World Neurosurg
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Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) are commonly performed in separate stages with a change in patient positioning to provide arthrodesis in the lumbar spine. Interest has emerged in performing these approaches as a single-stage surgery with the patient in the lateral decubitus position. The objective of this study was to evaluate the technical feasibility of performing minimally invasive anterolateral fixation in a single supine position. ⋯ This cadaveric feasibility study demonstrates that combined minimally invasive ALIF and LLIF may be performed as a single-stage procedure with the patient in the supine position. Clinical consideration and study of this approach are warranted.
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The association between high-risk cardiovascular factors and atherosclerotic is well established. However, whether plaque vulnerability is related to specific cardiovascular risk factors remains unknown. The association between plaque vulnerability and cardiovascular risk factors was evaluated in plaques removed in a carotid endarterectomy. ⋯ The composition heterogeneity in the atherosclerotic plaque was significantly correlated to specific cardiovascular risk factors.
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Discrimination, abuse, and mistreatment are prevailing problems reported in neurosurgical training programs globally. Moreover, the current coronavirus disease 2019 (COVID-19) pandemic may also show a negative impact on burnout levels in neurosurgery residents. This study aims to evaluate burnout, discrimination, and mistreatment in neurosurgical residents training in Latin America during the severe acute respiratory syndrome coronavirus 2 era. ⋯ The COVID-19 pandemic has been a significant burden on several aspects of health care workers' lives. Our results provide a broad overview of its impact on burnout, discrimination, and mistreatment as experienced by neurosurgery residents training in Latin America, laying the groundwork for future studies and potential interventions.
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Academic productivity, a key feature of academic neurosurgery, has been linked to academic rank, subspecialty, and institutional rank. Relative Citation Ratio (RCR) has emerged as a new metric of scholarly output that can make field-normalized comparisons between researchers, a feature unavailable in prior metrics such as h-index. Here we evaluate the influence of academic rank and neurosurgical subspecialties on RCR scores. ⋯ Professors have a higher m-RCR score relative to assistant professors, while general and pediatric neurosurgery were linked to lower m-RCR values. Although neurosurgical subspecialty choice did not influence w-RCR, a higher w-RCR score corresponded to a higher academic rank. Overall, the RCR metric can be utilized for field-normalized comparisons of faculty who differ in academic rank and subspecialty.
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Sellar reconstruction following endoscopic endonasal surgery (EES) requires modification based on the degree of cerebrospinal fluid (CSF) leak. For high-flow (grade II or III according to Esposito et al. 2007) intraoperative CSF leak, lumbar drainage (LD), in addition to the multilayer closing technique, is generally recommended. However, LD occasionally has complications including postpuncture headache, overdrainage symptoms, and increased length of stay. We retrospectively evaluated the outcome of our graded reconstruction strategy using a multilayer technique with a novel material, without LD, after EES. ⋯ A graded surgical repair strategy after EES could avoid postoperative CSF leak. Combined use of injectable HXA and acellular dermal grafts for high-flow CSF leak can limit LD requirement without significant risks.