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Tag: Journal of Neurosurgery

  • Count of neurosurgeon density reflects global unmet needs

    Count of neurosurgeon density reflects global unmet needs

    Newswise — Rolling Meadows, IL (January 16, 2024) How many neurosurgeons are needed worldwide? Recent reports have suggested that a neurosurgeon ratio of approximately 1 neurosurgeon per 65,000 individuals may not be adequate. Investigators from Harvard Medical School attempted to systematically provide the most accurate count of neurosurgeon density around the world, as well the number in each country. Using data collected from 99.5% of all countries and 96.2% of all additional territories, states, and disputed regions, the authors report that there are approximately 72,967 neurosurgeons globally, representing a pooled density of 0.93 neurosurgeons per 100,000 individuals, and a median national density of 0.44 neurosurgeons per 100,000 individuals. The study detailing these findings was published today in the Journal of Neurosurgery (https://thejns.org/doi/10.3171/2023.9.JNS231615). 

    The authors used contacts with national and regional neurosurgery societies, their own personal contacts, bibliometric and Google searches, and World Bank and United Nations data to obtain perhaps the most accurate count of global neurosurgeon density to date. There were wide disparities in the neurosurgery workforce and access to resources in different WHO regions and World Bank income categories. The African region, with 0.11 neurosurgeons per 100,000 individuals, and the Southeast Asia region, with 0.34 per 100,000 individuals, had the lowest neurosurgeon density, while the Western Pacific region (WPR) had the highest density, with 1.58 per 100,000 individuals. The authors found that there were 29 countries, 14 territories, and 1 independent state with no neurosurgeons at all, representing almost 36 million individualswithout access to a neurosurgeon. Among these 29 countries, 21 were low- and middle-income countries (LMICs; 72.4%), and most were located in the WPR (n = 10, 34.5%) or African region (n = 9, 31.0%). 

    The greatest growth in the number of neurosurgeons from 2016 to 2022 was in the Southeast Asia region (33.0% per year), while the slowest growth was in the African region (2.0% per year); 15 countries in the African region had a decrease in their neurosurgery densities, and 7 of these 15 countries were in West Africa. Some of the strongest predictors of annual relative growth in neurosurgery density included the presence of a national neurosurgery society, development aid, and national gross domestic product. 

    “We were excited to find that the neurosurgery workforce is growing worldwide, but the growth in LMICs has been disproportionately slow,” said Dr. Saksham Gupta, the lead author of the study. “The number of neurosurgeons in many LMICs remains insufficient to manage their countries’ needs, and neurosurgeons in LMICs have fewer resources to provide subspecialized care. These imbalances will negatively affect population health in LMICs and could contribute to burnout amongst already overworked LMIC neurosurgeons.” 

    In a related companion article (https://thejns.org/doi/10.3171/2023.9.JNS231616), the authors also attempted to determine the global density of neurosurgeon trainees. They estimated there were 1261 training programs with 10,546 neurosurgery trainees worldwide. The Southeast Asia (0.04 per 100,000 people) and African (0.05 per 100,000 people) regions had the lowest pooled trainee density, and there were no training programs in 22.4% of high-income countries (HICs) and in 35.2% of LMICs. Surveys of African young neurosurgeons and trainees highlighted some of the educational limitations that most trainees face, which included low exposure to educational conferences, the inability to attend national and international research conferences, and low access to cadaver laboratories.

    Regarding solutions to correct these imbalances, Gupta stated, “Collaboration between LMICs and HICs as well as between LMICs themselves is key and will help new perspectives flourish and best practices spread. Furthermore, there have been several impressive educational efforts, including but certainly not limited to Dr. Rutka’s work with the Ukraine Pediatric Fellowship Program, Dr. Baticulon’s work in the Philippines, the World Federation of Neurosurgical Societies (WFNS)—sponsored training center in Rabat, and numerous Foundation for International Education in Neurological Surgery courses and partnerships. Education is the bedrock of neurosurgery, and we should continue supporting existing educational tools (such as cadaver laboratories, weekend courses, year-long fellowships) while promoting emerging teaching modalities (webinars, high-fidelity dissection models, and open-access operative videos).”

    Articles:  Gupta S, Gal ZT, Athni TS, Calderon C, Callison WÉ, Dada OE, Lie W, Qian C, Reddy R, Rolle M, Baticulon RE, Chaurasia B, Dos Santos Rubio EJ, Esquenazi Y, Golby AJ, Pirzad AF, and Park KB, on behalf of the WFNS Global Neurosurgery Committee, EANS Global and Humanitarian Neurosurgery Committee, and CAANS Executive Leadership Committee. Mapping the global neurosurgery workforce. Part 1: Consultant neurosurgeon density. Journal of Neurosurgery. Published online January 16, 2024; DOI: 10.3171/2023.9.JNS231615. Mapping the global neurosurgery workforce. Part 2: Trainee density. Journal of Neurosurgery. Published online January 16, 2024; DOI: 10.3171/2023.9.JNS231616.

    Disclosures: The authors report no conflict of interest concerning the materials or methods used in these studies or the findings specified in these papers.

    Funding: Mr. Athni was supported by the National Institute of General Medical Sciences, NIH, under grant no. T32GM144273.

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    The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • December 2023 Issue of Neurosurgical Focus: “Enhanced Recovery After Cranial Surgery”

    December 2023 Issue of Neurosurgical Focus: “Enhanced Recovery After Cranial Surgery”

    Newswise — Rolling Meadows, IL (December 1, 2023). The October issue of Neurosurgical Focus (Vol. 55, No. 6 [https://thejns.org/focus/view/journals/neurosurg-focus/55/6/neurosurg-focus.55.issue-6.xml]) presents twelve articles and one editorial on enhanced recovery after cranial surgery. 

    Topic Editors: Walavan Sivakumar, Neil Martin, Sarah T. Menacho, Randy S. D’Amico, and Luca Regli 

    Following on earlier attention to enhanced recovery in spine surgery, the December issue of Neurosurgical Focus focuses on enhance recovery after cranial surgery. The issue’s editors present “a contemporary and global selection of evidence-based studies encompassing the range of cranial surgery” with the “hope that this issue will serve as a valuable reference for the readership in their own protocol development efforts.” 

    Contents of the December issue: 

    • “Introduction. Developing the foundation for enhanced recovery after cranial surgery” by Walavan Sivakumar et al.
    • “Theory-based implementation of an enhanced recovery protocol for cranial surgery” by Aimun A. B. Jamjoom et al.
    • “Editorial. Overcoming implementation barriers in enhanced recovery using theory-based approaches” by Walavan Sivakumar
    • “Development and implementation of an Enhanced Recovery After Cranial Surgery pathway following supratentorial tumor resection at a tertiary care center” by Hammad A. Khan et al.
    • “Enhanced recovery after brain tumor surgery: pilot protocol implementation in a large healthcare system” by Walavan Sivakumar et al.
    • “Enhanced recovery and same-day discharge after brain tumor surgery under general anesthesia: initial experience with Hospital-at-Home–based postoperative follow-up” by Cristina A. Pelaez-Sanchez et al.
    • “Effect of the enhanced recovery protocol in patients with brain tumors undergoing elective craniotomies: a systematic review and meta-analysis” by Suchada Supbumrung et al.
    • “Same-day discharge after craniotomy for brain tumor resection: enhancing patient selection through a prognostic scoring system” by Adam S. Levy et al.
    • “The Enhanced Recovery After Surgery protocol for the perioperative management of pituitary neuroendocrine tumors/pituitary adenomas” by Giulia Cossu et al.
    • “An institutional experience in applying quality improvement measures to pituitary surgery: clinical and resource implications” by Panayiotis E. Pelargos et al.
    • “Early versus delayed mobilization after aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of efficacy and safety” by Alberto Morello et al.
    • “Applications of enhanced recovery after surgery protocolsfor unruptured anterior circulation aneurysms in tertiary-level healthcare institutions: a national study” by Fatih Yakar et al.
    • “Effects of a sphenopalatine ganglion block on postcraniotomy pain management: a randomized, double-blind, clinical trial” by Giorgio Mantovani et al.
    • “The Enhanced Recovery After Surgery protocol for the surgical management of craniosynostosis: Lausanne experience” by Amani Belouaer et al.

     Please join us in reading this month’s issue of Neurosurgical Focus.

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     Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

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     The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • October 2023 Issue of Neurosurgical Focus: “Management and Controversies of Antithrombotic Medication in Neurosurgery”

    October 2023 Issue of Neurosurgical Focus: “Management and Controversies of Antithrombotic Medication in Neurosurgery”

    Newswise — Rolling Meadows, IL (October 1, 2023). The October issue of Neurosurgical Focus (Vol. 55, No. 4 [https://thejns.org/focus/view/journals/neurosurg-focus/55/4/neurosurg-focus.55.issue-4.xml]) presents 20 articles on the management and controversies of antithrombotic medication in neurosurgery.

     Topic Editors: Jehuda Soleman, R. Loch Macdonald, David Seiffge, and Ladina Greuter

    The October issue of Neurosurgical Focus includes a wide variety of articles on the use of antithrombotic medication in neurosurgery. The topic editors of the issue write that their goal is to “to successfully highlight the importance of this topic within the neurosurgical community, showing its growing role in almost all age groups and subspecialities of neurosurgery.” 

    Contents of the October issue: 

    • “Introduction. Antithrombotic medication in neurosurgery: management and controversies of a growing clinical dilemma” by Jehuda Soleman et al.
    • “Impact of premorbid oral anticoagulant use on survival in patients with traumatic intracranial hemorrhage” by David Botros et al.
    • “Effect of perioperative anticoagulant prophylaxis in patients with traumatic subdural hematoma and a history of anticoagulant use: a propensity-matched National Trauma Data Bank analysis” by Sam H. Jiang et al.
    • “Interaction of admission platelet count with current medications and the risk for chronic subdural recurrence” by Shawn R. Eagle et al.
    • “The implications of antithrombotic agents on subdural hematoma evacuation: what does “reversal” truly entail?” by Danielle D. Dang et al.
    • “Perioperative continuation or ultra-early resumption of antithrombotics in elective neurosurgical cranial procedures” by Jonathan Rychen et al.
    • “Stroke risk related to intentional discontinuation of antithrombotic therapy for invasive procedures” by Nobuyuki Mitsui et al.
    • “Anticoagulation for the treatment of septic cerebral venous sinus thrombosis in the setting of pediatric sinogenic and otogenic intracranial infections” by Pearl A. Sutter et al.
    • “Cilostazol for the management of moyamoya disease: a systematic review of the early evidence, efficacy, safety, and future directions” by Aidin Abedi et al.
    • “Safety of dual antiplatelet therapy in the acute phase of aneurysmal subarachnoid hemorrhage: a propensity score–matched study” by Farid Qoorchi Moheb Seraj et al.
    • “Does the clopidogrel CYP2C19 genotype assay predict postprocedure stenosis in cerebral aneurysms treated with a flow diverter?” by Austin J. Allen et al.
    • “Delayed ischemic events with low-dose prasugrel medication for stent-assisted coil embolization in intracranial aneurysm patients” by Hyun Ho Choi et al.
    • “Thrombocyte transfusion and rebleeding rate in patients using antiplatelet agents before aneurysmal subarachnoid hemorrhage” by Martina Sebök et al.
    • “To use or not to use antithrombotics in unruptured cerebrovascular malformations? A systematic review focusing on this clinical and surgical dilemma” by Andrea Bianconi et al.
    • “Bleeding risk evaluation in cerebral cavernous malformation, the role of medications, and hemorrhagic factors: a case-control study” by Alba Scerrati et al.
    • “Examining the safety profile of a standard dose tranexamic acid regimen in spine surgery” by Joshua Setliff et al.
    • “Safety and comparative efficacy of initiating low-molecular-weight heparin within 24 hours of injury or surgery for venous thromboembolism prophylaxis in patients with spinal cord injury: a prospective TRACK-SCI registry study” by Austin Lui et al.
    • “Systematic review and meta-analysis of topical tranexamic acid in spine surgery” by Chiemela Izima et al.
    • “Safety and functional outcomes of early antiplatelet therapy within 24 hours following mechanical thrombectomy for secondary prevention in emergent large-vessel occlusion strokes: a registry study” by Hepzibha Alexander et al.
    • “Effect of chronic antiplatelet therapy on clinical outcomes of endovascular thrombectomy for treatment of acute ischemic stroke” by Alis J. Dicpinigaitis et al.
    • “Association of tirofiban with improvement of functional outcomes of direct thrombectomy for acute anterior circulation occlusion: a retrospective, nonrandomized, multicenter, real-world study” by Qiaochu Guan et al.

     Please join us in reading this month’s issue of Neurosurgical Focus.

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    Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

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     The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • October 2023 Issue of Neurosurgical Focus: Video: “Intradural Spinal Tumors”

    October 2023 Issue of Neurosurgical Focus: Video: “Intradural Spinal Tumors”

    Newswise — Rolling Meadows, IL (October 1, 2023). The October issue of Neurosurgical Focus: Video (Vol. 9, No. 2 [https://thejns.org/video/view/journals/neurosurg-focus-video/9/2/neurosurg-focus-video.9.issue-2.xml]) presents 21 videos demonstrating techniques related to the treatment of intradural spinal tumors.

    Topic Editors: Michelle J. Clarke, Paul McCormick, Mark Bilsky, and Praveen Mummaneni

    The October issue of Neurosurgical Focus: Video is dedicated to the topic of intradural spinal tumors. The editors of this month’s issue present a selection of videos that “showcases both classic and novel techniques to treat these diverse lesions. Demonstrated surgical techniques include microsurgical resection, endoscopic techniques, and minimally invasive surgeries, providing a comprehensive overview of the state-of-the-art practices in this specialized area.”

    Contents of the October issue: 

    • “Introduction. Intradural spine tumor surgery” by Michelle J. Clarke et al.
    • “Dorsal cervical approach for recurrent intradural anaplastic ependymoma” by Maxwell T. Laws et al.
    • “Cervical ependymoma en bloc resection” by Matheus A. Bannach et al.
    • “Spinal cord tractography and neuromonitoring-based surgical strategy for intramedullary ependymoma” by Corentin Dauleac et al.
    • “The precise midline myelotomy through anatomical posterior median septum by dissecting dorsal column in microsurgical resection of ependymoma (2-dimensional operative video)” by Jun-Hoe Kim and Chun Kee Chung
    • “Resection of intradural intramedullary subependymoma of the cervicothoracic spine: 2-dimensional operative video” by Joshua Vignolles-Jeong et al.
    • “Surgical resection of recurrent intramedullary subependymoma of the cervical spinal cord” by Jennifer L. Perez et al.
    • “Anterolateral upper cervical approach for ventral C1–C2 meningioma” by Serdar Rahmanov et al.
    • “Surgical resection of an intradural extramedullary spinal tumor” by Joseph Yunga Tigre et al.
    • “Intramedullary sclerosing meningioma: operative video” by Giada Garufi et al.
    • “A rapid clinical deterioration of a cervical exophytic intradural intramedullary sporadic hemangioblastoma diagnosed during pregnancy” by Ufuk Erginoglu et al.
    • “Minimally invasive resection of cervical schwannoma (C1–C2 level) using tubular retractors” by Harsh Deora and Madhusudhan Nagesh
    • “Location-specific technical nuances of spinal meningioma resection: an operative video case series” by Wilson A. M. Fisher et al.
    • “Technical nuances for the resection of cervical dumbbell schwannomas” by Brandon M. Wilkinson et al.
    • “Thoracic laminectomy and midline myelotomy for resection of a spinal ependymoma” by Lea Scherschinski et al.
    • “Resection of a large thoracolumbar intradural ependymoma: a 2D operative video” by Daniel M. Aaronson et al.
    • “Removal of a thoracic intramedullary epidermoid tumor in a child” by Marianna Di Costanzo et al.
    • “Robot-assisted T12 pediculectomy and resection of a ventral thoracic meningioma” by Mahmudur Rahman et al.
    • “Minimally-invasive tubular resection of thoracolumbar intradural schwannoma” by Maya Harary et al.
    • “Resection of a large multisegmental filum terminale ependymoma through a multisegmental hemilaminectomy” by Paawan Bahadur Bhandari
    • “Tandem resection of multiple spinal schwannomas” by Joseph S. Bell et al.
    • “Surgical resection of lumbar intradural metastatic renal cell carcinoma” by Mohamed Macki et al.

     Please join us in viewing the videos in this month’s issue of Neurosurgical Focus: Video.

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    Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

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    The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • July 2023 Issue of Neurosurgical Focus: “Sacroiliac Joint Dysfunction: Diagnosis and Treatment Options”

    July 2023 Issue of Neurosurgical Focus: “Sacroiliac Joint Dysfunction: Diagnosis and Treatment Options”

    Newswise — Rolling Meadows, IL (July 1, 2023). The July issue of Neurosurgical Focus (Vol. 55, No. 1 [https://thejns.org/focus/view/journals/neurosurg-focus/55/1/neurosurg-focus.55.issue-1.xml]) presents three articles and one editorial on sacroiliac joint dysfunction.

    Topic Editors: Paul Park, Kristen E. Jones, Yamaan S. Saadeh, Cristiano M. Menezes, and Juan S. Uribe

    The July issue of Neurosurgical Focus presents a concise selection of the newest information about the treatment of sacroiliac joint (SIJ) dysfunction. Noting that “the prevalence of SIJ-mediated low-back pain is reportedly as high as 30%,” the Topic Editors of this issue have prepared a brief collection of articles on treatment techniques.

    Contents of the July issue:

    • “Introduction. Surgery for sacroiliac joint dysfunction: emerging techniques and assistive technologies” by Paul Park et al.
    • “Fusion and patient-reported outcomes after navigated decortication and direct arthrodesis in minimally invasive sacroiliac joint fusion using cylindrical threaded implants: a case series and literature review” by Gustavo Anton et al.
    • “Editorial. Sacroiliac joint fusion: durability of symptom relief by promoting bone arthrodesis” by Yamaan S. Saadeh et al.
    • “Robotic versus nonrobotic sacroiliac joint fusion” by John H. Lee et al.
    • “Bilateral sacroiliac joint fusion in long constructs using self-harvesting porous S2–alar iliac screws with an integrated tulip: technical considerations and early clinical and radiographic experience” by Nima Alan et al.

    Please join us in reading this month’s issue of Neurosurgical Focus.

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    The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • June 2023 Issue of Neurosurgical Focus: “Machine Learning in Neurosurgery”

    June 2023 Issue of Neurosurgical Focus: “Machine Learning in Neurosurgery”

    Newswise — Rolling Meadows, IL (June 1, 2023). The June issue of Neurosurgical Focus (Vol. 54, No. 6 [https://thejns.org/focus/view/journals/neurosurg-focus/54/6/neurosurg-focus.54.issue-6.xml]) presents sixteen articles on the rising use of machine learning in neurosurgical research and practice.

    Topic Editors: Mohamad Bydon, John H. Shin, Shelly D. Timmons, and Eric A. Potts

    The June issue of Neurosurgical Focus is focused on new developments that have led to the increased use of machine learning in neurosurgery. In this issue, “the authors study current machine learning models, evaluate novel algorithms, and discuss approaches to appraising machine learning techniques in neurosurgery,” as noted by the Topic Editors, who hope that this issue will contribute to providing “a long-lasting reference for clinicians and scientists, stimulate scientific thought, and provide a framework for a fruitful conversation on a highly complicated and challenging topic.”

    Contents of the June issue:

    • “Introduction. Machine learning in neurosurgery: transitioning to a new era of contemporary medicine” by Mohamad Bydon et al.
    • “Quantification of motion during microvascular anastomosis simulation using machine learning hand detection” by Nicolas I. Gonzalez-Romo et al.
    • “Critically reading machine learning literature in neurosurgery: a reader’s guide and checklist for appraising prediction models” by Sivaram Emani et al.
    • “Metabolomic differentiation of tumor core versus edge in glioma” by Mary E. Baxter et al.
    • “Which supervised machine learning algorithm can best predict achievement of minimum clinically important difference in neck pain after surgery in patients with cervical myelopathy? A QOD study” by Christine Park et al.
    • “Interhemispheric connections in the maintenance of language performance and prognosis prediction: fully connected layer-based deep learning model analysis” by Haosu Zhang et al.
    • “Developing nonlinear k-nearest neighbors classification algorithms to identify patients at high risk of increased length of hospital stay following spine surgery” by Shane Shahrestani et al.
    • “Machine learning predictive models in neurosurgery: an appraisal based on the TRIPOD guidelines. Systematic review” by Anmol Warman et al.
    • “Incorporation of a biparietal narrowing metric to improve the ability of machine learning models to detect sagittal craniosynostosis with 2D photographs” by Megan G. Anderson et al.
    • “Surgical classification using natural language processing of informed consent forms in spine surgery” by Michael D. Shost et al.
    • “MRI-based detection of cervical ossification of the posterior longitudinal ligament using a novel automated machine learning diagnostic tool” by Shachar Shemesh et al.
    • “Using machine learning to predict 30-day readmission and reoperation following resection of supratentorial high-grade gliomas: an ACS NSQIP study involving 9418 patients” by Abdul Karim Ghaith et al.
    • “Evaluating a 3D deep learning pipeline for cerebral vessel and intracranial aneurysm segmentation from computed tomography angiography–digital subtraction angiography image pairs” by Tatsat R. Patel et al.
    • “Comparison of machine learning models to predict long-term outcomes after severe traumatic brain injury” by Dooman Arefan et al.
    • “Immunohistochemical markers predicting long-term recurrence following clival and spinal chordoma resection: a multicenter study” by Abdul Karim Ghaith et al.
    • “Machine learning for automated and real-time two-dimensional to three-dimensional registration of the spine using a single radiograph” by Andrew Abumoussa et al.
    • “Radiomic signatures of meningiomas using the Ki-67proliferation index as a prognostic marker of clinical outcomes” by Omaditya Khanna et al.

     Please join us in reading this month’s issue of Neurosurgical Focus.

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     Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

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     The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • May 2023 Issue of Neurosurgical Focus: “Contemporary Indications for Flow Diversion”

    May 2023 Issue of Neurosurgical Focus: “Contemporary Indications for Flow Diversion”

    Newswise — Rolling Meadows, IL (May 1, 2023). The May issue of Neurosurgical Focus (Vol. 54, No. 5 [https://thejns.org/focus/view/journals/neurosurg-focus/54/5/neurosurg-focus.54.issue-5.xml]) presents eight articles on contemporary indications and applications of flow diversion.

    Topic Editors: Adam S. Arthur, Ramesh Grandhi, Stavropoula I. Tjoumakaris, and Peter K. Nelson

     The May issue of Neurosurgical Focus presents an overview of the use and development of flow diversion over the most recent decades. Noting that the “introduction of endoluminal devices, providing flow diversion effects across the aneurysm neck, established an entirely new paradigm for treatment,” the Topic Editors continue, “We expect to see continued expansion in the use of flow diversion and in the supporting knowledge base that will allow us to pursue this strategy for safely and effectively treating an assortment of aneurysmal pathologies.”

     Contents of the May issue: 

    • “Introduction. Contemporary indications for flow diversion” by Adam S. Arthur et al.
    • “The first decade of flow diversion for intracranial aneurysms with the Pipeline embolization device” by Andre Monteiro et al.
    • “Efficacy and safety of flow diverter combined with coil embolization and evidence-based antithrombotic regimen in the treatment of ruptured aneurysms” by Zhen Chen et al.
    • “Safety and efficacy of the Pipeline Flex embolization device with Shield Technology for the acute treatment of ruptured internal carotid artery pseudoaneurysms: a multi-institution case series” by Michael T. Bounajem et al.
    • “Flow diversion using the Pipeline embolization device for intracranial and extracranial pseudoaneurysms: a systematic review and meta-analysis of the literature” by Elena Greco et al.
    • “FRED Jr stent for acute flow diversion in ruptured cerebral aneurysms arising from small-caliber vessels: a clinical case series” by Omer Doron et al.
    • “Safety and efficacy of the p48 MW and p64 flow modulation devices: a systematic review and meta-analysis” by Juan Vivanco-Suarez et al.
    • “Flow diverter stent treatment for unruptured supraclinoid segment internal carotid artery aneurysms: a Turkish multicenter study” by Fatih Yakar et al.

     Please join us in reading this month’s issue of Neurosurgical Focus.

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    The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

    Journal of Neurosurgery

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  • February 2023 Issue of Neurosurgical Focus: “Neurosurgical Management of Psychiatric Disease”

    February 2023 Issue of Neurosurgical Focus: “Neurosurgical Management of Psychiatric Disease”

    Newswise — Rolling Meadows, IL (February 1, 2023). The February issue of Neurosurgical Focus (Vol. 54, No. 2 [https://thejns.org/focus/view/journals/neurosurg-focus/54/2/neurosurg-focus.54.issue-2.xml]) presents seven articles on the neurosurgical management of psychiatric disease.

    Topic Editors: Sameer A. Sheth, G. Rees Cosgrove, and Nicole C. R. McLaughlin

    Calling attention to the need to reduce the “the ever-narrowing gap between neurosurgery and neuroscience”, the Topic Editors of the February issue of Neurosurgical Focus have selected articles to produce a collection that “features a number of articles detailing the history of psychiatric neurosurgery and provides modern day examples of its continued success.”

    Contents of the February issue: 

    • “Introduction. Neurosurgical neuroscience” by Sameer A. Sheth et al.
    • “The Surgeon, or The Extraction of the Stone of Madness, by Jan Sanders van Hemessen (c 1500–1566)” by Eric J. Chalif
    • “Intracranial subsecond dopamine measurements during a “sure bet or gamble” decision-making task in patients with alcohol use disorder suggest diminished dopaminergic signals about relief” by Brittany Liebenow et al.
    • “Stereotactic electroencephalography in epilepsy patients for mapping of neural circuits related to emotional and psychiatric behaviors: a systematic review” by Christian G. Lopez Ramos et al.
    • “Efficacy of deep brain stimulation for the treatment of anorexia nervosa: a systematic review and network meta-analysis of patient-level data” by Annabelle Shaffer et al.
    • “Novel psychiatric disorders following mild traumatic brain injury: a retrospective multivariable analysis with screening recommendations” by Alexander M. Ballatori et al.
    • “Schizophrenia and neurosurgery: systematic review and theories” by Rajeev R. Dutta et al.
    • “Neurosurgery for psychiatric disorders: reviewing the past and charting the future” by Luke Bauerle et al.

     

    Please join us in reading this month’s issue of Neurosurgical Focus.

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    The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • January 2023 Issue of Neurosurgical Focus: “Minimally Invasive Surgery of Lumbar Spine”

    January 2023 Issue of Neurosurgical Focus: “Minimally Invasive Surgery of Lumbar Spine”

    Newswise — Rolling Meadows, IL (January 1, 2023). The January issue of Neurosurgical Focus (Vol. 54, No. 2 [https://thejns.org/focus/view/journals/neurosurg-focus/54/1/neurosurg-focus.54.issue-1.xml]) presents 10 articles on minimally invasive surgery of the lumbar spine.

    Topic Editors: Paul M. Arnold, Dean Chou, Cara L. Sedney, Xu Sun, Timothy F. Witham, Robert F. Heary

    Observing that “the first 2 decades of the new century have seen an explosion of new technology and surgical techniques in spine surgery,” the Topic Editors of the January issue of Neurosurgical Focus present an issue that “highlights several novel techniques that will be of interest to the practicing spine surgeon” as well as points to future developments in the field.

     Contents of the January issue: 

    • “Introduction. The growth of minimally invasive lumbar spine surgery” by Paul M. Arnold et al.
    • “Minimally invasive versus open transforaminal lumbar interbody fusion for grade I lumbar spondylolisthesis: 5-year follow-up from the prospective multicenter Quality Outcomes Database registry” by Andrew K. Chan et al.
    • “Radiographic alignment outcomes after the single-position prone transpsoas approach: a multi-institutional retrospective review of 363 cases” by Luis Diaz-Aguilar et al.
    • “Improvement following minimally invasive transforaminal lumbar interbody fusion in patients aged 70 years or older compared with younger age groups” by Pratyush Shahi et al.
    • “Multilevel tandem spondylolisthesis associated with a reduced ‘safe zone’ for a transpsoas lateral lumbar interbody fusion at L4–5” by Anthony Oyekan et al.
    • “How dimensions can guide surgical planning and training: a systematic review of Kambin’s triangle” by Romaric Waguia Kouam et al.
    • “The impact of cage positioning on lumbar lordosis and disc space restoration following minimally invasive lateral lumbar interbody fusion” by Tariq Ziad Issa et al.
    • “En bloc resection of ligamentum flavum with laminotomy of the caudal lamina in the minimally invasive laminectomy: surgical anatomy and technique” by Luis M. Tumialán
    • “Sacroiliac joint fusion navigation: how accurate is pin placement?” by Shea M. Comadoll et al.
    • “A triple minimally invasive surgery combination for subacute osteoporotic lower lumbar vertebral collapse with neurological compromise: a potential alternative to the vertebral corpectomy/expandable cage strategy” by Yoichi Tani et al.
    • “Does the Global Alignment and Proportion score predict mechanical complications in circumferential minimally invasive surgery for adult spinal deformity?” by David Gendelberg et al.

    Please join us in reading this month’s issue of Neurosurgical Focus.

     ***

    Embargoed Article Access and Author/Expert Interviews:

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    The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • January 2023 Issue of Neurosurgical Focus: Video: “Regaining Function via Peripheral Nerve Surgery”

    January 2023 Issue of Neurosurgical Focus: Video: “Regaining Function via Peripheral Nerve Surgery”

    Newswise — Rolling Meadows, IL (January 1, 2023). The January issue of Neurosurgical Focus (Vol. 8, No. 1 [https://thejns.org/video/view/journals/neurosurg-focus-video/8/1/neurosurg-focus-video.8.issue-1.xml]) presents 15 articles discussing peripheral nerve surgery.

    Topic Editors: Mariano Socolovsky, Zarina S. Ali, Brandon W. Smith, and Kevin N. Swong        

    Noting that “peripheral nerve surgery is unique in neurosurgery, as it allows for restoration of lost neurological function by way of regenerating and repairing damaged axons,” in this issue of Neurosurgical Focus: Video, the Topic Editors suggest the videos in this issue will present “innovative surgical techniques” that may help to provide “benefits not previously thought possible” for neurosurgical patients.

    Contents of the January issue: 

    • “Introduction. Regaining function via peripheral nerve surgery” by Mariano Socolovsky et al.
    • “Supraclavicular approach for neonatal brachial plexus palsy” by Yamaan S. Saadeh et al.
    • “Selective denervation for cervical dystonia” by Megan M. J. Bauman et al.
    • “Distal anterior interosseous nerve to ulnar nerve motor branch reverse end-to-side transfer in a case of severe ulnar neuropathy” by Rajesh Krishna Pathiyil et al.
    • “Oberlin transfer for C5-6 palsy after posterior cervical spine surgery” by Stephen P. Miranda et al.
    • “Masseter-to-facial nerve transfer for facial nerve reanimation” by Hussam Abou-Al-Shaar et al.
    • “Diagnosis and treatment of phrenic nerve hourglass constriction in patients with Parsonage-Turner syndrome” by Travis S. CreveCoeur et al.
    • “Lateral femoral cutaneous nerve transposition” by Garret P. Greeneway et al.
    • “Ulnar fascicle to brachialis branch of musculocutaneous nerve for restoration of elbow flexion associated with spinal cord tumor and radiation-induced lower motor neuron disease” by M. Benjamin Larkin et al.
    • “Distal nerve transfer (PT-AIN, SUP-PIN) for regaining hand function in C8, T1 root injury following extirpation of the right C8, T1 schwannoma” by Lukas Rasulić et al.
    • “Transfer of extensor carpi radialis brevis branch of radial nerve to anterior interosseous nerve for lower trunk brachial plexopathy after motor vehicle accident” by Alison M. Westrup et al.
    • “Targeted muscle reinnervation in above knee amputation: surgical technique” by Michael J. Boctor et al.
    • “Early grafting in severe adult traumatic brachial plexus injury” by Justus L. Groen et al.
    • “Partial hypoglossal-facial neurorrhaphy: a surgical technique” by Ujwal Yeole et al.
    • “Neurectomies for treatment of stroke-related upper extremity spasticity” by Mark A. Mahan
    • “Allograft nerve repair to prevent sensorimotor loss after nerve sheath tumor resection” by Stephen P. Miranda et al.

    Please join us in viewing the videos in this month’s issue of Neurosurgical Focus: Video.

     ***

    Embargoed Article Access and Author/Expert Interviews:

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    The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • Computer Vision Is Superior to Surgeons in Identifying Spinal Implants

    Computer Vision Is Superior to Surgeons in Identifying Spinal Implants

    Newswise — Rolling Meadows, IL (December 27, 2022). Identifying previously placed spinal hardware can be difficult and time consuming when a patient needs revision surgery. Detailed information on the implant model and type are often lacking when patients are referred elsewhere or may be missing in the surgical notes. To overcome this challenge, researchers developed a computer vision machine learning approach that more accurately and efficiently identifies previously placed thoracolumbar instrumentation. The study detailing the computer vision model was published today in the Journal of Neurosurgery: Spine and can be found at https://thejns.org/doi/10.3171/22.11.SPINE221009.

    To build their computer vision classifier, Dr. Alexander E. Ropper and colleagues used 1072 radiographs showing postoperative views of placed thoracolumbar instrumentation manufactured by five different device companies. Each image was labeled with the device implanted, and a bag-of-visual-words technique utilizing KAZE feature detection was used to construct a computer vision support vector machine classifier. Accuracy rates for binary classification of the two most commonly placed systems for lateral, anteroposterior, and fused images were 93.15%, 88.98%, and 91.08%, respectively, although accuracy decreased by 10% with each manufacturer added. The computer vision model outperformed two surgeons and three manufacturer representatives in both accuracy (79% versus 44%) and completion time (14 seconds versus 20 minutes). Further steps to improve the model’s accuracy include increasing the number of images per manufacturer to ensure an even distribution.

    When asked about the study, Dr. Ropper said, “This computer vision machine learning model will be able to assist surgeons in planning revision instrumented fusions. By accurately and quickly identifying existing hardware based on standard radiographsbefore a revision surgery, both surgeons and operating room staff will be better prepared to remove or revise the hardware.”

     

    Article: Adrish Anand, Alex R. Flores, Malcolm F. McDonald, Ron Gadot, David S. Xu, and Alexander E. Ropper. A computer vision approach to identifying the manufacturer of posterior thoracolumbar instrumentation systems. Journal of Neurosurgery: Spine, published online, ahead of print, December 27, 2022; DOI: 10.3171/22.11.SPINE221009.

    Disclosures:  Mr. Gadot reported a patent for 63/374,877 pending. Dr. Xu reported personal fees from NuVasive and Providence Medical Technologies, and grants from Medtronic outside the submitted work. Dr. Ropper reported personal fees from Globus Medical and Stryker outside the submitted work; in addition, Dr. Ropper had a patent for computer vision systems and methods for classifying implanted thoracolumbar pedicle screws pending.

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    The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • Balancing the Safety and Education of Pregnant Neurosurgeons

    Balancing the Safety and Education of Pregnant Neurosurgeons

    Newswise — Rolling Meadows, IL (NOVEMBER 8, 2022). Because there are unique circumstances that may impact the training, safety, and career trajectory of pregnant neurosurgeons, as well as risks inherent to the pregnant neurosurgical resident from occupational exposures and pregnancy physiology, the authors of this paper have come up with recommendations for both pregnant residents and their residency programs to mitigate these risks, focusing on the impact on their education as well as on their colleagues. Detailed findings of this study are described in the article “Best practices for the pregnant neurosurgical resident: balancing safety and education” by Krystal L. Tomei et al., published today in the Journal of Neurosurgery (https://thejns.org/doi/abs/10.3171/2022.9.JNS221727).

    As neurosurgery moves to improve diversity, including attracting women to the field, and as policies supporting parental leave are written into training and board certification requirements, it is imperative to consider the additional barriers to childbearing inherent in residency training.

    Noting the stigma associated with pregnant residents and the impact of their pregnancy on colleagues, the lack of policy and financial support regarding parental leave, postpartum challenges, and the higher medical complication rates in pregnant surgeons, including higher rates of pregnancy loss, a higher need for assisted reproductive technology, more frequent nonelective cesarean deliveries, and increased rates of postpartum depression, the authors set out to provide interventions for each of the three trimesters and the postpartum “fourth trimester,” as well as best practices for residency programs. These recommendations can be carried forward by the pregnant resident and residency programs, with specific consideration of situations unique to neurosurgical training. The accommodations proposed by the authors take into account the bodily needs of pregnant residents and the nausea they may experience, the levels of radiation and teratogen they may be exposed to, their postpartum parental leave and breastfeeding needs, and the possibility of medical and bereavement leave (in the case of pregnancy loss), with the goal of aiding pregnant residents in meeting their residency educational and training requirements in a safe and inclusive environment. Furthermore, the authors suggest that additional policies should strive to accommodate other pregnancy-related needs, including egg preservation and fertility treatments. In examining best practices, they also stress the need to support partner presence at prenatal appointments for neurosurgical residents whose partners are expecting, as well as normalizing and encouraging parental leave equally among all residents.

    When asked about the study, Dr. Tomei said, “Recently, our program had three residents over 3 years who became pregnant during various stages of their training. It was very important for me as a program director to balance their safety as well as their education and the impact upon their coresidents. When I started looking for resources to help guide this process, there was very limited information to go by. With the new changes put forth by the ABMS, ABNS, and ACGME, it was the opportune time to compile information for programs to be able to reference. I truly hope this is just the beginning as there are so many more opportunities to explore how we can best support our trainees during these milestones.”

     

    Article: Tomei KL, Hodges TR, Ragsdale E, Katz T, Greenfield M, Sweet JA. Best practices for the pregnant neurosurgical resident: balancing safety and education.  Journal of Neurosurgery, published online, ahead of print, November 8, 2022; DOI: 10.3171/2022.9.JNS221727.

    Disclosure: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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     Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

    ###

     The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • November 2022 Issue of Neurosurgical Focus: “Evolution of Radiation Therapy Technique”

    November 2022 Issue of Neurosurgical Focus: “Evolution of Radiation Therapy Technique”

    Newswise — November 2022 Issue of Neurosurgical Focus: “Evolution of Radiation Therapy Technique”

    Rolling Meadows, IL (November 1, 2022). The November issue of Neurosurgical Focus (Vol. 53, No. 5 [https://thejns.org/focus/view/journals/neurosurg-focus/53/5/neurosurg-focus.53.issue-5.xml]) presents one editorial and 10 articles on the history and development of radiation therapy in neurosurgical treatment.

    Topic Editors: Arjun Sahgal, Jason P. Sheehan, Ajay Niranjan, Lola B. Chambless, Lijun Ma, and Daniel M. Trifiletti

    The Topic Editors of this issue note that, “Radiation technology has undergone dramatic changes over the past 3 decades.” Therefore, this issue of Neurosurgical Focus aims to “further our understanding of stereotactic radiosurgery and stereotactic radiotherapy for primary brain tumors and functional conditions, as well as new developments for patients with brain metastases.”

    Contents of the November issue: 

    • “Introduction. Evolution of radiation therapy techniques” by Arjun Sahgal et al.
    • “Stereotactic radiosurgery for recurrent pediatric brain tumors: clinical outcomes and toxicity” by Elyn Wang et al.
    • “Stereotactic radiosurgery for trigeminal neuralgia secondary to tumor: a single-institution retrospective series” by Jennifer C. Hall et al.
    • “CyberKnife radiosurgery for trigeminal neuralgia: a retrospective review of 168 cases” by Albert Guillemette et al.
    • “Adjuvant stereotactic radiosurgery with or without postoperative fractionated radiation therapy in adults with skull base chordomas: a systematic review” by Othman Bin-Alamer et al.
    • “Outcomes following stereotactic radiosurgery for foramen magnum meningiomas: a single-center experience and systematic review of the literature” by Constantine L. Karras et al.
    • “Risk factors for peritumoral edema after radiosurgery for intracranial benign meningiomas: a long-term follow-up in a single institution” by Sheng-Han Huang et al.
    • “Neoadjuvant stereotactic radiosurgery for brain metastases: a new paradigm” by Yuping Derek Li et al.
    • “Stereotactic radiosurgery and resection for treatment of multiple brain metastases: a systematic review and analysis” by Uma V. Mahajan et al.
    • “A quantitative and comparative evaluation of stereotactic spine radiosurgery local control: proposing a consistent measurement methodology” by Ran Harel et al.
    • “Editorial. Assessing treatment response following stereotactic body
    • radiotherapy for spinal metastases” by Steven G. Roth and Lola B. Chambless
    • “The role of radiation therapy in the treatment of spine metastases from hepatocellular carcinoma: a systematic review and meta-analysis” by Gianluca Ferini et al.

     Please join us in reading this month’s issue of Neurosurgical Focus.

     ***

     ###

     

    The global leader for cutting-edge neurosurgery research since 1944, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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  • October 2022 Issue of Neurosurgical Focus: Video: “Flow Diversion for Cerebral Aneurysms”

    October 2022 Issue of Neurosurgical Focus: Video: “Flow Diversion for Cerebral Aneurysms”

    October 2022 Issue of Neurosurgical Focus: Video: “Flow Diversion for Cerebral Aneurysms”

    Rolling Meadows, IL (October 1, 2022). The October issue of Neurosurgical Focus (Vol. 7, No. 2 [https://thejns.org/video/view/journals/neurosurg-focus-video/7/2/neurosurg-focus-video.7.issue-2.xml]) presents 8 articles discussing flow diversion for cerebral aneurysms.

    Topic Editors: Peter T. Kan, Elad I. Levy, Felipe C. Albuquerque, and Mandy Jo Binning     

    Noting that “flow diversion represents a major advancement in the treatment of cerebral aneurysms,” in this issue of Neurosurgical Focus: Video, the Topic Editors present videos representing a “spectrum of cases” involving flow diversion for a variety of aneurysm treatment experiences.

     

    Contents of the October issue: 

    • “Introduction. Flow diversion for cerebral aneurysms” by Peter T. Kan et al.
    • “Flow diversion for cerebral aneurysms” by Joseph A. Carnevale et al.
    • “Challenging access during flow diversion treatment of a giant cavernous ICA aneurysm” by Visish M. Srinivasan et al.
    • “FRED flow diversion with LVIS protection of large posterior communicating artery aneurysm: the “FRELVIS” technique” by Steven B. Housley et al.
    • “Treatment of an acutely ruptured complex fusiform middle cerebral artery aneurysm with flow diverting stenting and adjunctive coil embolization” by Guilherme Barros and Michael R. Levitt
    • “Treatment of a ruptured blister aneurysm of the left internal carotid artery with telescoping Pipeline Flex embolization devices with Shield Technology” by Karol P. Budohoski et al.
    • “Combined deconstructive and reconstructive treatment of a giant vertebrobasilar fenestration aneurysm” by Lorenzo Rinaldo et al.
    • “Woven EndoBridge embolization in the retreatment of basilar apex aneurysm” by Jae Eun Lee et al.
    • “Flow diversion of a dissecting PICA aneurysm” by Tyler Lazaro et al.

     Please join us in viewing the videos in this month’s issue of Neurosurgical Focus: Video.

     ***

    Embargoed Article Access and Author/Expert Interviews: Contact JNSPG Director of Publications Gillian Shasby at [email protected] for advance access and to arrange interviews with the authors and external experts who can provide context for this research.

     ###

    The global leader for cutting-edge neurosurgery research for more than 75 years, the Journal of Neurosurgery (www.thejns.org) is the official journal of the American Association of Neurological Surgeons (AANS) representing over 12,000 members worldwide (www.AANS.org).

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