection of a pontomesencephalic CM through a pretemporal approach through the oculomotor-tentorial triangle (OTT).3 A 49-yr-old woman presented with an acute onset of left hemiparesis, diplopia, vertigo, partial oculomotor, and facial palsy. Neuroimaging revealed a 25-mm diameter right pontomesencephalic CM with evidence of prior hemorrhage...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Joshua E Meyers, Asham Khan, John Pollina
Recent years have shown an increase in implementing robotics in surgical procedures. Utilizing robotic technology in spine surgery remains limited in comparison to other surgical fields. We present a surgical video of minimally invasive robotic-assisted insertion of posterior pedicle screws using the newest generation robotic technology (Mazor X, Mazor Robotics Ltd, Caesarea, Israel), in a 29-yr-old man who suffers from Grade I degenerative spondylolisthesis at L5-S1 levels and severe, right-sided foraminal stenosis...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
Federico Landriel, Santiago Hem, Claudio Yampolsky
Dumbbell-shaped thoracic tumors usually involve the spinal canal and the posterior thoracic cavity. Gross total resection is the treatment of choice, but techniques for surgical excision remain controversial. An anterolateral transthoracic approach may remove the paravertebral component of the tumor, but has limited or no control of the intracanal lesion. A combined posteroanterior approach requires a 2-stage surgery with significant morbidity. The preferred approach depends mainly on the tumor location, size, shape, and its specific anatomical relationship with the surrounding vital structures...
August 30, 2018: Operative Neurosurgery (Hagerstown, Md.)
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