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Neurosurgical ablative procedures for intractable cancer pain

Assaf Berger, Uri Hochberg, Alexander Zegerman, Rotem Tellem, and Ido Strauss

discussed in the literature. 8 , 33 Patients who suffer from refractory cancer pain may benefit from targeted neurosurgical procedures that selectively intervene along the central pain pathways. Ablative procedures, such as percutaneous cordotomy, stereotactic mesencephalotomy, and cingulotomy, can be tailored to the patient’s specific pain syndrome. However, neurosurgical ablative procedures for intractable cancer pain remain relatively rarely used and have been for the most part replaced by neuromodulatory therapies (e.g., morphine pumps) that are perceived as

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Intraoperative hypothermia during vascular neurosurgical procedures

Raymond Choi, Robert H. Andres, Gary K. Steinberg, and Raphael Guzman

studies on the mechanisms by which mild (33–36°C) and moderate (28–32°C) hypothermia protects the brain from ischemic damage. Here we review the scientific evidence behind the use of hypothermia as a method of attenuating ischemic damage, and the available clinical evidence for the use of intraoperative hypothermia in vascular neurosurgical procedures. We also suggest future studies for this controversial clinical modality. Scientific Evidence A better understanding of the mechanisms of cell death following cerebral ischemia has been necessary to appreciate the

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Prophylactic parenteral antibiotics in clean neurosurgical procedures: a review

Robert Dempsey, Robert P. Rapp, Byron Young, Sarah Johnston, and Phillip Tibbs

P rophylactic parenteral antibiotic agents are routinely used by some neurosurgeons in clean surgical procedures such as craniotomy and laminectomy. This review examines why and how neurosurgeons have come to adopt the use of prophylactic antibiotics in clean neurosurgical procedures and offers some suggestions for their rational use. Clean surgery includes procedures where there is no break in sterile technique and there is no entry into the respiratory, gastrointestinal, or genitourinary tracts. 5 Clean surgical procedures generally carry a risk of

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Neurosurgical procedures in Olmsted County, Minnesota, 1970–1974

Neurosurgical needs of a community

Glen G. Glista, Ross H. Miller, Leonard T. Kurland, and Mark L. Jereczek

variety of diagnostic and surgical activities a neurological surgeon can be expected to perform for a hypothetical average community of 100,000 people. We are reporting the number and type of procedures performed by neurosurgeons in a circumscribed population (Olmsted County, Minnesota), over a 5-year period. We hope that this account will help to determine the neurosurgical needs of a community and provide young neurosurgeons with some idea of what procedures they may be called on to perform. Source of Information It is recognized that no single community can

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Cortical spreading depression occurs during elective neurosurgical procedures

Andrew P. Carlson, C. William Shuttleworth, Brittany Mead, Brittany Burlbaw, Mark Krasberg, and Howard Yonas

stroke with repeated CSD, 14 association with delayed cerebral ischemia (DCI) after subarachnoid hemorrhage, 7 progressive metabolic dysfunction with repeated events, 3 and association with worse clinical outcomes. 8 We recently hypothesized that CSD may occur during elective neurosurgical procedures based on physiological plausibility and an animal model of neurosurgical procedures. 4 Based on the observed deleterious effect of CSD after brain injury, we hypothesize that this may be a factor contributing to otherwise poorly explained surgery-related brain injury

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Operating room waste: disposable supply utilization in neurosurgical procedures

Corinna C. Zygourakis, Seungwon Yoon, Victoria Valencia, Christy Boscardin, Christopher Moriates, Ralph Gonzales, and Michael T. Lawton

costs associated with opened but unused items (i.e., “waste”) across a range of neurosurgical procedures at our institution. Methods Data Collection We collected data from 58 adult neurosurgical cases at the University of California, San Francisco (UCSF), in August 2015. Cases were not consecutive, but rather reflected all cases that a single observer (S.Y.) could attend with nonoverlapping end times. For each case, patient demographics, procedure type, and case length (in minutes) were recorded. Surgeon name and years of training postresidency were also

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Trends in Medicare reimbursement for neurosurgical procedures: 2000 to 2018

Jack M. Haglin, Kent R. Richter, and Naresh P. Patel

and spinal neurosurgery for the year 2016 were determined ( Table 1 ). The Physician Fee Schedule Look-Up Tool from the CMS was queried for each of these CPT codes, as they are representative of the most commonly performed neurosurgical procedures ( ). The coinciding monetary data include Medicare reimbursement fees for more than 100 different centers across the United States from each year between 2000 and 2018. Pricing information for individual CPT codes was

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Waterjet dissection in neurosurgical procedures: clinical results in 35 patients

Juergen Piek, Joachim Oertel, and Michael Robert Gaab

dissection in combination with conventional neurosurgical procedures. The intensity and quality of the waterjet dissection, as well as the instrument's usefulness, handling aspects, and ability to preserve blood vessels were noted directly after each procedure, along with the pressures used and complications encountered. Intraoperative blood loss and tendency toward edema formation were monitored. Follow-up review included clinical examination and postoperative MR studies. In six patients who were admitted for surgery to treat TLE, early postoperative MR imaging (within 8

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Impact of the 2006 Massachusetts health care insurance reform on neurosurgical procedures and patient insurance status

Nicolas W. Villelli, Rohit Das, Hong Yan, Wei Huff, Jian Zou, and Nicholas M. Barbaro

measured racial disparities of patients who undergo MIS; and an increase in discretionary surgeries compared with nondiscretionary operations. 4 , 6 , 8 Although 1 study included spinal surgery among all inpatient procedures, 4 to our knowledge, no study has analyzed the effect of this policy change on neurosurgical procedures as a whole. We compared data from Massachusetts before and after enactment of the Massachusetts reform to analyze changes in the number of neurosurgical procedures performed and the percentage performed on uninsured patients. Our goal is to

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Severe limitation in mouth opening following transtemporal neurosurgical procedures: diagnosis, treatment, and prevention

D. W. Nitzan, B. Azaz, and S. Constantini

in all patients upon mouth opening, was demonstrated on protrusive movements in three (Cases 7, 10, and 11). The combination of limited maximum mouth opening and normal radiographic appearance of the temporomandibular joint following a transtemporal neurosurgical procedure is strongly suggestive of temporalis muscle shortening which prevents the free rotation of the coronoid process ( Fig. 1 ). Such shortening typically preserves the normal protrusive joint sliding movements since it does not require stretching of the temporalis muscle. In the two patients (Cases