Effectiveness of an Annular Closure Device to Prevent Recurrent Lumbar Disc Herniation: A Secondary Analysis With 5 Years of Follow-up.

Importance: Patients with large annular defects following lumbar microdiscectomy for disc herniation are at increased risk for symptomatic recurrence and reoperation.

Objective: To determine whether a bone-anchored annular closure device in addition to lumbar microdiscectomy resulted in lower reherniation and reoperation rates vs lumbar microdiscectomy alone.

Design, Setting, And Participants: This secondary analysis of a multicenter randomized clinical trial reports 5-year follow-up for enrolled patients between December 2010 and October 2014 at 21 clinical sites.

High accuracy of external ventricular drainage placement using anatomical landmarks.

Background: The conventional approach for external ventricular drainage (EVD) application is the freehand method. Technical devices can improve the accuracy of placement, but they have not yet replaced anatomical landmarks owing to the cost and effort that they entail. There is disagreement as to whether freehand EVD application is safe enough to be accepted as a standard technique.

Focusing on foot drop: Results from a patient survey and clinical examination.

Background: Epidemiological data concerning the symptom 'foot drop' are scarce in the literature. However, everyday practice shows that this symptom is frequent, and that patients who suffer from it are significantly disabled.

Methods: A special 'foot-drop consulting hour' to examine and advise people with foot drop was founded.

Use of processed bovine pericard in peripheral nerve surgery.

Objective: Nerve damage often means a loss of the epi- and perineural sheaths, an adherence to the surrounding tissue and a loss of smooth movements. This leads to pain and functional deficits. Creating a gliding apparatus for damaged nerves is a possibility to restore physiological function and interrupt the vicious circle of pain.

Posterolateral myelotomy for intramedullary spinal cord tumors: the other way to do it?

Background And Purpose: To evaluate posterolateral myelotomy (PLM) as a surgical method for all cases of intramedullary spinal cord tumors (IMSCT) by assessing the surgical and functional outcomes of patients treated in our clinic.

Materials And Methods: Patients with IMSCT who underwent surgery using PLM from 2013 to 2018 were reviewed retrospectively. Objective and quantitative assessment of the preoperative, postoperative, and follow-up neurological status was performed by using the modified McCormick functional schema and sensory pain scale.

Comparison between optical coherence tomography imaging and histological sections of peripheral nerves.

Objective: Optical coherence tomography (OCT) is an imaging technique that uses the light-backscattering properties of different tissue types to generate an image. In an earlier feasibility study the authors showed that it can be applied to visualize human peripheral nerves. As a follow-up, this paper focuses on the interpretation of the images obtained.

Brainatomy: A Novel Way of Teaching Sphenoid Bone Anatomy With a Simplified 3-Dimensional Model.

Background: The diagnosis and treatment of diseases at and around the sphenoid bone demands throughout understanding of its anatomy in 3-dimensional (3-D) space. However, despite the complex anatomic nature of the sphenoid bone, the current educational resources for its 3-D anatomy are insufficient for fast and long-term retention of the anatomic relationships.

Objective: To provide a simplified 3-D model of the sphenoid bone that anyone can easily learn and recall as an internal mental model.

The Interdisciplinary Management of Foot Drop.

Background: Foot drop can be caused by a variety of diseases and injuries. Although it is a common condition, its overall incidence has not been reported to date. Foot drop markedly restricts the everyday activities of persons suffering from it.

High-resolution in vivo imaging of peripheral nerves using optical coherence tomography: a feasibility study.

Objective: Because of their complex topography, long courses, and small diameters, peripheral nerves are challenging structures for radiological diagnostics. However, imaging techniques in the area of peripheral nerve diseases have undergone unexpected development in recent decades. They include MRI and high-resolution sonography (HRS).

Experimental investigations of a manually versus an electrically driven skull drill for bedside usage.

Background: Manual skull drilling is an old but in modern neurosurgery still established procedure which can be applied quickly and universally in emergency situations. Electrical drilling requires more complex equipment and is usually reserved to the Operating Room (OR). It also seems desirable to apply an electrical drill for bedside usage but a suitable product does not exist so far.

Rare finding in peripheral nerve surgery: an unicentric Castleman disease presenting as median nerve tumour.

A 51 year old man presented with progressive swelling in the upper arm. MRI revealed a solitary mass extending from the median nerve. Intraoperative finding was a tumour extending within the nerve in its proximal fibres.

Development of a brain simulator for intracranial targeting: Technical note.

Learning and enhancing of manual skills in the field of neurosurgery requires an intensive training which can be maintained by using virtual reality (VR)-based or physical model (PM)-based simulators. However, both simulator types are limited to one specific intracranial procedure, e.g.

Reliability and scientific use of a surgical planning software for anterior cervical discectomy and fusion (ACDF).

Purpose: Software-based planning of a spinal implant inheres in the promise of precision and superior results. The purpose of the study was to analyze the measurement reliability, prognostic value, and scientific use of a surgical planning software in patients receiving anterior cervical discectomy and fusion (ACDF).

Methods: Lateral neutral, flexion, and extension radiographs of patients receiving tailored cages as suggested by the planning software were available for analysis.

One-step CAD/CAM titanium cranioplasty after drilling template-assisted resection of intraosseous skull base meningioma: technical note.

Introduction: Cranial defects following intra-osseous tumor removal may be large and require adequate reconstruction. CAD/CAM implants have been used for years to achieve an optimal cosmetic result. The disadvantage is that such implants require a second surgery.

Complications associated with cervical vertebral body replacement with expandable titanium cages.

Our aim was to analyze complications and risk factors for cervical vertebral body replacement (VBR) with expandable titanium cages (ETC). Fifty patients; 22 women and 28 men, mean age 61years, undergoing cervical VBR from 2010 to 2015 were analyzed. Complications were stratified by hardware-association (HA).

Radiological and clinical results of patients after ACDF with and without preoperative software-assisted cage selection.

Objective: Comparison of software facilitated preoperatively-selected cages versus standard intraoperatively-selected cages, assessing radiological and clinical outcomes of patients after single level cervical discectomy and fusion (ACDF).

Methods: Cages of study group patients were preoperatively chosen via software-aided dimensioning. Controls obtained cages determined by intraoperative trail implants.

Sonographic examination of the median nerve in dialysis patients and after renal transplantation.

Objective: Patients with renal insufficiency are predisposed to develop CTS (carpal tunnel syndrome). In particular, long-term dialysis seems to contribute to changes in median nerve texture which lead to an increased risk for CTS. The current study was designed to evaluate if these structural changes can be detected by HRS (high-resolution sonography).

Single-center experience in the endovascular treatment of wide-necked intracranial aneurysms with a bridging intra-/extra-aneurysm implant (pCONus).

Purpose: To retrospectively evaluate the safety and efficacy of the endovascular treatment of wide-necked intracranial aneurysms assisted by a novel intra-/extra-aneurysm stent-like implant (pCONus).

Methods: Initial and follow-up angiographic and clinical results are presented of 25 patients with 25 unruptured and ruptured wide-necked intracranial aneurysms treated by reconstruction of the aneurysm neck using the pCONus implant followed by coil occlusion of the fundus.

Results: Successful intra-/extra-aneurysm deployment of the pCONus with coil occlusion of the fundus was achieved in all but one case.

Lumbar juxta-facet joint cysts in association with facet joint orientation, -tropism and -arthritis: A case-control study.

Objective: To assess the association between juxta-facet-joint cysts (JFC) occurrence at the lumbar spine and Facet Joint (FJ) orientation, -tropism and -arthritis.

Methods: Study group, 36 consecutive patients with JFC and the same number of controls, with degenerative diseases without JFC were match paired for demographics and spine segment. Parameter assessment was by T2-weighted axial MRI scans.

Repeat-surgery at Glioblastoma recurrence, when and why to operate?

Objective: Glioblastoma (GB) recurrence is inevitable; guidelines for treatment at disease recurrence are deficient. Clinicians are faced with deciding whom to choose for repeat-surgery. This study analyzes recurrence therapy modalities, investigates characteristics of patients operated on at recurrence and evaluates outcome benefit.

Risk factors for glioblastoma therapy associated complications.

Objective: Thromboembolic events, seizures, neurologic symptoms and adverse effects from corticosteroids and chemotherapies are frequent clinical complications seen in Glioblastoma (GB) patients. The exact impact these have on dismal patient outcome has not been fully elucidated. We aimed at assessing treatment associated complications, evaluating the impact on survival and defining risk factors.

Aortic morphometry at endograft position as assessed by 3D image analysis affects risk of type I endoleak formation after TEVAR.

Purpose: The purpose of this study was to identify morphologic factors affecting type I endoleak formation and bird-beak configuration after thoracic endovascular aortic repair (TEVAR).

Methods: Computed tomography (CT) data of 57 patients (40 males; median age, 66 years) undergoing TEVAR for thoracic aortic aneurysm (34 TAA, 19 TAAA) or penetrating aortic ulcer (n = 4) between 2001 and 2010 were retrospectively reviewed. In 28 patients, the Gore TAG® stent-graft was used, followed by the Medtronic Valiant® in 16 cases, the Medtronic Talent® in 8, and the Cook Zenith® in 5 cases.

Charlson comorbidity index: an additional prognostic parameter for preoperative glioblastoma patient stratification.

Purpose: Dismal glioblastoma (GB) patient outcome calls for the elucidation of further reliable predictors of prognosis. Established "biomarkers," age and functional status, employed in today's patient stratification have limits in fingerprinting this heterogeneous tumor entity. We aimed at ascertaining additional prognostic factors that may facilitate patient stratification for surgery.

Influence of cervical bone mineral density on cage subsidence in patients following stand-alone anterior cervical discectomy and fusion.

Purpose: Anterior cervical discectomy and fusion (ACDF) is a common procedure for the treatment of cervical degenerative diseases. However, cage subsidence remains a frequent problem. We therefore investigated if cage design and site-specific bone mineral density (BMD) contribute to the rate and direction of subsidence following ACDF.