Microfluidic 'brain-on chip' systems to supplement neurological practice: development, applications and considerations.

Among the greatest general challenges in bioengineering is to mimic human physiology. Advanced efforts in tissue engineering have led to sophisticated 'brain-on-chip' (BoC) microfluidic devices that can mimic structural and functional aspects of brain tissue. BoC may be used to understand the biochemical pathways of neurolgical pathologies and assess promising therapeutic agents for facilitating regenerative medicine.

Effectiveness of X-stop Interspinous Distractor Device Versus Laminectomy for Treatment of Lumbar Stenosis: A Systematic Review and Meta-Analysis.

Lumbar spinal stenosis refers to the narrowing of the spinal canal in the lumbar region. There is an increasing need to determine the treatment modality for lumbar spinal stenosis by comparing the outcomes of X-stop interspinous distractors and laminectomy. The objective of this study is to determine the effectiveness of the X-stop interspinous distractor compared to laminectomy.

Postoperative Intracranial Hemorrhage after an Endoscopic L5-S1 Laminectomy and Discectomy: A Case Report and Literature Review.

Background: Postoperative intracranial hemorrhage (PIH) is a fairly rare but catastrophic perioperative complication following lumbar spine surgery. This is a case report of a 54-year-old male patient who experienced PIH 2 h after an endoscopic L5-S1 laminectomy and discectomy.

Case Presentation: A 54-year-old male patient presented with right L5-S1 radiculopathy that corresponded with the picture revealed in medical imaging and the signs seen upon physical examination.

A Bibliometric and Visual Analysis of the Most Cited Articles on Disc Arthroplasty.

Study Design: Bibliometric literature review.

Objective: Total disc arthroplasty (TDA) is an evolving technique used by surgeons to preserve neural elements and range of motion in patients with degenerative disc disease, spondylosis and more. In comparison to discectomy, disc arthroplasty has been shown to decrease morbidity, reduce adjacent-level disease, and preserve pre-operative range of motion.

A Comprehensive Overview of Pediatric Neoplasms at the Craniocervical Junction: Meningiomas, Schwannomas, and Chordomas.

Tumors of the craniocervical junction (CCJ) are complicated pathologies with high patient mortality or low quality of life. In the pediatric population, these tumors are less prevalent, with various symptomatic presentations that include motor and neurological manifestations. Three of the most common neoplasms at the CCJ in children are meningiomas, schwannomas, and chordomas.

Peritumoral edema in meningiomas: pathophysiology, predictors, and principles for treatment.

Meningiomas is a tumor of the meninges and is among the most common intracranial neoplasms in adults, accounting for over a third of all primary brain tumors in the United States. Meningiomas can be associated with peritumoral brain edema (PTBE) which if not managed appropriately can lead to poor clinical outcomes. In this review, we summarize the relevant pathophysiology, predictors, and principles for treatment of PTBE.

Negative Pressure Wound Therapy in Spinal Surgery.

Negative pressure wound therapy (NPWT) has demonstrated promise in the management of surgical site infections as well as assisting in surgical wound healing. In this manuscript, we describe the mechanisms and applications of NPWT for surgical wounds and existing evidence for NPWT in cardiac, plastic, and general surgery, followed by a discussion of the emerging evidence base for NPWT in spinal surgery. We also discuss the different applications of NPWT for open wounds and closed incisions, and the promise of newer closed-incision NPWT (ciNPWT) devices.

Long-Term Intensive Care Unit (ICU) Stays Can Lead to Long-Term Cognitive Impairment (LTCI): Neurosurgery Nursing Strategies to Minimize Risk.

Long-term cognitive impairment (LTCI) is a phenomenon predominantly seen in patients within intensive care units (ICU) that causes chronic dysfunction, defined as new or worsening deficits in memory, attention, mental processing speed, executive function, intellectual function, and visual-spatial abilities for over 12 months, inhibiting the necessary return to baseline function without appropriate intervention. Our objective is to provide a guideline of nursing strategies to reduce LTCI through different studies that evaluate pharmacological and non-pharmacological methods. Current literature demonstrates that pharmacotherapy focused on neuronal protection as well as robust physical therapy regimens and regulated sleep schedules show promise in strengthening cognitive function and reducing LTCI.

Single Center Retrospective Analysis of Cerebral Aneurysms from a Patient Sample Data Collection at a Comprehensive Stroke Center.

Introduction: Institutional self-monitoring of cerebral aneurysm data should occur regularly. The objective of this retrospective single center study was to examine the reproducibility of a data collection and analytic method to examine cerebral aneurysm characteristics and trends.

Methods: A single center retrospective analysis was performed from 2018 to 2021 of the most recent 100 patient presentations with a newly diagnosed cerebral aneurysm.

Bellevue Hospital, the Oldest Public Health Center in the United States of America.

Bellevue Hospital is known as the oldest public hospital in the United States of America. Although its historical beginnings date back to the 1600s, it was officially founded on the second floor of the New York City Almshouse in 1736, 40 years before the American Revolution. It has since been at the forefront of administering comprehensive patient care and medical education.

Bariatric Surgery With Roux-En-Y Gastric Bypass or Sleeve Gastrectomy for Treatment of Obesity and Comorbidities: Current Evidence and Practice.

Background: With the growing prevalence of obesity in the global population, alternative measures for weight loss and treatment of comorbidities must be considered due to the increasing difficulty of conservative management alone. Here we discuss the benefits of bariatric surgery on weight loss as well comorbidities that are present in a majority of obese patients.  Methods: In this review, we discuss the current practice and evidence of bariatric surgery as it pertains to weight loss and the beneficial effect on comorbidities commonly present in obesity.

Laser oromaxillofacial photobiomodulation therapy: molecular mechanisms, outcomes and considerations.

Tweetable abstract Photobiomodulation therapy is largely characterized as a safe therapeutic model that can modulate the activity of inflammatory and immune biomarkers while facilitating a metabolic response that can regenerate damaged tissue.

Placental-based allograft use for tissue regeneration and scar prevention for neurosurgical wounds.

Tweetable abstract Proper wound healing, including internal and surface tissue regeneration with the minimization of scar formation, is one of the most significant topics in surgical discussions and EpiFix dehydrated human amnion/chorion membrane allograft promotes healthy healing.

Report of cerebral vasospasm as a complication of intracranial subarachnoid hemorrhage following traumatic lumbar puncture.

Background: This case report is the first documented and illustrated case of the identification and treatment of intracranial vasospasm as a sequalae of traumatic lumbar puncture (LP). LP is a routine procedure performed for both diagnostic and therapeutic purposes. Although rare, this procedure has risks and complications that should be considered before performing.

Intraoperative localization and "snowman" muscle pledget repair for ventral dural defect in a case of spontaneous intracranial hypotension.

Background: This image report with technical notes is the first to illustrate and describe the technique used to treat spinal cerebrospinal fluid (CSF) leaks with the "snowman" muscle pledget. A 49-year-old male presented with orthostatic headaches as well as the left abducens nerve palsy. Patient's workup including findings of diffuse meningeal enhancement on magnetic resonance imaging, lumbar puncture opening pressure of 4 cm H2O, and CT myelogram demonstrating evidence of ventral spinal thoracic CSF leak.

Holocord spontaneous pneumorrhachis in the setting of refractory emesis.

Background: Pneumorrhachis (PNR) is the presence of air within the spinal canal and may be either intramedullary or extramedullary in location. The etiology is most commonly iatrogenic or traumatic in nature. Treatment is dependent on underlying cause and physical exam.

Sternotomy Approach to the Anterior Cervicothoracic Spine.

The anterior cervicothoracic spine is a challenging region to approach given the various vascular, osseous, nervous, and articular structures, which prevent adequate exposure. This region is susceptible to lesions ranging from tumors, degenerative disease, infectious processes, and traumatic fractures. Our objective was to critically evaluate the sternotomy approach in spine surgery to give the technical implications of its usage.

Anterior Cervical Discectomy and Fusion With "Kissing" Allograft Interbodies.

Background: There is recent evidence to suggest that the use of polyetheretherketone (PEEK) interbodies are inherently associated with a higher rate of pseudarthrosis, in particular, at the C5-6 and C6-7 levels. Herein, we describe our technique utilizing two parallel structural allografts or "kissing" allografts, designed to mitigate the risk of pseudarthrosis and subsidence at these levels.

Materials And Methods: We retrospectively reviewed all anterior cervical discectomy and fusion (ACDF) procedures with "kissing" for degenerative spine pathology at a single institution between 2018 and 2019 for the C5-6 and C6-7 levels.

Management of Lambdoid Craniosynostosis: A Comprehensive and Systematic Review.

Background: Craniosynostosis is a condition characterized by the premature fusion of 2 or more skull bones. Craniosynostosis of the lambdoid suture is one of the rarest forms, accounting for 1-4% of all craniosynostoses. Documented cases are separated into simple (single suture), complex (bilateral), and associated with adjacent synostoses ("Mercedes Benz" Pattern) or syndromes (i.

Outcomes of anterior vs. posterior approach to single-level lumbar spinal fusion with interbody device: An analysis of the nationwide inpatient sample.

Background: Interbody devices have revolutionized lumbar spinal fusion surgery by improving mechanical stability and maximizing fusion potential. Several approaches for interbody fusion exist with two of the most common being anterior lumbar interbody fusion (ALIF) and posterior lumbar interbody fusion (PLIF). This study aims to compare patient data, hospital outcomes, and post-operative complications between an anterior vs.

Sacroiliac Joint and Pelvic Dysfunction Due to Symphysiolysis in Postpartum Women.

Pregnancy-related pain in the sacroiliac joint (SIJ), lumbosacral region, pubic symphysis, or in any combination of these joints has been coined as pelvic girdle pain (PGP) and has been estimated to affect almost half of all pregnant women. SIJ dysfunction in pregnancy is due to multiple biomechanical mechanisms, such as increased weight, change in posture, increased abdominal and intrauterine pressure, and laxity of the spine and pelvic structures. Moreover, when compared to men, women have increased SIJ mobility due to increased pubic angle and decreased SIJ curvature.

Traumatic Spinal Injury Associated with All-Terrain Vehicle (ATV) Accidents: A 10-Year Retrospective Analysis of the Coachella Valley.

Objective: The use of all-terrain vehicles (ATVs) and associated injuries have significantly increased in the last decade. This study aimed to determine the frequency of ATV-associated spinal cord injuries (SCIs) in the Coachella Valley, California, and provide recommendations for data reproducibility in other areas with a similarly substantial level of ATV usage and injuries.

Methods: This retrospective analysis included data obtained through screening the trauma database of a level II trauma center for ATV-related injuries between January 1, 2010 and January 1, 2020.