By Tetsu Kanno
The first goal of neurosurgeons is to accomplish the very best final result for sufferers whereas minimizing nervous-system harm via their interventions. nice advances within the perform of minimally invasive neurosurgery during the last couple of many years were made attainable via technological advances supplying more and more subtle instrumentation to be used within the working room, necessitating the purchase of latest surgical abilities and information. Dissemination of this type of wisdom used to be the typical objective of 2 meetings, the sixth foreign Congress of Minimally Invasive surgical procedure and the third international Congress of the Academy for Multidisciplinary Neurotraumatology, held simultaneously in Nagoya, Japan, in March 2005. This quantity of complaints comprises of their entirety the studies submitted at either those conferences, and offers worthwhile insights into the newest recommendations in medical neurosurgery for practitioners from a extensive diversity of disciplines.
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Braided suture material generally is less stiff, leads to more friction during the knot-tying process and is more pliable, making maintenance of knot security easier, although it may be slightly more difficult to slide the knot into place. The newer “unbreakable” sutures are not all the same. MaxBraid is a braided polyethylene suture with a hollow core. It has enhanced lubiricity, meaning it slides very well while tying knots. Because the core is hollow, as the knot is tied, the suture material deforms.
Screw anchors are typically very efficient with excellent failure-load statistics that usually outperform the tack or pronged design (35). Screw anchors have eyelets that can hold a variety of suture types and sizes, allow for suture substitution, and permit tying slipknots. The nonscrew anchors have many different designs that include expanding anchors, toggle anchors, push-in anchors, and wedges (36). The nonscrew designs also allow the tying of sliding knots, although some nonscrew anchors do not permit suture substitution.
At revision, if another anchor needs to be placed into the same footprint of a biodegradable anchor, a drill is simply used to clear a new track for insertion of the anchor. There are very few metal anchors with instrumentation that permit the surgeon to “unscrew” and remove a previously placed anchor. Metal nonscrew anchors typically cannot be easily removed once inserted. Anchor Type While there are several different types of anchors on the market, all can be grouped into either a screw or nonscrew type design (33,34).