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Marc Asher

Surgery, ed 2. Philadelphia: Lippincott-Raven, 1997). Page 175, Right column, Line 4: The first neurosurgeon, George Jacobs of New York, became a member (associate) of the Scoliosis Research Society in 1997, the year I was president; I supported his application. Reference 6, Harrington's obituary in the Journal of Bone and Joint Surgery, American Volume, was written by his practice associate Jesse Hamilton Dickson, whose initials are at the end. I appreciate the opportunity to comment. Disclosure The author reports no conflict of interest. Reference

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Ann-Christine Duhaime and Daniel Schwartz

to answer questions will we ultimately learn what works best to improve quality and safety in surgery for all of the patients we serve, including those at the lowest end of the age spectrum. References 1 Deletis V , Intraoperative monitoring of the functional integrity of the motor pathways . Devisky O , Beric A , Dugali M : Advances in Neurology Volume 63: Electrical and Magnetic Stimulation of the Brain New York , Raven Press , 2002 . 201 – 214 2 DiCindio S , Schwartz DM : Anesthesia management for pediatric spinal fusion

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Jared S. Fridley, Andrew Jea, Chris D. Glover and Kim P. Nguyen

duraplasty following spinal cord detethering. Conclusions Based on our small experience with symptomatic CSF leakage after spine surgery, we recommend an ultrasonography study to determine the presence of a pseudomeningocele, to determine the extent of the leakage, to aspirate CSF, and to place an EBP in the pediatric patient. The use of ultrasound guidance assures correct placement of the needle, determines the volume of aspiration needed to evacuate the CSF fully, and confirms the injection of the blood in the epidural space. A postinjection ultrasound can also be

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Andrew Jea, Shobhan Vachhrajani, Keyne K. Johnson and James T. Rutka

disconnection syndromes, related to surgical manipulation, frontal lobe retraction, and venous injury. These same small reports noted no signs of postradiosurgical side effects in short-and long-term follow-up. However, the true risk of induction of secondary malignancy is unknown. Also, a complete callosotomy cannot be performed in a single radiosurgical procedure due to the large treatment volume so if a total callosotomy is indicated a 2-staged procedure must be planned. Guerrero and Cohen 7 described the use of a rigid endoscope to enhance microsurgical visualization

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Jonathan N. Sellin, Aditya Vedantam, Thomas G. Luerssen and Andrew Jea

decompression, and delayed CSF leaks, causality has not been definitively established. We did not note any symptomatic CSF leaks in our discectomy cohort. However, it could be the case that CSF leaks occurred but the volume of dead space after discectomy, particularly minimally invasive discectomy, was not clinically significant enough for the accumulation of CSF and subsequent low-pressure symptomatology. Hence, these patients did not come to clinical attention. Our study was not able to detect asymptomatic radiographic pseudomeningoceles, because we did not use surveillance

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Spinal instrumentation in infants, children, and adolescents: a review

JNSPG 75th Anniversary Invited Review Article

Stephen Mendenhall, Dillon Mobasser, Katherine Relyea and Andrew Jea

arteries, small bone volume in the lateral mass to safely accommodate a screw of sufficient width and length (3.5 × 14 mm), 134 and violation of the facet joint, which predisposes to untoward adjacent-level changes. 9 , 12 , 25 Often, the spine surgeon is allowed only one opportunity to accurately place a screw, as the small size of the lateral mass does not allow for multiple attempts. Furthermore, a shorter screw may need to be placed (3.5 × 10 mm), compromising the strength of the construct. Our technique for placing subaxial lateral mass screws is illustrated in

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Sheila L. Ryan, Anish Sen, Kristen Staggers, Thomas G. Luerssen and Andrew Jea

% October 2012 0 15 0% November 2012 0 15 0% December 2012 0 22 0% January 2013 0 23 0% February 2013 0 12 0% March 2013 1 9 11.11% April 2013 0 21 0% May 2013 1 16 6.25% June 2013 0 40 0% July 2013 0 41 0% August 2013 2 25 8.0% September 2013 1 11 9.10% overall 6 267 2.2% Each surgeon performed between 1 and 87 procedures. Surgeon-specific infection rates varied (0%–9.38%) and did not appear to correlate with surgeon procedure volume ( Table 3

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Leonardo Rangel-Castilla, Steven W. Hwang, George Al-Shamy, Andrew Jea and Daniel J. Curry

complications (hypovolemia and coagulopathies), especially given the blood volume in young children. 2 The small craniotomy required for periinsular hemispherectomy decreases blood loss and operative time. Another early or late complication of anatomical hemispherectomy is hydrocephalus, occurring in as many as 50% of the patients, which is related to the elimination of subarachnoid space over the operated convexity. 7 , 12 , 23 Periinsular hemispherotomy spares a substantial amount of subarachnoid space, significantly decreasing the incidence of hydrocephalus

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Kyung Shin Kang, Jeff Lastfogel, Laurie L. Ackerman, Andrew Jea, Alexander G. Robling and Sunil S. Tholpady

weeks after surgery. Scans were obtained in isoflurane-anesthetized mice in which the scanning condition was as follows: isotropic voxel size 17.5 μm 3 , 55 kVp, and integration time 200 msec. The relatively newly formed bone area was evaluated by comparing the values with each first scan within a manually delineated region of interest. The new bone volume formed was calculated as the bone volume at Week 8 over the bone volume on Day 1 within each group. Histopathological Analysis Two months after surgery, the animals were euthanized with an intracardiac injection of

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Aditya Vedantam, Daniel Hansen, Valentina Briceño, Amee Moreno, Sheila L. Ryan and Andrew Jea

that higher-volume pediatric surgical centers may achieve better outcomes. 32 Furthermore, other data indicate that high-volume centers may achieve better outcomes for certain neurosurgical conditions, 13 which has further stimulated regionalization of care and the trend toward transfer of patients to specialized centers. 6 , 14 , 22 , 24 The management of some pediatric neurosurgical conditions requires dedicated teams, such as neurointensivists, that may not be available at other facilities; in the adult neurosurgical patient population, this has been shown to