The History of the Development and Use of Suction Devices in Neurosurgery.

This article reviews the major devices, individuals, and other historical landmarks in the development of suction in the field of neurosurgery, where the operating fields are characteristically deep and narrow. Our review spans the 159 years since the first use of aspiration in surgery to modern applications. This report exemplifies a comprehensive history of suction, the minute iteration of devices, and the massive impact this technological development has had on medicine and neurosurgery.

Use of intraoperative MRI for resection of intracranial tumors: A nationwide analysis of short-term outcomes.

Objective: Recent evidence supports the use of intraoperative MRI (iMRI) during resection of intracranial tumors due to its demonstrated efficacy and clinical benefit. Though many single-center investigations have been conducted, larger nationwide outcomes have yet to be characterized.

Methods: We used the American College of Surgeons National Surgical Quality Improvement Program database to examine baseline characteristics and 30-day postoperative outcomes among patients undergoing craniotomy for tumor resection with and without iMRI.

Incidence, Management, and Outcomes of Adult Patients with Spinal Chondrosarcoma in the United States.

Objective: Spinal chondrosarcomas are rare primary malignant neoplasms composed of cartilage-producing cells. They are slow-growing but locally aggressive lesions that have high rates of recurrence and progression after treatment. We provide the largest comprehensive analysis of prognostic factors, treatment modalities, and survival outcomes in patients with spinal chondrosarcoma using a large, prospectively collected national database.

High-Grade Spinal Hemangioma: A National Cancer Database Analysis.

Background: Spinal hemangiomas are common primary tumors of the vertebrae. Although these tumors are most frequently benign and asymptomatic, they can rarely exhibit aggressive growth and invasion into neighboring structures. Treatment for these aggressive variants is controversial, often involving surgery, chemotherapy, and/or radiotherapy.

Risk Factors for Hyponatremia and Perioperative Complications With Malignant Intracranial Tumor Resection in Adults: An Analysis of the Nationwide Inpatient Sample from 2012 to 2015.

Background: The present study aims to study the incidence and risk factors for developing hyponatremia and associated perioperative outcomes in adult patients admitted for malignant brain tumor resection.

Methods: The 2012-2015 Nationwide Inpatient Sample was queried for all patients undergoing surgical resection of malignant brain tumors. These patients were then grouped by the presence of concurrent diagnosis of hyponatremia, and compared with respect to various clinical features, perioperative and postoperative complications, all-cause mortality, discharge disposition, length of stay, and hospitalization costs.

Primary Malignant Melanoma of the Brain: A Population-Based Study.

Background: Primary melanocytic neoplasms of the central nervous system (CNS) are rare and account for 1% of all melanomas. This study used the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the epidemiology of primary CNS melanoma and further characterize their treatment.

Methods: Data from the National Cancer Institute SEER program, collected from 1973-2015, were retrospectively analyzed.

Epidural Abscess: A Propensity Analysis of Surgical Treatment Strategies.

Study Design: Observational analysis of retrospectively collected data.

Objective: A retrospective study was performed in order to compare the surgical profile of risk factors and perioperative complications for laminectomy and laminectomy with fusion procedures in the treatment of spinal epidural abscess (SEA).

Summary Of Background Data: SEA is a highly morbid condition typically presenting with back pain, fever, and neurologic deficits.

Use of concentrated insulin human regular (U-500) for patients with diabetes.

Purpose: The efficacy and safety of and key clinical considerations for using U-500 insulin human regular in the treatment of high-dose insulin-treated patients in a wide variety of settings are examined.

Summary: U-500 regular insulin has been available in the United States since 1952, but only recently has it become more commonly prescribed for patients requiring large amounts of insulin to improve their blood glucose control. This use coincides with the increasing rates of obesity and type 2 diabetes associated with significant insulin resistance, which can necessitate the need for doses of insulin exceeding 200 units/day.