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OBJECTIVE Navigation systems enable neurosurgeons to guide operations with imaging data. Sensor-based neuronavigation uses an electromagnetic field and sensors to measure the positions of the patient's brain anatomy and the surgical instruments. The aim of this investigation was to determine the accuracy level of sensor-based tracking in a large patient(More)
INTRODUCTION Controversy exists on the application of intraoperative monitoring (IOM) procedures during malignant glioma surgery. Because resection rate correlates with the survival rate, it is of paramount importance to determine these values. This study evaluates the impact of IOM on the resection rates, the survival rate, the quality of life, and the(More)
BACKGROUND Brain tumor surgery is limited by the risk of postoperative neurological deficits. Intraoperative neurophysiological examination techniques, which are based on the electrical excitability of the human brain cortex, are thus still indispensable for surgery in eloquent areas such as the primary motor cortex (Brodman Area 4). METHODS This study(More)
OBJECTIVE Transcranial magnetic stimulation (TMS) is a noninvasive method for analyzing cortical function. To utilize TMS for presurgical functional diagnostics, the magnetic impulse must be precisely targeted by stereotactically positioning the coil. The aim of this study was to evaluate the usefulness of TMS for operation planning when combined with a(More)
Intraoperative monitoring of motor function by means of motor evoked potentials (MEPs) is a new method. The current study examines the influence of preoperative paresis on the feasibility and reliability of this method. Intraoperative monitoring of MEPs was performed in 58 patients during surgery in the central region. The patients were divided into three(More)
Intraoperative electrical stimulation of the motor cortex is a sensitive method for intraoperative mapping and monitoring of this region. Two different stimulation techniques have been established, the bipolar and monopolar techniques. Controversy exists regarding the most suitable method. Both methods have advantages and disadvantages and different(More)
Controversy still exists about the necessity of somatosensory evoked potential (SSEP) monitoring during cervical surgery. The purpose of this prospective study is to determine the impact of SSEP monitoring on anterior cervical surgery. Intraoperative SSEP monitoring was performed in 100 patients treated by an anterior cervical approach. The patients were(More)
OBJECT The treatment of insular tumors is controversial. Surgical treatment is associated with a higher morbidity rate than other therapies. The present work presents a new method in which the descending motor pathways are monitored during surgery for insular tumors. METHODS Intraoperative monitoring was performed in a combination of 2 techniques. The(More)
OBJECTIVE Intraoperative speech mapping has evolved into the "gold standard" for neurosurgical removal of lesions near the language cortex. The integration of neuronavigation into a multimodal protocol can improve the reliability of this type of operation, but most systems require rigid fixation of the patient's head throughout the operation. This article(More)
OBJECTIVE Transpedicular screws are commonly and successfully used for posterior fixation in spinal instability, but their insertion remains challenging. Even using navigation techniques, there is a misplacement rate of up to 11%. The aim of this study was to assess the accuracy of a novel pedicle screw system. METHODS Thoracic and lumbar fusions were(More)