World Neurosurg
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Physician burnout in neurosurgery is highly prevalent and occurs most severely during residency. Although earlier assessments have identified stressors contributing to neurosurgery resident burnout, recovery interventions have not been studied extensively. We aimed to characterize burnout patterns and factors contributing to recovery through a single-institution assessment of neurosurgery residents across 4 decades. ⋯ Institutional support structures promoting mentorship and camaraderie are actionable methods to encourage resident burnout recovery. This study serves as a model for other programs to identify their "critical periods" of burnout and effective wellness interventions.
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In the initial evaluation of suspected cervical fracture, computed tomography (CT) is the gold standard for assessing bony anatomy and fracture morphology with high sensitivity and specificity. However, CT is relatively insensitive to ligamentous, discogenic, and myelopathic injury, leading to supplementary use of MRI, which is more sensitive and specific to these diseases. Here, we assess whether preoperative cervical spine magnetic resonance imaging (MRI) affects surgical management of subaxial cervical fractures. ⋯ The addition of MRI to CT in the evaluation of subaxial cervical spine fractures does not seem to affect surgical management.
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We sought to analyze the clinical data of patients with ipsilateral coexistence of hemifacial spasm (HFS) and trigeminal neuralgia (TN) and their treatment by microvascular decompression. ⋯ Our study suggests that patients with ipsilateral coexistence of HFS and TN usually have a narrower and smaller posterior fossa and have a large looped VBA as the responsible artery. In addition, patients with VBA involvement often develop HFS symptoms first and are more severe than those with non-vertebral artery involvement. Microvascular decompression is effective for patients with ipsilateral coexistence of HFS and TN.