Objective: Pharmacoresistant tremors, often seen in Parkinson disease and essential tremor, significantly impair patient quality of life. Although deep brain stimulation has been effective, its invasive nature limits its applicability. MR-guided focused ultrasound (MRgFUS) thalamotomy offers a noninvasive alternative, but its cognitive impacts are not fully understood.
View Article and Find Full Text PDFBackground And Objectives: Deep brain stimulation (DBS) is a well-established treatment for Parkinson disease (PD), with programming methods continually evolving. This study aimed to compare the efficacy and patient burden between conventional ring-mode programming (CP-RM) and image-guided volume of tissue activated (IG-VTA) programming for subthalamic nucleus (STN) DBS in PD.
Methods: In this retrospective study, patients with PD who underwent STN-DBS between 2011 and 2014 (CP-RM group) and 2019 and 2021 (IG-VTA group) were evaluated.
Background: Essential tremor (ET) affects numerous adults, impacting quality of life (QOL) and often defying pharmacological treatment. Surgical interventions like deep brain stimulation (DBS) and lesional approaches, including radiofrequency, gamma-knife radiosurgery, and magnetic resonance imaging (MRI)-guided focused ultrasound, offer solutions but are not devoid of limitations.
Objectives: This retrospective, single-center, single-blinded pilot study aimed to assess the safety and efficacy of unilateral MRI-guided laser interstitial thermal therapy (MRIg-LITT) thalamotomy for medically intractable ET.
Background: Medically intractable Parkinson's disease (PD) tremor is a common difficult clinical situation with major impact on patient's quality of life (QOL). Deep brain stimulation (DBS) is an effective therapy but is not an option for many patients. Less invasive lesional brain surgery procedures, such as thalamotomy, have proven to be effective in these indications.
View Article and Find Full Text PDFBackground: Despite the growing sophistication of robot-assisted surgery, it is necessary to demonstrate that robots can reliably perform complex procedures on site and then remotely. Although a flow diverter stent is one of the most effective and widely used devices, its placement is sometimes challenging.
Objective: To evaluate the feasibility and safety of the CorPath GRX robotic platform for the embolization of cerebral and cervical aneurysms using flow diverter stents.
Background: Intracranial solitary fibrous tumour (iSFT) is an exceptional mesenchymal tumour with high recurrence rates. We aimed to analyse the clinical outcomes of newly diagnosed and recurrent iSFTs.
Methods: We carried out a French retrospective multicentre ( = 16) study of histologically proven iSFT cases.
Introduction: Transforaminal lumbar interbody fusion (TLIF) surgery is well established for the treatment of discopathy, foraminal disc herniation, and recurrent disc herniation. At the Amiens university medical center, we have been using a robot-assisted technique for performing the TLIF. The purpose of this study is to evaluate the radiological and clinical outcome, specifically pain, of patients having undergone robot-assisted TLIF.
View Article and Find Full Text PDFThe global pandemic of coronavirus disease 2019 (COVID-19) has challenged healthcare systems worldwide. Lockdown, social distancing, and screening are thought to be the best means of stopping the virus from spreading and thus of preventing hospital capacity from being overloaded. However, it has also been suggested that effective outpatient treatment can control pandemics.
View Article and Find Full Text PDFSubthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for idiopathic Parkinson's disease. Despite recent progress, the mechanisms responsible for the technique's effectiveness have yet to be fully elucidated. The purpose of the present study was to gain new insights into the interactions between STN-DBS and cortical network activity.
View Article and Find Full Text PDFObjective: High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) is effective in the treatment of motor symptoms of Parkinson's disease. Using a patient-specific lead and volume of tissue activated (VTA) software, it is possible to visualize contact positions in the context of the patient's own anatomy. In this study, the authors' aim was to demonstrate that VTA software can be used in clinical practice to help determine the clinical effectiveness of stimulation in patients with Parkinson's disease undergoing DBS of the STN.
View Article and Find Full Text PDFPurpose: Intercavernous sinuses (ICSs) are physiological communications between the cavernous sinuses. The ICSs run between the endosteal and meningeal layers of the dura mater of the sella turcica. Whereas the anterior and posterior ICSs have been frequently described, the inferior ICS (iICS) has been less well studied in the literature; however, poor awareness of the ICS's anatomy can lead to serious problems during transsphenoidal, transsellar surgery.
View Article and Find Full Text PDFBackground Context: Although open lumbar microdiscectomy (OLMD) is considered to be the gold standard method for discectomy, recent progress in endoscopic spinal surgery has increased the popularity of percutaneous endoscopic lumbar discectomy (PELD) for this indication. However, one of the main drawbacks of PELD is incomplete decompression, especially at the start of the surgeon's learning curve. The functional outcomes of PELD and OLMD in patients matched for age, hernia level, and hernia location have not previously been compared.
View Article and Find Full Text PDFIntroduction: To evaluate the feasibility of safely managing subcondylar fractures using an original surgical procedure combining an intraoral approach, the use of a custom-made occlusal overlay splint, and intraoperative imaging.
Materials And Methods: Condylar fragment was freed from surrounding soft tissues, was laterally exposed to the ramus, and a miniplate was fixed in place for osteosynthesis. An overlay splint maintaining the dental occlusion was used to facilitate reduction and stabilization during fixation.
Large cystic craniopharyngioma management combining cyst puncture through an Ommaya reservoir with hypofractionated stereotactic radiotherapy was evaluated. The planning optimization was focused on the gradient and selectivity. Punctured and filled cyst treatment plans were compared with a retrospective analysis of volumetric and functional outcomes.
View Article and Find Full Text PDFBackground: Craniopharyngioma is a difficult entity to treat, which is particularly true for mixed craniopharyngioma (i.e., a mixture of both solid and cystic components).
View Article and Find Full Text PDFBackground: Frameless robotic-assisted surgery is an innovative technique for deep brain stimulation (DBS) that has not been assessed in a large cohort of patients.
Objective: To evaluate accuracy of DBS lead placement using the ROSA® robot (Zimmer Biomet) and a frameless registration.
Methods: All patients undergoing DBS surgery in our institution between 2012 and 2016 were prospectively included in an open label single-center study.
BMJ Open
September 2019
Introduction: Robotic guidance (RG) and computer-assisted navigation (NV) have seen increased adoption in instrumented spine surgery over the last decade. Although there exists some evidence that these techniques increase radiological pedicle screw accuracy compared with conventional freehand (FH) surgery, this may not directly translate to any tangible clinical benefits, especially considering the relatively high inherent costs. As a non-randomised, expertise-based study, the European Robotic Spinal Instrumentation Study aims to create prospective multicentre evidence on the potential comparative clinical benefits of RG, NV and FH in a real-world setting.
View Article and Find Full Text PDFThe aim of this study was to evaluate the frequency of hypopituitarism following TBI in a cohort of children who had been hospitalized for mild TBI and to identify the predictive factors for this deficiency. A prospective study was conducted on children between 2 and 16 years of age who had been hospitalized for mild TBI according to the Glasgow Coma Scale between September 2009 and June 2013. Clinical parameters, basal pituitary hormone assessment at 0, 6, and 12 months, as well as a dynamic testing (insulin tolerance test) 12 months after TBI were performed.
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