World Neurosurg
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As value-based care grows in popularity across the United States, more payers have turned toward bundled payment models for surgical procedures. Though episode costs in spine are highly variable, physical therapy (PT) has been identified as a driver of 90-day cost. The goal of this study is to assess the impact of postoperative PT on patient-reported outcomes and cost after lumbar fusion surgery using bundled insurance data. ⋯ Our study finds that PT after lumbar fusion is not associated with significant improvement in Oswestry Disability Index, PCS, mental component score, or visual analog scale pain scores. Additionally, the number of PT sessions a patient attends has no correlation with improvement in these outcomes.
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This study aimed to pinpoint independent predictors influencing overall survival (OS) and cancer-specific survival (CSS) in elderly patients with small cell lung cancer (SCLC) brain metastasis (BM), and to create and validate nomograms for OS and CSS prediction. ⋯ Prognostic nomograms for elderly patients with SCLC BM have been developed, demonstrating good performance in terms of accuracy, reliability, and practicality.
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Historical data and a partial description of the ongoing neurosurgical scenario in Nepal were reported and published earlier. However, updated data on neurosurgical manpower in Nepal has not yet been published. This study aims to explore the neurosurgical workforce in Nepal involved in different administrative territories and in different health sectors. ⋯ The number of neurosurgeons in the country is still small, however its ratio with population is better than most of the other South Asian countries. In a short period of time, neurosurgical service flourished significantly in Nepal and is available in all the provinces and thus it has become more easily accessible.
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This study aimed to identify which lumbar vertebral level above a lumbosacral transitional vertebra (LSTV) demonstrated the longest transverse process (TVP) lengths. ⋯ In the absence of whole-spine imaging, these findings indicate that L3 TVPs may offer an alternative bony landmark, which may aid in spinal enumeration estimation in the setting of LSTV. This is of value for radiograph appraisal and may aid with correct-level intervention.
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To evaluate the feasibility of a novel method for occipitocervical fixation (OCF) through the endonasal corridor. ⋯ Endonasal OCF is technically and anatomically feasible. The application of this technique may allow for same-stage endonasal decompression and fixation, offering a minimally invasive alternative to current methods of fixation and advancing surgeons' ability to treat pathology of the craniovertebral junction. Next steps will focus on biomechanical testing.