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Objective We investigated the effectiveness of a right hemispheric surgical approach in treating unruptured anterior communicating artery aneurysms. Methods Between January 2005 and June 2012, 305 patients with anterior communicating artery (Acom) aneurysms were treated using the pterional approach. Among them, 113 who underwent microsurgery with an unruptured Acom aneurysm were enrolled in this study. Every patient was evaluated with digital subtraction angiography preoperatively and CT scans were taken several times postoperatively. Surgical outcomes and complications were evaluated at discharge using the Glasgow Outcome Scale and at 6 months after surgery with CT angiography. Results Enrolled patients included 55 males and 58 females with a mean age of 56.3 years (range: 30–75 years). The mean diameter of the aneurysm was 5.8 mm (range: 1.9–24.1). Left A1 dominancy was found in 71 patients (62.8%) whereas right A1 dominancy was found in 20 patients (17.7%), and right pterional craniotomies were performed in 92 patients (81.4%) while left pterional craniotomies were performed in 21 patients (18.6%). Complete clip application was achieved in 94.9% of patients (74 of 78) in right-side approach group but in only 81.3% of patients (13 of 16) in left-side approach group. Despite a left A1 dominancy and approached from the right, more than 90% of the patients had an excellent outcome at discharge (GOS 5) and more than 90% a complete aneurysm clipping at the 6-month follow-up CT angiography although it was not statistically significant. Conclusion Microsurgical clipping of the unruptured Acom aneurysm through a right-side surgical approach showed favorable postoperative clinical and anatomical outcomes, especially aneurysms smaller than 10 mm.

Objective To analyze the interspinous distance and the height, length, and thickness of the lumbar spinous process for interspinous device implantation in Korean patients. Methods Morphometric data obtained from plain radiographs of the lumbar and sacral spine were analyzed. The study included 60 matched subjects who visited an outpatient clinic for back pain. Exclusion criteria included collapsed intervertebral disc, lumbarization, and sacralization. There were 34 men and 26 women; age range was the 20s to 70s, with 10 subjects in each decade. The interspinous distance and height, length, and thickness of the lumbar spinous process were obtained on lateral radiographs using an image analysis program (M-view 5.4; Marotech). Results The largest interspinous distance was at L2-3, with a mean of 12 mm (range 6–22 mm), and the smallest distance was at L5-S1, with a mean of 8 mm (range 3–16 mm). The interspinous distance became shorter from L1-2 to L5-S1. A negative correlation was noted between age and interspinous distance in the L1-5 levels (L1-2, y=−0.11x + 17.27, r 2 = 0.34, P r 2 = 0.12, P = 0.0058; L3-4, y=−0.08x + 14.39, r 2 = 0.27, P r 2 = 0.096, P = 0.0158; L5-S1, y=−0.02x + 9.25, r 2 = 0.028, P = 0.1982). Conclusions There is a decreasing trend in the interspinous distance in the L1-5 levels with advancing years. Taking progressive collapse of the interspinous distance with the aging process into consideration, interspinous implants should be carefully selected in younger patients.