The utility of surgical drains in adult and pediatric posterior spinal fusion: systematic review and meta-analysis.

Surgical drains are utilized in spinal surgery to reduce the incidence of epidural hematomas (EDHs) and to facilitate optimal wound healing. Despite their widespread use, there is a paucity of data to support their utility. The goal of this systematic review and meta-analysis is to compare the effect of using drains versus no drains on postoperative outcomes in adult and pediatric patients undergoing posterior spinal fusions for deformity or degenerative conditions.

Incidence, Risk Factors, and Functional Outcomes of Symptomatic Postoperative Spinal Epidural Hematoma: A Case-Control Study.

Background: Symptomatic postoperative spinal epidural hematomas (PEDHs) are rare complications, with significant implications on patients' functional outcomes. Strategies for PEDH prevention are poorly understood. This study sought to evaluate preoperative and intraoperative variables predicting the risk of PEDH and patients' functional outcomes after PEDH evacuation.

Minimally invasive robot-assisted direct pars repair: illustrative cases.

Background: Robot-assisted techniques are increasingly integrated into the field of spine surgery, with the potential benefits of increased accuracy and reduced radiation exposure. The objective of this study was to describe the technique of minimally invasive robot-assisted direct pars repair with 2 case illustrations.

Observations: An 18-year-old male and a 42-year-old male, both with bilateral L5 spondylolysis, underwent successful minimally invasive L5 direct pars repairs with robotic assistance after conservative measures failed, and their cases are presented herein.

Considerations for delayed-onset spinal arachnoid web after intracranial subarachnoid hemorrhage.

Spinal arachnoid web (AW) is a rare condition causing spinal cord-related issues. Its cause is often idiopathic but can be linked to past trauma or spine surgery. We describe two cases of AWs that developed after subarachnoid hemorrhage (SAH).

Single-center pilot study of remote therapeutic monitoring in patients with operative spinal pathologies.

Objectives: Spine pathology affects a significant portion of the population, leading to neck and back pain, impacting quality of life, and potentially requiring surgical intervention. Current pre- and postoperative monitoring methods rely on patient reported outcome (PRO) measures and lack continuous objective data on patients' recoveries. Remote therapeutic monitoring (RTM) using wearable devices offers a promising solution to bridge this gap, providing real-time physical function data.

Clinical outcomes and complications of eyelid versus eyebrow approaches to supraorbital craniotomy: systematic review and indirect meta-analysis.

Objective: Eyebrow supraorbital craniotomy is a versatile keyhole technique for treating intracranial pathologies. The eyelid supraorbital approach, an alternative approach to an eyebrow supraorbital craniotomy, has not been widely adopted among most neurosurgeons. The purpose of this systematic review and meta-analysis was to perform a pooled analysis of the complications of eyebrow or eyelid approaches for the treatment of aneurysms, meningiomas, and orbital tumors.

Reducing implicit bias in the neurosurgery application and interview process: a single-institution experience.

Objective: The neurosurgical match is a challenging process for applicants and programs alike. Programs must narrow a wide field of applicants to interview and then determine how to rank them after limited interaction. To streamline this, programs commonly screen applicants using United States Medical Licensing Examination (USMLE) Step scores.

Biomechanical Analysis of 2 Versus 4 Rods Across the Cervicothoracic Junction in a Human Cadaveric Model.

Background And Objectives: Posterior reconstruction of the cervicothoracic junction poses significant biomechanical challenges secondary to transition from the mobile cervical to rigid thoracic spines and change in alignment from lordosis to kyphosis. After destabilization, the objectives of the current investigation were to compare the rod strain and multidirectional flexibility properties of the cervicothoracic junction using a 4-rod vs traditional 2-rod reconstructions.

Methods: Ten human cadaveric cervicothoracic specimens underwent multidirectional flexibility testing including flexion-extension, lateral bending, and axial rotation.

Validation of Impaction Grafting for Single-Level Transforaminal Lumbar Interbody Fusion-Technical Pearls and MicroCT Analysis.

Study Design: Cadaveric study.

Background Context: Transforaminal lumbar interbody fusion (TLIF) represents a well-documented operative surgical technique utilized in the management of lumbar pathology requiring interbody arthrodesis. The microstructural properties of impaction grafting (IG) after TLIF has yet to be reported.

Basis for error in stereotactic and computer-assisted surgery in neurosurgical applications: literature review.

Technological advancements in optoelectronic motion capture systems have allowed for the development of high-precision computer-assisted surgery (CAS) used in cranial and spinal surgical procedures. Errors generated sequentially throughout the chain of components of CAS may have cumulative effect on the accuracy of implant and instrumentation placement - potentially affecting patient outcomes. Navigational integrity and maintenance of fidelity of optoelectronic data is the cornerstone of CAS.

Facilitation of Pediatric Posterior Fossa Vascular Malformation Resection Using Virtual Reality Platform: 2-Dimensional Operative Video.

Pediatric posterior fossa arteriovenous malformations (AVMs) are rare entities that pose significant cumulative lifetime risk of rupture and require treatment. Microsurgical resection remains a good option for definitively treating posterior fossa AVMs in one setting. The drawback of endovascular embolization is the lower rates of nidus obliteration.

Treatment of chronic subdural hematoma in a patient with a left ventricular assist device: Case report and review of the literature.

Patients with left ventricular assist devices (LVADs) provide a unique challenge with regard to the management of subdural hematomas (SDH), due to preexisting comorbidities and induced coagulopathy. We report on the case of a 63-year-old female with a preexisting LVAD who developed an acute on chronic SDH with 15 mm of midline shift. She was successfully treated with middle meningeal artery (MMA) embolization and placement of a bedside subdural evacuating port system without hematoma recurrence at 1-year follow-up.

The Utility of Prolonged Prophylactic Systemic Antibiotics (PPSA) for Subfascial Drains After Degenerative Spine Surgery.

Study Design: Retrospective cohort study.

Objective: The aim of the current investigation was to evaluate the impact of prolonged prophylactic systemic antibiotics (PPSA) on the development of surgical site infection rate (SSIR) in degenerative spine surgery.

Summary Of Background Data: Surgical drains are utilized postoperatively in posterior spine surgery to help minimize the risk of seroma formation.

Effect of Incisional Negative Pressure Wound Therapy vs Standard Wound Dressing on the Development of Surgical Site Infection after Spinal Surgery: A Prospective Observational Study.

Background: Use of a closed-incisional negative pressure therapy (ci-NPT) dressing is an emerging strategy to reduce surgical site infections (SSIs) in spine surgery that lacks robust data.

Objective: To determine the impact of a ci-NPT, as compared with a standard dressing, on the development of SSIs after spine surgery.

Methods: This was a prospective observational study over a 2-yr period.

Combination targeting of subthalamic nucleus and ventral intermediate thalamic nucleus with a single trajectory in deep brain stimulation for tremor-dominant Parkinson's disease.

Deep brain stimulation (DBS) has traditionally been used to target the subthalamic nucleus (STN) or globus pallidus internus (GPi) to treat Parkinson's disease (PD) and the ventral intermediate thalamic nucleus (VIM) to treat essential tremor (ET). Recent case reports have described targeting both the STN and VIM with a single trajectory and electrode to treat patients with tremor-dominant PD, yet outcome data for this procedure remains sparse. Our objective is to determine the safety and efficacy of combination STN-VIM DBS.

Intracranial hemorrhage in critically ill patients hospitalized for COVID-19.

In this study, we report three cases of spontaneous intracranial hemorrhage in patients who were initially hospitalized at our tertiary care center in Washington, DC with symptoms of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed in all three patients, who were critically ill, requiring intubation and ventilatory support. During their protracted hospitalizations, subsequent imaging disclosed intracranial hemorrhages, including intracerebral and subarachnoid hemorrhages, in the context of anticoagulation and coagulopathy.

General surgery involvement with ventriculoperitoneal shunt insertions reduces revision rates.

Background: Ventriculoperitoneal shunts (VPS) are placed for a variety of etiologies. It is common for general surgery to assist with insertion of the distal portion in the peritoneum.

Objective: To determine if there is a difference in revision rates in patients undergoing VPS placement with general surgery as well as those undergoing laparoscopic insertion.

Case Volumes and Perioperative Coronavirus Disease 2019 Incidence in Neurosurgical Patients During a Pandemic: Experiences at Two Tertiary Care Centers in Washington, DC.

Objective: The true incidence of perioperative coronavirus disease 2019 (COVID-19) has not been well elucidated in neurosurgical studies. We reviewed the effects of the pandemic on the neurosurgical case volume to study the incidence of COVID-19 in patients undergoing these procedures during the perioperative period and compared the characteristics and outcomes of this group to those of patients without COVID-19.

Methods: The neurosurgical and neurointerventional procedures at 2 tertiary care centers during the pandemic were reviewed.

Predicting episodic memory formation for movie events.

Episodic memories are long lasting and full of detail, yet imperfect and malleable. We quantitatively evaluated recollection of short audiovisual segments from movies as a proxy to real-life memory formation in 161 subjects at 15 minutes up to a year after encoding. Memories were reproducible within and across individuals, showed the typical decay with time elapsed between encoding and testing, were fallible yet accurate, and were insensitive to low-level stimulus manipulations but sensitive to high-level stimulus properties.