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Michael M. McDowell, Yin Zhao, Christopher P. Kellner, Sunjay M. Barton, Eric Sussman, Jan Claassen, Andrew F. Ducruet and E. Sander Connolly

Characteristics A total of 1493 patients were enrolled in SHOP during the specified time period. Of the 1277 patients with a confirmed ruptured intracranial aneurysm, 890 (69.7%) had 1 aneurysm and 387 (30.3%) had more than 1 aneurysm. In patients with multiple aneurysms, 267 of 1493 (20.9%) had 2 aneurysms, and 120 of 1493 (9.4%) had 3 or more aneurysms (mean 3.75 aneurysms; range 3–10 aneurysms). The mean body mass index (BMI) was 24.39. The mean BMIs were 23.4, 25.9, and 27.8 for patients with 1, 2, and 3 or more aneurysms, respectively. Obesity was statistically

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Shane Shahrestani, Alexander M. Ballatori, Xiao T. Chen, Andy Ton, Ben A. Strickland, Andrew Brunswick and Gabriel Zada

W ithin the last several decades, the field of preventative medicine has grown immensely alongside an increased emphasis on avoiding unnecessary surgical care. 1 A mainstay of preventive medicine includes thorough analysis of clinical effects of various modifiable risk factors (MRFs) and nonmodifiable risk factors (NMRFs). A wide range of MRFs and NMRFs, including BMI and age, have been associated with neurosurgical complications. 2–4 Pituitary adenomas (PAs) are among the most common intracranial tumors; studies outlining the influence of MRFs and NMRFs on

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Joseph Laratta, Leah Y. Carreon, Avery L. Buchholz, Andrew Y. Yew, Erica F. Bisson, Praveen V. Mummaneni and Steven D. Glassman

M edical comorbidities, such as obesity, anxiety, and depression, represent an ever-expanding challenge globally and a nationwide epidemic with significant public health and economic implications in the United States. In terms of obesity, nearly 35% of adults in the United States are considered obese, as defined by the World Health Organization as a BMI greater than 30 kg/m 2 . 1 , 2 In addition to a strong association with medical comorbidities and detrimental effects on overall health, obesity has been linked with increased rates of disc degeneration

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Joseph J. Pancrazio

B rain-machine interfaces provide a pathway for communication between the brain and devices that are either external or internal to the patient. In bypassing regions of the nervous system damaged as a result of trauma or disease, BMIs have significant implications for the restoration of communication for locked-in patients, volitional control of paralyzed limbs through the activation of implanted neuromuscular stimulation systems, and perhaps sensorimotor function in prosthetic limbs. 4 Such interfaces are being realized through cooperative

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Lorenzo Rinaldo, Joshua D. Hughes, Alejandro A. Rabinstein and Giuseppe Lanzino

P revious work has suggested the possibility of a protective effect of increased body mass index (BMI) on patients suffering from aneurysmal subarachnoid hemorrhage (aSAH). 13 , 38 This finding, however, has not been consistently observed in other studies; 9 , 17 , 28 , 29 , 33 in fact, certain studies have observed a negative effect of increased BMI on patient outcomes. 15 , 27 Ruptured aneurysms are typically secured with either surgical clipping or endovascular coiling. The physiological effects of elevated BMI may confer higher levels of procedural risk

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Nitin Agarwal, Federico Angriman, Ezequiel Goldschmidt, James Zhou, Adam S. Kanter, David O. Okonkwo, Peter G. Passias, Themistocles Protopsaltis, Virginie Lafage, Renaud Lafage, Frank Schwab, Shay Bess, Christopher Ames, Justin S. Smith, Christopher I. Shaffrey, Douglas Burton, D. Kojo Hamilton and the International Spine Study Group

is often considered the single most important factor with regard to surgical efficacy. 1 , 2 , 8 Obesity is an increasingly common problem in the United States, with recent estimates showing that roughly 35% of adults in the United States are either overweight or obese. 15 Spine surgeons in particular have been affected by this growing epidemic. Previously published studies have determined that patients with a higher BMI experience higher rates of perioperative complications related to spine surgery. 16 , 21 With interventions for spinal deformity, obesity was

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Ankur S. Narain, Fady Y. Hijji, Brittany E. Haws, Krishna T. Kudaravalli, Kelly H. Yom, Jonathan Markowitz and Kern Singh

O besity is a health epidemic in the United States, with 35.5% of the adult population considered to be obese according to body mass index (BMI). 26 Excess weight and obesity have been linked to significant comorbidities including diabetes, cardiovascular disease, and obstructive sleep apnea. 1 , 15 , 18 A high BMI can also have adverse effects on spinal health, as evidenced by the increased rates of spinal degenerative disease among obese patients. 13 Regarding the cervical spine, obese patients have an increased risk of cervical myelopathy and radiculopathy

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Brandon W. Smith, Jennifer Strahle, Erick Kazarian, Karin M. Muraszko, Hugh J. L. Garton and Cormac O. Maher

T he association between an increased body mass index (BMI) and Chiari malformation Type I (CM-I) is not clear. There are several individual reports of obese individuals with CM-I, which have led some authors to speculate that an elevated BMI may be a causative factor for CM-I. 4 , 18 The authors of 2 recent case series found that patients with CM-I frequently had a BMI in the obese range, and they postulated that an elevated BMI may play a pathophysiological role in CM-I, syrinx formation, or CM-I symptoms. 4 , 9 CM-I is defined on imaging by

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Kenan I. Arnautovic, Dario Muzevic, Bruno Splavski and Frederick A. Boop

the subsequent development of syringomyelia. Decompression of the foramen magnum, reestablishment of CSF flow across the craniocervical junction, and resolution of the syrinx are well-recognized goals of operative treatment in symptomatic patients with CM-I. This treatment usually resolves or at least stabilizes symptoms in the majority of patients. To the best of our knowledge, there has been no previous study of the association between increased BMI and CM-I or the influence of an increasing BMI on the de novo formation of a spinal cord syrinx in adults. We have

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Brian J. Dlouhy, Karthik Madhavan, John D. Clinger, Ambur Reddy, Jeffrey D. Dawson, Erin K. O'Brien, Eugene Chang, Scott M. Graham and Jeremy D. W. Greenlee

defined as a BMI of 25.0 to 29.9 and “obese” was defined as a BMI of 30.0 or higher. 11 Obesity places individuals at risk for a host of medical problems including cardiovascular disease, 16 diabetes, 11 and cancer. 37 With regard to neurological/neurosurgical disorders, obesity is associated with both idiopathic intracranial hypertension 24 and spontaneous CSF rhinorrhea. 8 Recent studies investigating the risk factors associated with spontaneous CSF leaks revealed that ICP elevation, 8 , 38 an underlying diagnosis of idiopathic intracranial hypertension, 39