ABSTRACT
OBJECTIVE@#To explore the dynamic changes of lumbosacral sagittal parameters after real-time three-dimensional navigation assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and traditional open TLIF for treatment of lumbar degenerative disease.@*METHODS@#The clinical data of 61 patients with lumbar degenerative disease underwent single-segment surgery from September 2017 to September 2019 were retrospectively analyzed. Among them, 31 cases underwent MIS-TLIF with 3D navigation techniques (MIS-TLIF group) and another 30 cases underwent conventional open TLIF (traditional open TLIF group). The basic information, operative time and intraoperative blood loss were collected. The sagittal radiologic parameters were measured before surgery and 3 months after surgery, including lumbar lordosis (LL), segmental lordosis (SL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), anterior disc height (ADH), posterior disc height(PDH).And the average disc height(DH) and pelvic incidence to lumbar lordosis mismatch (PI-LL) were calculated.@*RESULTS@#Operative time and intraoperative blood loss in MIS-TLIF group were significantly less than in traditional open TLIF group(@*CONCLUSION@#Real-time navigation-assisted MIS-TLIF and traditional open TLIF can recover DH in a short term for lumbar degenerative diseases, improve LL and PI-LL, and make the arrangement of the sagittal plane of the lumbosacral region more coordinated after surgery. But only the navigation assisted MIS -TLIF can significantly improve SL. Compared with traditional open TLIF, real-time navigation assisted MIS-TLIF in the treatment of degenerative lumbar diseases has the advantages of short operation time and less intraoperative bleeding.
Subject(s)
Humans , Lumbar Vertebrae/surgery , Lumbosacral Region , Minimally Invasive Surgical Procedures , Retrospective Studies , Spinal Fusion , Treatment OutcomeABSTRACT
Objective To evaluate the effectiveness of the endoscope-assisted supraorbital keyhole approach in the early surgical treatment of patients with ruptured anterior communicating artery aneurysms (AcoA). Methods Thirty-five patients with ruptured AcoA, admitted to our hospital from January 2002 to January 2010, adopted clipping via endoscope-assisted supraorbital keyhole approach within 72 h of onset. The neurostatus of these patients were ranged from grade 1 to 3 (Hunt-Hiss Scale scores). The surgical details were described, and the clinical results were assessed according to the scores of Glasgow Outcome Scale.Results Operations were successfully finished in all patients; the endoscope-assisted supraorbital keyhole approach offered sufficient exposure of neurovascular structures for clipping AcoA. Intraoperative accidental aneurysm rupture occurred in 2 patients, but these events were managed successfully by blocking-up the parent artery and performing quick aneurysm neck dissection; no serious complications caused by the surgical approach occurred; postoperative DSA or CTA indicated that the aneurysm was totally clipped and the parent artery appeared no stenosis, and distal artery was unobstructed. Three months after the operation, 30 patients (85.7%) achieved very good outcomes (GOS:4-5 scores). All the patients achieved good cosmetic results. Conclusion In selected AcoA patients with grade 1-3, the endoscope-assisted supraorbital keyhole approach is safe and effective for gaining access to and treating the aneurysms on early hemorrhage stage.
ABSTRACT
Objective To investigate the method, time window, dosage of thrombolytic drug used in different intra-arterial thrombolytic therapies of patients with acute cerebral infarction Methods Sixty patients with acute cerebral infarction within 12 h were chosen in our study; they were treated by different intra-arterial thrombolytic therapies. The therapeutic effect (recanalization) were evaluated through cerebral angiography. Results The complete recanalization rate was 55％ (33/60), partial recanalization rate 38.3％ (23/60) and non-efficiency 6.7％ (4/60). Thirty-eight patients (63.3％) were clinically cured, 10 (16.7％) obviously improved, 9 (15％) partially improved and 3 (5％) invalid; no death was noted. Conclusion Treatment of acute cerebral infarction by different intra-arterial thrombolytic therapies is safe and effective. The cure rate will be improved and the death rate and disability rate will be decreased by setting up first aid system and standard therapeutic measurements.
ABSTRACT
<p><b>OBJECTIVE</b>To study the method with endoscope-assisted microsurgical technique through the supraorbital keyhole approach to treat aneurysms in the anterior circulation.</p><p><b>METHODS</b>According to preoperative diagnostic imagings, to work out of the individual operation planning. Skin incision was made in the eyebrow, and the diameter of supraorbital craniotomy was about 2 cm, endoscope-assisted microsurgical technique was used to clip aneurysm. The technique was used in the most recent 12 consecutive patients.</p><p><b>RESULTS</b>Five different kinds of aneurysms in the anterior circulation were clipped through this method and 12 patients were cured. One patient, intraoperative accidental aneurysm rupture occurred. There were no approach-related complications.</p><p><b>CONCLUSIONS</b>This endoscope-assisted microsurgical technique via supraorbital keyhole approach is a safe, minimal invasive and effective way for the treatment of aneurysms in the anterior circulation, and there is more sufficient operating space.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Craniotomy , Methods , Follow-Up Studies , Intracranial Aneurysm , General Surgery , Microsurgery , Neuroendoscopy , Neurosurgical Procedures , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study endoscope-assisted microsurgical technique with supraorbital keyhole approach for the treatment of suprasellar region tumor so as to maximize tumor removal and minimize operative-trauma.</p><p><b>METHODS</b>According to high resolution CT and MR images before operation, individual operation schemes were worked out. Skin incision was made in the eyebrow, and the diameter of supraorbital craniotomy was approximately 2 cm. Endoscope-assisted microsurgical technique was used to resect lesions in 16 consecutive patients.</p><p><b>RESULTS</b>Total Tumors were removed in all of the 16 patients via the supraorbital keyhole approach. No postoperative complications occurred.</p><p><b>CONCLUSIONS</b>Supraorbital keyhole approach may diminish tissue injury considerably and has proven to provide sufficient operating space in the suprasellar region for tumor removal.</p>