World Neurosurg
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Pseudarthrosis is a common complication of transforaminal lumbar interbody fusion (TLIF) that can affect the long-term prognosis and increase revision surgery risk. Therefore, it is crucial to investigate the risk factors associated with pseudarthrosis and develop a predictive model. ⋯ History of smoking, osteoporosis, and change of mean disc height are all independent risk factors of pseudarthrosis following TLIF surgery; a nomogram based on these may help predict the probability of pseudarthrosis.
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Burnout syndrome impacts 1 of 2 neurosurgeons and negatively impacts both the individual and institution. The impact of burnout on neurosurgeons may have increased due to the SARS-CoV-2 pandemic. Characteristics of burnout may differ among neurosurgeons and non-neurosurgeon physicians, and this may better target wellness initiatives designed to alleviate burnout. ⋯ We show that although the rate of burnout does not differ for neurosurgeons, the characteristics of burnout may. This may represent the key to providing specialty-specific targeted interventions to alleviate burnout. Furthermore, there is a significant proportion of neurosurgeons at risk for subsequent burnout for which additional importance must be placed to prevent progression to burnout.
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Endothelial dysfunction, induced by high shear stress from increased nidal blood flow, may promote a cycle of inflammation, possibly leading to instability and cerebral arteriovenous malformations (AVMs) rupture. Macrophages, identified with Cluster of Differentiation 68, are key inflammatory components in AVM pathology. We aim to evaluate the relationship of inflammation with AVM flow and hemosiderin. ⋯ These findings suggest a relationship among AVM vessel wall inflammation, hemosiderin, and hemorrhage presentation. Further investigations with larger sample sizes are warranted to understand the role of altered hemodynamics, hemosiderin deposition, and inflammation in AVM vessel walls.
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This study evaluates the efficiency and cost-effectiveness of an oncological outpatient neurosurgery protocol using enhanced recovery after surgery principles in a European healthcare setting. Additionally, it assesses the impact of incorporating hospital at home (HaH) for perioperative follow-up on program efficiency and costs. ⋯ Outpatient neurosurgery with HaH follow-up offers substantial cost savings without compromising care quality in a public health setting. Inpatient care's higher costs are largely due to bed utilization, while the integration of HaH does not add significant costs, making it a viable alternative for postoperative management.