World Neurosurg
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Spontaneous intracerebral hematoma (ICH) is a common disease with a dismal overall prognosis. Recent development of minimally invasive ICH evacuation techniques has shown promising results. Commercially available tubular retractors are commonly used for minimally invasive ICH evacuation yet are globally unavailable. ⋯ The novel cost-effective tubular retractor and microsurgical technique offer a safe and effective method for minimally invasive ICH evacuation. Cost-effective tubular retractors may continue to present a valid alternative to commercial tubular retractors.
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Global use of telemedicine has increased rapidly during the coronavirus disease 2019 (COVID-19) pandemic to bridge the gap in existing health care services. Intercontinental trends in neurosurgeons' perception and practices of telemedicine have been sparingly reported. ⋯ Telemedicine in neurosurgery is a viable alternative to physical outpatient services during the COVID-19 pandemic and could potentially play a vital role after the pandemic.
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Chondrosarcomas of the skull base are rare intracranial tumors of chondroid origin. The rarity of these lesions has made it difficult to form a consensus on optimal treatment regimens. The aim of this study was to provide a comprehensive analysis of prognostic factors, treatment modalities, and survival outcomes in patients with chondrosarcoma of the skull base. ⋯ In the largest study to our knowledge of skull base chondrosarcoma to date, both partial resection and radical resection significantly improved OS, thus supporting the goal of maximal safe resection to preserve vital neurovascular structures without sacrificing outcome. In patients who received radiotherapy, proton-based modalities and high-dose radiation were associated with increased OS.
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Expandable vertebrectomy devices are a key technology that has facilitated the adoption of minimally invasive approaches to spine oncology surgery. However, advanced technology still requires proper attention to surgical fundamentals. ⋯ Examination of the postoperative radiographs suggests that haptic feedback from the expandable technology may have given the false impression of bony engagement. This case highlights the need for proper mortise work and complete visualization of the segments to be instrumented even during minimally invasive surgery.
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To assess trends in gender, racial, and ethnic diversity of applicant pools and subsequent resident cohorts in neurosurgical residency programs in the United States. ⋯ Current efforts to improve racial and ethnic diversity have not been sufficient in generating parity in the recruitment and retention of racially underrepresented groups in neurosurgery. Although the presence of women in applicant and resident pools has increased, not much is known about the impact on women who also identify within racially underrepresented groups. More proactive measures for recruitment and retention are needed to reach equity in the future neurosurgical workforce.