World Neurosurg
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Multicenter Study
Syrinx Secondary to Chiari-like Tonsillar Herniation in Spontaneous Intracranial Hypotension.
Syrinx development in patients with spontaneous intracranial hypotension (SIH) has rarely been described. To better understand this entity, we compared the clinical and radiographic findings in a series of patients with SIH and acquired Chiari-like tonsillar herniation with and without syrinx formation. ⋯ Our results have shown that SIH can be an underrecognized cause of syrinx with key differences in body habitus and obex displacement compared with SIH without syrinx. In patients with tonsillar herniation into the foramen magnum associated with syrinx, the presence of SIH should be considered to avoid unnecessary foramen magnum decompression, even in those with a normal opening pressure.
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Comparative Study
Does Fusion Affect the Anterior Bone Loss of Adjacent Cervical Disc Arthroplasty in Contiguous 2-Level Hybrid Surgery?
To investigate whether anterior bone loss (ABL) in cervical discarthroplasty (CDA) in 2-level hybrid surgery (HS) is affected by adjacent fusion in vivo compared with 1-level CDA alone. ⋯ ABL was common in both CDA and HS. Although HS had a lower incidence rate and degree than did CDA, the fusion location in HS did not affect the ABL of adjacent CDA.
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Coronavirus disease-2019 (COVID-19) is a novel disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that rapidly spread around the globe. The dramatic increase in the number of cases and deaths have placed tremendous strain on health care systems worldwide. As health care workers and society adjust to focus treatment and prevention of COVID-19, other facets of the health care enterprise are affected, particularly surgical volume and revenue. The purpose of this study was to describe the financial impact of COVID-19 on an academic neurosurgery department. ⋯ COVID-19 had a profound detrimental effect on surgical productivity and revenue generation.
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Comparative Study
Use of C7 Slope as a Surrogate Marker for T1 Slope: A Radiographic Study in Patients with and without Cervical Deformity.
T1 slope has emerged as an important radiographic parameter in the evaluation and surgical management of adult cervical spinal deformity. Given the high rates of nonvisualization of T1 slope on upright cervical radiographs, however, this study examined the evaluation of C7 slope as a potential surrogate marker. ⋯ Results demonstrated that C7 and T1 were in direct correlation in a variety of different cohorts regardless of deformity status or prior fusion. This study indicates that C7 slope may be reliably used a surrogate marker especially when visualization of T1 slope is not possible.
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The National Surgical Quality Improvement Program (NSQIP) and National Readmission Database (NRD) are 2 widely used databases that provide valuable information regarding the quality of health care. However, the 2 differ in sampling methodology, which may result in conflicting findings when used for research studies. The objective of this study is to evaluate the differences regarding predictors of 30-day readmissions after anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF). ⋯ Two databases differed in terms of significant predictors of 30-day readmissions following ACDF and PLF. This difference may emphasize the differences in the sampling methodology. Further analyses, potentially with an institutional validation, are needed to draw conclusions regarding the accuracy of the 2 databases for predictive analytics.