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Discovering neurosurgery: new frontiers

The 2011 AANS Presidential Address

James T. Rutka

. While the discovery of insulin must be ranked with some of the most important discoveries in modern medicine, in neurosurgery we too have much to be proud of in terms of the discoveries that have helped to shape our field. Today, I am delighted to share my thoughts on neurosurgical discoveries with you as we explore the theme of this year's meeting, Discovering Neurosurgery: New Frontiers . Discovering Denver as a Frontier City First, a few words about our assemblage here in Denver, a true “frontier” city. I begin with the famous word “eureka,” from the Greek

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Neurosurgery and industry

Presidential address

Jon H. Robertson

-Murphey Clinic and to the resident staff of the Department of Neurosurgery at the University of Tennessee in Memphis who made it possible for me to devote the time and energy required during my term as your president. Most importantly, I wish to take this opportunity to express my deep appreciation to my wife, Carol Ann, for her love and devotion throughout my medical career. This year has been a joy for our family. I am especially pleased that our children and their spouses can be with us today. It is my special privilege to recognize the mentors who were responsible for my

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Robert E. Harbaugh

S ince its founding early in the 20th century, 6 neurosurgery has grown and prospered. Neurosurgeons now treat more patients with lower risk, less pain, shorter hospital stays, and better outcomes than was the case only a few years ago. Our specialty has flourished because we have adhered to our founding principles. Now, with increasing frequency, we are being told that it would be expedient to abandon these principles. It is essential that we do not. Neurosurgery—a vigorous, exciting specialty during its first century—will continue to grow and prosper

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Hani J. Marcus, Archie Hughes-Hallett, Richard M. Kwasnicki, Ara Darzi, Guang-Zhong Yang and Dipankar Nandi

T echnological innovation within health care may be defined as the introduction of a new technology that initiates a change in clinical practice. 20 , 24 Neurosurgery is a particularly technology-intensive surgical discipline, and new technologies have preceded many of the major advances in operative neurosurgical techniques, including the development of microneurosurgery. 11 , 13 Although the study of innovation is a relatively mature academic field in social science and industry, 19 its application in the health care setting has been largely

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Neurosurgery, “neurospine,” and neuroscience: a vital synergy?

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2007

Adrian Nowitzke

neurosurgery, with the emergence of a strong component specializing in surgery of the spine. In North America, this new and young specialty understandably seeks recognition both in academic and in organizational circles. It could be argued that many of the advances in neurosurgery as a specialty in the past 15 years have developed in spine surgery, and certainly spine surgery contributes significantly to organizational neurosurgery through its strong financial association with the corporate world. It is partly for these reasons that some have advocated that surgery of the

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Jared D. Ament and Kee D. Kim

N eurosurgery , like many subspecialized fields in medicine, has become increasingly technological. And, expectedly, this is associated with escalating costs. In an era of cost containment and accountability, neurosurgery resultantly finds itself in a quandary. The awestruck days of “well, it's neurosurgery” are fleeting, as is the reliance on mild improvements in functional domains or clinical outcomes. We contend that addressing and attempting to maximize health-related QOL in neurosurgery is an important, relatively underutilized, investigative approach

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Srinivas Chivukula, Gregory M. Weiner and Johnathan A. Engh

T he popularization of general anesthesia and the discovery of the concept of antisepsis in the 19th century paved the way for rapid advancement in neurosurgery. 25 William Morton's (1819–1868) now famous demonstration of ether anesthesia in 1846 at the Massachusetts General Hospital, and Joseph Lister's (1827–1912) later identification of microorganisms as causative of postoperative infection contributed greatly to improvement in neurosurgical outcomes; prior to this time, operations resulted in severe morbidity, and not infrequently were fatal. 22 , 34

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Cary D. Alberstone, Edward C. Benzel and Deborah Garcia

Although trends in the marketplace demand for neurosurgeons should be of interest to neurosurgeons and prospective neurosurgeons, little data are available that accurately document these trends. A recent report published in the general medical journal Journal of the American Medical Association (JAMA) used the Conference Board help-wanted index to evaluate trends in physician marketplace demand. The authors of the JAMA study concluded that over the past 5 years there has been a significant fall in demand for specialist physicians. Because the discipline of neurosurgery was not included in the JAMA study, the authors of the present report attempt to evaluate the trend in the marketplace demand for neurosurgeons, using the same methodology of the JAMA study. The authors' data suggest that the conclusion of the JAMA study of steep declines in the demand for specialist physicians does not accurately reflect the job market for neurosurgeons, which in fact appears to be relatively stable. The present study attempts to document the stability of the neurosurgery market and outline the steps necessary to protect this market from existing threats.

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Eben Alexander Jr.

planned at the time to be a pediatric surgeon. However, there was a 6-month interval before the resident position in pediatric surgery would become available and, during that interval, I served with Franc Ingraham, the chief of neurosurgery. That experience inspired me to become a neurosurgeon. My story is not unique. Before I could begin any additional training, I enlisted in the Air Force as a general medical officer (classification 3150). I was later transferred to the ground forces of the United States Army as a neurosurgeon with the classification 3131C ( Fig. 1

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Cody L. Nesvick, Clinton J. Thompson, Frederick A. Boop and Paul Klimo Jr.

implement checklists to standardize the reporting of research studies. The journal Neurosurgery , for example, now requires the authors of all observational epidemiological studies to submit a completed checklist from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) consortium, a group of biostatisticians, epidemiologists, and other methodological experts who devised standardized guidelines for the reporting of epidemiological studies in medicine. 5 , 107 Nevertheless, there remains no standardized method for evaluating the basic design