Introduction: To investigate the use of a tubular retractor to provide access to the craniovertebral junction (CVJ) sparing the soft palate with the aim of reducing complications associated with traditional transoral approach but yet allowing adequate decompression of the CVJ.
Materials And Methods: Twelve consecutive patients with severe myelopathy (JOA-score less than 11) from ventral CVJ compression were operated between 2014-2020 using a tubular retractor assisted transoral decompression.
Results: All patients improved neurologically statistically (p=0.02). There were no posterior pharynx wound infections or rhinolalia. There was one case with incomplete removal of the lateral wall of odontoid and one incidental durotomy.
Conclusions: A Tubular retractor provides adequate access for decompression of the ventral compression of CVJ. As the tubular retractor pushed away the uvula, soft palate and pillars of the tonsils as it docked on the posterior pharyngeal wall, the traditional complications associated with traditional transoral procedures is completely avoided.
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http://dx.doi.org/10.5704/MOJ.2307.006 | DOI Listing |
Neurosurg Rev
January 2025
Department of Neurosurgery, King's College Hospital Foundation Trust, London, UK.
Minimally invasive parafascicular surgery (MIPS) with the use of tubular retractors achieve a safe resection in deep seated tumours. Diffusion changes noted on postoperative imaging; the significance and clinical correlation of this remains poorly understood. Single centre retrospective cohort study of neuro-oncology patients undergoing MIPS.
View Article and Find Full Text PDFBiomedicines
November 2024
Department of Neurosurgery, King's College Hospital NHS Foundation Trust, London SE5 9RS, UK.
Background/objectives: 5-aminulevulinic acid (5-ALA)-guided surgery for high-grade gliomas remains a challenge in neuro-oncological surgery. Inconsistent fluorescence visualisation, subjective quantification and false negatives due to blood, haemostatic agents or optical impediments from the external light source are some of the limitations of the present technology.
Methods: The preliminary results from this single-centre retrospective study are presented from the first 35 patients operated upon with the novel Nico Myriad Spectra System©.
J Neurosurg Pediatr
December 2024
2Fetal Medicine Division, Hospital e Maternidade Santa Joana, São Paulo; and.
Objective: The authors aimed to describe a low-cost and easily reproducible alteration of the Bruner and Tulipan procedure to preserve uterine muscular fibers. They conducted a retrospective cohort study of 10 pregnant women whose fetuses developed lumbosacral myelomeningocele (MM). The MM was repaired through a fetal neurosurgical procedure using a tubular single-port endoscope-assisted technique.
View Article and Find Full Text PDFNeurosurg Focus
December 2024
1Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California.
Objective: Despite its potential advantages, robotic surgery has yet to be applied to skull base procedures. Complex anatomy and restricted access have limited the development of robotic skull base surgery. The authors' aim was to conduct a feasibility study of robotic surgery for posterior fossa skull base lesions.
View Article and Find Full Text PDFNeurosurg Clin N Am
January 2025
Department of Neurosurgery, Center for Spine Health, Cleveland Clinic Foundation, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Posterior approach interbody fusion techniques such as posterior lumbar interbody fusion and transforaminal interbody fusion are known as the workhorse procedures for lumbar spinal fusion. Over the years, advancements in procedural steps, technique, and technology have sought to improve patient outcomes. Within the last 2 decades, considerable emphasis has been placed upon minimally invasive techniques utilizing tubular retractors and conscious sedation.
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