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Ricky R. Kalra and John R. W. Kestle

measures in determinations of promotions and tenure. 2 More recently, subspecialties within medicine have started to adopt the h index as a measure of productivity and have demonstrated its correlation with rank. 3 , 9 Some evidence suggests that the h index varies from one scientific field to another 5 as a result of the number of investigators and the overall citation rate. We were therefore interested in studying the h index within pediatric neurosurgery. Our goal was to compare the h index and the g index with the rank of faculty in academic pediatric

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Subash Lohani and Alan R. Cohen

myelomeningocele. By 1926, Cushing had operated on more than 150 brain tumors in children. In 1929, he recognized the need for a dedicated specialty of pediatric neurosurgery. He asked his disciple, Franc D. Ingraham, to begin a pediatric neurosurgery service at BCH ( Fig. 1 ). 36 Such was the origin of the first neurosurgical unit in the world dedicated to the care of children. F ig . 1. Franc D. Ingraham. Pediatric neurosurgery was largely an unexplored specialty at the time. It was the era when the roentgenogram was the best available imaging modality, hemostasis

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Roberta Rehder, Subash Lohani and Alan R. Cohen

D onald Darrow Matson (1913–1969), whose life was cut short in its prime by catastrophic illness, made seminal contributions to the field of pediatric neurosurgery and is considered one of its founding fathers ( Fig. 1 ). 3 Matson was a remarkable man and a skillful neurosurgeon, yet he has not received the recognition he deserves for his pioneering work in pediatric neurosurgery. Here we discuss his extraordinary career and his role in introducing the modern era of neurosurgery in general, and pediatric neurosurgery in particular. Based on a review of

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Silky Chotai, Bradley S. Guidry, Emily W. Chan, Katherine D. Sborov, Stephen Gannon, Chevis Shannon, Christopher M. Bonfield, John C. Wellons III and Robert P. Naftel

applied to patients undergoing complex neurosurgical procedures. Studies on readmission and reoperation associated with pediatric neurosurgical diagnoses are sparse. 11 , 23 , 31 , 35 , 46 In a single-center retrospective study of 1358 patients undergoing pediatric neurosurgery, Wrubel et al. 46 reported 10.89% (n = 148) unexpected readmissions, and 8.02% (n = 109) related readmissions. Those authors found that in children with shunt-related surgery and shorter LOS, these variables were associated with related readmissions within 30 days of surgery. Chern et al. 11

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Anil K. Roy, Jason Chu, Caroline Bozeman, Samir Sarda, Michael Sawvel and Joshua J. Chern

monitor placement, 40 cases of halo vest placement, 20 cases of halo vest removal, 35 cases of lumbar drain placement, 27 cases of lumbar puncture, and 13 aborted cases, among other procedures. Reoperations Within 48 Hours of Index Surgery The rate of early reoperations for each category is reported in Table 3 . There were 221 reoperations (2.78%) within 48 hours of the conclusion of the index surgery. Three physicians (senior neurosurgical resident, pediatric neurosurgery fellow, and a board-certified pediatric attending) adjudicated on whether the reoperation was

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Paul Klimo Jr. and John R. W. Kestle

outcome measure when an appropriate one is not available. To assist clinical investigators in pediatric neurosurgery, we also describe a number of outcome measures that may be useful to them. Outcome Measures An outcome measure refers to any tool used to evaluate the effect of a disease and/or treatment on the health status of a patient. Traditionally, surgeons have been interested in outcomes that represent pathological, physiological, or clinical variables, such as death, pain, tumor growth, or bone fusion. As the science of outcome measurement has evolved, two

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James M. Drake, Ash Singhal, Abhaya V. Kulkarni, Gabrielle DeVeber, D. Douglas Cochrane and The Canadian Pediatric Neurosurgery Study Group

Pediatric and Congenital Heart Disease for complications after cardiac surgery for congenital heart disease, including consensus definitions. 2 There are, however, no standardized or consensus-driven definitions for complications or adverse events in pediatric neurosurgery. We recently reported the incidence of complications from all surgical procedures in a single pediatric neurosurgical center prospectively over a 2-year period. 12 It became clear that broadening this approach to other centers would require standardized definitions to ensure accuracy and

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there is unanimity. It is of importance to note that these are matters of interest and that, accordingly, they are being discussed. I once heard someone quote Harvey Cushing as having said that a new neurosurgical organization should be formed every 10 years. If this is true, we surely took his advice. There is now a Section for Pediatric Neurosurgery within the American Association of Neurological Surgeons, an International Society for Paediatric Neurosurgery, and a Japanese Society for Pediatric Neurosurgery. I know that serious thought is being given to forming

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Akash J. Patel, Ahilan Sivaganesan, Robert J. Bollo, Alison Brayton, Thomas G. Luerssen and Andrew Jea

neurosurgery. Methods Study Design A retrospective assessment of complications in pediatric neurosurgery at Texas Children's Hospital over a 5-year period (July 1, 2007–June 30, 2012) was performed. Operative data and morbidity and mortality data were collected in a prospective manner and were entered into the neurosurgery and hospital databases. No inclusion or exclusion criteria were applied. All pediatric patients undergoing a neurosurgical procedure in a consecutive manner during the study period were eligible for inclusion. Definition of Complication

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Daniel Hansen, Aditya Vedantam, Valentina Briceño, Sandi K. Lam, Thomas G. Luerssen and Andrew Jea

S tudies of outcomes in pediatric neurosurgery can demonstrate treatment effectiveness. They have the potential to enable pediatric health care providers, patients, and patients' families to make informed decisions. Since the Patient Protection and Affordable Care Act (PPACA) was signed into law in 2010, there has been a renewed focus on physician reimbursement and, in particular, a shift toward pay-for-performance reimbursement. This overhaul to the health care system has prompted all participants, insurance companies, hospitals, and regulatory bodies to