World Neurosurg
-
Research output on global neurosurgery (GNS) has exponentially increased in recent years. As research efforts increase, we must first analyze how the current body of GNS literature fits into the macroscopic schema of systems-based policies. The aim of this study was to identify and categorize GNS research based on health system domains. ⋯ This review highlighted the pressing need for more research into information management in the context of GNS. In addition, health system-focused GNS literature represented only 20% of all LMICs (30/143). The trends in authorship should be noted, because many ethical (and practical) issues may arise if there is a disconnect in the objectives of the authors and the neurosurgeons in LMICs.
-
Review Comparative Study
Intracranial Tubular Retractor Systems: A Comparison and Review of the Literature of the BrainPath™, Vycor™, and METRx™ Tubular Retractors in the Management of Deep Brain Lesions.
In neurosurgery, parenchymal injury resulting from focal exertion of pressure on retracted tissue is a common complication associated with the use of plate and self-sustaining retractors to access deep intraparenchymal lesions. Tubular retractors, including Vycor, BrainPath, and METRx, were developed to reduce retraction injuries via radial dispersion of force. Our study seeks to compare these retraction systems and assess their respective indications, benefits, and associated complications. ⋯ This report is the first formal comparison of the BrainPath, Vycor, and METRx tubular retraction systems. We found that all 3 retractors were effective in accessing intraparenchymal lesions. Although we found that the retractor systems were used more commonly in different locations and for different diseases, there was no significant difference in complications or mortality among the 3 retractors.
-
Review Case Reports
Diagnosis, management, and clinical outcomes of tandem thoracic and lumbar stenosis: a systematic literature review and case series.
A scarcity of data has been reported on tandem thoracic lumbar stenosis, which might be related to either the rarity or underdiagnosis of the condition. We have presented a systematic review of the clinical presentation, diagnosis, and treatment patterns for patients with symptomatic tandem thoracic and lumbar stenosis. ⋯ Ossification of the ligamentum flavum might play a key role in the pathogenesis of the condition. Most patients with tandem thoracic and lumbar stenosis will show improvement after surgical decompression. Although the limited evidence available has raised concerns regarding neurologic deterioration after initial lumbar decompression in patients with coexisting thoracic stenosis, the data are insufficient to definitively determine an optimal surgical strategy. Further research is needed to identify the optimal diagnostic and management criteria for patients with symptomatic tandem thoracic and lumbar stenosis.
-
We aim to elucidate the clinical characteristics of patients with primary spinal cord glioblastoma (PSC GBM) and prognostic factors for their outcomes. ⋯ Despite aggressive treatment, PSC GBM still has a dismal prognosis and leads to severe neurologic deficit. Age at diagnosis and duration of the preoperative symptoms were confirmed as prognostic factors, yet the role of adjuvant radiochemotherapy and extent of resection are still unclear, necessitating further research.
-
Multicenter Study
Neurosurgical Procedures and Safety During the COVID-19 Pandemic: A Case-Control Multi-Center Study.
Quantitative documentation of the effects of outbreaks, including the coronavirus disease 2019 (COVID-19) pandemic, is limited in neurosurgery. Our study aimed to evaluate the effects of the COVID-19 pandemic on neurosurgical practice and to determine whether surgical procedures are associated with increased morbidity and mortality. ⋯ During the early phase of the COVID-19 pandemic, the overall number of neurosurgical procedures declined, but the load of emergency procedures remained the same, thus highlighting the need to allocate sufficient resources for emergencies. More importantly, performing neurosurgical procedures during the pandemic in regions with limited effects of the outbreak on the health care system was safe. Our findings may aid in developing guidelines for acute and long-term care during pandemics in surgical subspecialties.