World Neurosurg
-
Most of the scientific and healthcare resources in Mexico are limited to the large major cities. However, many communities with complex socioeconomic and cultural backgrounds have limited access to neurosurgical care. A cross-sectional study aiming to evaluate the population's perception regarding neurosurgical care was conducted. ⋯ Our findings suggest that sociodemographic factors such as age, education, and income correlate with the population's self-perceived knowledge, trust and beliefs about safety and effectiveness regarding neurosurgical care in Mexico. These findings can be instrumental for developing healthcare policies that address the needs of Mexico's patient population.
-
Alkaline phosphatase (ALP) is an enzyme which has been proven useful as a biomarker for bone turnover and inflammation. We hypothesized that high serum ALP levels are associated with increased complication rates following lumbar spinal fusion. ⋯ Elevated serum ALP in patients undergoing lumbar fusion procedures is associated with increased risk for multiple in-hospital complications as well as higher rates of readmission and reoperation.
-
Unplanned 30-day readmissions after surgery are a source of patient dissatisfaction, monitored by the Centers for Medicare and Medicaid Services, have financial penalties for hospitals, and are publicly reported. Neurosurgical operations have a higher 30-day unplanned readmission rate after the index discharge than other specialties. After a simple initiative for a 48-72-hour postdischarge telephone call, there was an observed significant decrease in readmission rates from 17% to 8% in 7 months at Thomas Jefferson University. To better understand the role of postoperative telephone calls in this reduction, a retrospective evaluation over a longer period was performed. ⋯ Telephone calls and peridischarge efficient communication are needed after neurologic surgery. This approach decreased unplanned readmissions in certain instances without having a significant impact on neurosurgical patients.
-
Schwannomas and meningiomas are the most common intradural extramedullary spinal tumors; however, differentiating between them using magnetic resonance imaging (MRI) is a frequent challenge. In this study, we aimed to investigate the use of the contrast ratio (CR) as a quantitative MRI method in the differentiation of schwannomas and meningiomas. ⋯ The evaluation of CRs by using MRI to distinguish between schwannomas and meningiomas is a beneficial quantitative tool.
-
The rise of minimally invasive lumbar fusions and advanced imaging technologies has facilitated the introduction of novel surgical techniques with the trans-facet approach being one of the newest additions. We aimed to quantify any pathology-driven anatomic changes to the trans-facet corridor, which could thereby alter the ideal laterality of approach to the disc space. ⋯ Our results illustrate that pathology, like spondylolisthesis, can increase the area of the trans-facet corridor. By understanding this effect, surgeons can better decide on the optimal approach to the disc while taking into consideration a patient's unique anatomy.