Peri-Insular Hemispherotomy: A Systematic Review and Institutional Experience.

Introduction: Peri-insular hemispherotomy (PIH) is a hemispheric separation technique under the broader hemispherotomy group, a surgical treatment for patients with intractable epilepsy. Hemispherotomy techniques such as the PIH, vertical parasagittal hemispherotomy (VPH), and modified-lateral hemispherotomy are commonly assessed together, despite significant differences in anatomical approach and patient selection. We aim to describe patient selection, outcomes, and complications of PIH in its own right.

Growth of Intramedullary Spinal Cord Dermoid Cyst from a Congenital Thoracic Dermal Sinus Tract after Negative Screening Ultrasound Imaging.

Introduction: Intramedullary thoracic dermoid cysts are rare lesions that are associated with dermal sinus tracts (DSTs). Current recommendations advocate for imaging-based screening of suspected DSTs shortly after birth to exclude associated inclusion lesions.

Case Presentation: A 6-year-old male child presented with a 2-week history of progressive ataxia, lower limb weakness, and hyperreflexia.

Experiences and views of patients, carers and healthcare professionals on using modems in domiciliary non-invasive ventilation (NIV): a qualitative study.

Background: Advances in technology means that domiciliary non-invasive ventilation (NIV) devices can be remotely monitored via modems in patients' homes. Possible benefits and challenges of modem technology have yet to be established. This study explored the perspectives and experiences of patients, their carers and healthcare professionals (HCPs) on the addition of modem technology in managing home NIV.

Using domiciliary non-invasive ventilator data downloads to inform clinical decision-making to optimise ventilation delivery and patient compliance.

Introduction: Ventilation parameter data from patients receiving home mechanical ventilation can be collected via secure data cards and modem technology. This can then be reviewed by clinicians and ventilator prescriptions adjusted. Typically available measures include tidal volume (V), leak, respiratory rate, minute ventilation, patient triggered breaths, achieved pressures and patient compliance.

The surgical learning curve and accuracy of minimally invasive lumbar pedicle screw placement using CT based computer-assisted navigation plus continuous electromyography monitoring - a retrospective review of 627 screws in 150 patients.

Objective: This study retrospectively assessed the accuracy of placement of lumbar pedicle screws placed by a single surgeon using a minimally-invasive, intra-operative CT-based computer navigated technique in combination with continuous electromyography (EMG) monitoring. The rates of incorrectly positioned screws were reviewed in the context of the surgeon's experience and learning curve.

Methods: Data was retrospectively reviewed from all consecutive minimally invasive lumbar fusions performed by the primary author over a period of over 4 years from April 2008 until October 2012.

Complications from minimally invasive lumbar interbody fusion: experience from 100 patients.

Minimally invasive lumbar fusion is well described and is reported to offer significant advantages to patients in terms of blood loss, a reduction in post-operative pain and a quicker recovery. However, this technique may expose patients to a greater risk of complications when compared to open lumbar instrumented fusion that may negate these advantages. Between January 2007 and March 2001, we conducted a prospective observational study of 100 consecutive patients (48 males and 52 females, mean age of 54 years) to investigate complications occurring from minimally invasive lumbar interbody fusion surgery using an image-guided technique.

Minimally invasive lumbar decompression: long-term outcome, morbidity, and the learning curve from the first 50 cases.

Study Design: Prospective observational study.

Objective: To describe our experience with the first 50 cases of minimally invasive lumbar canal decompression in terms of patient outcome up to 2 years, the learning curve incurred, and complications when compared with our most recent 50 cases.

Summary Of Background Data: Lumbar canal stenosis is a common condition in the elderly population, the symptoms of which respond well to surgical decompression.

Safety and efficacy of intradural extramedullary spinal tumor removal using a minimally invasive approach.

Background: Although minimally invasive surgery for intradural tumors offers the potential benefits of less postoperative pain, a quicker recovery, and the avoidance of long-term instability from multilevel laminectomy, there are concerns over whether one can safely and effectively remove intradural extramedullary tumors in a fashion comparable to open techniques and whether the advantages of minimally invasive surgery are clinically significant.

Objective: To review our early experience with minimally invasive techniques for intradural extramedullary tumors of the spine.

Methods: Thirteen intradural tumors (1 cervical, 6 thoracic, 6 lumbar) in 11 patients were operated on using a muscle-splitting, tube-assisted paramedian oblique approach with hemilaminectomy to access the spinal canal while preserving the spinous process and ligaments.

Promoting fusion in minimally invasive lumbar interbody stabilization with low-dose bone morphogenic protein-2--but what is the cost?

Background: Using bone morphogenic protein (BMP) to augment fusion in spine surgery is widespread and lends itself in particular to minimally invasive lumbar fusion, where the surface area for fusion is significantly less than the equivalent open procedure.

Purpose: Here we described the use of very low-dose BMP in promoting fusion in minimally invasive lumbar interbody fixation but also highlight some of the potential complications of BMP-2 use and techniques available to reduce or avoid them.

Study Design: Prospective observational study of consecutive patients undergoing minimally invasive lumbar interbody fusion with percutaneous pedicle screws.

An unusual form of occipitocervical assimilation presenting with spastic tetraparesis in a child.

A diagnosis of 'cerebral palsy' in childhood is relatively common. Abnormalities of the upper cervical spine causing spinal cord compression are rare, but can be a cause of symptoms and signs that may otherwise be attributed to brain injury acquired during development. We present an interesting case of a congenital abnormality of the atlas causing severe cervical spinal cord compression in a 9-year-old child, together with a discussion of the relevant aspects of spinal development and a review of the literature.

Improving accuracy and reducing radiation exposure in minimally invasive lumbar interbody fusion.

Object: The authors assessed the accuracy of placement of lumbar transpedicular screws by using a computer-assisted, imaged-guided, minimally invasive technique with continuous electromyography (EMG) monitoring.

Methods: This was a consecutive case series with prospective assessment of procedural accuracy. Forty-seven consecutive patients underwent minimally invasive lumbar interbody fusion and placement of pedicle screws (PSs).

Pinless frameless electromagnetic image-guided neuroendoscopy in children.

Objectives: Frameless imaged-guided neuronavigation is a useful adjunct to neuroendoscopy in paediatric patients, especially those with abnormal or complex ventricular or cyst anatomy. The development of electromagnetic neuronavigation has allowed the use of image-guided navigation in the very young patient in whom rigid fixation in cranial pins is contraindicated. The technique and the authors' experience of its use in a series of paediatric patients are described.

Epidemiological aspects of spontaneous subarachnoid haemorrhage in Queensland, Australia.

Aims: To examine the epidemiology of spontaneous subarachnoid haemorrhage (SAH) within the population of Queensland, Australia in 2002.

Methods: A retrospective population and hospital-based survey of all cases of spontaneous SAH occurring within the population of Queensland (3.7 million) during the calendar year 2002 was performed.

Clinical applications for change-point analysis of herpes zoster pain.

Pain is the most frequent and disabling complication of herpes zoster. The analysis of pain severity data is complicated by the nonlinear rate of resolution. Further, three distinct phases characterize pain resolution--acute, subacute, and chronic.

History of Varicella Zoster Virus.

The earliest reports of vesicular rashes of the type we now recognize to be caused by herpes simplex and zoster date to the ancient civilizations. It was not until 1888, however, that a relationship between herpes zoster and chickenpox was suggested. Establishing this link represented one of the major hurdles in the history of varicella zoster virus.

Penicillins. A current review of their clinical pharmacology and therapeutic use.

The penicillins are a large group of bicyclic ring compounds which contain a 4-membered beta-lactam ring (penams) fused to a 5-membered thiazolidine ring. Benzylpenicillin (penicillin G) was the first natural penicillin with potent activity against all Gram-positive pathogens, Gram-negative cocci and some spirochaetes and actinomycetes. For the last 50 years benzylpenicillin has been the mainstay of therapy for serious pneumococcal, streptococcal, meningococcal and gonococcal infections.