Neurosurgery最新文献

{"title":"Letter: Delineating Neurosurgery Resident Development: Insights From a Ten-Year National ACGME Milestones and Learning Trajectories.","authors":"Laiba Azhar, Md Nabil Nizam, M Marzia Noor, Md Moshiur Rahman","doi":"10.1227/neu.0000000000003417","DOIUrl":"10.1227/neu.0000000000003417","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e138-e139"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply: Nighttime Treatment of Ruptured Intracranial Aneurysms are Associated With Poor Outcomes.","authors":"Chloe Dumot, Abdullah Keles, Mustafa K Baskaya","doi":"10.1227/neu.0000000000003415","DOIUrl":"10.1227/neu.0000000000003415","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e135-e137"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply: Surgery on the C3-4 Level and the Presence of Ligamentum Flavum Hypertrophy Increases the Risk of 30-Day Reoperation Rate After Anterior Cervical Discectomy and Fusion.","authors":"Hong Kyung Shin, Sun Woo Jang, Jin Hoon Park","doi":"10.1227/neu.0000000000003437","DOIUrl":"10.1227/neu.0000000000003437","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e143"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Decoding Glioblastoma Heterogeneity: Neuroimaging Meets Machine Learning.","authors":"M Marzia Noor, Md Moshiur Rahman","doi":"10.1227/neu.0000000000003422","DOIUrl":"10.1227/neu.0000000000003422","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e144-e145"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Surgery on the C3-4 Level and the Presence of Ligamentum Flavum Hypertrophy Increases the Risk of 30-Day Reoperation Rate After Anterior Cervical Discectomy and Fusion.","authors":"Atul Goel","doi":"10.1227/neu.0000000000003436","DOIUrl":"10.1227/neu.0000000000003436","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e142"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Validation and Comparison of Common Thoracolumbar Injury Classification Treatment Algorithms and a Novel Modification.","authors":"Mohamed M Aly","doi":"10.1227/neu.0000000000003435","DOIUrl":"10.1227/neu.0000000000003435","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e131-e132"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines Update for the Role of Emerging Therapies in the Management of Patients With Metastatic Brain Tumors.","authors":"Yuhao Shi, Erik P Sulman","doi":"10.1227/neu.0000000000003438","DOIUrl":"10.1227/neu.0000000000003438","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1178-1180"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Neurosurgery Training: Accreditation Council for Graduate Medical Education Case Minimums Versus Surgical Autonomy.","authors":"Vishal Venkatraman, Margot Kelly-Hedrick, Alexander D Suarez, Rajeev Dharmapurikar, Shivanand P Lad, Michael M Haglund","doi":"10.1227/neu.0000000000003241","DOIUrl":"10.1227/neu.0000000000003241","url":null,"abstract":"<p><strong>Background and objectives: </strong>The Accreditation Council for Graduate Medical Education (ACGME) requires neurosurgery residents to reach a set number of cases in specified procedure types (case minimums) before graduation and mandates completion of Milestones. We used the Surgical Autonomy Program, a validated method of autonomy-based resident evaluation, to determine the number of cases it took for residents to become competent and compared these with the ACGME case minimums.</p><p><strong>Methods: </strong>We collected data from neurosurgery residents at Duke University on 7 procedures (tumor craniotomy, trauma craniotomy, ventriculoperitoneal shunt, anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCF), discectomy/laminectomy, and posterior thoracolumbar spinal fusion [PSF]). We defined competency as being graded at the highest autonomy level in the Surgical Autonomy Program by attending neurosurgeons for the first and second time and determined the case volume on the ACGME case log when these were achieved. These results were analyzed with summary statistics.</p><p><strong>Results: </strong>The median case volume among residents (N = 4-8) for the first and second competency rating (and ACGME minimum) for each procedure type was found to be: tumor: 44.5 and 64.5 (min. 60), trauma: 21 and 30 (min. 60), ventriculoperitoneal shunt: 11.3 and 13 (min. 20), ACDF: 30 and 32.5 (min. 20), PCF: 24 and 40 (min. 30), discectomy/laminectomy: 28 and 36 (min. 30), and PSF: 51 and 54 (min. 30).</p><p><strong>Conclusion: </strong>We found variation in the case numbers to reach competency and that for some procedures (tumor, ACDF, PCF, discectomy/laminectomy, and PSF), most residents required more cases than the ACGME case minimums to achieve competency. The ACGME case minimums may not accurately reflect the number of cases required for neurosurgical residents to reach competency. To promote trainee-centered education, individualized, competency-based evaluation systems may be better determining readiness for graduation, including a system that builds off the established ACGME Milestones.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1333-1340"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurosurgery in Pakistan: Past, Present, and Future.","authors":"Erum Ajmal, Hamza Khilji, Ernest J Barthélemy, Tariq Khan","doi":"10.1227/neu.0000000000003257","DOIUrl":"10.1227/neu.0000000000003257","url":null,"abstract":"<p><strong>Background and objectives: </strong>Since its independence from India in 1947, Pakistan has struggled with economic crises such as global debt, corruption, constant regime change, and a decades-long war against terrorism. The resulting socioeconomic barriers have stymied efforts to develop a comprehensive and equitably accessible healthcare system, especially regarding safe, timely, and affordable surgical care. This article evaluates neurosurgery's development, current state, and prospects in Pakistan, a lower-middle-income country.</p><p><strong>Methods: </strong>We performed a literature search using PubMed and analyzed relevant articles to better understand the state and landscape of neurosurgery in Pakistan. Moreover, we conducted ecological research by querying the databases of the World Bank and the Institute of Health Metrics and Evaluation to evaluate the neurological and neurosurgical disease burden in the Pakistani population.</p><p><strong>Results: </strong>The neurosurgical workforce in Pakistan has demonstrated rapid growth over the past two decades, with approximately 450 neurosurgeons and a neurosurgeon-per-100 000 population density of 0.114. Nonetheless, access to essential neurosurgical procedures for the treatment of diseases such as stroke has been difficult to ensure, which likely contributes to Pakistan's stroke burden, ie, stroke was still the third most common cause of death in 2019, causing 21.7% of all deaths.</p><p><strong>Conclusion: </strong>While Pakistan's political and economic instability has adversely affected the development of neurosurgery, the field has still made great strides and demonstrates a promising future in providing equitable neurosurgical care to all Pakistan's people.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1430-1439"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding Glioblastoma Heterogeneity: Neuroimaging Meets Machine Learning.","authors":"Jawad Fares, Yizhou Wan, Roxanne Mayrand, Yonghao Li, Richard Mair, Stephen J Price","doi":"10.1227/neu.0000000000003260","DOIUrl":"10.1227/neu.0000000000003260","url":null,"abstract":"<p><p>Recent advancements in neuroimaging and machine learning have significantly improved our ability to diagnose and categorize isocitrate dehydrogenase (IDH)-wildtype glioblastoma, a disease characterized by notable tumoral heterogeneity, which is crucial for effective treatment. Neuroimaging techniques, such as diffusion tensor imaging and magnetic resonance radiomics, provide noninvasive insights into tumor infiltration patterns and metabolic profiles, aiding in accurate diagnosis and prognostication. Machine learning algorithms further enhance glioblastoma characterization by identifying distinct imaging patterns and features, facilitating precise diagnoses and treatment planning. Integration of these technologies allows for the development of image-based biomarkers, potentially reducing the need for invasive biopsy procedures and enabling personalized therapy targeting specific pro-tumoral signaling pathways and resistance mechanisms. Although significant progress has been made, ongoing innovation is essential to address remaining challenges and further improve these methodologies. Future directions should focus on refining machine learning models, integrating emerging imaging techniques, and elucidating the complex interplay between imaging features and underlying molecular processes. This review highlights the pivotal role of neuroimaging and machine learning in glioblastoma research, offering invaluable noninvasive tools for diagnosis, prognosis prediction, and treatment planning, ultimately improving patient outcomes. These advances in the field promise to usher in a new era in the understanding and classification of IDH-wildtype glioblastoma.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"1181-1192"},"PeriodicalIF":3.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}