World Neurosurg
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To explore the value and potential of qualitative research to neurosurgery and provide insight and understanding to this underused methodology. ⋯ There is enormous potential for qualitative research to contribute to the advancement of person-centered care within neurosurgery. There are signs that more qualitative research is being conducted and that neurosurgical journals are increasingly open to this methodology. While studies that do not engage fully within the qualitative paradigm can make important contributions to the evidence base, due regard should be given to immersive inquiry within qualitative paradigms to allow complex, in-depth, investigations of the human experience.
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The expansion in treatments for medically refractory epilepsy heightens the importance of identifying patients who are likely to benefit from vagus nerve stimulation (VNS). Here, we identify predictors with a positive VNS response. ⋯ Patients with age at epilepsy onset ≥15 years, left-hand dominance, or baseline seizure frequency <5/month are ideal candidates for VNS.
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From a pathophysiological point of view, early neurosurgical treatment seems essential to prevent secondary brain injury and has been stated as the "time-is-brain" concept. However, the question immediately rises: "Is there an optimal time window for acute intracranial neurosurgical interventions?" In neurosurgery, treatment modality has been studied far more extensively than timing to surgery ("time-to-surgery"). The majority of acute intracranial neurosurgical interventions are carried out for traumatic brain injury and hemorrhagic or ischemic stroke. ⋯ In acute intracranial neurosurgical interventions, "delayed consent" procedures could play an important role for this field of research. Whether there is an optimal time window for acute intracranial neurosurgical interventions seems difficult to be answered with randomized controlled trials referred to in the current guidelines. Observational designs, such as comparative effectiveness research, and special statistical techniques, may provide a better understanding in the optimal "time-to-surgery."
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Regression analysis quantifies the relationships between one or more independent variables and a dependent variable and is one of the most frequently used types of analysis in medical research. The aim of this article is to provide a brief theoretical and practical tutorial for neurosurgeons wishing to conduct or interpret regression analyses. ⋯ Regression analysis is a powerful and versatile instrument in data analysis. This material is intended as a starter for those wishing to critically interpret or perform regression analysis and we recommend multidisciplinary collaborations with trained methodologists, statisticians, or epidemiologists.
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To compare the clinical outcomes of uniportal and biportal lumbar endoscopic unilateral laminotomy for bilateral decompression (LE-ULBD) in patients with lumbar spinal stenosis. ⋯ Both uniportal and biportal LE-ULBD procedures are safe and effective for treating patients with lumbar spinal stenosis. It is more feasible to decompress the spinal canal during biportal LE-ULBD than during uniportal LE-ULBD.