Impact of preoperative medical management on postoperative outcomes after index percutaneous rhizotomy for trigeminal neuralgia.

Objective: Initial medical management fails in nearly half of patients with trigeminal neuralgia (TN), and patients will seek surgical management with either rhizotomy or microvascular decompression. The impact of preoperative medical management on post-rhizotomy outcomes is unclear. The authors aimed to further evaluate this relationship.

Detection of human brain cancers using genomic and immune cell characterization of cerebrospinal fluid through CSF-BAM.

Patients with radiographically detectable lesions in their brain or other symptoms compatible with brain tumors pose challenges for diagnosis. The only definitive way to diagnose such patients is through brain biopsy, an invasive and dangerous procedure. Here we present a new workflow termed "CSF-BAM" that simultaneously identifies B cell or T cell receptor sequences, Aneuploidy, and Mutations using amplification of both strands of the DNA from cerebrospinal fluid (CSF) samples.

Impact of signaling on interview invitations in the neurological surgery match process.

Objective: Neurosurgery remains one of the most competitive residency programs with an increasing application volume. Signaling was introduced to allow applicants to express interest in specific programs and streamline program director application review; however, there are limited data on how signaling affects interview invitations in neurosurgery. This study investigates the impact of signaling on interview invitation odds and subsequent residency program selection.

The role of extent of resection, chemoradiation, and MGMT promoter methylation in overall survival in a large cohort of IDH-wildtype glioblastoma.

Objective: Although MGMT promoter methylation, gross-total resection (GTR), and adjuvant chemoradiation therapy are known to independently improve clinical outcomes for patients with glioblastoma (GBM), their combined influence remains unclear. In the present study, the authors investigated the complementary role of these factors in GBM prognosis.

Methods: The 2022 National Cancer Database was queried for individuals with histologically confirmed IDH-wildtype GBM WHO grade 4 and available MGMT promoter methylation status data.

Incidence, demographics, and survival of patients with brain metastases from stage IV colorectal cancer: a population-based study from 2013 to 2023.

Introduction: Colorectal cancer (CRC) is the third most common cancer globally with rising incidence in the young population. While rare, brain metastasis (BM) in CRC patients leads to significant morbidity and mortality. The incidence of BM is expected to rise due to improved screening and treatments extending patient survival.

Outcomes of leptomeningeal disease after only vertebral osseous metastases: a real-world analysis using the TriNetX database.

Purpose: Leptomeningeal disease (LMD) is a morbid complication of systemic cancer typically associated with brain metastases. However, vertebral bone metastases may also serve as a route for cerebrospinal fluid spread, though this pathway is less characterized. This study aims to determine the incidence, timing, and outcomes of LMD in patients with vertebral metastases in the absence of brain or other systemic metastases, using a large real-world database.

An Assessment of Surgical Outcomes in Malignant Peripheral Nerve Sheath Tumors: A Systematic Review and Meta-Analysis of Surgical Interventions.

Background/objectives: Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive malignancies with a challenging prognosis, especially for patients with Neurofibromatosis type 1 (NF1). Their low incidence necessitates comprehensive studies to investigate the survival outcome.

Methods: We conducted a systematic review and meta-analysis, including data from 16 studies and 4265 patients, to explore surgical outcomes and survival rates, focusing on time-related outcomes, including overall survival (OS), progression-free survival (PFS), and recurrence rate.

PTEN Mutations Associated with Increased Recurrence and Decreased Survival in Patients with Prostate Cancer Spinal Metastasis.

Introduction: Prostate cancer with spinal metastases (PCSM) is associated with high morbidity and mortality. The impact of biomarkers on the prognosis of spinal metastases, however, remains unclear.

Objective: This study explored associations between potential biomarkers, treatment modalities, survival, and neurological outcomes in PCSM patients.

Automated feature learning and survival prognostication in grade 4 glioma using supervised machine learning models.

Objective: WHO grade 4 glioma is the most common primary malignant brain tumor, with a median survival of only 14.6 months. Predicting survival outcomes remains challenging due to the tumor's heterogeneity and the influence of multiple clinical factors.

Cerebrospinal fluid diversion procedure utilization and physician reimbursement in adult hydrocephalus patients.

Background: As the population continues to age, the number of adults receiving care for hydrocephalus is expected to increase. Here, we assess trends in the utilization and physician reimbursement for ventriculoperitoneal shunts (VPS), lumboperitoneal shunting (LPS), and endoscopic third ventriculostomy (ETV) for adult hydrocephalus.

Methods: The Medicare Part B National Summary Data files from 2000 to 2021 were collected, and information was extracted on procedures performed per year, total charges billed, and actual payments.

Characterizing the Optimal Diversity Training Programs for Physicians: A Survey sponsored by Pacific Spine and Pain Society.

Introduction: Recently, increasing research has shown inferior outcomes in patients with respect to specific social determinants of health. Therefore, optimizing diversity training given to pain management providers is imperative for physicians to provide culturally competent healthcare and to improve patient outcomes. In this paper, we attempt to describe trends in the Pacific Spine and Pain Society (PSPS) membership to help discover optimal diversity education paradigms for pain management providers by performing a survey on behalf PSPS.

Drivers of neurosurgeon selection among operative intracranial tumor patients.

Objective: Despite increased access to online information, little is known about what factors patients consider when selecting a neurosurgeon for intracranial tumor resection. This study aims to identify patient priorities in neurosurgeon selection.

Methods: Patients who underwent intracranial tumor resection between January 1, 2023, and January 31, 2024, at a single institution were surveyed.

Preserving function through the sulcus: A technical note on the awake trans-sulcal approach for resection of primary motor cortex glioblastomas.

Background: Tumors located in the primary motor cortex or associated motor areas present significant surgical challenges due to their proximity to critical motor pathways. Traditional transcortical approaches often risk motor deficits due to extensive cortical disruption. The trans-sulcal approach leverages natural sulcal corridors to minimize cortical damage, potentially improving outcomes.

Napsin A as a key prognostic biomarker in spinal metastases of lung cancer: implications for survival and neurological function.

Objective: Lung cancer's propensity for metastasizing to the spine significantly impacts morbidity and mortality. Understanding the impact of somatic mutations on the prognosis of these metastases is crucial for treatment development and optimization.

Methods: A retrospective analysis was performed on a neurosurgical cohort of 76 patients with lung cancer with spinal metastasis (LCSM) at a single comprehensive cancer center from 2013 to 2023.

Histology-Specific Treatment Strategies and Survival Prediction in Lung Cancer Patients with Spinal Metastases: A Nationwide Analysis.

Background/objectives: Spinal metastases are a common and severe complication of lung cancer, particularly in small cell lung cancer (SCLC), and are associated with poor survival. Despite advancements in treatment, optimal management strategies remain unclear, with significant differences between non-small cell lung cancer (NSCLC) and SCLC. This study evaluates treatment patterns, survival outcomes, and prognostic factors in lung cancer patients with spinal metastases, integrating deep learning survival prediction models.

The association of hospital volume status with treatment and survival outcomes of intracranial meningioma patients: a multivariable analysis of the National Cancer Database.

Purpose: This study investigates the influence of treatment center volume on survival outcomes and treatment strategies for patients with intracranial meningioma.

Methods: This is a retrospective cohort study of patients from the National Cancer Database treated for intracranial meningioma from 2004 to 2019. High-volume facility was defined as performing > 45 meningioma procedures/year (top 15%).

Current and future clinical trials for the use of neuromodulation in the treatment of stroke: A review of the clinical Trials.gov database.

Neuromodulation is a rapidly growing field in neurosurgery and has shown promise in the treatment of stroke. The aim of this study is to review current clinical trials assessing the role of neuromodulation in the treatment of stroke and post-stroke impairments. Clinical trials were found using the search terms "stroke" and "stimulation.

The Safety and Effectiveness of Surgical Management of Brachial Plexus Tumors: A Retrospective Case Series.

Background And Objectives: Brachial plexus tumors represent a challenge for neurosurgeons because of complex anatomy, risks during surgery, and limited evidence-based guidance in managing these rare tumors. We aim to investigate the clinical characteristics, complications, and neurological outcomes of surgical resection of benign brachial plexus tumors.

Methods: We reviewed the medical records of patients diagnosed with benign brachial plexus tumors at (Johns Hopkins Medical Institutes) from July 2014 to April 2023.

Association between interhospital transfer status and outcomes following nontraumatic subdural hemorrhage.

Background: Patients with nontraumatic subdural hemorrhage often require immediate surgical intervention that may not be available at community hospitals and are therefore transferred to tertiary care centers. This study aims to evaluate the effects of interhospital transfer (IHT) on postoperative complications and outcomes following ntSDH.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was queried for patients treated for ntSDH from January 2014 to January 2020.

The role of combination surgery and radiotherapy in patients with metastatic spinal cord compression: What are the remaining grey areas? A systematic review.

Objective: Traditional management of patients with metastatic epidural spinal cord compression (MESCC) consists of radiotherapy (RT) with or without surgical decompression. With extensive literature and the introduction of clinical frameworks, such as the neurologic, oncologic, mechanical, and systemic criteria and the epidural spinal cord compression scale, progress has been made in refining the appropriate treatment regimen. In this review, we analyze the existing literature to identify the consensus frameworks and the remaining gaps in clinical knowledge.

Augmented Reality Versus Freehand Spinopelvic Fixation in Spinal Deformity: A Case-Control Study.

Purpose: This study sought to compare screw placement accuracy and outcomes between freehand (FH) and AR-guided pelvic fixation. While pelvic fixation is a critical technique in spinal deformity surgery, S2-alar iliac (S2AI) screw placement poses challenges.

Methods: We conducted a case-control study of 50 consecutive patients who underwent spinopelvic fixation at a single institution.

Survival Factors in 1580 Adults with Spinal Ependymoma: Insights from a Multicenter Oncology Database.

Background: Using a multi-institutional oncology database, we investigate the survival rates and the impacts of demographic, clinical, and management characteristics on overall survival among adult patients diagnosed with spinal ependymoma.

Methods: Utilizing the SEER registry, patients with histologically or radiologically confirmed ependymomas were included. Factors impacting overall survival were analyzed using Kaplan-Meier survival curves and log-rank statistical analyses.

Surgical resection of glioblastoma in the very elderly: An analysis of survival outcomes using the surveillance, epidemiology, and end results database.

Objective: Patients with glioblastoma (GBM) often undergo surgery to prolong survival. However, the use of surgery, and more specifically achieving gross total resection (GTR), in patients >80 years old has yet to be fully assessed. Using the Surveillance, Epidemiology, and End Results (SEER) database, we aim to assess the efficacy of surgical resection, radiotherapy (RT) and chemotherapy (CT) on overall survival (OS) in very elderly GBM patients compared to elderly counterparts (age 65-79 years).