World Neurosurg
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Biography Historical Article
Madjid Samii: a visionary, creative man and a world neurosurgery leader.
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Randomized Controlled Trial
Burst spinal cord stimulation for limb and back pain.
Spinal cord stimulation via epidurally implanted electrodes is a common treatment for medically intractable neuropathic pain of different origins. Because tonic electrical stimulation evokes paresthesias over the painful area, this method has never been proven scientifically to be superior to placebo. Recently, burst stimulation (in which closely spaced, high-frequency stimuli are delivered to the spinal cord) has been developed, which does not generate paresthesias. ⋯ The differences between tonic and burst stimulation are likely attributable to a more-selective modulation of the medial pain pathways by burst stimulation, as shown by the activation of the dorsal anterior cingulate cortex.
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Neurosurgery is a challenging and stressful field. Excessive stress and professional dissatisfaction can lead to medical errors, negatively impact patient care, and cause physician burnout. Our objective is to develop and critically evaluate a survey measuring professional stress and satisfaction and to obtain preliminary data on sources and degree of stress and the prevalence of burnout among American neurosurgeons. ⋯ Our survey was well received and, according to respondents, encompassed the major issues associated with career stress, satisfaction, and burnout but needs to be shortened. Respondents were generally satisfied with their career but identified several major stressors. A larger study to identify predictors of career satisfaction/dissatisfaction will help generate dialogue on improving the quality of professional life for neurosurgeons.