Neurosurgery
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Infection is one of the most common complications of deep brain stimulation (DBS). Long-term infection rates beyond the immediate postoperative period are rarely evaluated. ⋯ There is a persistent risk of DBS infection and erosion beyond the first year of DBS implantation. Start of the academic year was associated with increased infection rate at our institution.
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Pediatric hydrocephalus represents a high health care burden in the United States (US). Surgery is the mainstay of treatment. ⋯ There was no significant effect on time to failure between patients undergoing ETV and shunt, except in infants' age <1 yr.
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Chordomas are rare but challenging neoplasms involving the skull base. A preoperative grading system will be useful to identify both areas for treatment and risk factors, and correlate to the degree of resection, complications, and recurrence. ⋯ The proposed chordoma grading system can help surgeons to predict the difficulty of the case and know which areas of the skull base will need attention to plan further therapy.
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The lifetime economic burden of thoracic spinal cord injury (SCI) is known to be high, but evidence of variability of costs in relation to the American Spinal Injury Association Impairment Scale (AIS) grade is limited. ⋯ Persons with less severe thoracic SCI, as reflected in AIS grade, spend fewer days in hospital over their lifetimes, leading to lower costs of inpatient care. Therapies improving AIS grade following thoracic SCI may provide cost savings in addition to addressing substantial unmet need.
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Lumbar fusion remains the treatment of choice for many degenerative pathologies. Healthcare costs related to the procedure are a concern, and postdischarge needs often contribute to greater expenditure. The Quality Outcomes Database (QOD) is a prospective, multicenter clinical registry designed to analyze outcomes after neurosurgical procedures. ⋯ We present a simple scoring system to assist in predicting postdischarge needs for patients undergoing lumbar fusion for degenerative disease. Further validation studies are needed to assess the generalizability of our scale.