World Neurosurg
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Technological advances have significantly fostered the use of robotics in neurosurgery. Due to their novelty, there is a need to develop training methods within neurosurgical residency programs that provide trainees the skills to utilize these systems in their future practices safely and effectively. ⋯ Our curriculum was developed to become a structured tool for assessment of robotic education in neurosurgical training. This curriculum based on ACGME milestone requirements serve as a template for resident and fellow education in robotics in neurosurgery.
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Stent occlusion is a challenging complication following endovascular interventions that require intracranial stenting.1-4 Although there are small series describing revascularization for stenoocclusive disease failing best medical management,5-14 there are few reports in the literature regarding surgical bypass as a treatment for stent occlusion.5 We present the case of a 37-year-old man who presented with right-sided weakness, numbness, and difficulty with speech and ambulation. His history is notable for a left M1 (segment of middle cerebral artery) occlusion 6 months prior that was treated with mechanical thrombectomy requiring repeat thrombectomy and rescue acute middle cerebral artery (MCA) stent placement given vessel reocclusion. Diagnostic cerebral angiography demonstrated stent occlusion. ⋯ To our knowledge, there is no literature to date describing a 2-donor-2-recipient direct bypass for the rescue treatment of symptomatic intracranial stent occlusion with recurrent ischemia. We review the case presentation, angiographic findings, surgical nuances, and postoperative course with imaging. The patient provided informed consent for the procedure and verbal support for publishing his image and inclusion in this submission.
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A novel agar-based phantom was developed and assessed for ultrasonography (USG)-guided brain biopsy training. The phantom provides visual cues combined with sonologic cues, allowing multimodal training. Impact of multimodal training is evaluated through pretraining and posttraining trials. ⋯ Simulation and phantom-based models can never supplant training through supervised skill application in vivo but our model supplements training by enabling technical skill acquisition, especially for beginners in USG-guided brain biopsy.
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The U.S. military requires medical readiness to support forward-deployed combat operations. Because time and distance to neurosurgical capabilities vary within the deployed trauma system, nonneurosurgeons are required to perform emergent cranial procedures in select cases. It is unclear whether these surgeons have sufficient training in these procedures. ⋯ These survey results show a gap in readiness for neurosurgical procedures for forward-deployed general surgeons. Capitalizing on capabilities such as mixed/augmented reality would be a force multiplier and a potential means of improving neurosurgical capabilities in the forward-deployed environments.
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To determine characteristics of Latin American (LA) productivity in spine surgery published worldwide between 2004 and 2021 compared between periods and global literature. ⋯ This scientometric study is one of the first regional evaluations worldwide. The number of publications in the spine surgery field in Latin America has continued to increase over evaluated decades from 58.3 per year to 108, and a 1.79-fold increase between the most productive years for each decade. Brazil is still the greatest contributor (51.14%), with Mexico (26.40%) and Argentina (8.64%) as growing contributor countries. Most publications were classified as Level of Evidence 4, and this result reflects the importance of continuous research development in the quality of research for our region.