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OBJECTIVE Anterior cervical microforaminotomy was developed by the senior author (H-DJ) under the concept of “functional spine surgery,” which directly eliminates compressive pathological factors while preserving functional anatomic features. The surgical results are reported. METHODS Among approximately 400 patients who underwent anterior cervical microforaminotomy at the University of Pittsburgh between March 1993 and May 1999, 104 patients met the inclusion criteria for this study. Forty-five patients were men and 59 were women. Patient ages ranged from 26 to 74 years (median, 46 yr). Compressive pathological lesions included spondylotic spurs in 44 cases (42.3%), soft disc herniation in 54 cases (51.9%), and a combination of the two in 6 cases (5.8%). RESULTS Eighty-three patients (79.8%) experienced excellent results, 20 patients (19.2%) experienced good results, and 1 patient experienced fair results. No patient demonstrated a poor or unchanged outcome. All patients demonstrated excellent decompression in their postoperative magnetic resonance imaging scans, and all patients except one with discitis maintained their motion segments well, as indicated in postoperative dynamic roentgenograms. Two patients developed transient Horner's syndrome, one patient developed transient hemiparesis, and one patient developed discitis, resulting in spontaneous bone fusion. CONCLUSION Anterior microforaminotomy provided good or excellent outcomes, with minimal morbidities, for 98% of 104 patients with cervical discogenic radiculopathy. The functional anatomic features were well preserved for 99% of the patients.

Transforaminal PELD can be effective for very high-grade migrated lumbar disc herniation, and a standardized technique may provide a reliable and reproducible result.

Objective : Chronic subdural hematoma (CSDH) is one of the most common types of traumatic intracranial hemorrhage, usually occurring in the older patients, with a good surgical prognosis. Burr hole craniostomy is the most frequently used neurosurgical treatment of CSDH. However, there have been only few studies to assess the role of the number of burr holes in respect to recurrence rates. The aim of this study is to compare the postoperative recurrence rates between one and two burr craniostomy with closed-system drainage for CSDH. Methods : From January 2002 to December 2006, 180 consecutive patients who were treated with burr hole craniostomy with closed-system drainage for the symptomatic CSDH were enrolled. Pre-and post-operative computed tomography (CT) scans and/or magnetic resonance imaging (MRI) were used for radiological evaluation. The number of burr hole was decided by neurosurgeon's preference and was usually made on the maximum width of hematoma. The patients were followed with clinical symptoms or signs and CT scans. All the drainage catheters were maintained below the head level and removed after CT scans showing satisfactory evacuation. All patients were followed-up for at least 1 month after discharge. Results : Out of 180 patients, 51 patients were treated with one burr hole, whereas 129 were treated with two burr holes. The overall postoperative recurrence rate was 5.6% (n = 10/180) in our study. One of 51 patients (2.0%) operated on with one burr hole recurred, whereas 9 of 129 patients (7.0%) evacuated by two burr holes recurred. Although the number of burr hole in this study is not statistically associated with postoperative recurrence rate (p > 0.05), CSDH treated with two burr holes showed somewhat higher recurrence rates. Conclusion :In agreement with previous studies, burr hole craniostomy with closed drainage achieved a good surgical prognosis as a treatment of CSDH in this study. Results of our study indicate that burr hole craniostomy with one burr hole would be sufficient to evacuate CSDH with lower recurrence rate.

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Abstract-The authors examine three different types of plasma discharges in their ability to stabilize a lifted jet diffusion flame in coflow. The three discharges include a single-electrode corona discharge, an asymmetric dielectric-barrier discharge (DBD), and a repetitive ultrashort-pulsed discharge. The degree of nonequilibrium of this pulsed discharge is found to be higher than that for the DBD. Furthermore, this pulsed discharge causes the most significant improvement in the flame stability. The optimal placement of the discharge electrodes is investigated, and it is found that there is a close relation between this placement and the emission spectra, suggesting use of the emission spectra as a possible indicator of fuel/air mixture fraction. The optimal placement is mapped into mixture-fraction space by use of a fully premixed flame experiment of known mixture fraction. The result shows that the mixture fraction, which corresponds to the optimal placement, is much leaner than that of a conventional lifted jet flame.

Cerebrospinal fluid (CSF) leakage is a potential complication of cranial and spinal surgery. Postoperative CSF leakage can induce delayed healing, wound infection and meningitis. DuraSeal® (Covidien, Waltham, MA, USA) is a synthetic product which has been increasingly used to facilitate watertight repair of dural defects after cranial and spinal surgery. Despite some advantages of Duraseal®, the authors report a patient who developed cord compression following the use of DuraSeal® in cervical spine surgery in which the expansion of the DuraSeal® was believed to be the causative factor.