The New England Neurosurgical Society: growth and evolution over 70 years.

The New England Neurosurgical Society (NENS) was founded in 1951 under the leadership of its first President (Dr. William Beecher Scoville) and Secretary-Treasurer (Dr. Henry Thomas Ballantine).

A level-wise spine registration framework to account for large pose changes.

Purposes: Accurate and efficient spine registration is crucial to success of spine image guidance. However, changes in spine pose cause intervertebral motion that can lead to significant registration errors. In this study, we develop a geometrical rectification technique via nonlinear principal component analysis (NLPCA) to achieve level-wise vertebral registration that is robust to large changes in spine pose.

Poroelastic Mechanical Properties of the Brain Tissue of Normal Pressure Hydrocephalus Patients During Lumbar Drain Treatment Using Intrinsic Actuation MR Elastography.

Rationale And Objectives: Hydrocephalus (HC) is caused by accumulating cerebrospinal fluid resulting in enlarged ventricles and neurological symptoms. HC can be treated via a shunt in a subset of patients; identifying which individuals will respond through noninvasive imaging would avoid complications from unsuccessful treatments. This preliminary work is a longitudinal study applying MR Elastography (MRE) to HC patients with a focus on normal pressure hydrocephalus (NPH).

Reducing Radiation and Lowering Costs With a Standardized Care Pathway for Nonoperative Thoracolumbar Fractures.

Study Design: Retrospective observational study.

Objective: There is marked variation in the management of nonoperative thoracolumbar (TL) compression and burst fractures. This was a quality improvement study designed to establish a standardized care pathway for TL fractures treated with bracing, and to then evaluate differences in radiographs, length of stay (LOS), and cost before and after the pathway.

Differential Patterns of Referral to Neurosurgery: A Comparison of Allopathic Physicians, Osteopathic Physicians, Nurse Practitioners, Physician Assistants, and Chiropractors.

Background: Rising cost and limited resources remain major challenges to U.S. health care and neurosurgery in particular.

A Cohort Study of the Natural History of Odontoid Pseudoarthrosis Managed Nonoperatively in Elderly Patients.

Objective: Although the primary goal of treatment of type II odontoid fracture is bony union, some advocate continued nonsurgical management of minimally symptomatic older patients who have fibrous union or minimal fracture motion. The risk of this strategy is unknown. We reviewed our long-term outcomes after dens nonunion to define the natural history of Type II odontoid fractures in elderly patients managed nonoperatively.

Stereovision Co-Registration in Image-Guided Spinal Surgery: Accuracy Assessment Using Explanted Porcine Spines.

Background: Current methods of spine registration for image guidance have a variety of limitations related to accuracy, efficiency, and cost.

Objective: To define the accuracy of stereovision-mediated co-registration of a spinal surgical field.

Methods: A total of 10 explanted porcine spines were used.

Use of Stereovision for Intraoperative Coregistration of a Spinal Surgical Field: A Human Feasibility Study.

Background: The use of image guidance during spinal surgery has been limited by several anatomic factors such as intervertebral segment motion and ineffective spine immobilization. In its current form, the surgical field is coregistered with a preoperative computed tomography (CT), often obtained in a different spinal confirmation, or with intraoperative cross-sectional imaging. Stereovision offers an alternative method of registration.

Surgical management of arrested hydrocephalus: Case report, literature review, and 18-month follow-up.

Objective: Arrested hydrocephalus is stable ventriculomegaly without evidence of neurologic deterioration or symptoms. Management of arrested hydrocephalus in asymptomatic adults is controversial, with little clinical data. This case highlights the potential for decompensation in adults with arrested hydrocephalus and reviews the literature regarding pathophysiology and management of this clinical entity.

Utility of Routine Outpatient Cervical Spine Imaging Following Anterior Cervical Corpectomy and Fusion.

Background: Construct failure is an uncommon but well-recognized complication following anterior cervical corpectomy and fusion (ACCF). In order to screen for these complications, many centers routinely image patients at outpatient visits following surgery. There remains, however, little data on the utility of such imaging.

Intraoperative CT as a registration benchmark for intervertebral motion compensation in image-guided open spinal surgery.

Purpose: An accurate and reliable benchmark of registration accuracy and intervertebral motion compensation is important for spinal image guidance. In this study, we evaluated the utility of intraoperative CT (iCT) in place of bone-implanted screws as the ground-truth registration and illustrated its use to benchmark the performance of intraoperative stereovision (iSV).

Methods: A template-based, multi-body registration scheme was developed to individually segment and pair corresponding vertebrae between preoperative CT and iCT of the spine.

Dynamic Compression of the Spinal Cord by Paraspinal Muscles following Cervical Laminectomy: Diagnosis Using Flexion-Extension MRI.

Introduction. Flexion-extension, or kinematic, MRI has been used to identify dynamic spondylotic spinal cord compression not seen with traditional static MRI. The use of kinematic MRI to diagnose postoperative complications, specifically dynamic compression, is not as well documented.

Patient Registration Using Intraoperative Stereovision in Image-guided Open Spinal Surgery.

Despite its widespread availability and success in open cranial neurosurgery, image-guidance technology remains more limited in use in open spinal procedures, in large part, because of patient registration challenges. In this study, we evaluated the feasibility of using intraoperative stereovision (iSV) for accurate, efficient, and robust patient registration in an open spinal fusion surgery. Geometrical surfaces of exposed vertebrae were first reconstructed from iSV.

Outpatient follow-up of nonoperative cerebral contusion and traumatic subarachnoid hemorrhage: does repeat head CT alter clinical decision-making?

Objectives: Many neurosurgeons obtain repeat head CT at the first clinic follow-up visit for nonoperative cerebral contusion and traumatic subarachnoid hemorrhage (tSAH). The authors undertook a single-center, retrospective study to determine whether outpatient CT altered clinical decision-making.

Methods: The authors evaluated 173 consecutive adult patients admitted to their institution from April 2006 to August 2012 with an admission diagnosis of cerebral contusion or tSAH and at least 1 clinic follow-up visit with CT.

Postoperative Mycoplasma hominis infections after neurosurgical intervention.

Object: Mycoplasma hominis is a rare cause of infection after neurosurgical procedures. The Mycoplasma genus contains the smallest bacteria discovered to date. Mycoplasma are atypical bacteria that lack a cell wall, a feature that complicates both diagnosis and treatment.

Brain mechanical property measurement using MRE with intrinsic activation.

Many pathologies alter the mechanical properties of tissue. Magnetic resonance elastography (MRE) has been developed to noninvasively characterize these quantities in vivo. Typically, small vibrations are induced in the tissue of interest with an external mechanical actuator.

Coregistered fluorescence-enhanced tumor resection of malignant glioma: relationships between δ-aminolevulinic acid-induced protoporphyrin IX fluorescence, magnetic resonance imaging enhancement, and neuropathological parameters. Clinical article.

Object: The aim of this study was to investigate the relationships between intraoperative fluorescence, features on MR imaging, and neuropathological parameters in 11 cases of newly diagnosed glioblastoma multiforme (GBM) treated using protoporphyrin IX (PpIX) fluorescence-guided resection.

Methods: In 11 patients with a newly diagnosed GBM, δ-aminolevulinic acid (ALA) was administered to enhance endogenous synthesis of the fluorophore PpIX. The patients then underwent fluorescence-guided resection, coregistered with conventional neuronavigational image guidance.

Cause-specific mortality among neurosurgeons.

Object: The authors sought to determine a cause-specific mortality profile for US neurosurgeons during the period 1979-2005.

Methods: Neurosurgeons who died during the study period were identified from the Physician Master File database. Using the National Death Index, the reported cause of death was identified for 93.

Programmable CSF shunt valves: radiographic identification and interpretation.

The programmable CSF shunt valve has become an important tool in hydrocephalus treatment, particularly in the NPH population and in pediatric patients with complex hydrocephalus. The purpose of this study is to provide a single reference for the identification of programmable shunt valves and the interpretation of programmable shunt valve settings. Four major manufacturers of programmable shunts agreed to participate in this study.

Low-dose kaolin-induced feline hydrocephalus and feline ventriculostomy: an updated model.

Object: Intracisternal injection of kaolin is a well-described model of feline hydrocephalus. Its principal disadvantage is a high rate of procedure-related morbidity and mortality. The authors describe a series of modifications to a commonly used protocol, intended to ameliorate animal welfare concerns without compromising the degree of ventricular enlargement.

Robotic placement of a CNS ventricular reservoir for administration of chemotherapy.

The application of robotic technology to surgery holds great promise for improving surgical outcomes and reducing morbidity. We hypothesized that image-guided, robotic placement of a CNS ventriculostomy reservoir for intraventricular chemotherapy is safe, highly accurate, and highly reproducible. Eleven patients requiring catheter ventriculostomy for reservoir placement were included in this retrospective study.

Model-based estimation of ventricular deformation in the cat brain.

The estimation of ventricular deformation has important clinical implications related to neuro-structural disorders such as hydrocephalus. In this paper, a poroelastic model was used to represent deformation effects resulting from the ventricular system and was studied in 5 feline experiments. Chronic or acute hydrocephalus was induced by injection of kaolin into the cisterna magna or saline into the ventricles; a catheter was then inserted in the lateral ventricle to drain the fluid out of the brain.

Robotic catheter ventriculostomy: feasibility, efficacy, and implications.

Object: Robotic applications hold great promise for improving clinical outcomes and reducing complications of surgery. To date, however, there have been few widespread applications of robotic technology in neurosurgery. The authors hypothesized that image-guided robotic placement of a ventriculostomy catheter is safe, highly accurate, and highly reproducible.

Ventriculoperitoneal shunt insertion for the treatment of refractory perilymphatic fistula.

Object: The goal of this study was to provide preliminary data regarding clinical and functional outcome, including postoperative morbidity, related to ventriculoperitoneal (VP) shunt insertion for refractory perilymphatic fistula.

Methods: The authors retrospectively reviewed the records of seven consecutive patients who had undergone VP shunt insertion for medically and surgically refractory perilymphatic fistula between 1996 and 2004. Patients were also contacted by telephone and asked to assess retrospectively their symptomatic improvement, changes in functional status, and changes in work status following shunt placement.