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Iwanaga J, Boggio NA, Bui CJ, Dumont AS, Tubbs RS. Can anatomical feasibility studies drive neurosurgical procedures and reach patients faster than traditional translational research? Neurosurg Rev 2021; 45:891-896. [PMID: 34409576 DOI: 10.1007/s10143-021-01626-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 04/07/2021] [Accepted: 05/03/2021] [Indexed: 10/20/2022]
Abstract
Often, surgical techniques are practiced and studied in the anatomy laboratory. Occasionally, new surgical methods are developed with cadaveric anatomical studies. Some cadaveric feasibility studies, if published, might go on to be used by surgeons from around the world for improved patient care. Herein, we review our experience with 37 published anatomical feasibility studies over an 18-year period (2002-2020) and analyze the literature for published examples of surgical application of these same anatomical studies. We found that, for cadaveric anatomical feasibility studies within 7 years of their publication date, approximately 22% will be used in neurosurgery with the clinical applications published. Of these studies awarded clinical citation within 7 years of publication, the median time to that citation was approximately 3.4 years. As the average time for translational research to reach patient care is 17 years, cadaveric anatomical studies in this series reached patient care much sooner than traditional translational research. Cadaveric anatomical studies, based on our experience, can drive neurosurgical procedures.
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Affiliation(s)
- Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA. .,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA. .,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Nicole A Boggio
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - C J Bui
- Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, 131 S. Robertson St. Suite 1300, New Orleans, LA, 70112, USA.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Surgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
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Hirtler L, Huber FA, Wlodek V. Cutaneous innervation of the distal forearm and hand — Minimizing complication rate by defining danger zones for surgical approaches. Ann Anat 2018; 220:38-50. [DOI: 10.1016/j.aanat.2018.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 01/11/2023]
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Loukas M, Abel N, Tubbs RS, Matusz P, Zurada A, Cohen-Gadol AA. Neural interconnections between the nerves of the upper limb and surgical implications. J Neurosurg 2011; 114:225-35. [PMID: 20486894 DOI: 10.3171/2010.3.jns10144] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The knowledge of neural interconnections between adjacent nerves of the upper limb is important to the surgeon as such variations may lead to issues with surgical identification and thus iatrogenic injury. Trauma or entrapment of these nerves may cause functional losses different from those expected and thus result in misdiagnosis. The authors review the literature regarding such nervous system derangements.
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Affiliation(s)
- Marios Loukas
- 1Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies
| | - Nicole Abel
- 1Department of Anatomical Sciences, School of Medicine, St. George's University, Grenada, West Indies
| | - R. Shane Tubbs
- 2Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama
| | - Petru Matusz
- 3Department of Anatomy, University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - Anna Zurada
- 4Department of Anatomy, Medical Faculty, University of Warmia and Masuria in Olsztyn, Poland; and
| | - Aaron A. Cohen-Gadol
- 5Clarian Neuroscience, Goodman-Campbell Brain and Spine, and Department of Neurosurgery, Indianapolis, Indiana
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Loukas M, Bellary SS, Tubbs RS, Shoja MM, Cohen Gadol AA. Deep palmar communications between the ulnar and median nerves. Clin Anat 2010; 24:197-201. [PMID: 21322041 DOI: 10.1002/ca.21093] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 10/03/2010] [Accepted: 10/05/2010] [Indexed: 11/08/2022]
Abstract
Innervation of the hand is supplied via the radial, median, and ulnar nerves. A common border of sensory distribution between the ulnar and median nerves is along the fourth digit. However, this sensory distribution may be affected by communication between these two nerves. Among the known communications between the median and ulnar nerves, the deep anastomotic branch in the hand is the least described and rarely illustrated in the literature. This study aims to provide data on the prevalence of a deep communicating branch via cadaveric dissection. We examined 50 hands taken from 25 adult cadavers. Communicating branches were found in 16% of the hands examined, with rami occurring bilaterally in two specimens. By describing the origin and pathway of this communicating branch, we hope to provide surgeons and clinicians with knowledge that may help avoid iatrogenic injuries.
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Affiliation(s)
- Marios Loukas
- Department of Anatomical Sciences, School of Medicine, St George's University, Grenada, West Indies.
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