Mini-Tubular Access Surgery: A Single Surgeon's 12 Years in the Corridors of the Neuroaxis
Bibliographic record
Abstract
BACKGROUND: Tubular approach surgery now includes complex spinal and cranial procedures. Aided by modified instrumentation and frameless stereotaxy, minimal access surgery is being offered for a growing array of neurosurgical conditions. METHODS: This article explores the flexibility and adaptability of the tubular retractor system for multiple indications by highlighting the 12-year experience of the primary surgeon using a tubular retractor system reported for the entire neuroaxis including intracranial, foramen magnum, and the craniocaudal extent of the spine for intra- and extradural pathologies. For this article we have not analyzed our experience with degenerative spinal disease. Patient characteristics, pathology, resection results, length of hospital stay, and complications are discussed. RESULTS: From August 2005 through March 2017, 538 patients underwent neurosurgical procedures with mini-tubular access. Of these, the 127 patients who underwent mini-tubular access operations for nontraditional indications are discussed here. There were 65 women and 61 men with an average age of 53.5 years. The cases by anatomical location are as follows: 27 cranial cases, 11 foramen magnum decompressions, and 89 for spinal indications. The cranial pathologies included primary and metastatic tumors. The spinal pathologies included intra- and extradural spinal tumors, spina bifida occulta, syringomyelia, and other cystic lesions in the spine. In the vast majority of the patients where gross total resection was the goal, it was achieved. The mean length of stay was 2.94 days. CONCLUSIONS: This report demonstrates that mini-tubular access surgery can be adapted to pathologies in the entire neuroaxis with outcomes that are comparable with open techniques. Limited tissue dissection, smaller incisions, and limited bone resection make the mini-tubular access approach a desirable option when feasible. Greater experience with all of these techniques is needed before the definitive status of these procedures in the neurosurgical armamentarium can be demonstrated.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".