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
Search Results
Assaf Berger, Uri Hochberg, Alexander Zegerman, Rotem Tellem, and Ido Strauss
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
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
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
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
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
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 ( https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PFSLookup/index.html?redirect=/PFSLookup ). 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
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
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
Richard E. Balch
D espite the most diligent attention to asepsis during any surgical procedure, postoperative infection remains a threat. The magnitude of this problem on the Neurosurgical Service at the UCLA Center for the Health Sciences is the subject of this report. This study was undertaken to provide the surgeon with a clear idea of the infection rate so that techniques of asepsis could be better evaluated and to provide a basis for discussion of risks of a surgical procedure with patients and their families. An attempt was made to determine the total incidence of
