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Zoe E. Teton, Daniel Blatt, Amr AlBakry, James Obayashi, Gulsah Ozturk, Vural Hamzaoglu, Philippe Magown, Nathan R. Selden, Kim J. Burchiel and Ahmed M. Raslan

L evel 1 evidence supports the use of neuromodulation technology for multiple indications: deep brain stimulation (DBS) for Parkinson’s disease (PD), 2 , 12 , 23 , 24 , 35 essential tremor (ET), 25 and dystonia; 34 vagus nerve stimulation (VNS) for refractory epilepsy; 17 , 21 , 33 and spinal cord stimulation (SCS) for chronic pain. 18 , 19 , 22 Neuromodulatory interventions may be difficult to sustain for some patients, in part because they depend on the ongoing function of implanted medical devices. The length of survival for various neuromodulatory

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Taku Yoneyama, Takakazu Kawamata, Masahiko Tanaka, Koji Yamaguchi and Yoshikazu Okada

T he effectiveness of carotid endarterectomy (CEA) for advanced carotid stenosis has been established in many large studies. Various surgical instruments for CEA are being used, including standard retractors. 3 , 6 In a conventional CEA, after skin incision a Weitlaner retractor is applied to hold the skin edges. The retractor is placed progressively deeper into the operative field as neck dissection continues, especially on the lateral side. A second retractor, such as a hinged Richards device, together with hooks, are sometimes placed deeply to retain

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Neurosurgical materials and devices

Report on regulatory agencies and advisory groups

Charles V. Burton and Joseph T. McFadden

I n 1967, American neurological surgery assumed an active role in the development of voluntary consensus standards for neurosurgical materials and devices. These endeavors, in conjunction with the various neurosurgical and other specialty societies, the established national and international standards writing societies and their coordinating bodies, the Food and Drug Administration, and many other organizations and agencies, have led neurosurgeons into a bewildering array of names and abbreviations, at times only remotely related to the practice of

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Robert F. Spetzler and Alfred A. Iversen

. 1. Four different sizes of the malleable microsurgical suction device. The third sample incorporates suction and irrigation action. The fourth sample has been bent to demonstrate the memory of the suction tubing. This device comes in various sizes to allow irrigation and drainage from any operative field. With the use of this suction device, microsurgical procedures can be performed in a cleaner operative field and without the need to put down an instrument in order to pick up the suction tube ( Fig. 2 ). We have used this suction instrument in over 100

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Ballard D. Wright and Byron Young

T he clinical usefulness of intracranial pressure (ICP) monitoring has spawned a number of innovative devices and techniques. These devices measure ICP by means of sensors or transducers that are either implanted in the skull or connected to an intraventricular catheter. The calibrated output of the sensors is displayed as an electronic waveform on an oscilloscope. 1–4 These devices are properly referred to as monitors since they have no intrinsic regulating function. We are describing a device (invented by B.D.W.) that enables pressure monitoring as well as

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Robin I. Davidson and Cyril Rodgers

S ince the initial introduction of the Frazier suction apparatus for use in neurosurgical operative procedures, an extensive number of modifications have been developed for it. A partial list has included the development of a combination suction-cautery tip, 3 a fiber-optic illuminated suction device, 12 a self-retaining multipore-suction tube, 8 a suction device with a split tip to avoid tissue impaction, 11 a malleable suction device, 10 and a variety of suction tips for microneuro-surgery. 4, 7, 9 Modifications have been developed to enhance the

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Giampaolo Cantore, Pasquale Ciappetta and Roberto Delfini

dura mater and underlying nervous structures, especially when thick wire is used. Snapping of the wires and/or fracture of the occipital bone postoperatively due to the stresses involved in flexion and extension of the head are other possible complications. For these reasons, we have devised a stainless steel assembly for occipital fixation which allows easy and risk-free passage of the wires out of the skull and supplies considerable tensile strength regardless of the status of the occipital bone. Description of the Device Figure 1 shows the components of

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Tamara Denning, Yoky Matsuoka and Tadayoshi Kohno

. Neuroethics, on the other hand, strives to ensure that the therapies produced by neural engineering follow certain ethical guidelines and respect the sanctity of the individual. 11 To date, neither of these approaches considers how a neural device might be appropriated to perform unintended actions that are unethical or unsafe. In this paper we define “neurosecurity” and discuss related challenges that will arise as neural engineering technologies continue to evolve. In addition, we discuss why neurosecurity must be a critical consideration in the design of future neural

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Ray H. Kinnaird and Richard K. Jelsma

transferred for diagnostic studies or other reasons. To eliminate these problems, a traction device without hanging weights has been constructed. Description and Use of Device This traction device is constructed with four stainless-steel, ferromagnetic, constant-force springs (similar to a coiled self-retracting tape measure), each of which exerts 7 lb of traction over an extension range of 24 in. ( Fig. 1 ) The springs are mounted on journal bearings that are secured to an outer aluminum frame, and each spring terminates in an extension ring that fits into a slot on

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Philippe Decq, Caroline Le Guerinel, Stéphane Palfi, Michel Djindjian, Yves Kéravel and Jean-Paul Nguyen

through the foramen of Monro into the third ventricle is very easy under visual control. Nevertheless, ventriculostomy in the premammillary recess is not always so easy to perform and requires modified instrumentation. Modifications of the Instrument The new device is a modified endoscopic flexible grasping forceps ( Fig. 1 ). Its outer diameter is less than 1 mm, allowing it to be used with No. 3 French catheters for instrument channels. Its characteristics are: 1) the tip of the forceps is thin enough to allow easy perforation of the floor of the ventricle, and its