You trained with the best, you succeeded and your patients have benefited. Now you can show your gratitude through the Neurosurgery Research & Education Foundation (NREF) by honoring a mentor who helped you achieve success in your field.
By honoring a mentor, you are helping recognize the incredible people who have advanced neurosurgery. Each Honor Your Mentor fund has a specific purpose. Your gift will fund a research or educational endeavor in their name. This is your opportunity to acknowledge those who have established the specialty by aiding those who will follow.
Don't see your mentor on the list? To establish a new fund, please contact Joanne Bonaminio at 847.378.0541 or via email at email@example.com.
New England Journal of Medicine Article Response
The leadership of the AANS, AAOS and NASS have jointly submitted a response to the editor-in-chief of the New England Journal of Medicine regarding the articles and editorial published on the value of fusion in the surgical treatment of spondylolisthesis in the April 14, 2016 issue of the journal. Please click the link below to view the letter.
AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves Updated Position Statement: Intraoperative Electrophysiological Monitoring January 2018
Intraoperative somatosensory evoked potential (SSEP) and motor evoked potential (MEP) monitoring are commonly referred to as intraoperative monitoring (IOM). There is Level I evidence that IOM is a reliable diagnostic tool for assessment of spinal cord integrity during surgery. MEPs have been shown to be superior to SSEPs in the assessment of spinal cord integrity during surgery. Intraoperative MEPs have been shown to pr;edict recovery in traumatic cervical spinal cord injury.
There is insufficient evidence (Level III) of a therapeutic benefit of IOM during spinal surgery. While IOM is generally regarded as integral to lateral spine surgery, there is insufficient evidence to support a therapeutic benefit. The cost-effectiveness of IOM has been inadequately studied.
There is no published data to suggest that IOM results in alterations of procedures, abortion of procedures, increased procedure/anesthesia time, increased procedural difficulty, or increased risk of needle-sticks for the operative team.
IOM should be performed in procedures when the operating surgeon feels that the diagnostic information is of value, such as deformity correction, spinal instability, spinal cord compression, intradural spinal cord lesions and when in proximity to peripheral nerves or roots. Spontaneous and evoked electromyography is recommended for minimally invasive lateral retroperitoneal transpsoas approaches to the lumbar spine, and may also be of utility during pedicle screw insertion.
Hypothermia and Human Spinal Cord Injury: Updated Position Statement and Evidence Based Recommendations from the AANS/CNS Joint Sections on Disorders of the Spine & Peripheral Nerves and Neurotrauma & Critical Care
Scientific studies have documented a potential benefit of systemic hypothermia in animal models of acute spinal cord injury; however there remains a paucity of clinical evidence to recommend for or against the practice of either local or systemic hypothermia for acute SCI in humans. The level IV evidence suggesting the safety of modest systemic hypothermia is promising, but controlled, comparative clinical studies investigating safety and efficacy must be performed prior to the introduction of hypothermia in the routine clinical care of patients with acute SCI.
Grade I - There is insufficient evidence to recommend for or against the practice of either local or systemic therapeutic hypothermia as a treatment for acute spinal cord injury.
Grade C - There is level IV evidence based on one retrospective comparative cohort study and one prospective cohort study to suggest that systemic modest hypothermia might be applied safely to this population.
Concensus statement on Vertebroplasty and Kyphoplasty
A consensus statement developed by the Society of Interventional Radiology (SIR), American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS), American College of Radiology (ACR), American Society of Neuroradiology (ASNR), American Society of Spine Radiology (ASSR), Canadian Interventional Radiology Association (CIRA), and the Society of NeuroInterventional Surgery (SNIS) was recently published in the Journal of Vascular and Interventional Radiology. Barr JD, et al. Journal of Vascular and Interventional Radiology 25:171-181, 2014. In this manuscript, the societies state their position that vertebroplasty and kyphoplasty (i.e., percutaneous vertebral augmentation) is a safe, efficacious, and durable procedure for the treatment of appropriate patients with pathologic fractures due to osteoporosis or neoplastic processes. It is stressed that these treatments must be performed in accordance with published standards. The position statement also notes that these procedures are only offered when non-operative medial therapy has not provided adequate relief or if their symptoms are significantly effecting their quality of life.
Read a thoughtful critique to the Deyo JAMA article . This article has identified a potential trend towards the application of more complex fusion procedures to Medicare patients who are treated with fusion as an adjunct to decompressive procedures for lumbar stenosis. However, without a clear understanding of patient selection criteria, outcomes achieved, and risk stratification, over-interpretation of such data is potentially misleading and dangerous.
Thoracic spinal surgery and peripheral nerve surgery, including
sympathectomy, are traditional and integral components of neurosurgical
training and practice. Video-assisted thoracic surgery (VATS) of the spine
is a minimally invasive technique performed by neurosurgeons for conditions
traditionally treated by neurosurgery. These conditions include thoracic
sympathectomy for hyperhydrosis, upper extremity complex regional pain
syndromes, and thoracic spinal surgery for thoracic disc herniation, spinal
tumor, spinal instability, and scoliotic deformity.
Neurosurgeons currently in training receive experience in VATS during
residency and are examined for competency in the procedure and its
indications by the American Board of Neurological Surgery. Neurosurgical
residency programs provide opportunity for training in minimally invasive
neurosurgical techniques, including VATS for sympathectomy and spinal disorders.
To advance spine and peripheral nerve patient care through education, research and advocacy
Purpose of the Spine and Peripheral Nerves Section
To foster the use of spinal neurosurgical methods for the treatment of
diseases of the spinal neural elements, the spine and peripheral nerves.
To advance spinal neurosurgery and related sciences, to improve patient
care, to support meaningful basic and clinical research, to provide leadership
in undergraduate and graduate continuing education, and to promote administrative
facilities necessary to achieve these goals.
Founders: The Section on Disorders
of the Spine and Peripheral Nerves was founded at the suggestion of Albert
L. Rhoton, MD in 1978 to Charles Drake, MD, President of the AANS in 1978.
Also instrumental were Stewart B. Dunsker, MD and Russell Travis, MD.