World Neurosurg
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Laparoscopy for ventriculoperitoneal shunt creation might offer smaller incisions and more reliable placement. We assessed the reliability and cost-effectiveness of this technique compared with mini-laparotomy shunt placement. ⋯ Both laparoscopy and open peritoneal shunt creation are safe procedures, with a 12-month distal revision rate in the present series of ~4%. Laparoscopy provided no relative improvement in safety or complication avoidance but had resulted in a mean increase in costs of >$1200 per patient.
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The relationship between race and neurosurgical outcomes is poorly characterized despite its importance. The influence of race on short-term patient outcomes in a pituitary tumor surgery population was assessed. ⋯ This study suggests that the effect of race on outcomes is partly mitigated for individuals who can attain access, and when socioeconomic factors and comorbidities are controlled for. The noted significant difference in emergency department visits could be indicative of confounding variables that were not well controlled for and requires further exploration.
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To evaluate change in fear of movement and the relationship of fear of movement and pain intensity to low back disability and general health-related quality of life over a 2-year period. ⋯ We found that greater levels of fear of movement were related to greater levels of low back disability, following lumbar spine surgery, in a longitudinal study. This shows the need to address fear of movement in prehabilitation/rehabilitation pre- or postsurgically to improve health outcomes for patients who undergo lumbar spine surgery.
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More than 90% of trauma mortality occurs in low- and middle-income countries, especially in sub-Saharan Africa. Head injury is the primary driver of trauma mortality in the prehospital and in-hospital setting. ⋯ We show a survival advantage and better functional outcomes in children following TBI. This may be attributable to increased resiliency to TBI in children or the prioritization of children in a resource-poor environment. Investments in neurosurgical care following TBI are needed to improve outcomes.
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The pterion is an H-shaped suture complex. This study's goal was to determine the location of its external and internal surfaces and extension and emphasize and discuss its surgical importance. ⋯ By using a subdivision into 4 quadrants, and considering our anatomic findings, we determined the way surgical procedures can be performed more easily and reliably. Even with modern localization technologies, anatomic landmarks can be useful to the neurosurgeon.