Homajoun Maslehaty September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVEThe aim of this study was to define predictive factors for rupture of middle cerebral artery (MCA) mirror bifurcation aneurysms.METHODSThe authors retrospectively analyzed the data in patients with ruptured MCA bifurcation aneurysms with simultaneous presence of an unruptured MCA bifurcation mirror aneurysm treated in two neurosurgical centers.… Read More...

Gurpreet S. Gandhoke September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVEThe price of coils used for intracranial aneurysm embolization has continued to rise despite an increase in competition in the marketplace. Coils on the US market range in list price from $500 to $3000. The purpose of this study was to investigate potential cost savings with the use of a price capitation model.METHODSThe authors built a clinical decision analytical tree and compared their institution’s current expenditure on endovascular coils to the costs if a capped-price model were implemented.… Read More...

Tal Shahar September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVEResection of intraaxial tumors adjacent to the optic radiation (OR) may be associated with postoperative visual field (VF) deficits. Intraoperative navigation using MRI-based tractography and electrophysiological monitoring of the visual pathways may allow maximal resection while preserving visual function.… Read More...

John Y. K. Lee September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVEPituitary adenomas account for approximately 10% of intracranial tumors and have an estimated prevalence of 15%–20% in the general US population. Resection is the primary treatment for pituitary adenomas, and the transsphenoidal approach remains the most common.… Read More...

Simon Heinrich Bayerl September 5, 2017

Journal of Neurosurgery: Spine, Ahead of Print. OBJECTIVEMicrosurgical decompression (MD) in patients with lumbar spinal stenosis (LSS) shows good clinical results. Nevertheless, 30%–40% of patients do not have a significant benefit after surgery—probably due to different anatomical preconditions. The sagittal profile types (SPTs 1–4) defined by Roussouly based on different spinopelvic parameters have been shown to influence spinal degeneration and surgical results.… Read More...

Juan C. Fernandez-Miranda September 5, 2017

Journal of Neurosurgery, Ahead of Print. OBJECTIVETumors with cavernous sinus (CS) invasion represent a neurosurgical challenge. Increasing application of the endoscopic endonasal approach (EEA) requires a thorough understanding of the CS anatomy from an endonasal perspective. In this study, the authors aimed to develop a surgical anatomy–based classification of the CS and establish its utility for preoperative surgical planning and intraoperative guidance in adenoma surgery.METHODSTwenty-five colored silicon–injected human head specimens were used for endonasal and transcranial dissections of the CS.… Read More...

Darryl Lau September 5, 2017

Journal of Neurosurgery: Spine, Ahead of Print. OBJECTIVECervical curvature is an important factor when deciding between laminoplasty and laminectomy with posterior spinal fusion (LPSF) for cervical spondylotic myelopathy (CSM). This study compares outcomes following laminoplasty and LPSF in patients with matched postoperative cervical lordosis.METHODSAdults undergoing laminoplasty or LPSF for cervical CSM from 2011 to 2014 were identified.… Read More...

Jian Guan September 5, 2017

Journal of Neurosurgery: Spine, Ahead of Print. OBJECTIVEBlood loss during surgery for thoracolumbar scoliosis often requires blood product transfusion. Rotational thromboelastometry (ROTEM) has enabled the more targeted treatment of coagulopathy, but its use in deformity surgery has received limited study. The authors investigated whether the use of ROTEM reduces transfusion requirements in this case-control study of thoracolumbar deformity surgery.METHODSData were prospectively collected on all patients who received ROTEM-guided blood product management during long-segment (≥ 7 levels) posterior thoracolumbar fusion procedures at a single institution from April 2015 to February 2016.… Read More...

Hyeoncheol Hwang September 5, 2017

Journal of Neurosurgery: Pediatrics, Ahead of Print. OBJECTIVEThe aim of this study was to establish optimal electric stimulation parameters for intraoperatively monitoring the bulbocavernosus reflexes (BCRs) in infants.METHODSThe authors retrospectively reviewed the medical records of all infants (age < 24 months) who had undergone an untethering operation for tethered cord syndrome between May 2013 and February 2014 at a single institution and whose baseline BCR had been elicited during surgery. Using different combinations of stimulation parameters—number of stimulation pulses: 4 or 8 pulses, interpulse interval: 1, 2, or 5 msec, and polarity of stimulation: biphasic or monophasic—the authors compared the relative mean amplitude of 10 BCR responses (rmaBCRs) to each combination of parameters.RESULTSThe rmaBCRs were larger with the 8-pulse stimulations than with the 4-pulse stimulations (p < 0.0001). There was a tendency, though not statistically significant, for larger rmaBCRs to be obtained with the longer interpulse interval in the 8-pulse stimulation (p = 0.1289). The biphasic stimulation produced larger rmaBCRs than the monophasic stimulation (p = 0.0005).CONCLUSIONSBiphasic 8-pulse stimulations with 5-msec or 2-msec intervals yield the largest BCR responses. Considering that an 8-pulse stimulation with 5-msec intervals may overlap the onset of the BCR, a biphasic 8-pulse stimulation with 2-msec intervals is recommended as the optimal stimulation paradigm to monitor intraoperative BCRs in infants.

http://thejns.org/doi/abs/10.3171/2017.6.PEDS16664?mi=67t04w&af=RRead More...

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