The evolution of neurosurgery: how has our practice changed?

Kamat, Ameya S.; Parker, Andrew

doi:10.3109/02688697.2013.786805

Cited by 17 publications

(10 citation statements)

References 6 publications

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“…Increasing population, aging and advances in diagnostic and treatment increased the number of procedures performed [33,34], meaning that the absolute numbers of CSF leakage will also increase. The unmet need for a dural sealant in combination with the growing number of procedures will persuade researchers to develop a more effective dural sealant.…”

Section: Expert Opinionmentioning

confidence: 99%

Dural sealants for the management of cerebrospinal fluid leakage after intradural surgery: current status and future perspectives

Kinaci

Doormaal

2019

Expert Review of Medical Devices

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Introduction: Cerebrospinal fluid leakage is a complication after intradural surgery and is associated with severe secondary complications like compromised wound healing and meningitis. Dural sealants are meant to augment the primary dural closure in order to achieve a watertight closure. Areas covered: This review summarizes the efficacy of currently available dural sealants. Potential future improvements and biomaterials are discussed. Expert opinion: The use of a dural sealant seems to be the logical method to prevent CSF leakage. However, based on the efficacy of currently available dural sealants according to systematic reviews and in vitro studies, a significant effective dural sealant seems is still lacking. A new dural sealant has to be thoroughly assessed before clinical application in in vitro, in vivo and clinical trials. A new research area within sealant development might be the introduction of dural sealants with both antimicrobial and analgesic properties.

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Section: Expert Opinionmentioning

confidence: 99%

Dural sealants for the management of cerebrospinal fluid leakage after intradural surgery: current status and future perspectives

Kinaci

Doormaal

2019

Expert Review of Medical Devices

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“…Surgical technology has played a significant part in the safety of this observed increase in the extent of tumor resection and subsequent improvement in postoperative TAE rates. There have been advances in image guidance (both CT and MR), and these have also benefitted from the ability to combine standard anatomical images with information gleaned from functional and diffusion-weighted advanced MR sequences [140,141] . Initial research on fluorescein-assisted glioma surgery has also shown an increase in the ability to achieve gross total resection over partial resection [142] .…”

Section: Future Directions For Improved Seizure Outcomementioning

confidence: 99%

Peritumoral epilepsy: Relating form and function for surgical success

Cowie

Cunningham

2014

Epilepsy & Behavior

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Seizures are a prominent symptom in patients with both primary and secondary brain tumors. Medical management of seizure control in this patient group is problematic as the mechanisms linking tumorigenesis and epileptogenesis are poorly understood. It is possible that several mechanisms contribute to tumor-associated epileptic zone formation. In this review, we discuss key candidates that may be implicated in peritumoral epileptogenesis and, in so doing, hope to highlight areas for future research. Furthermore, we summarize the current role of antiepileptic medications in this type of epilepsy and examine the changes in surgical practice which may lead to improved seizure rates after tumor surgery. Lastly, we speculate on possible future preoperative and intraoperative considerations for improving seizure control after tumor resection.This article is part of a Special Issue entitled “NEWroscience 2013”.

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“…Our centre, a tertiary referral hospital based in Wellington, serves a population of approximately 910 000 people living in the lower North and QUANTITATIVE RESEARCH ORIGINAL SCIENTIFIC PAPER upper South Islands of NZ. 5 The service is presently staffed by four full-time neurosurgeons and three full-time neurosurgical registrars. Patients are referred by GPs or hospital specialists either directly to our emergency service, or to our outpatient clinics.…”

Section: Introductionmentioning

confidence: 99%

Optimising neurosurgical outpatient care: a paradigm shift?

Kamat

Parker

2015

J Prim Health Care

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INTRODUCTION: The Wellington Regional Hospital (WRH) neurosurgical service has noted a substantial increase in patient volumes over the last decade, with referrals to the neurosurgical outpatient clinic appearing to have increased even more substantially. AIM: To quantify the increase in referrals to the WRH neurosurgical outpatient service and to determine whether this has translated into an increase in the number of neurosurgical procedures performed. METHODS: All referrals to the WRH neurosurgical department from the lower North and upper South Islands of New Zealand spanning 10 years were collected. Key outcome data were the number of interventions performed. In addition to GP referrals, all specialist referrals to the WRH neurosurgical outpatient service were also analysed as a comparison. RESULTS: In total, 19 201 patients were referred to the WRH neurosurgical service over the 10 years of the study. Within this timeframe, 7105 patients were referred by GPs and 12 096 were referred by specialist teams. Only 348 patients (4.9%) referred by GPs underwent some form of therapeutic intervention, compared to 3489 patients (28.8%) referred by specialist teams. DISCUSSION: Our data shows that specialist referrals result in a proportionally greater number of therapeutic interventions than GP referrals. This is in part due to the wider array of diagnostic tests available to specialists compared to GPs. The development of relevant guidelines for primary care referral to a neurosurgical service appears warranted and could facilitate initiation of appropriate investigations in primary care. KEYWORDS: Neurosurgery; outpatients; primary health care; referrals

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The evolution of neurosurgery: how has our practice changed?

Abstract: The most important changes have occured in the fields of neuro-oncology, vascular neurosurgery and spinal surgery. Inter-specialty collaboration is establishing itself as a model of care. These data may guide resource allocation for a population increasing both in number and in age.

Cited by 17 publications

References 6 publications

Dural sealants for the management of cerebrospinal fluid leakage after intradural surgery: current status and future perspectives

Dural sealants for the management of cerebrospinal fluid leakage after intradural surgery: current status and future perspectives

Peritumoral epilepsy: Relating form and function for surgical success

Optimising neurosurgical outpatient care: a paradigm shift?

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