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CORE TECHNIQUES IN OPERATIVE NEUROSURGERY CORE TECHNIQUES IN OPERATIVE NEUROSURGERY Rahul Jandial, MD, PhD Assistant Professor Division of Neurosurgery City of Hope Comprehensive Cancer Center Los Angeles, California Paul C. McCormick, MD, MPH, FACS Herbert and Linda Gallen Professor of Neurological Surgery Director, Spine Center Columbia University Medical Center New York, New York Peter M. Black, MD, PhD Founding Chair, Department of Neurosurgery Franc D. Ingraham Professor of Neurosurgery, Harvard Medical School Brigham and Women’s Hospital Department of Neurosurgery Boston, Massachusetts 1600JohnF.KennedyBlvd. Ste1800 Philadelphia,PA19103-2899 CoreTechniquesinOperativeNeurosurgery ISBN:978-1-4377-0907-0 Copyright#2011bySaunders,animprintofElsevierInc. Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans,electronicor mechanical,includingphotocopying,recording,oranyinformationstorageandretrievalsystem,without permissioninwritingfromthePublisher.Detailsonhowtoseekpermission,furtherinformationabout thePublisher’spermissionspolicies,andourarrangementswithorganizationssuchastheCopyright ClearanceCenterandtheCopyrightLicensingAgency,canbefoundatourwebsite:www.elsevier.com/ permissions. ThisbookandtheindividualcontributionscontainedinitareprotectedundercopyrightbythePublisher (otherthanasmaybenotedherein). Notices Knowledgeandbestpracticeinthisfieldareconstantlychanging.Asnewresearchandexperience broadenourunderstanding,changesinresearchmethods,professionalpractices,ormedicaltreatment maybecomenecessary. Practitionersandresearchersmustalwaysrelyontheirownexperienceandknowledgeinevaluating andusinganyinformation,methods,compounds,orexperimentsdescribedherein.Inusingsuch informationormethods,theyshouldbemindfuloftheirownsafetyandthesafetyofothers,including partiesforwhomtheyhaveaprofessionalresponsibility. Withrespecttoanydrugorpharmaceuticalproductsidentified,readersareadvisedtocheckthemost currentinformationprovided(i)onproceduresfeaturedor(ii)bythemanufacturerofeachproductto beadministeredtoverifytherecommendeddoseorformula,themethodanddurationof administration,andcontraindications.Itistheresponsibilityofpractitioners,relyingontheirown experienceandknowledgeoftheirpatients,tomakediagnoses,todeterminedosagesandthebest treatmentforeachindividualpatient,andtotakeallappropriatesafetyprecautions. Tothefullestextentofthelaw,neitherthePublishernortheauthors,contributors,oreditorsassume anyliabilityforanyinjuryand/ordamagetopersonsorpropertyasamatterofproductsliability, negligenceorotherwise,orfromanyuseoroperationofanymethods,products,instructions,orideas containedinthematerialherein. LibraryofCongressCataloging-in-PublicationData Coretechniquesinoperativeneurosurgery/[editedby]RahulJandial,PaulC.McCormick, PeterMcLarenBlack. p.;cm. Operativeneurosurgery Includesbibliographicalreferencesandindex. ISBN978-1-4377-0907-0(hardcover:alk.paper) 1.Nervoussystem–Surgery. I. Jandial,Rahul. II. McCormick,Paul,1956- III. Black,Peter McL. IV. Title:Operativeneurosurgery. [DNLM:1.NeurosurgicalProcedures–methods.2.CentralNervousSystemDiseases–surgery. 3.OrthopedicProcedures–methods.WL368] RD593.C672011 617.408–dc22 2011009300 AcquisitionsEditor:JulieGoolsby DevelopmentalEditor:TaylorBall PublishingServicesManager:AnneAltepeter SeniorProjectManager:CherylA.Abbott DesignDirection:LouisForgione MarketingManager:CaraJespersen PrintedintheUnitedStatesofAmerica Lastdigitistheprintnumber: 9 8 7 6 5 4 3 2 1 To my life’s greatest and most lasting formative influence To my best teacher, confidant, and mentor To my father, Satya Pal Jandial Rahul Jandial Preface CoreTechniquesinOperativeNeurosurgerywasconceivedwith authorexperience.Bothforneophytestudentsofneurolog- clear recognition of the evolving pedagogical landscape. ical surgery and for established neurosurgeons seeking a The presentation of medical information is undergoing a targeted review of operations that may have become an renaissance, and the pressing need and unparalleled oppor- infrequent aspect of their practices, this text intends to tunity to develop digital medical textbooks are upon us. serve both as a reference and a conduit to further learning. Soontheconceptsof“bookeditions”and“pagelength”will My intention is for Core Techniques to Operative Neuro- become obsolete, as information is continually updated surgery to function as a bridge between the best of conven- and infinitely linked from digital sources that coalesce. In tional paper textbooks and the transition toward discrete this transition, neurological surgery—the most challenging quanta of information that facilitate delivery through the and complicated of medical endeavors—should be at the digital milieu. Indeed, the last punctuation within methods forefront. and models of didactic delivery was the printing press, The structure of this text consists of two main sections: adding accessibility and reproducibility of knowledge pre- Cranial and Spinal. Specific design elements have been viously impossible. Similarly, the transition of paper included to allow for quick reference in preoperative con- texts to digital texts will add another indelible exclamation siderations regarding “Indications,” “Contraindications,” mark in the advancement of didactic methods. My hope is and“PlanningandPositioning.”Further,thoughtful “Tips that Core Techniques in Operative Neurosurgery will lead that from the Masters” and “Bailout Options” are included, evolution. which present condensed and accessible pearls that have been distilled from more exhaustive texts, as well as senior Rahul Jandial xxi Acknowledgments I would like to thank the Elsevier team that has helped bring this project to fruition: Adrianne Brigido, Julie Goolsby, Cheryl Abbott, and most of all, Taylor Ball. Rahul Jandial xxiii Contents PART ONE (cid:129) CRANIAL Section 2 SKULL BASE SectionEditor:Andrew T.Parsa Section 1 GENERAL 15 Frontotemporal Craniotomy with Orbitozygomatic SectionEditor:AlfredoQui˜nones-Hinojosa, Osteotomy 90 withShaanM.Raza MichaelE.Sughrue, AndrewT.Parsa 1 Pterional (Frontosphenotemporal) Craniotomy 4 16 Subfrontal and Bifrontal Craniotomies with or Geoffrey P.Colby,MohamadBydon,RafaelJ.Tamargo without Orbital Osteotomy 97 MichaelE.Sughrue, AndrewT.Parsa 2 Occipital Craniotomy 13 JorgeE.Alvernia,NnennaMbabuike,MarcusL.Ware 17 Far-Lateral Suboccipital Approach 104 MichaelE.Sughrue, AndrewT.Parsa 3 Temporal and Frontotemporal Craniotomy 17 18 Temporopolar (Half-and-Half) Approach to the ShaanM.Raza,AlfredoQui˜nones-Hinojosa Basilar Artery and the Retrosellar Space 111 MichaelE.Sughrue, AndrewT.Parsa 4 Subtemporal (Intradural and Extradural) 19 Middle Fossa Craniotomy and Approach to the Craniotomy 21 Internal Auditory Canal or Petrous Apex 117 ShaanM.Raza,GraemeF.Woodworth,AlfredoQui˜nones-Hinojosa MichaelE.Sughrue, AndrewT.Parsa 5 Suboccipital Craniotomy 26 20 Retrolabyrinthine Approach 122 ShaanM.Raza,AlfredoQui˜nones-Hinojosa MichaelE.Sughrue, AndrewT.Parsa 6 Extended Retrosigmoid Craniotomy 31 ShaanM.Raza,AlfredoQui˜nones-Hinojosa Section 3 VASCULAR SectionEditor:Steven Giannotta, 7 Presigmoid Approaches to Posterior with AzadehFarin Fossa: Translabyrinthine and Transcochlear 36 21 Pterional Craniotomy for Anterior Communicating AlejandroRivas, HowardW.Francis Artery Aneurysm Clipping 129 ChadW. Washington,Ralph G.Dacey,Jr.,Gregory J.Zipfel 8 Transcallosal Approach 46 22 Pterional Craniotomy for Posterior Communicating Jason Liauw,GaryGallia,AlessandroOlivi Artery Aneurysm Clipping 138 9 Transnasal Transsphenoidal Approach to Sellar PaulGigante,ChristopherP.Kellner,E.SanderConnolly,Jr. and Suprasellar Lesions 53 23 Paraclinoid Carotid Artery Aneurysms 142 KaisornL.Chaichana,AlfredoQui˜nones-Hinojosa AnilNanda,Vijayakumar Javalkar 10 Supracerebellar Infratentorial Approach 60 24 Middle Cerebral Artery Aneurysms: Pterional ShaanM.Raza,AlfredoQui˜nones-Hinojosa (Frontotemporal) Craniotomy for Clipping 153 11 Occipital Transtentorial Approach 65 MohamedSamyElhammady,RobertoC.Heros 25 Paramedian Craniotomy and Unilateral Anterior Nader Sanai,MichaelW.McDermott Interhemispheric Approach for Clipping of Distal 12 TraumaFlap:DecompressiveHemicraniectomy 70 Anterior Cerebral Artery Aneurysm 161 MichaelE.Sughrue,MathewB.Potts,ShirleyI.Stiver,GeoffreyT.Manley MartinLehecka,MikaNiemel¨a,JuhaHernesniemi 13 Parasagittal Approach 75 26 VertebralArteryAneurysms:Far-LateralSuboccipital PabloF.Recinos,MichaelLim Approach for Clipping 170 GavinP.Dunn,Christopher S.Ogilvy 14 Supraorbital (Keyhole) Craniotomy with Optional Orbital Osteotomy 82 27 Basilar Artery Aneurysm: Orbitozygomatic ChetanBettegowda, ShaanM.Raza,GeorgeI.Jallo, Craniotomy for Clipping 176 AlfredoQui˜nones-Hinojosa,Behnam Badie NaderSanai,MichaelT.Lawton xxv xxvi n n n CONTENTS 28 Craniotomy for Resection of Intracranial Cortical Section 5 OTHER Arteriovenous Malformation 183 SectionEditor:MichaelL.Levy, Christopher S.Eddleman,ChristopherC.Getch,BernardR.Bendok, with LissaC.Baird H.Hunt Batjer 45 Cranioplasty (Autogenous, Cadaveric, 29 Subcortical Arteriovenous Malformations: Corpus and Alloplastic) 322 Callosum, Lateral Ventricle, Thalamus, and Basal RyanC.Frank,StevenR.Cohen,HalMeltzer Ganglia 192 46 Endoscopic Transsphenoidal Approach 328 MarcoLee,GaryK.Steinberg JustinF.Fraser,Vijay K.Anand, TheodoreH.Schwartz 30 Cranial Dural Arteriovenous Fistula Disconnection 199 47 Endoscopic Colloid Cyst Removal 339 IvanRadovanovic, M.Christopher Wallace CharlesTeo 31 Cavernous Malformations 208 48 Encephalocele Repair 343 David Gonda,LissaC. Baird,MichaelL.Levy GiulianoGiliberto,GiuseppeLanzino 49 Craniosynostosis: Frontoorbital Advancement 32 Superficial Temporal Artery—Middle Cerebral and Cranial Vault Reshaping (Open and Artery Bypass 218 Endoscopic) 349 Matthew R.Reynolds, GregoryJ. Zipfel RyanC.Frank,StevenR.Cohen,HalMeltzer 33 Extracranial-Intracranial High-Flow Bypass 227 50 Arachnoid Cyst Fenestration 356 Takanori Fukushima LissaC.Baird,AndrewP.Thomas,MichaelL.Levy 34 Open Evacuation of Intracerebral Hematoma 239 51 Endoscopic Third Ventriculostomy 361 Issam Awad,MahuaDey,Jennifer Jaffe LissaC.Baird,MichaelL.Levy 35 Image-Guided Catheter Evacuation and 52 Insertion of Ventriculoperitoneal Shunt 367 Thrombolysis for Intracerebral Hematoma 244 HalMeltzer Issam Awad,MahuaDey,Jennifer Jaffe PART TWO (cid:129) SPINAL Section 4 FUNCTIONAL Section 6 CERVICAL SectionEditor:KimBurchiel, SectionEditor:JonPark, withSamuelA.Hughes with MelanieG.Hayden Gephart 36 Anteromedial Temporal Lobe Resection 254 53 Anterior C1-2 Fixation 376 Alexander M.Papanastassiou, KennethP.Vives,DennisD.Spencer CarminaF.Angeles,JonPark 37 Selective Amygdalohippocampectomy 264 54 Transarticular Screws for C1-2 Fixation 384 AhmedRaslan,SamuelA.Hughes,KimBurchiel VincentY.Wang, DeanChou 38 Seizure Focus Monitor Placement 271 55 C1-2 Posterior Cervical Fusion 391 TsuleeChen, JorgeAlvaroGonzalez-Martinez, WilliamE.Bingaman DanielC.Lu, ValliP.Mummaneni,RameshTeegala, PraveenV.Mummaneni 39 Awake Craniotomy 279 DanielL.Silbergeld, AdamO.Hebb 56 Occipitocervical Fusion 397 NestorD.Tomycz,David O.Okonkwo 40 Corpus Callosotomy (Anterior and Complete) 284 57 Transoral Odontoidectomy 403 JamesM.Johnston,Jr.,MatthewD.Smyth MatthewJ. Tormenti,Ricky Madhok,AdamS.Kanter 41 Thalamotomy and Pallidotomy 290 58 Odontoid Screw Fixation 409 JaliyaR.Lokuketagoda, RobertE.Gross DanielS.Hutton, KeeD.Kim 42 Deep Brain Stimulation 301 59 Anterior Cervical Diskectomy 416 AhmedRaslan,KimBurchiel BenjaminM.Zussman,PeterG.Campbell,JamesS.Harrop 43 Motor Cortex Stimulator Placement 308 60 Anterior Cervical Corpectomy and Fusion 422 Louis AnthonyWhitworth,Erika AnnePetersen CarminaF.Angeles,JonPark 44 Occipital and Supraorbital Nerve Stimulator Placement 315 61 Cervical Laminectomy and Laminoplasty 430 Konstantin V.Slavin,SebastianR.Herrera,PrasadVannemreddy, StephenS.Scibelli,KamalR.M.Woods,ShoshannaVaynman, Zilvinas Zakarevicius J.PatrickJohnson CONTENTS n n n xxvii 62 Lateral Mass Fixation 434 81 Lumbar Microdiskectomy 548 MikeYueChen, MatthewJ. Duenas,RahulJandial OmarN.Syed, MichaelG.Kaiser 63 Posterior Cervicothoracic Osteotomy 439 82 MinimallyInvasiveThoracicCorpectomy 553 TimothyLink,Rahul Jandial,VolkerSonntag JohnE.O’Toole Section 7 THORACIC 83 Thoracoscopic Diskectomy 560 SectionEditor:ChristopherP.Ames, ShahidM.Nimjee, RobertE.Isaacs withBrian Jian 84 Percutaneous Pedicle Screw Placement 566 64 ThoracicDiskectomy—TransthoracicApproach 444 GirishK.Hiremath,MickPerez-Cruet VincentY.Wang,DeanChou 85 TranS1 Sacral 576 65 Thoracic Corpectomy—Anterior Approach 449 WilliamD.Tobler SaadB.Chaudhary,VirgilioMatheus,EdwardC. Benzel 86 Minimally Invasive Direct Lateral Transpsoas 66 Costotransversectomy 456 Interbody Fusion 588 TimothyD.Uschold,RichardA.Lochhead,RandallW.Porter PatrickA.Sugrue,John C.Liu 67 Thoracic Transpedicular Corpectomy 465 Section 10 OTHER RichardA.Lochhead, TimothyD.Uschold,NicholasTheodore SectionEditor:GeorgeI.Jallo 68 Smith-Petersen Osteotomy 474 87 Spinal Cord Arteriovenous Malformations 600 RamR.Vasudevan,FrankAcosta AnandV.Germanwala,GeorgeI.Jallo 69 Thoracic Pedicle Screws 478 88 SurgicalManagementofSpinalDuralArteriovenous RamR.Vasudevan,FrankAcosta Fistulas 607 Section 8 LUMBOSACRAL KaisornL.Chaichana,RafaelJ. Tamargo SectionEditor:JosephD.Ciacci, 89 Intramedullary Spinal Cord Cavernous withJayant P.Menon Malformation 613 70 Lumbar Laminectomy 484 ChetanBettegowda,VivekMehta,RyanM.Kretzer, GeorgeI.Jallo JayantP.Menon,AllenHo,JosephD.Ciacci 71 Lumbar Microdiskectomy 489 90 Spinal Cord Stimulator 619 JayantP.Menon,AllenHo,JosephD.Ciacci RyanM.Kretzer,JamesE.Conway,Ira M.Garonzik 72 Anterior Lumbar Interbody Fusion 494 91 Endoscopic Thoracic Sympathectomy 626 JosephL.Martinez,MichaelY.Wang Bong-SooKim,MarkusBookland, JackI.Jallo 73 Posterior Lumbar Interbody Fusion 500 92 Primary Myelomeningocele Closure 632 Matthew J.Tormenti;Edward A.Monaco,III;Adam S.Kanter MatthiasSchulz,Ulrich W.Thomale 74 TransforaminalLumberInterbodyFusion 505 93 Tethered Cord Release 639 Edward A.Monaco,III;Matthew J.Tormenti;Adam S.Kanter UlrichW.Thomale,MatthiasSchulz 75 Anterior Lumbar Corpectomy 510 94 Exploration for Injury to an Infant’s Brachial J. DawnWaters,JosephD.Ciacci Plexus 646 76 Pedicle Subtraction Osteotomy 516 RickAbbott SassanKeshavarzi, DzenanLulic,PawelJankowski, HenryE.Aryan 95 Ulnar Nerve Release 652 77 Lumbar Disk Arthroplasty 522 MichaelJ.Dorsi,AllanJ.Belzberg JosephL.Martinez,MichaelY.Wang 96 Open Carpal Tunnel Release 656 78 Pelvic Fixation 528 MichaelJ.Dorsi,AllanJ.Belzberg NeilBadlani, R.Todd Allen 97 Intradural Nerve Sheath Tumors 660 79 Partial Sacrectomy 535 VivekMehta, ChetanBettegowda, RyanM.Kretzer, MikeYueChen, JulioGarcia-Aguilar AllanJ.Belzberg, GeorgeI.Jallo Section 9 MINIMALLY INVASIVE SPINE 98 Intradural Tumor—Meningioma 666 SectionEditor:AlfredOgden RyanM.Kretzer,ChetanBettegowda,GeorgeI.Jallo 80 Minimally Invasive C1-2 Fusion 542 99 Intramedullary Glioma 673 SathishSubbaiah, RichardG.Fessler RyanM.Kretzer,ChetanBettegowda,GeorgeI.Jallo

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