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Operative neurosurgery

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https://www.readbyqxmd.com/read/28340495/residents-learning-curve-of-lumbar-transforaminal-epidural-steroid-injections
#1
Holger Joswig, Sarah Roberta Haile, Gerhard Hildebrandt, Martin Nikolaus Stienen
Background and Study Aims There is a paucity of literature on beginners' training and on its connection with patient safety for transforaminal epidural steroid injections (TFESIs). This study retrospectively assessed the learning curves and associated complications of neurosurgery residents never previously exposed to TFESI and compared them with experienced board-certified faculty neurosurgeons (BCFNs). Material and Methods Procedure time in minutes, dose-area product (DAP) in cGy*cm(2), periprocedural observations, and complications in 354 TFESIs for radicular pain secondary to lumbar disk herniation or lumbar spinal stenosis were extracted from operative notes and the electronic infiltration logbook in the per-injection format...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28338454/impact-of-preoperative-diagnosis-on-patient-satisfaction-following-lumbar-spine-surgery
#2
Charles H Crawford, Leah Y Carreon, Mohamad Bydon, Anthony L Asher, Steven D Glassman
OBJECTIVE Patient satisfaction is a commonly used metric in the current health care environment. While factors that affect patient satisfaction following spine surgery are complex, the authors of this study hypothesized that specific diagnostic groups of patients are more likely to be satisfied after spine surgery and that this is reflected in patient-reported outcome measures. The purpose of this study was to determine if the preoperative diagnosis-disc herniation, stenosis, spondylolisthesis, adjacent segment degeneration, or mechanical disc collapse-would impact patient satisfaction following surgery...
March 24, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28334917/late-onset-cystic-brain-necrosis-after-radiotherapy-for-nasopharyngeal-carcinoma
#3
Wenli Fang, Beibei Gu, Xiuna Jing, Songhua Xiao, Shengnuo Fan, Wang Liao, Yuqiu Zheng, Jun Liu
Background: Cystic brain radionecrosis (CBRN) is a late-onset devastating complication after radiotherapy for head and neck neoplasms, especially for nasopharyngeal carcinoma (NPC). To our knowledge, it has scarcely been reported. Methods: We retrospectively reviewed all available medical records of NPC patients with CBRN who were treated with surgical intervention. Results: Sixteen patients were identified in this study and the mean latency of CBRN was 9...
February 24, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28327952/risk-of-venous-thromboembolism-and-operative-duration-in-patients-undergoing-neurosurgical-procedures
#4
Kimon Bekelis, Nicos Labropoulos, Shannon Coy
BACKGROUND: The association of operative duration with the risk of venous thromboembolism (VTE) has not been quantified in neurosurgery. OBJECTIVE: To investigate the association of surgical duration for several neurosurgical procedures and the incidence of VTE. METHODS: We performed a retrospective cohort study involving patients who underwent neurosurgical procedures from 2005 to 2012 and were registered in the American College of Surgeons National Quality Improvement Project registry...
January 28, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28326451/application-of-endoscopic-third-ventriculostomy-for-treating-hydrocephalus-correlated-chiari-type-i-malformation-in-a-single-chinese-neurosurgery-centre
#5
Yiping Wu, Chuzhong Li, Xuyi Zong, Xinsheng Wang, Songbai Gui, Caiping Gu, Yazhuo Zhang
The correlation between hydrocephalus and Chiari type I malformation (CIM) has been debated since Chiari's first descriptions of CIM but some studies have shown that CIM and hydrocephalus (HCP) could cause symptoms/disease of each other or vice versa. Recent research has found that treatment focused on hydrocephalus with ventricle enlargement also provides alleviation of CIM and even of syringomyelia. However, the lack of consensus among previous studies left unanswered the question of how endoscopic third ventriculostomy (ETV) addresses CIM and why it fails...
March 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28325443/vascular-segmentation-of-head-phase-contrast-magnetic-resonance-angiograms-using-grayscale-and-shape-features
#6
Ruoxiu Xiao, Hui Ding, Fangwen Zhai, Tong Zhao, Wenjing Zhou, Guangzhi Wang
BACKGROUND AND OBJECTIVE: In neurosurgery planning, vascular structures must be predetermined, which can guarantee the security of the operation carried out in the case of avoiding blood vessels. In this paper, an automatic algorithm of vascular segmentation, which combined the grayscale and shape features of the blood vessels, is proposed to extract 3D vascular structures from head phase-contrast magnetic resonance angiography dataset. METHODS: First, a cost function of mis-segmentation is introduced on the basis of traditional Bayesian statistical classification, and the blood vessel of weak grayscale that tended to be misclassified into background will be preserved...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28322180/operative-landscape-at-canadian-neurosurgery-residency-programs
#7
Michael K Tso, Ayoub Dakson, Syed Uzair Ahmed, Mark Bigder, Cameron Elliott, Daipayan Guha, Christian Iorio-Morin, Michelle Kameda-Smith, Pascal Lavergne, Serge Makarenko, Michael S Taccone, Bill Wang, Alexander Winkler-Schwartz, Tejas Sankar, Sean D Christie
Background Currently, the literature lacks reliable data regarding operative case volumes at Canadian neurosurgery residency programs. Our objective was to provide a snapshot of the operative landscape in Canadian neurosurgical training using the trainee-led Canadian Neurosurgery Research Collaborative. METHODS: Anonymized administrative operative data were gathered from each neurosurgery residency program from January 1, 2014, to December 31, 2014. Procedures were broadly classified into cranial, spine, peripheral nerve, and miscellaneous procedures...
March 21, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28303207/management-strategies-for-neoplastic-and-vascular-brain-lesions-presenting-during-pregnancy-a-series-of-29-patients
#8
Celestino Esteves Pereira, Jose Carlos Lynch
BACKGROUND: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. METHODS: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D'Or/São Luis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28300715/operative-learning-curve-after-transition-to-endoscopic-transsphenoidal-pituitary-surgery
#9
Tasneem Shikary, Norberto Andaluz, Jareen Meinzen-Derr, Collin Edwards, Philip Theodosopoulos, Lee A Zimmer
OBJECTIVES: No clear consensus yet defines the endpoints for operative learning curves in the transition to minimally invasive endoscopic techniques. This retrospective review of our first 202 patients who underwent endoscopic pituitary resection examines the statistical learning curve related to operative times--a measure of our surgical team's efficiency and complication rates, a reflection of surgical skill and maturity. METHODS: Retrospective chart review included patient demographics, tumor type, operative times, complication rates, and follow-up...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28300710/frameless-and-maskless-stereotactic-navigation-with-a-skull-mounted-tracker-a-technical-report
#10
Andrew A Fanous, Timothy G White, Matthew B Hirsch, Shamik Chakraborty, Peter D Costantino, David J Langer, John A Boockvar
Intraoperative image-guided navigation has revolutionized neurosurgery. It undoubtedly increases the surgeon's confidence and the perception of safety. While fiducials and facial masks are currently the most widely used tools for intraoperative navigation, their use is associated with certain complications. For instance, such tools require rigid fixation of the head, which increases the risk of skull fractures and epidural hematomas, and decreases both surgical flexibility and surgeon's comfort. In addition, the use of a facial mask is at times undesirable, as it may represent an obstacle during surgeries involving the face and forehead...
March 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28299589/respiratory-variation-in-peak-aortic-velocity-accurately-predicts-fluid-responsiveness-in-children-undergoing-neurosurgery-under-general-anesthesia
#11
Kavita G Morparia, Srijaya K Reddy, Laura J Olivieri, Michael C Spaeder, Jennifer J Schuette
The determination of fluid responsiveness in the critically ill child is of vital importance, more so as fluid overload becomes increasingly associated with worse outcomes. Dynamic markers of volume responsiveness have shown some promise in the pediatric population, but more research is needed before they can be adopted for widespread use. Our aim was to investigate effectiveness of respiratory variation in peak aortic velocity and pulse pressure variation to predict fluid responsiveness, and determine their optimal cutoff values...
March 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28292507/opioid-exit-plan-a-pharmacist-s-role-in-managing-acute-postoperative-pain
#12
Cheryl Genord, Timothy Frost, Deeb Eid
OBJECTIVES: The benefits of a pharmacist's involvement in medication reconciliation and discharge counseling are well documented in the literature as improving patient outcomes. In contrast, no studies have focused on the initiation of a pharmacist-led opioid exit plan (OEP) for acute postoperative pain management. This paper summarizes a pharmacist-led OEP practice model and the potential role that pharmacists and student pharmacists can have at the point of admission, during postoperative recovery, and on discharge in acute pain management patients...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28291221/-a-new-concept-of-organization-and-scope-of-neurosurgical-care-in-the-us-army-during-armed-conflicts-in-the-early-2000s
#13
Yu V Khrapov, D E Alekseev, D V Svistov
Military operations in various parts of the world in the early 2000s are becoming more regionalized; new warfare tactics emerge, which makes it necessary to review and modify the neurosurgical care system. The article reviews the results of original studies on this issue and summarizes the experience of the US Army medical service in Afghanistan and Iraq. The article discusses the structure of sanitary losses, organization and scope of medical and evacuation neurosurgical measures, types and techniques of surgical interventions, and the rate of complications...
2017: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
https://www.readbyqxmd.com/read/28286273/shunts-is-surgical-education-safe
#14
Holger Joswig, Dario Jucker, Adrien Lavalley, Lima Sprenger, Oliver P Gautschi, Gerhard Hildebrandt, Karl Schaller, Martin N Stienen
BACKGROUND: More data regarding complications in neurosurgery residents' cases is needed to assess patients' safety during hands-on surgical education. METHODS: Retrospective 2-center study comparing consecutive patients undergoing shunt implantation by a supervised neurosurgery resident (teaching cases) versus a board-certified faculty neurosurgeon (BCFN; nonteaching cases). Primary endpoint was surgical revision after shunting. Uni- and multivariate Cox's proportional hazard models (Breslow method for ties) with time censored at 2 years were used to examine time-to-event data...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28282628/blood-transfusion-indications-in-neurosurgical-patients-a-systematic-review
#15
REVIEW
Shefali Bagwe, Lawrance K Chung, Carlito Lagman, Brittany L Voth, Natalie E Barnette, Lekaa Elhajjmoussa, Isaac Yang
Neurosurgical procedures can be complicated by significant blood losses that have the potential to decrease tissue perfusion to critical brain tissue. Red blood cell transfusion is used in a variety of capacities both inside, and outside, of the operating room to prevent untoward neurologic damage. However, evidence-based guidelines concerning thresholds and indications for transfusion in neurosurgery remain limited. Consequently, transfusion practices in neurosurgical patients are highly variable and based on institutional experiences...
April 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28269815/electroclinical-semiology-of-the-bilateral-asymmetric-tonic-seizures-observed-in-patients-with-supplementary-sensorimotor-area-epilepsy-confirmed-by-pre-and-post-operative-mri
#16
Guilan Cai, Jing Wang, Xi Mei, Wei Zhang, Guoming Luan, Xingzhou Liu
OBJECTIVE: To retrospectively reappraise characteristics of the electro-clinical seizure semiology of the bilateral asymmetric tonic seizure (BATS) in the patients with supplementary sensorimotor area (SSMA) epilepsy. METHODS: From the retrospective analysis of the pre- and post-operative Magnetic Resonance Imaging (MRI) data involving 386 patients who received epilepsy surgery, 123 BATS were identified meeting the clinical criteria and included in the study. For comparison in four extremities involvement, limbs were paired and comparatively evaluated between the contralateral and ipsilateral sides, proximal and distal segments, and upper and lower limbs...
2017: Journal of X-ray Science and Technology
https://www.readbyqxmd.com/read/28263047/mapping-the-connectome-in-awake-surgery-for-gliomas-an-update
#17
Hugues Duffau
The traditional principle underlying oncological neurosurgery is to remove a tumor mass displacing the brain in order to increase survival. Recently, advances in connectomics enabled an improved understanding of cerebral processing, and led to a paradigmatic shift in tumor surgery based upon interactions between neurooncology and cognitive neurosciences. First, glioma is not a focal tumor invaginated within the parenchyma but a diffuse neoplastic disease migrating in the brain. This concept resulted in a new surgical ideology, i...
March 6, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28261083/automatic-and-precise-localization-and-cortical-labeling-of-subdural-and-depth-intracranial-electrodes
#18
Chaoyi Qin, Zheng Tan, Yali Pan, Yanyan Li, Lin Wang, Liankun Ren, Wenjing Zhou, Liang Wang
Object: Subdural or deep intracerebral electrodes are essential in order to precisely localize epileptic zone in patients with medically intractable epilepsy. Precise localization of the implanted electrodes is critical to clinical diagnosing and treatment as well as for scientific studies. In this study, we sought to automatically and precisely extract intracranial electrodes using pre-operative MRI and post-operative CT images. Method: The subdural and depth intracranial electrodes were readily detected using clustering-based segmentation...
2017: Frontiers in Neuroinformatics
https://www.readbyqxmd.com/read/28254672/is-the-use-of-minimally-invasive-fusion-technologies-associated-with-improved-outcomes-after-elective-interbody-lumbar-fusion-analysis-of-a-nationwide-prospective-patient-reported-outcomes-registry
#19
Matthew J McGirt, Scott L Parker, Praveen Mummaneni, John Knightly, Deborah Pfortmiller, Kevin Foley, Anthony L Asher
BACKGROUND CONTEXT: Over the last decade, clinical investigators and biomedical industry groups have used significant resources to develop advanced technologies that enable less invasive spine fusions. These minimally invasive surgery (MIS) technologies often require increased expenditures by hospitals and payers. While several small single center studies have suggested MIS technologies decrease surgical morbidity and reduce hospital stay, evidence documenting benefit from a patient perspective remains limited...
February 27, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28253483/factors-that-influence-recurrent-lumbar-disc-herniation
#20
M E Yaman, A Kazancı, N D Yaman, F Baş, G Ayberk
INTRODUCTION: The most common cause of poor outcome following lumbar disc surgery is recurrent herniation. Recurrence has been noted in 5% to 15% of patients with surgically treated primary lumbar disc herniation. There have been many studies designed to determine the risk factors for recurrent lumbar disc herniation. In this study, we retrospectively analysed the influence of disc degeneration, endplate changes, surgical technique, and patient's clinical characteristics on recurrent lumbar disc herniation...
March 3, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
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