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Gabriel A. Smith, Phillip Dagostino, Mitchell G. Maltenfort, Aaron S. Dumont, and John K. Ratliff

administrative database and attempting to control for patient and facility variables, reported greater charges with open aneurysm ligation, with clipping resulting in $15,325 more in total charges for patients with ruptured aneurysms as well as $11,263 more in total charges for unruptured cases. Previous reports on health policy have focused on regional variations in health care spending and resource utilization. Fisher et al. 7 reported on regional variation in Medicare expenditures and noted that physician factors must play a predominant role in variation in health care

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Whitney Sheen James, Anand I. Rughani, and Travis M. Dumont

of meninges 3.6 16.9 30.3 35.6 35.7  tumor of spinal cord 5.0 24.2 33.6 38.1 45.9 location  cervical 0.6 4.6 8.0 8.7 10.5  thoracic 0.7 6.1 7.6 11.6 11.6  thoracolumbar 0.5 3.4 6.7 9.3 10.9  lumbar 0.6 7.2 7.5 11.8 12.6 IONM use between hospital geographic regions, relative population (urban/rural), and teaching status was not uniform. Regional variations were most pronounced in 2011 (the most recent year studied), when the regional low was 8% of cases in the Northeast

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Micheal Raad, Jay S. Reidler, Mostafa H. El Dafrawy, Raj M. Amin, Amit Jain, Brian J. Neuman, Lee H. Riley III, Daniel M. Sciubba, Khaled M. Kebaish, and Richard L. Skolasky

Alosh et al. 1 reported similar results, whereby the highest rates of anterior cervical spine surgery were in the South and the lowest were in the Northeast. In an attempt to explain regional variation in procedure choice for the treatment of degenerative lumbar disease in Ontario, Canada, Bederman et al. 3 showed that surgeon preference was the dominant factor affecting procedure type. Similar findings were reported for patients undergoing knee replacement surgery in Ontario. 23 Although surgeon preferences may have contributed to the differences in surgical

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J. Robert S. Hales, John D. Yeo, Stefanie Stabback, Alan A. Fawcett, and Raymond Kearns

, more recent microsphere studies have obtained significantly higher values. 1, 21 The reason for these discrepancies in absolute level of SCBF is unknown, but the pattern of differences in BF at different spinal levels was the same as far as can be ascertained. Some other reports show only small regional BF differences because of inadequate tissue sampling. 9 The regional variation in whole SCBF ( Fig. 1 upper ) is largely attributable to a parallel variation in the proportion of mass of gray to white matter ( Fig. 1 lower ), but also to regional variations in

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Patrick M. Flanigan, Anthony L. Mikula, Pierce A. Peters, Soliman Oushy, Jeremy L. Fogelson, Mohamad Bydon, Brett A. Freedman, Arjun S. Sebastian, Bradford L. Currier, Ahmad Nassr, Kurt A. Kennel, Paul A. Anderson, David W. Polly, and Benjamin D. Elder

compared to placebo. 27 , 28 Thus, the use of such an anabolic medication may be useful to prevent and treat such complications related to spinal surgery. With the renewed attention on sacroiliac joint fixation and fusion, it is important to better understand the regional variation in bone density in the sacrum and ilium and any potential benefits of teriparatide. We hypothesized that a minimum of 6 months of teriparatide treatment would result in significant improvement in the regional bone density of the lumbosacral spine and ilium, using HUs as a surrogate for BMD

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Dennis R. Groothuis, Donald C. Wright, and Christoph B. Ostertag

section (right) for Dog 9 in Table 1 . The pseudocolor scale represents the K values of AIB, in units of ml/gm/min × 10 4 . The K values illustrate the sharply demarcated zone of blood-brain barrier (BBB) disruption around the 125 I radiation lesion at 110 days after insertion of the 125 I seed, as well as the regional variation in the magnitude of BBB disruption within this zone. An area of decreased K values is shown below and lateral to the pellet cavity, which corresponds to an area of edema in the histological section. Results The initial

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Gregory D. Schroeder, Christopher K. Kepler, John D. Koerner, Jens R. Chapman, Carlo Bellabarba, F. Cumhur Oner, Max Reinhold, Marcel F. Dvorak, Bizhan Aarabi, Luiz Vialle, Michael G. Fehlings, Shanmuganathan Rajasekaran, Frank Kandziora, Klaus J. Schnake, and Alexander R. Vaccaro

available in color online only. In an effort to better understand the regional variation in treatment, Schroeder et al. investigated the perception of severity of each subclassification of the AOSpine Thoracolumbar Spine Injury Classification System. 21 They found that the perceived severity of each fracture is independent of region and experience. These findings indicated that regional perception of severity was not primarily driving treatment variations, but rather other variables such as cultural preferences for immediate stability, local education and training

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Frederic Collignon, Nicholas M. Wetjen, Aaron A. Cohen-Gadol, Gregory D. Cascino, Joseph Parisi, Fredric B. Meyer, W. Richard Marsh, Patrick Roche, and Stephen D. Weigand

differences indicate increased expression among the MTLE group compared with controls. On the right axis are probability values for the test of no group difference. As indicated in Table 3 , SI in patients with epilepsy was lower for Cx32, higher for Cx43, and not significantly different from controls for Cx36. There was, however, some regional variation within each Cx subtype. For example, the SI values for Cx32 within the dentate region were not significantly different between persons with or without epilepsy. For Cx36, there was some evidence that SI in the CA2 region

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Russell R. Lonser, Scott D. Wait, John A. Butman, Alexander O. Vortmeyer, McClellan M. Walther, Lance S. Governale, and Edward H. Oldfield

of the involved nerve root as well as the surrounding nerve root compression caused by the tumor itself. The frequent intrinsic involvement of the hemangioblastomas with the lumbosacral sensory nerve roots demonstrated in five of our six patients is consistent with the sensory-related location of spinal cord hemangioblastomas in von Hippel—Lindau syndrome, which occur most commonly in the posterior aspect (93%) of the spinal cord and specifically in the dorsal root entry zone (66%). 19 Consistent with CNS regional variation of space available to accommodate the

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Ethan A. Winkler, John K. Yue, Hansen Deng, Kunal P. Raygor, Ryan R. L. Phelps, Caleb Rutledge, Alex Y. Lu, Roberto Rodriguez Rubio, Jan-Karl Burkhardt, and Adib A. Abla

are statistically significantly higher for the treatment of aneurysms than for moyamoya or vascular occlusive disease (p < 0.001). Much of this increased cost was driven by the treatment of ruptured aneurysms (unruptured $87,464 ± $2129 vs ruptured $171,569 ± $5377, p < 0.001). FIG. 4. A: Mean cost for cerebral bypass surgery in the US from 2002 to 2014. B: Graph showing longitudinal trends in mean cost per hospitalization for bypass surgery stratified by indication for cerebral bypass. USD = US dollars. Regional Variation When the US was subdivided into four