Rod derotation techniques for thoracolumbar spinal deformity.

Objective: The operative correction of scoliosis requires multiple intraoperative techniques and tools to achieve an adequate result. Frequently, multiple methods are used to accomplish this, such as rod cantilever techniques, in situ bending, Smith-Petersen and pedicle subtraction osteotomies, closed reduction methods, and rod derotation techniques. Rod derotation techniques will be reviewed and discussed in this article.

Postmortem analysis following 71 months of deep brain stimulation of the subthalamic nucleus for Parkinson disease.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a clinically effective neurosurgical treatment for Parkinson disease. Tissue reaction to chronic DBS therapy and the definitive location of active stimulation contacts are best studied on a postmortem basis in patients who have undergone DBS. The authors report the postmortem analysis of STN DBS following 5 years and 11 months of effective chronic stimulation including the histologically verified location of the active contacts associated with bilateral implants.

Intersurgeon variability in the selection of anterior and posterior commissures and its potential effects on target localization.

Background: This study reports the intersurgeon variability in manual selection of the anterior and posterior commissures (AC and PC). The study also investigates the effect of this variability on the localization of targets like the subthalamic nucleus, ventralis intermedius nucleus and globus pallidus internus. The additional effect of variation in the selection of the mid-plane on target localization is also evaluated.

Neuromodulation of the cingulum for neuropathic pain after spinal cord injury. Case report.

The authors present a case in which high-frequency electrical stimulation of the cingulum using standard deep brain stimulation (DBS) technology resulted in pain relief similar to that achieved with cingulotomy and superior to that achieved with periventricular gray matter (PVG) stimulation. This patient had a complete spinal cord injury at the C-4 level and suffered from medically refractory neuropathic pain. He underwent placement of bilateral cingulum and unilateral PVG DBS electrodes and a 1-week blinded stimulation trial prior to permanent implantation of a pulse generator.

Work hours restrictions as an ethical dilemma for residents: a descriptive survey of violation types and frequency.

Background: The Accreditation Council for Graduate Medical Education (ACGME) implemented requirements regarding allowable duty hours for resident training in the United States in July 2003. In a previous pilot study at Vanderbilt University Medical Center, a significant number of residents reported violation of requirements. In addition, almost half of those individuals admitted under-reporting their hours worked.

Delayed occurrence of multiple spinal drop metastases from a posterior fossa choroid plexus papilloma. Case report.

Choroid plexus papilloma is a benign central nervous system tumor that occasionally spreads along the subarachnoid space. The authors report the case of a 49-year-old man who presented with back pain 19 years after resection of a posterior fossa choroid plexus papilloma. Magnetic resonance imaging revealed multiple spinal lesions without any residual or recurrent intracranial tumor.

Automatic selection of DBS target points using multiple electrophysiological atlases.

In this paper we study and evaluate the influence of the choice of a particular reference volume as the electrophysiological atlas on the accuracy of the automatic predictions of optimal points for deep brain stimulator (DBS) implants. We refer to an electrophysiological atlas as a spatial map of electrophysiological information such as micro electrode recordings (MER), stimulation parameters, final implants positions, etc., which are acquired for each patient and then mapped onto a single reference volume using registration algorithms.