Neurosurgery
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Neurosurgery in Uganda was virtually non-existent up until late 1960s. This changed when Dr. Jovan Kiryabwire spearheaded development of a neurosurgical unit at Mulago Hospital in Kampala. ⋯ Benjamin Warf, have saved thousands of children's lives. The influx of the Duke Program caused a dynamic shift at Mulago Hospital with dramatic effects, as evidenced by the substantial increase in neurosurgical capacity. The future looks bright for neurosurgery in Uganda and it all traces back to a rural village where 1 man had a vision to help the people of his country.
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Convex-rod derotation may have potential advantages for adolescent idiopathic scoliosis (AIS) correction; however, study of this technique has been limited. ⋯ Compared with concave-rod derotation, convex-rod derotation can potentially improve the major-curve corrective rate and tends to reduce the risk of pedicle breach in Lenke type I AIS patients.
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Healthcare delivery is evolving rapidly with an increasing emphasis on the concept of "value." At the same time, neurosurgeons are disproportionately working in employed positions where external definition of value becomes directly linked with compensation, work environment, and career satisfaction. Few neurosurgeons have an understanding of the various ways in which value is and can be defined and there are limited resources to assist in this realm. This paper covers the essential value concepts of National Standards, Pitfalls of National Standards, Call Coverage Compensation, Valuation Through Demand, Value Beyond Productivity, and Neurosurgical Value in the Accountable Care Organization Era. This framework should help neurosurgeons better understand critical trends impacting practice across the country.
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In providing spinal care to neurosurgical patients, cost and quality metrics are areas of interest to many. The federal government has legislated changes mandated for Centers for Medicare and Medicaid Services-enrolled patient care. The ever-changing administrative and patient-care challenges and opportunities are explored in this article, highlighting the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act of 2015 (MACRA), in the context of the Affordable Care Act. Trends in contemporary spinal care, addressing bundling, patient satisfaction, and ambulatory surgical centers are featured.