World Neurosurg
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An increasing body of literature describing use of high-fidelity surgical training models is challenging long-held dogma that cadavers provide the best medium for postgraduate surgical skills training. The purpose of this study was to describe a surgical skills course comprising entirely synthetic training models developed by resident and attending neurosurgeons and to evaluate their perceptions of the overall usefulness of this course and its usefulness compared with cadaveric courses. ⋯ Resident and attending neurosurgeons subjectively believe that high-fidelity synthetic models were superior to cadavers as a surgical skills teaching platform. This study raises the question of whether cadavers should remain the gold standard for surgical skills courses. Expanded use of these teaching models and further study are warranted.
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Froin syndrome is characterized by xanthochromia and hypercoagulability of the cerebrospinal fluid (CSF) due to elevated protein levels. This entity results from blockage of the spinal canal by a mass lesion leading to an isolated caudal CSF space. ⋯ We report the first case of Froin syndrome after SCI. Froin syndrome can impact intrathecal drug delivery and CSF diagnostics.
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To provide a quantitative assessment of clinical outcomes of anterior cervical surgery for patients with Hirayama disease. ⋯ Anterior cervical surgery can provide clinical efficacy and imaging improvement, including reduced range of cervical flexed motion and angle mobility of lower cervical spine and increased cervical lordosis and spinal cord area.
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Normal pressure hydrocephalus (NPH) is an underdiagnosed and undertreated condition affecting the elderly population and with costs associated with its surgical management reported to be less than those associated with conservative management. ⋯ There was a 1.66-fold increase in the rate of diagnosis of NPH, from 0.12% in 1999 to 0.2% in 2008. The total costs per surgical patient rose by approximately 145% to 160% comparing 2001 and 2010. This increase was mainly due to hospital (by 167% to 168%) and home health costs (by 118% to 148%). Providing appropriate care across the socioeconomic spectrum warrants further study and requires identifying the factors that limit access to care.
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Comparative Study
A comparison of visual rating scales and simulated virtual reality metrics in neurosurgical training: a generalizability theory study.
Adequate assessment and feedback remains a cornerstone of psychomotor skills acquisition, particularly within neurosurgery where the consequence of adverse operative events is significant. However, a critical appraisal of the reliability of visual rating scales in neurosurgery is lacking. Therefore, we sought to design a study to compare visual rating scales with simulated metrics in a neurosurgical virtual reality task. ⋯ To our knowledge, this is the first study comparing participant's ratings with simulated performance. Given rating scales capture less well instrument force, quantity of brain volume removed, and blood loss, we suggest adopting a hybrid educational approach using visual rating scales in an operative environment, supplemented by simulated sessions to uncover potentially problematic surgical technique.