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.

Consecutive Surgeon and Anesthesia Team Improve Turnover Time in the Operating Room.

Efficient management of the operating room (OR) contributes to much of today's healthcare expenditure and plays a critical role in generating revenue for most healthcare systems. Scheduling of OR cases with the same team and surgeon have been reported to improve turnover time between cases which in turn, improves efficiency and resource utilization. We aim to assess different operating room procedures within multiple subspecialties and explore the factors that positively and negatively influence turnover time (TOT) in the operating room.

The Retroauricular Incision as an Effective and Safe Alternative Incision for Decompressive Hemicraniectomy.

Background: The reverse question mark (RQM) incision has been traditionally utilized to perform decompressive hemicraniectomies (DHC) to relieve refractory intracranial hypertension. Alternative incisions have been proposed in the literature but have not been compared directly.

Objective: To present the retroauricular (RA) incision as an alternative incision that we hypothesize will increase calvarium exposure to maximize the removal of the hemicranium and will decrease wound-related complications compared to the RQM incision.

Perioperative Coronavirus Disease 2019 (COVID-19) Incidence and Outcomes in Neurosurgical Patients at Two Tertiary Care Centers in Washington, DC, During a Pandemic: A 6-Month Follow-up.

Objective: Coronavirus disease 2019 (COVID-19) continues to affect all aspects of health care delivery, and neurosurgical practices are not immune to its impact. We aimed to evaluate neurosurgical practice patterns as well as the perioperative incidence of COVID-19 in neurosurgical patients and their outcomes.

Methods: A retrospective review of neurosurgical and neurointerventional cases at 2 tertiary centers during the first 3 months of the first peak of COVID-19 pandemic (March 8 to June 8) as well as following 3 months (post-peak pandemic; June 9 to September 9) was performed.

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.

Impact of Operating Room Environment on Postoperative Central Nervous System Infection in a Resource-Limited Neurosurgical Center in South Asia.

Background: Postoperative central nervous system infections (PCNSIs) are serious complications following neurosurgical intervention. We previously investigated the incidence and causative pathogens of PCNSIs at a resource-limited, neurosurgical center in south Asia. This follow-up study was conducted to analyze differences in PCNSIs at the same institution following only one apparent change: the operating room air filtration system.

Delayed Chyle Leak Following Anterior Cervical Spinal Surgery: A Case Report and Management Algorithm.

Injury to the thoracic duct during anterior cervical spine surgery is a rare occurrence. A delayed chyle leak following an elective anterior cervical spinal surgery has not been reported in the literature. We present a report of a 59-year-old female with multiple prior neck surgeries who underwent an anterior cervical corpectomy and fusion (ACCF).

Implementation and Evaluation of a Smartphone Application for the Perioperative Care of Neurosurgery Patients at an Academic Medical Center: Implications for Patient Satisfaction, Surgery Cancelations, and Readmissions.

Background: Smartphone applications (apps) in the health care arena are being increasingly developed with the aim of benefiting both patients and their physicians. The delivery of adequate instructions both before and after a procedure or surgery is of paramount importance in ensuring the best possible outcome for patients.

Objective: To demonstrate that app-based instructions with built-in reminders may improve patient understanding and compliance and contribute to reducing the number of surgery cancellations and postoperative complications and readmissions.

Clinical outcomes of gastrointestinal brain metastases treated with radiotherapy.

Background: Brain metastases of gastrointestinal origin are a rare occurrence. Radiation therapy (RT) in the form of stereotactic radiosurgery (SRS) or whole brain radiation therapy (WBRT) is an effective established treatment modality in either the definitive or adjuvant setting. The aim of this study is to assess the long-term clinical outcomes of patients with gastrointestinal (GI) brain metastases treated with SRS or WBRT.

Mobile Schwannoma of the Lumbar Spine: A Case Report and Review of the Literature.

Mobile schwannomas of the spine have been sparsely documented in the literature. In cases referred to in existing literature, the migratory schwannoma was documented to occur in the lumbar spine. We added another case to the small available literature.

Surgical Adhesive Drape (IO-ban) as Postoperative Surgical Site Dressing.

Study Design: Retrospective chart analysis.

Objective: The objective of this study is to describe the senior author's (MNN) experience applying a widely available surgical drape as a postoperative sterile surgical site dressing for both cranial and spinal procedures.

Summary Of Background Data: Surgical site infection (SSI) is an important complication of spine surgery that can result in significant morbidity.

Five-fraction stereotactic radiosurgery (SRS) for single inoperable high-risk non-small cell lung cancer (NSCLC) brain metastases.

Background: Achieving durable local control while limiting normal tissue toxicity with definitive radiation therapy in the management of high-risk brain metastases remains a radiobiological challenge. The objective of this study was to examine the local control and toxicity of a 5-fraction stereotactic radiosurgical approach for treatment of patients with inoperable single high-risk NSCLC brain metastases.

Methods: This retrospective analysis examines 20 patients who were deemed to have "high-risk" brain metastases.

Fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body metastases: acceptable local control and normal tissue tolerance with 5 fraction approach.

This retrospective analysis examines the local control and toxicity of five-fraction fiducial-free CyberKnife stereotactic body radiation therapy (SBRT) for single vertebral body (VB) metastases. All patients had favorable performance status (ECOG 0-1), oligometastatic disease, and no prior spine irradiation. A prescribed dose of 30-35 Gy was delivered in five fractions to the planning target volume (PTV) using the CyberKnife with X-sight spine tracking.