All posts by administrator

Curso Teórico-Práctico de Base del Cráneo

Comienza hoy y le recomendamos visitar la web del curso.

Tendrá lugar hasta el 14 de Marzo  en Barcelona, y está organizado por los Drs. Pere Tresserres y Fernando Muñoz del Servicio de Neurocirugía del Hospital de Sant Pau de Barcelona.

Se trata de uno de los principales cursos a nivel nacional y que desde el año 2005 viene formando a los neurocirujanos especialistas en base de cráneo.

Bibliometrics of Intracranial Aneurysm

16468 global papers were identified that were cited 273500 times until 2013-08-15. The United States accounted for 31.497% of the articles, 58.64% of the citations, and the highest h-index (127). Japan and Germany followed in frequency. China’s articles ranked eighth (third in 2012) in total number, with most of the contributions occurring since 2002 (91.33%). China was at the early stage of the logic growth curve (exponential growth), with the citation frequency and h-index per year increasing. The quality of the publications was low. The main research centers were located in Beijing, Shanghai, Taiwan, and Hong Kong. The main Asian funding body was the National Natural Science Foundation of China. The number of publications and frequency of citations of papers from mainland China was greater than that of Taiwan or Hong Kong.

Global intracranial aneurysm research has been developing swiftly since 1991, with the United States making the largest contribution. Research in China started later, in 2002. Since then, China has increased its rate of publication, and became the third largest contributor by 20121

  1. Jia ZJ, Hong B, Chen DM, Huang QH, Yang ZG, Yin C, Deng XQ, Liu JM. China’s Growing Contribution to Global Intracranial Aneurysm Research (1991-2012): A Bibliometric Study. PLoS One. 2014 Mar 12;9(3):e91594. doi: 10.1371/journal.pone.0091594. eCollection 2014. PubMed PMID: 24622581. []

Seven AVMs: Tenets and Techniques for Resection

Seven AVMs: Tenets and Techniques for Resection

Seven AVMs: Tenets and Techniques for Resection
From Thieme

Buy at Amazon

Product Description

This sequel to Dr. Lawtons best-selling Seven Aneurysms focuses on microsurgical resection techniques for AVMs found in the lobes and deep regions of the brain and categorizes them into subtypes to simplify the broad spectrum of brain AVMs neurosurgeons may encounter. The book is organized into three sections: The Tenets, which establishes eight steps for AVM resection; The Seven Arteriovenous Malformations, which describes the anatomical terrain and surgical strategies for thirty-two AVM subtypes; and The Selection section, in which Dr. Lawton discusses what he believes to be the keys to successful AVM surgery: good patient selection and best application of multiple treatment modalities.

Summarizing the common AVMs encountered in practice, neurosurgeons and neurosurgical residents will find this hybrid atlas-text to be an essential part of their armamentarium.


Product Details

  • Amazon Sales Rank: #203984 in eBooks
  • Published on: 2014-03-10
  • Released on: 2014-03-10
  • Format: Kindle eBook

Editorial Reviews

Review

It is a valuable resource for residents, fellows, or young surgeons with an interest in scoliosis surgery because of the concise manner it goes through basic fundamentals of idiopathic scoliosis treatment up to the most complex cases.–AANS Young Neurosurgeons’ Newsletter In attempting to convey lessons and insights gained from his experience in aneurysm surgery to current and future generations of neurosurgeons,in aneurysm surgery to current and futuregenerations of neurosurgeons, Dr. Lawton has achieved a resounding success through this book. –Journal of Neurosurgery

From the Back Cover

This sequel to Dr. Lawtons best-selling Seven Aneurysms focuses on microsurgical resection techniques for AVMs found in the lobes and deep regions of the brain. It categorizes the techniques into subtypes to simplify the broad spectrum of brain AVMs neurosurgeons may encounter. The book is organized into three sections: The Tenets, which establishes eight steps for AVM resection; The Seven Arteriovenous Malformations, which describes the anatomical terrain and surgical strategies for thirty-two AVM subtypes; and The Selection section, in which Dr. Lawton discusses what he believes to be the keys to successful AVM surgery: good patient selection and best application of multiple treatment modalities.

Key Features:

  • Includes more than 700 spectacular full-color illustrations developed exclusively for this book
  • Creates a system for conceptualizing and approaching AVMs
  • Illustrates a stepwise process for AVM resection using strategic battle plans

Summarizing the common AVMs encountered in practice, neurosurgeons and neurosurgical residents will find this hybrid atlas-text to be an essential part of their armamentarium.

About the Author

Professor and Vice Chairman, Department of Neurological Surgery; Tong-Po Kan Endowed Chair; Chief, Vascular Neurosurgery, Director, Cerebrovascular Disorders Program, University of California San Francisco School of Medicine, San Francisco, USA.

Customer Reviews

Most helpful customer reviews

See all customer reviews…

Almería exporta la ecografía de bolsillo usada en Torrecárdenas

La última tecnología está ya al servicio de los pacientes. Así lo ve el jefe de neurocirugía del hospital Torrecárdenas, José Masegosa, que asegura que Almería no sólo ha sido receptora de nuevas técnicas de cirugía, sino también exportadora. Un taller permitió, por ejemplo, dar a conocer el ecógrafo de bolsillo que Torrecárdenas utiliza desde hace dos años gracias al empuje del doctor Ginés López.
“Almería ha dejado patente que Torrecárdenas está, por lo menos, al mismo nivel de calidad asistencial que otros en España y el mundo”, asegura el que ha sido presidente del congreso. Masegosa explica cómo la ecografía, utilizada como uno de los métodos diagnósticos más comunes, se realiza habitualmente gracias a un aparataje pesado, instalado en Radiología, caro y que, para desplazarlo, es casi obligatorio hacerlo con ruedas.
Algo totalmente superado con una nueva tecnología que miniaturiza los ecógrafos y no sólo permite al especialista llevarlos en el bolsillo, sino que son más económicos.

Pioneros en Almería Ginés López, pionero en el ecógrafo de bolsillo, explicó durante el taller, al que asistieron más de un centenar de especialistas de diferentes puntos de España y también del extranjero, cómo esta nueva tecnología permite, incluso durante una operación de neurocirugía, hacer una ecografía sin mover al paciente. Procedimiento que ayuda al neurocirujano a llegar mejor al punto de operación y reducir mucho las lesiones “colaterales”.
Esta aplicación es solo una de las muchas que permite el ecógrafo de bolsillo, presentado como uno de los últimos avances en el Congreso celebrado en la capital al reducir costes y tiempos.

Se trata de las intervenciones mínimamente incisivas que reducen los riesgos y mejoran considerablemente la recuperación del paciente, recuerda Masegosa, que reconoce, no obstante, que todavía no se puede utilizar en todos los casos. Los hay que requieren de unas técnicas más complejas.
También como algo “revolucionario” se ha abordado en Almería la terapia celular e ingeniería tisular, que permitirá disminuir la cirugía de columna en muchos casos, ya que es una terapia con células madre. Está actualmente en investigación pero “ofrece un futuro prometedor”.

Apuesta por la formación Un trabajo que ha servido de ejemplo para muchos especialistas, señalan desde Torrecárdenas. Un complejo hospitalario cuya gerente, Francisca Antón, apuesta por la formación.
“Cuanta más formación se pueda traer a Almería, mejor para los profesionales sanitarios, pero también, para los usuarios”, insisten tanto ella como José Masegosa.
Y es que todo lo que se aprenda acaba por repercutir en la salud de los almerienses, confirma este neurocirujano que ha logrado reunir a “lo último” a nivel mundial en la capital almeriense.

Practical Clinics for Practical Learning at the 2014 AANS Annual Scientific Meeting

The 2014 American Association of Neurological Surgeons (AANS) Annual Scientific Meeting features dozens of practical clinics, including cadaver sessions. There, you have the opportunity to learn and perfect surgical techniques under the close guidance of expert faculty.

Below are just a few of the hands-on and cadaver sessions open for registration. View the full list and register today to secure your first choice.


001 Techniques for Adult Spinal Deformity Surgery: A Hands-on Course for NeurosurgeonsObserve techniques of thoracic and lumbar pedicle screw placement, sacropelvic fixation, posterior column osteotomies, and vertebral column resection. Strategies for rod placement, deformity correction and achieving arthrodesis also will be covered.

010 Spinal Image Guidance and Advanced Intraoperative Imaging TechniquesLearn applications of image guidance to cervical, thoracic, lumbar, minimally invasive, revision and deformity spinal surgery procedures. In addition, advanced intraoperative techniques both for localization and for assessment of decompression will be discussed.

013 Transfacet Technology: An Alternative to Pedicle Screw Fixation with Interbody TechniquesDiscuss both the biomechanical properties and clinical applications of transfacet screw technology as they relate to ALIF, TLIF, and PLIF procedures. Perform sawbone trials of all the techniques discussed.

026 MIS: Direct Lateral Retroperitoneal Transpsoas FusionThis clinic focuses on the rationale, indications, technique, outcomes and complications of the lateral retroperitoneal transpsoas approach in an evidence-based fashion. Practice surgical technique and perform a retroperitoneal dissection to understand the pertinent neural structures and visceral anatomy.

029 State-of-the-Art: Cranial EndoscopyReceive didactic and hands-on instruction in intracranial endoscopy, including indications, techniques, outcomes and complications. Topics include management of hydrocephalus (including third ventriculostomy), removal of colloid cysts and other intraventricular tumors, endoscope-assisted microneurosurgery, and transsphenoidal procedures.

Visit Online for Dozens More Practical Clinics and Breakfast Seminars

Spots in practical clinics are strictly limited in order to achieve optimal faculty-to-learner ratios. Make sure to register online now to secure your top choice.

Journal of Neurosurgery March 2014

Featured Article

Nonfunctioning pituitary adenoma

Nonfunctioning pituitary adenomas (NFAs) are the most common type of pituitary adenoma and, when symptomatic, typically require surgical removal as an initial means of management.
Treatment

Gamma Knife radiosurgery (GKRS) is an alternative therapeutic strategy for patients whose comorbidities substantially increase the risks of resection. In

Lee et al, evaluated the efficacy and safety of initial GKRS for NFAs.

An international group of three academic Gamma Knife centers retrospectively reviewed outcome data in 569 patients with NFAs.

Forty-one patients (7.2%) underwent GKRS as primary management for their NFAs because of an advanced age, multiple comorbidities, or patient preference. The median age at the time of radiosurgery was 69 years. Thirty-seven percent of the patients had hypopituitarism before GKRS. Patients received a median tumor margin dose of 12 Gy (range 6.2-25.0 Gy) at a median isodose of 50%. The overall tumor control rate was 92.7%, and the actuarial tumor control rate was 94% and 85% at 5 and 10 years postradiosurgery, respectively. Three patients with tumor growth or symptom progression underwent resection at 3, 3, and 96 months after GKRS, respectively. New or worsened hypopituitarism developed in 10 patients (24%) at a median interval of 37 months after GKRS. One patient suffered new-onset cranial nerve palsy. No other radiosurgical complications were noted. Delayed hypopituitarism was observed more often in patients who had received a tumor margin dose > 18 Gy (p = 0.038) and a maximum dose > 36 Gy (p = 0.025).

GKRS resulted in long-term control of NFAs in 85% of patients at 10 years. This experience suggests that GKRS provides long-term tumor control with an acceptable risk profile. This approach may be especially valuable in older patients, those with multiple comorbidities, and those who have endocrine-inactive tumors without visual compromise due to mass effect of the adenoma1.

Spine

Three-dimensional motion analysis of the cervical spine for comparison of anterior cervical decompression and fusion versus artificial disc replacement in 17 patients.

Cervical arthroplasty

Cervical arthroplasty with an artificial disc (AD) has emerged as an alternative to anterior cervical discectomy and fusion (ACDF) for the management of cervical spondylosis.

It is an effective, reliable, and safe procedure for the treatment of cervical degenerative disc disease. However, there is no definitive evidence that DCI arthroplasty has better intermediate-term results than anterior cervical discectomy and fusion (ACDF).

3D motion analysis data comparing patients after ACDF and AD replacement in ten patients who underwent C5-6 ACDF and 7 who underwent C5-6 AD replacement were enrolled. Using biplanar fluoroscopy and a model-based track technique (accurate up to 0.6 mm and 0.6°), motion analysis of axial rotation and flexion-extension of the neck was performed. Three nonoperative segments (C3-4, C4-5, and C6-7) were assessed for both intervertebral rotation (coronal, sagittal, and axial planes) and facet shear (anteroposterior and mediolateral). Results There was no difference in total neck motion comparing ACDF and AD replacement for neck extension (43.3° ± 10.2° vs 44.3° ± 12.6°, p = 0.866) and rotation (36.0° ± 6.5° vs 38.2° ± 9.3°, p = 0.576). For extension, when measured as a percentage of total neck motion, there was a greater amount of rotation at the nonoperated segments in the ACDF group than in the AD group (p = 0.003). When comparing specific motion segments, greater normalized rotation was seen in the ACDF group at C3-4 (33.2% ± 4.9% vs 26.8% ± 6.6%, p = 0.036) and C6-7 (28.5% ± 6.7% vs 20.5% ± 5.5%, p = 0.009) but not at C4-5 (33.5% ± 6.4% vs 31.8% ± 4.0%, p = 0.562). For neck rotation, greater rotation was observed at the nonoperative segments in the ACDF group than in the AD group (p = 0.024), but the differences between individual segments did not reach significance (p ≥ 0.146). Increased mediolateral facet shear was seen on neck extension with ACDF versus AD replacement (p = 0.008). Comparing each segment, C3-4 (0.9 ± 0.5 mm vs 0.4 ± 0.1 mm, p = 0.039) and C4-5 (1.0 ± 0.4 mm vs 0.5 ± 0.2 mm, p = 0.022) showed increased shear while C6-7 (1.0 ± 0.4 mm vs 1.0 ± 0.5 mm, p = 0.767) did not.

This study illustrates increased motion at nonoperative segments in patients who have undergone ACDF compared with those who have undergone AD replacement. Further studies will be required to examine whether these changes contribute to adjacent-segment disease 2.

Pediatrics

The comparative effectiveness of ventricular shunt placement versus endoscopic third ventriculostomy for initial treatment of hydrocephalus in infants.

In infants with hydrocephalus, a greater 1-year CSF diversion failure rate may occur after ETV compared with shunt placement. This risk is most significant for procedures performed within the first 90 days of life. Further investigation of the need for multiple reoperations, cost, and impact of surgeon and hospital experience is necessary to distinguish which treatment is more effective in the long term3

  1. Lee CC, Kano H, Yang HC, Xu Z, Yen CP, Chung WY, Pan DH, Lunsford LD, Sheehan JP. Initial Gamma Knife radiosurgery for nonfunctioning pituitary adenomas. J Neurosurg. 2014 Jan 3. [Epub ahead of print] PubMed PMID: 24405068. []
  2. McDonald CP, Chang V, McDonald M, Ramo N, Bey MJ, Bartol S. Three-dimensional motion analysis of the cervical spine for comparison of anterior cervical decompression and fusion versus artificial disc replacement in 17 patients. J Neurosurg Spine. 2013 Dec 20. [Epub ahead of print] PubMed PMID: 24359000. []
  3. Jernigan SC, Berry JG, Graham DA, Goumnerova L. The comparative effectiveness of ventricular shunt placement versus endoscopic third ventriculostomy for initial treatment of hydrocephalus in infants. J Neurosurg Pediatr. 2014 Jan 3. [Epub ahead of print] PubMed PMID: 24404970. []