Awake Mapping With Transopercular Approach in Right Insular–Centered Low-Grade Gliomas Improves Neurological Outcomes and Return to Work
CONCLUSION:
This is the first study comparing asleep vs awake surgery for right insula–centered LGG. Despite similar extent of resection, functional outcomes were significantly better in awake patients by avoiding permanent neurological impairment and by increasing RTW. These results support the mapping of higher-order functions during awake procedure. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Tumor Source Type: research
Fulfillment of Patient Expectations After Spine Surgery is Critical to Patient Satisfaction: A Cohort Study of Spine Surgery Patients
CONCLUSION:
Given the dominant impact of expectation fulfillment on satisfaction level, there is an opportunity for improving overall patient satisfaction by specifically assessing and mitigating the potential discrepancies between patients' preoperative expectations and likely surgical outcomes. The findings are likely relevant across elective surgical populations. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Spine Source Type: research
Surgeon-Led Initiatives to Increase Access to Surgical Treatment of Epilepsy at an Academic Level 4 Epilepsy Center: An Observational Cohort Study
BACKGROUND:
Underutilization of surgical treatment for epilepsy is multifactorial, and the multidisciplinary nature of caring for these patients represents a significant hurdle in expanding surgical treatment of epilepsy.
OBJECTIVE:
To develop internal and external surgical referral relationships for patients with medically refractory epilepsy with the goal of improving access to care.
METHODS:
To expand access to surgical epilepsy treatment at University of California (UC)–Irvine, 4 broad approaches focused on developing referral relationships and process improvement of surgical evaluation were underta...
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Stereotactic Functional Source Type: research
Prognostic Value of Lateral Spread Response Recorded 1 Month After Microvascular Decompression for the Treatment of Hemifacial Spasm
BACKGROUND:
The predictive value of intraoperative disappearance of the lateral spread response (LSR) during microvascular decompression surgery for hemifacial spasm treatment is unclear. Studies evaluating the clinical implications of the LSR recorded during the postoperative period are also limited.
OBJECTIVE:
To analyze the LSR 1 month postoperatively and to evaluate its prognostic value until 1 year postsurgery.
METHODS:
In total, 883 patients who underwent microvascular decompression between 2016 and 2018 were included. LSR was recorded preoperatively, intraoperatively before decompression, intraoper...
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Stereotactic Functional Source Type: research
Safe Electromyography Stimulation Thresholds Within Kambin's Triangle During Endoscopic Transforaminal Lumbar Interbody Fusion
CONCLUSION:
We demonstrated for the first time the feasibility of direct intraoperative neuromonitoring within Kambin's triangle in transforaminal endoscopic surgery. Eight milliampere seems to be a reasonable compromise between sensitivity and specificity for this monitoring technique. In the future, larger-scale studies are required to refine safe stimulation thresholds. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Spine Source Type: research
Hounsfield Unit as a Predictor of Adjacent-Level Disease in Lumbar Interbody Fusion Surgery
CONCLUSION:
Patients who underwent lumbar interbody fusion that did not require reoperation for adjacent-level degeneration were found to have a higher mean preoperative HU than patients who did require surgical intervention. Lower preoperative CT HU was a significant independent predictor for the requirement of adjacent-level surgery after spinal arthrodesis. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Spine Source Type: research
Unilateral Campotomy of Forel for Acquired Hemidystonia: An Open-Label Clinical Trial
CONCLUSION:
The unilateral stereotaxy-guided ablation of Forel H1 and H2 fields significantly improved in patients with HD compared with optimized clinical treatment. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Stereotactic Functional Source Type: research
Initial Clinical Outcome With Bilateral, Dual-Target Deep Brain Stimulation Trial in Parkinson Disease Using Summit RC + S
CONCLUSION:
Patients with PD preferred combined DBS stimulation in this preliminary cohort. Future studies will address efficacy of adaptive DBS as we further define biomarkers and control policy. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Stereotactic Functional Source Type: research
Is the Centers for Medicare and Medicaid Services Hierarchical Condition Category Risk Adjustment Model Satisfactory for Quantifying Risk After Spine Surgery?
CONCLUSION:
The addition of key demographic and socioeconomic characteristics substantially improves the CMS HCC risk-adjustment models when modeling spinal fusion outcomes. This finding may have important implications for payers, hospitals, and policymakers. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Spine Source Type: research
Early Detection and Management of Venous Thrombosis in Skull Base Surgery: Role of Routine Doppler Ultrasound Monitoring
BACKGROUND:
Venous thromboembolism (VTE), encompassing deep venous thrombosis (DVT) and pulmonary embolism (PE), causes postoperative morbidity and mortality in neurosurgical patients. The use of pharmacological prophylaxis for DVT prevention in the immediate postoperative period carries increased risk of intracranial hemorrhage, especially after skull base surgeries.
OBJECTIVE:
To investigate the impact of routine Doppler ultrasound monitoring in prevention and tiered management of VTE after skull base surgery.
METHODS:
We retrospectively analyzed a large cohort of consecutive adult patients who were pro...
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Skull Base Source Type: research
The Phenotypes of Anxiety and Depression: Analysis of Combined Comorbidity and Treatment in Patients Undergoing Spinal Fusion
CONCLUSION:
Spine surgeons should use appropriate measures/questionnaires to screen depressed patients for anxiety and vice versa because the presence of both adds significant risk of higher healthcare utilization and costs over patients with 1 diagnosis, especially anxiety alone. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Spine Source Type: research
Seizure Outcomes and Reoperation in Surgical Rasmussen Encephalitis Patients
CONCLUSION:
Obtaining complete disconnection is critical for favorable seizure outcomes from hemispherectomy, and neurosurgeons should have a low threshold to reoperate in patients with RE with recurrent seizures. Rapid progression of motor deficits and bilateral MRI abnormalities may indicate a subpopulation of patients with RE with increased risk of needing reoperation. Overall, we believe that hemispherectomy is a curative surgery for the majority of patients with RE, with excellent long-term seizure outcome. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Pediatrics Source Type: research
Neurosurgical Performance in the First 2 Years of Merit-Based Incentive Payment System: A Descriptive Analysis and Predictors of Receiving Bonus Payments
BACKGROUND:
The merit-based incentive payment system (MIPS) program was implemented to tie Medicare reimbursements to value-based care measures. Neurosurgical performance in MIPS has not yet been described.
OBJECTIVE:
To characterize neurosurgical performance in the first 2 years of MIPS.
METHODS:
Publicly available data regarding MIPS performance for neurosurgeons in 2017 and 2018 were queried. Descriptive statistics about physician characteristics, MIPS performance, and ensuing payment adjustments were performed, and predictors of bonus payments were identified.
RESULTS:
There were 2811 physician...
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Socioeconomics, Health Policy and Law Source Type: research
Impact of Increasing Aspiration Catheter Size and Refinement of Technique: Experience of Over 1000 Strokes Treated With ADAPT
CONCLUSION:
Medium-bore catheters had better performance measures compared with small-bore catheters. However, large-bore catheters did not show significantly better performance results that suggest a plateau effect. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Endovascular Source Type: research
Racial and Ethnical Diversity Within the Neurosurgery Resident and Faculty Workforce in the United States
CONCLUSION:
NS has evolved, expanded, and diversified in numerous directions, including race and gender representation. Our data show that ample opportunities remain to improve URiM representation within NS. (Source: Neurosurgery)
Source: Neurosurgery - June 22, 2022 Category: Neurosurgery Tags: Research—Human—Clinical Studies: Socioeconomics, Health Policy and Law Source Type: research
