Seasonal Effects on Postoperative Complications After Spinal Surgery: A National Database Analysis.

Objective: To investigate the role of seasonality on postoperative complications after spinal surgery.

Methods: Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2018. Current Procedural Terminology codes were used to identify the following procedures: posterior cervical decompression and fusion, cervical laminoplasty, posterior lumbar fusion, lumbar laminectomy, and spinal deformity surgery.

Comparative Analysis of Early Outcomes and Complications of PSO Among Neurosurgeons and Orthopedic Surgeons.

Study Design: Retrospective comparative cohort study using the National Surgical Quality Improvement Program.

Objective: The aim of this study was to evaluate trends in the annual number of PSOs performed, describe the patient populations associated with each cohort, and compare outcomes between specialties.Summary of Background Data:Pedicle subtraction osteotomies (PSO) are complex and advanced spine deformity surgical procedures performed by neurosurgeons and orthopedic surgeons.

The Knosp Criteria Revisited: 3-Dimensional Volumetric Analysis as a Predictive Tool for Extent of Resection in Complex Endoscopic Pituitary Surgery.

Background: The Knosp criteria have been the historical standard for predicting cavernous sinus invasion, and therefore extent of surgical resection, of pituitary macroadenomas. Few studies have sought to reappraise the utility of this tool after recent advances in visualization and modeling of tumors in complex endoscopic surgery.

Objective: To evaluate our proposed alternative method, using 3-dimensional (3D) volumetric imaging, and whether it can better predict extent of resection in nonfunctional pituitary adenomas.

Detectability of Small Low-Attenuation Lesions With Deep Learning CT Image Reconstruction: A 24-Reader Phantom Study.

Iterative reconstruction (IR) techniques are susceptible to contrast-dependent spatial resolution, limiting overall radiation dose reduction potential. Deep learning image reconstruction (DLIR) may mitigate this limitation. The purpose of our study was to evaluate low-contrast detectability performance and radiation-saving potential of a DLIR algorithm in comparison with filtered back projection (FBP) and IR using a human multireader noninferiority study design and task-based observer modeling.

Augmented reality-assisted microsurgical resection of brain arteriovenous malformations: illustrative case.

Background: Arteriovenous malformations (AVMs) of the brain are vessel conglomerates of feeding arteries and draining veins that carry a risk of spontaneous and intraoperative rupture. Augmented reality (AR)-assisted neuronavigation permits continuous, real-time, updated visualization of navigation information through a heads-up display, thereby potentially improving the safety of surgical resection of AVMs.

Observations: The authors report a case of a 37-year-old female presenting with a 2-year history of recurrent falls due to intermittent right-sided weakness and increasing clumsiness in the right upper extremity.

MIS-TLIF Procedure is Improving With Experience: Systematic Review of the Learning Curve Over the Last Decade.

Study Design: This was a systematic review.

Objective: This review evaluates the minimally invasive transforaminal lumbar interbody fusions (MIS-TLIF) learning curve in the literature and compares outcomes during and after completing the curve.

Summary Of Background Data: MIS-TLIF are performed for various spine conditions.

Neurosurgical Performance in the First 2 Years of Merit-Based Incentive Payment System: A Descriptive Analysis and Predictors of Receiving Bonus Payments.

Background: The merit-based incentive payment system (MIPS) program was implemented to tie Medicare reimbursements to value-based care measures. Neurosurgical performance in MIPS has not yet been described.

Objective: To characterize neurosurgical performance in the first 2 years of MIPS.

Post-operative vision loss: analysis of 587 patients undergoing endoscopic surgery for pituitary macroadenoma.

Purpose: Vision loss following surgery for pituitary adenoma is poorly described in the literature and cannot be reliably predicted with current prognostic models. Detailed characterization of this population is warranted to further understand the factors that predispose a minority of patients to post-operative vision loss.

Materials And Methods: The medical records of 587 patients who underwent endoscopic transsphenoidal surgery at the Mount Sinai Medical Centre between January 2013 and August 2018 were reviewed.

Seasonal Effects on Surgical Site Infections Following Spine Surgery.

Background: Studies investigating seasonality as a risk factor for surgical site infections (SSIs) after spine surgery show mixed results. This study used national data to analyze seasonal effects on spine surgery SSIs.

Methods: National Surgical Quality Improvement Program data (2011-2018) were queried for posterior cervical fusions (PCFs), cervical laminoplasties, posterior lumbar fusions (PLFs), lumbar laminectomies, and deformity surgeries.

Intraoperative Navigation in Spine Surgery: Effects on Complications and Reoperations.

Introduction: Intraoperative navigation during spine surgery improves pedicle screw placement accuracy. However, limited studies have correlated the use of navigation with clinical factors, including operative time and safety. In the present study, we compared the complications and reoperations between surgeries with and without navigation.

Clinical Trials in Spinal Tumors: A Two-Decade Review.

Objective: Clinical trials are essential for assessing the advancements in spine tumor therapeutics. The purpose of the present study was to characterize the trends in clinical trials for primary and metastatic tumor treatment during the past 2 decades.

Methods: The ClinicalTrials.

The Impact of American Society of Anesthesiologists Status on Cost of Care and Length of Stay Following Posterior Cervical Decompression and Fusion.

Background: Increased posterior cervical decompression and fusion (PCDF) procedures over the past decade have raised the prospect of bundled payment plans. The American Society of Anesthesiologists (ASA) Physical Status Classification system may enable accurate estimation of health care costs, length of stay (LOS), and other postoperative outcomes in patients undergoing PCDF.

Methods: Low (I and II) versus high (III and IV) ASA class was used to evaluate 971 patients who underwent PCDF between 2008 and 2016 at a single institution.

Comparison of Cost and Perioperative Outcome Profiles for Primary and Revision Posterior Cervical Fusion Procedures.

Study Design: Retrospective analysis.

Objective: To compare perioperative outcomes and hospitalization costs between patients undergoing primary or revision posterior cervical discectomy and fusion (PCDF).

Summary Of Background Data: While prior studies found differences in outcomes between primary and revision anterior cervical discectomy and fusion (ACDF), risk, and outcome profiles for posterior cervical revision procedures have not yet been elucidated.

Is there a morphometric cause of Chiari malformation type I? Analysis of existing literature.

Although many etiologies have been proposed for Chiari malformation type I (CM-I), there currently is no singular known cause of CM-I pathogenesis. Advances in imaging have greatly progressed the study of CM-I. This study reviews the literature to determine if an anatomical cause for CM-I could be proposed from morphometric studies in adult CM-I patients.

Rescue therapy for vasospasm following aneurysmal subarachnoid hemorrhage: a propensity score-matched analysis with machine learning.

Objective: Rescue therapies have been recommended for patients with angiographic vasospasm (aVSP) and delayed cerebral ischemia (DCI) following subarachnoid hemorrhage (SAH). However, there is little evidence from randomized clinical trials that these therapies are safe and effective. The primary aim of this study was to apply game theory-based methods in explainable machine learning (ML) and propensity score matching to determine if rescue therapy was associated with better 3-month outcomes following post-SAH aVSP and DCI.

Academic Productivity of United States Neurosurgeons Trained Abroad.

Background: Previous research in neurosurgery has examined academic productivity for U.S. medical graduates and residents.

The Impact of Non-Elective Admission on Cost of Care and Length of Stay in Anterior Cervical Discectomy and Fusion: A Propensity-Matched Analysis.

Study Design: Retrospective cohort study.

Objective: To evaluate the impact of admission status on patient outcomes and healthcare costs in anterior cervical discectomy and fusion (ACDF).

Summary Of Background Data: Undergoing ACDF non-electively has been associated with higher patient comorbidity burdens.

Sport Contact Level Affects Post-Concussion Neurocognitive Performance in Young Athletes.

Objective: Contact level affects the incidence of sports-related concussion. However, the effects of contact level on injury severity and recovery are less clear and are the focus of this study.

Method: Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) for athletes aged 12-22 was performed at baseline (n = 10,907 for 7,058 athletes), after suspected concussion determined by physicians or athletic trainers (n = 5,062 for 4,419 athletes), and during follow-up visits (n = 3,264 for 2,098 athletes).

Comparison of Surgical Outcomes of Microdiskectomy Procedures by Patient Admission Status.

Objective: We sought to compare the cost and in-hospital outcomes following lumbar microdiskectomy procedures by admission type.

Methods: Patients undergoing lumbar microdiskectomy at a single institution from 2008 to 2016 following an elective admission (EL) were compared against those who were admitted from the emergency department (ED) or from elsewhere within or outside the hospital system (TR) for their perioperative outcomes and cost. Multivariable modeling controlled for age, sex, self-reported race, Elixhauser comorbidity score, payer type, number of segments, and procedure length.

Virtual Unenhanced Dual-Energy CT Images Obtained with a Multimaterial Decomposition Algorithm: Diagnostic Value for Renal Mass and Urinary Stone Evaluation.

Background Virtual unenhanced (VUE) images obtained by using a dual-energy CT (DECT) multimaterial decomposition algorithm hold promise for diagnostic use in the abdomen in lieu of true unenhanced (TUE) images. Purpose To assess VUE images obtained from a DECT multimaterial decomposition algorithm in patients undergoing renal mass and urinary stone evaluation. Materials and Methods In this retrospective Health Insurance Portability and Accountability Act-compliant study, DECT was performed in patients undergoing evaluation for renal mass or urinary stone.

Trials in thrombectomy for acute ischemic stroke: Describing the state of clinical research in the field.

Background: Endovascular thrombectomy has revolutionized treatment of ischemic stroke. Given the clinical and socioeconomic support for thrombectomy, new devices, procedures, and pharmaceuticals have emerged in recent years, and have been subject to a growing number of clinical trials worldwide.

Objective: To define the current state of thrombectomy clinical trials, highlight recent trends, and help guide future research in this area.

Aneurysmal Subarachnoid Hemorrhage: the Last Decade.

Aneurysmal subarachnoid hemorrhage (SAH) affects six to nine people per 100,000 per year, has a 35% mortality, and leaves many with lasting disabilities, often related to cognitive dysfunction. Clinical decision rules and more sensitive computed tomography (CT) have made the diagnosis of SAH easier, but physicians must maintain a high index of suspicion. The management of these patients is based on a limited number of randomized clinical trials (RCTs).

The Impact of Diabetes on Outcomes and Health Care Costs Following Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective cohort study.

Objectives: Anterior cervical discectomy and fusion (ACDF) is commonly used to treat an array of cervical spine pathology and is associated with good outcomes and low complication rates. Diabetes mellitus (DM) is a common comorbidity for patients undergoing ACDF, but the literature is equivocal about the impact it has on outcomes.