World Neurosurg
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Meta Analysis
Recurrence rates following treatment of spinal vascular malformations: a systematic review and meta-analysis.
Spinal vascular malformations (SVMs), including arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs), are a varied group of vascular lesions that can be subclassified according to localization, vascular structure, and hemodynamics. Early intervention is necessary to halt progression of disease and minimize irreversible dysfunction. We sought to characterize initial treatment success and recurrence rates following interventional treatment of various types of SVMs. ⋯ Surgical resection of SVMs provided higher rates of initial complete occlusion and lower rates of recurrence than endovascular techniques. Attaining technical success through obliteration must still be weighed against clinical impact and natural history of the specific vascular malformation.
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Neurosurgery program websites serve as a valuable resource for applicants. However, each website exists in isolation, and it can be difficult to understand the general trends in U.S. neurosurgery resident demographics. In the present study, we collected data from program websites and analyzed the trends in the demographics of the current U.S. neurosurgery residents. ⋯ In addition to summarizing the current resident demographics, our analysis identified a significant increase in the proportion of female residents between 2015 (15.1%) and 2021 (25.6%). This publicly available dataset should enable additional analyses of the evolution of neurosurgery resident demographics.
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Review Meta Analysis
Comparison of infection rates following immediate and delayed cranioplasty for post-craniotomy surgical site infections - Results of a meta-analysis.
Postoperative surgical site infections (SSIs) in neurosurgery are rare. However, they pose a formidable challenge to the treating neurosurgeon and substantially worsen patient outcomes. These infections require prompt intervention in the form of débridement, including removal of craniotomy bone. ⋯ Our analysis revealed that the pooled proportion of treatment failure was 10.4% (95% confidence interval [CI] 5.9%-17.8%) when an immediate cranioplasty was done and 16.1% (95% CI 7.2%-32.1%) when delayed cranioplasty was done. The pooled proportion of treatment failure was 12% (95% CI 5.9%-22.9%) when the same bone was used for cranioplasty and was 8% (95% CI 3%-20%) when prosthetic material such as titanium was used for cranial vault reconstruction. Thus, the rate of treatment failure was less when an immediate single-stage cranioplasty was done compared with a delayed cranioplasty following SSIs.
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We developed a spinal deformity complexity checklist (SDCC) to assess the difficulty in performing a circumferential minimally invasive surgery (MIS) for adult spinal deformity. ⋯ The SDCC is a comprehensive list of pertinent radiographic and patient-related characteristics affecting complexity level for MIS deformity surgery. The value of the SDCC is that it allows rapid assessment of key factors when determining whether MIS surgery can be performed effectively and safely. Patients with scores of 4 in any characteristic should be considered challenging to treat with MIS; open surgery may be a better alternative.