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Zhang JK, Dinh TU, Teasdale G, Mercier P, Mattei TA. The Message of the Glasgow Coma Scale: A Comprehensive Bibliometric Analysis and Systematic Review of Clinical Practice Guidelines Spanning the Past 50 years. World Neurosurg 2024; 185:393-402.e27. [PMID: 38437980 DOI: 10.1016/j.wneu.2024.02.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Despite the ubiquitous use of the Glasgow Coma Scale (GCS) worldwide, no study to date has objectively and quantitatively assessed its impact on the scientific literature and clinical practice. Therefore, we comprehensively analyzed scientific publications and clinical practice guidelines employing the GCS to gauge its clinical and academic impact, identify research hotspots, and inform future research on the topic. METHODS A cross-sectional bibliometric analysis was performed on Scopus to obtain relevant publications incorporating the GCS from 1974 to 2022. In addition, a systematic review of existing clinical practice guidelines in PubMed, Scopus, Web of Science, and Trip Database was performed. Validated bibliometric parameters including article title, journal, publication year, authors, citation count, country, institution, keywords, impact factor, and references were assessed. When evaluating clinical practice guidelines, the sponsoring organization, country of origin, specialty, and publication year were assessed. RESULTS A total of 37,633 articles originating from 3924 different scientific journals spanning 1974-2022 were included in the final analysis. The compound annual growth rate of publications referencing the GCS was 16.7%. Of 104 countries, the United States had the highest total number of publications employing the GCS (n = 8517). World Neurosurgery was the scientific periodical with the highest number of publications on the GCS (n = 798). The top trending author-supplied keyword was "traumatic brain injury" (n = 3408). The 97 included clinical practice guidelines most commonly employed the GCS in the fields of internal medicine (n = 22, 23%), critical care (n = 21, 22%), and neurotrauma (n = 19, 20%). CONCLUSIONS At the turn of the 50th anniversary of the GCS, we provided a unique and detailed description of the "path to success" of the GCS both in terms of its scientific and clinical impact. These results have not only a historical but also an important didactic value. Ultimately our detailed analysis, which revealed some of the factors that led the GCS to become such a widespread and highly influential score, may assist future researchers in their development of new outcome measures and clinical scores, especially as such tools become increasingly relevant in an evidence-based data-driven age.
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Affiliation(s)
- Justin K Zhang
- Division of Neurological Surgery, Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA; Department of Neurological Surgery, University of Utah, Salt Lake City, Missouri, USA
| | - Thai Uyen Dinh
- Division of Neurological Surgery, Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Graham Teasdale
- Emeritus Professor of Neurosurgery, University of Glasgow, Glasgow, United Kingdom
| | - Philippe Mercier
- Division of Neurological Surgery, Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Tobias A Mattei
- Division of Neurological Surgery, Department of Neurosurgery, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
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Jiao L, Wang S, Yang X, Ma JX, Zheng L, Wang H, Xiang LB, Yu HL, Chen Y. Current Global Research Trends of Tethered Cord Syndrome Surgery: A Scientometric and Visual Analysis. World Neurosurg 2024; 183:206-213. [PMID: 38143026 DOI: 10.1016/j.wneu.2023.12.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Since tethered cord syndrome (TCS) may lead to neurologic and motor dysfunction, surgeries often are applied to relieve the symptoms. The aim of the research was to explore the current global research trends of TCS surgery. METHODS In this article, articles on TCS surgery in the Web of Science Core Collection from 1980 to 2023 were searched. Research trends, countries, institutions, journals, authors, highly cited articles, and key words were analyzed using bibliometric methods. The literature co-citation network was mapped using VOSviewer, and research hotspots and trends were analyzed using CiteSpace. RESULTS A total of 432 publications were included. The number of publications and related research interest in the field of TCS surgery has increased globally year by year. The United States is the largest contributor (154 publications). The journal Childs Nervous System has the greatest number of publications (48 publications) and the most frequently cited journal is Neurosurgery (973 citations). In network visualization, the institution with the greatest contribution is University of California System (16 publications). Lee JY and Wang KC are the authors with the greatest number of publications (8 publications), and the most frequently cited author is Klekamp J (268 citations). Neurogenic bladder and spina bifida may be the next hot spot in this field. CONCLUSIONS This study will help researchers to identify the mainstream research directions and the latest hotspots in the field of TCS surgery and provide a reference for further research.
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Affiliation(s)
- Liang Jiao
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China
| | - Shuang Wang
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiao Yang
- Department of Anesthesiology, The Air Force Hospital of Northern Theater PLA, Shenyang, China
| | - Jun-Xiong Ma
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China
| | - Liang Zheng
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China
| | - Hong Wang
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China
| | - Liang-Bi Xiang
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China
| | - Hai-Long Yu
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China
| | - Yu Chen
- Department of Orthopedics, General Hospital of Northern Theater Command, Shenyang, China.
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Gadjradj PS, Depauw PR, Schutte PJ, Vreeling AW, Harhangi BS. Body Image and Cosmesis after Percutaneous Transforaminal Endoscopic Discectomy versus Conventional Open Microdiscectomy for Sciatica. Global Spine J 2024; 14:390-399. [PMID: 35610755 PMCID: PMC10802533 DOI: 10.1177/21925682221105271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Randomized controlled trial. OBJECTIVE Percutaneous transforaminal endoscopic discectomy (PTED) was introduced as a less invasive procedure to treat sciatica. Even though the PTED has a small scar size, it is unknown if PTED also leads to better scar-related patient-reported outcomes. Therefore, we aimed to compare scar-related outcomes between patients undergoing PTED vs open microdiscectomy. METHODS Patients with at least 6 weeks of radiating leg pain were randomized in a 1:1 ratio to PTED or open microdiscectomy. Scar-related patient-reported outcomes were measured using the Body Image Score (BIS), Cosmesis Scale (CS) and a 0-10 numeric rating scale (NRS) on scar esthetic. RESULTS Of the 530 included patients, 286 patients underwent PTED and 244 underwent open microdiscectomy as allocated. At 12 months of follow-up, 95% of the patients had data available. At 12 months, the BIS was 6.2 ± 1.7 in the PTED-group and 6.6 ± 1.9 in the open microdiscectomy group (between-group difference .4, 95% CI .2 to .7). CS was 21.3 ± 3.0 in the PTED-group and 18.6 ± 3.4 in the open microdiscectomy group (between-group difference -2.7, 95% CI -3.1 to -2.3). Average NRS for scar esthetic was 9.2 ± 1.3 and 7.8 ± 1.6 in the PTED and open microdiscectomy groups, respectively (between-group difference -1.4, 95% CI -1.6 to -1.2). CONCLUSIONS PTED leads to a higher self-rated scar esthetic as compared to open microdiscectomy, while self-reported body image seems to be comparable between both groups. Therefore, from an esthetic point, PTED seems to be the preferred technique to treat sciatica.
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Affiliation(s)
- Pravesh S. Gadjradj
- Department of Neurological Surgery, Weill Cornell Brain and Spine Center, Weill Cornell Medicine, New York Presbyterian Hospital, New York, New York, USA
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Paul R. Depauw
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Pieter J. Schutte
- Department of Neurosurgery, Alrijne Hospital, Leiden, The Netherlands
| | - Arnold W. Vreeling
- Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Biswadjiet S. Harhangi
- Department of Neurosurgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
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Jiang X, Liu F, Zhang M, Hu W, Zhao Y, Xia B, Xu K. Advances in genetic factors of adolescent idiopathic scoliosis: a bibliometric analysis. Front Pediatr 2024; 11:1301137. [PMID: 38322243 PMCID: PMC10845672 DOI: 10.3389/fped.2023.1301137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/11/2023] [Indexed: 02/08/2024] Open
Abstract
Objective This study offers a bibliometric analysis of the current situation, hotspots, and cutting-edge domains of genetic factors of adolescent idiopathic scoliosis (AIS). Methods All publications related to genetic factors of AIS from January 1, 1992, to February 28, 2023, were searched from the Web of Science. CiteSpace software was employed for bibliometric analysis, collecting information about countries, institutions, authors, journals, and keywords of each article. Results A cumulative number of 308 articles have been ascertained. Since 2006, publications relating to genetic factors of AIS have significantly increased. China leads in both productivity and influence in this area, with the Chinese Academy of Medical Sciences being the most productive institution. The most prolific scholars in this field are Y. Qiu and Z. Z. Zhu. The publications that contributed the most were from Spine and European Spine Journal. The most prominent keywords in the genetic factors of AIS were "fibrillin gene", "menarche", "calmodulin", "estrogen receptor gene", "linkage analysis", "disc degeneration", "bone mineral density", "melatonin signaling dysfunction", "collagen gene", "mesenchymal stem cell", "LBX1", "promoter polymorphism", "Bone formation", "cerebrospinal fluid flow" and "extracellular matrix". Conclusion This analysis provides the frontiers and trends of genetic factors in AIS, including relevant research, partners, institutions and countries.
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Affiliation(s)
| | - Fuyun Liu
- Department of Orthopedics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Jitpakdee K, Liu Y, Heo DH, Kotheeranurak V, Suvithayasiri S, Kim JS. Minimally invasive endoscopy in spine surgery: where are we now? EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:2755-2768. [PMID: 36856868 DOI: 10.1007/s00586-023-07622-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Endoscopic spine surgery (ESS) is a minimally invasive surgical technique that offers comparable efficacy and safety with less collateral damage compared to conventional surgery. To achieve clinical success, it is imperative to stay abreast of technological advancements, modern surgical instruments and technique, and updated evidence. PURPOSES To provide a comprehensive review and updates of ESS including the nomenclature, technical evolution, bibliometric analysis of evidence, recent changes in the spine communities, the prevailing of biportal endoscopy, and the future of endoscopic spine surgery. METHODS We conducted a comprehensive review of the literature on ESS for the mentioned topics from January 1989 to November 2022. Three major electronic databases were searched, including MEDLINE, Scopus, and Embase. Covidence Systematic Review was used to organize the eligible records. Two independent reviewers screened the articles for relevance. RESULTS In total, 312 articles were finally included for review. We found various use of nomenclatures in the field of ESS publication. To address this issue, we proposed the use of distinct terms to describe the biportal and uniportal techniques, as well as their specific approaches. In the realm of technical advancement, ESS has rapidly evolved from addressing disc herniation and spinal stenosis to encompassing endoscopic fusion, along with technological innovations such as navigation, robotics, and augmented reality. According to bibliometric analysis, China, South Korea, and the USA have accounted for almost three-quarters of total publications. The studies of the biportal endoscopy are becoming increasingly popular in South Korea where the top ten most-cited articles have been published. The biportal endoscopy technique is relatively simple to adopt, as it relies on a more familiar approach, requires less expensive instruments, has a shorter learning curve, and is also well-suited for interbody fusion. The uniportal approach provided the smallest area of soft tissue dissection. While robotics and augmented reality in ESS are not widely embraced, the use of navigation in ESS is expected to become more streamlined, particularly with the emergence of recent electromagnetic-based navigation technologies. CONCLUSIONS In this paper, we provide a comprehensive overview of the evolution of ESS, as well as an updated summary of current trends in the field, including the biportal and uniportal approaches. Additionally, we summarize the nomenclature used in ESS, present a bibliometric analysis of the field, and discuss future directions for the advancement of the field.
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Affiliation(s)
- Khanathip Jitpakdee
- Spine Unit, Department of Orthopaedics, Queen Savang Vadhana Memorial Hospital, Thai Red Cross Society, Chonburi, Thailand
- Spine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yanting Liu
- Spine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Dong Hwa Heo
- Endoscopic Spine Surgery Center, Neurosurgery, Champodonamu Spine Hospital, Seoul, South Korea
| | - Vit Kotheeranurak
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Siravich Suvithayasiri
- Spine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
- Orthopaedic and Musculoskeletal Centre, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Jin-Sung Kim
- Spine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Lewandrowski KU, Yeung A, Lorio MP, Yang H, Ramírez León JF, Sánchez JAS, Fiorelli RKA, Lim KT, Moyano J, Dowling Á, Sea Aramayo JM, Park JY, Kim HS, Zeng J, Meng B, Gómez FA, Ramirez C, De Carvalho PST, Rodriguez Garcia M, Garcia A, Martínez EE, Gómez Silva IM, Valerio Pascua JE, Duchén Rodríguez LM, Meves R, Menezes CM, Carelli LE, Cristante AF, Amaral R, de Sa Carneiro G, Defino H, Yamamoto V, Kateb B. Personalized Interventional Surgery of the Lumbar Spine: A Perspective on Minimally Invasive and Neuroendoscopic Decompression for Spinal Stenosis. J Pers Med 2023; 13:jpm13050710. [PMID: 37240880 DOI: 10.3390/jpm13050710] [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: 02/01/2023] [Revised: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 05/28/2023] Open
Abstract
Pain generator-based lumbar spinal decompression surgery is the backbone of modern spine care. In contrast to traditional image-based medical necessity criteria for spinal surgery, assessing the severity of neural element encroachment, instability, and deformity, staged management of common painful degenerative lumbar spine conditions is likely to be more durable and cost-effective. Targeting validated pain generators can be accomplished with simplified decompression procedures associated with lower perioperative complications and long-term revision rates. In this perspective article, the authors summarize the current concepts of successful management of spinal stenosis patients with modern transforaminal endoscopic and translaminar minimally invasive spinal surgery techniques. They represent the consensus statements of 14 international surgeon societies, who have worked in collaborative teams in an open peer-review model based on a systematic review of the existing literature and grading the strength of its clinical evidence. The authors found that personalized clinical care protocols for lumbar spinal stenosis rooted in validated pain generators can successfully treat most patients with sciatica-type back and leg pain including those who fail to meet traditional image-based medical necessity criteria for surgery since nearly half of the surgically treated pain generators are not shown on the preoperative MRI scan. Common pain generators in the lumbar spine include (a) an inflamed disc, (b) an inflamed nerve, (c) a hypervascular scar, (d) a hypertrophied superior articular process (SAP) and ligamentum flavum, (e) a tender capsule, (f) an impacting facet margin, (g) a superior foraminal facet osteophyte and cyst, (h) a superior foraminal ligament impingement, (i) a hidden shoulder osteophyte. The position of the key opinion authors of the perspective article is that further clinical research will continue to validate pain generator-based treatment protocols for lumbar spinal stenosis. The endoscopic technology platform enables spine surgeons to directly visualize pain generators, forming the basis for more simplified targeted surgical pain management therapies. Limitations of this care model are dictated by appropriate patient selection and mastering the learning curve of modern MIS procedures. Decompensated deformity and instability will likely continue to be treated with open corrective surgery. Vertically integrated outpatient spine care programs are the most suitable setting for executing such pain generator-focused programs.
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Affiliation(s)
- Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona, Tucson, AZ 85712, USA
- Department of Orthopaedics, Fundación Universitaria Sanitas, Bogotá 111321, Colombia
- Department of Orthopedics at Hospital Universitário Gaffree Guinle Universidade Federal do Estado do Rio de Janeiro, R. Mariz e Barros, 775-Maracanã, Rio de Janeiro 20270-004, Brazil
- Brain Technology and Innovation Park, Pacific Palisades, CA 90272, USA
| | - Anthony Yeung
- Desert Institute for Spine Care, 1635 E Myrtle Ave Suite 400, Phoenix, AZ 85020, USA
- Department of Neurosurgery, University of New Mexico School of Medicine, 915 Camino de Salud NE Albuquerque, Albuquerque, NM 87106, USA
| | - Morgan P Lorio
- Advanced Orthopedics, 499 East Central Parkway, Altamonte Springs, FL 32701, USA
| | - Huilin Yang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou 215031, China
| | - Jorge Felipe Ramírez León
- Department of Orthopaedics, Fundación Universitaria Sanitas, Bogotá 111321, Colombia
- Minimally Invasive Spine Center Bogotá D.C. Colombia, Reina Sofía Clinic Bogotá D.C. Colombia, Bogotá 110141, Colombia
| | | | - Rossano Kepler Alvim Fiorelli
- Department of General and Specialized Surgery, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro 20000-000, Brazil
| | - Kang Taek Lim
- Good Doctor Teun Teun Spine Hospital, Seoul 775 , Republic of Korea
| | - Jaime Moyano
- Torres Médicas Hospital Metropolitano, San Gabriel y Nicolás Arteta Torre Médica 3, Piso 5, Quito 170521, Ecuador
| | - Álvaro Dowling
- DWS Spine Clinic Center, CENTRO EL ALBA-Cam. El Alba 9500, Of. A402, Región Metropolitana, Las Condes 9550000, Chile
- Department of Orthopaedic Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP) da Universidade de São Paulo (USP), Ribeirão Preto 14040-900, Brazil
| | | | - Jeong-Yoon Park
- Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 731, Republic of Korea
| | - Hyeun-Sung Kim
- Department of Neurosurgery, Nanoori Hospital Gangnam Hospital, Seoul 731, Republic of Korea
| | - Jiancheng Zeng
- Department of Orthopaedic Surgery, West China Hospital Sichuan University, Chengdu 610041, China
| | - Bin Meng
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215005, China
| | | | - Carolina Ramirez
- Centro de Cirugía Mínima Invasiva-CECIMIN, Avenida Carrera 45 # 104-76, Bogotá 0819, Colombia
| | - Paulo Sérgio Teixeira De Carvalho
- Department of Neurosurgery, Pain and Spine Minimally Invasive Surgery Service at Gaffree Guinle University Hospital, Rio de Janeiro 20270-004, Brazil
| | - Manuel Rodriguez Garcia
- Spine Clinic, The American-Bitish Cowdray Medical Center I.A.P, Campus Santa Fe, Mexico City 05370, Mexico
| | - Alfonso Garcia
- Department of Orthopaedic Surgery, Espalda Saludable, Hospital Angeles Tijuana, Tijuana 22010, Mexico
| | - Eulalio Elizalde Martínez
- Department of Spine Surgery, Hospital de Ortopedia, UMAE "Dr. Victorio de la Fuente Narvaez", Ciudad de México 07760, Mexico
| | - Iliana Margarita Gómez Silva
- Department of Spine Surgery, Hospital Ángeles Universidad, Av Universidad 1080, Col Xoco, Del Benito Juárez, Ciudad de México 03339, Mexico
| | | | - Luis Miguel Duchén Rodríguez
- Center for Neurological Diseases, Bolivian Spine Association, Spine Chapter of Latin American Federation of Neurosurgery Societies, Public University of El Alto, La Paz 0201-0220, Bolivia
| | - Robert Meves
- Santa Casa Spine Center, São Paulo 09015-000, Brazil
| | - Cristiano M Menezes
- Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 31270-901, Brazil
| | | | | | - Rodrigo Amaral
- Instituto de Patologia da Coluna (IPC), Faculdade de Medicina de Ribeirão Preto (FMRP) da Universidade de São Paulo (USP), São Paulo 14040-900, Brazil
| | | | - Helton Defino
- Hospital das Clínicas of Ribeirao Preto Medical School, Sao Paulo University, Ribeirão Preto 14040-900, Brazil
| | - Vicky Yamamoto
- Brain Technology and Innovation Park, Pacific Palisades, CA 90272, USA
- The USC Caruso Department of Otolaryngology-Head and Neck Surgery, USC Keck School of Medicine, Los Angeles, CA 90033, USA
- USC-Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA
- World Brain Mapping Foundation (WBMF), Pacific Palisades, CA 90272, USA
| | - Babak Kateb
- Brain Technology and Innovation Park, Pacific Palisades, CA 90272, USA
- World Brain Mapping Foundation (WBMF), Pacific Palisades, CA 90272, USA
- Society for Brain Mapping and Therapeutics (SBMT), Pacific Palisades, CA 90272, USA
- National Center for Nano Bio Electronic (NCNBE), Los Angeles, CA 90272, USA
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Kotheeranurak V, Liawrungrueang W, Quillo-Olvera J, Siepe CJ, Li ZZ, Lokhande PV, Choi G, Ahn Y, Chen CM, Choi KC, Van Isseldyk F, Hagel V, Koichi S, Hofstetter CP, Del Curto D, Zhou Y, Bolai C, Bae JS, Assous M, Lin GX, Jitpakdee K, Liu Y, Kim JS. Full-Endoscopic Lumbar Discectomy Approach Selection: A Systematic Review and Proposed Algorithm. Spine (Phila Pa 1976) 2023; 48:534-544. [PMID: 36745468 DOI: 10.1097/brs.0000000000004589] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/28/2022] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN A systematic review of the literature to develop an algorithm formulated by key opinion leaders. OBJECTIVE This study aimed to analyze currently available data and propose a decision-making algorithm for full-endoscopic lumbar discectomy for treating lumbar disc herniation (LDH) to help surgeons choose the most appropriate approach [transforaminal endoscopic lumbar discectomy (TELD) or interlaminar endoscopic lumbar discectomy (IELD)] for patients. SUMMARY OF BACKGROUND DATA Full-endoscopic discectomy has gained popularity in recent decades. To our knowledge, an algorithm for choosing the proper surgical approach has never been proposed. MATERIALS AND METHODS A systematic review of the literature using PubMed and MeSH terms was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient samples included patients with LDH treated with full-endoscopic discectomy. The inclusion criteria were interventional research (randomized and nonrandomized trials) and observation research (cohort, case-control, case series). Exclusion criteria were case series and technical reports. The criteria used for selecting patients were grouped and analyzed. Then, an algorithm was generated based on these findings with support and reconfirmation from key expert opinions. Data on overall complications were collected. Outcome measures included zone of herniation, level of herniation, and approach (TELD or IELD). RESULTS In total, 474 articles met the initial screening criteria. The detailed analysis identified the 80 best-matching articles; after applying the inclusion and exclusion criteria, 53 articles remained for this review. CONCLUSIONS The proposed algorithm suggests a TELD for LDH located in the foraminal or extraforaminal zones at upper and lower levels and for central and subarticular discs at the upper levels considering the anatomic foraminal features and the craniocaudal pathology location. An IELD is preferred for LDH in the central or subarticular zones at L4/L5 and L5/S1, especially if a high iliac crest or high-grade migration is found.
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Affiliation(s)
- Vit Kotheeranurak
- Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | | | - Javier Quillo-Olvera
- Department of Neurosurgery, The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Spine Center, Hospital H+, Queretaro City, Mexico
| | - Christoph J Siepe
- Schön Clinic Munich Harlaching, Munich, Germany
- Paracelsus Medical University (PMU), Salzburg, Austria
| | - Zhen Zhou Li
- The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China
| | | | - Gun Choi
- Wooridul Spine Hospital, Pohang, South Korea
| | - Yong Ahn
- Gachon University, Incheon, South Korea
| | | | | | | | - Vincent Hagel
- University Spine Center Zürich, Balgrist University Hospital, Zürich, Switzerland
| | - Sairyo Koichi
- Tokushima University Graduate School, Kuramoto, Tokushima, Japan
| | | | - David Del Curto
- School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Yue Zhou
- Xinquiao Hospital, Third Military Medical University, Chongquing, China
| | - Chen Bolai
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Jun Seok Bae
- Wooridul Spine Hospital, Gangnam-Gu Seoul, Korea
| | - Muhammed Assous
- Razi Spine Clinic-Minimally Invasive Spine Surgery, Amman, Jordan
| | - Guang-Xun Lin
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, China
| | - Khanathip Jitpakdee
- Orthopedic Department, Queen Savang Vadhana Memorial Hospital. Sriracha, Chonburi, Thailand
| | - Yanting Liu
- Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Jin-Sung Kim
- Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
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Kwon WK, Kim SH. Why Endoscopic Spine Surgery? Neurospine 2023; 20:7-10. [PMID: 37016848 PMCID: PMC10080456 DOI: 10.14245/ns.2346014.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/30/2023] [Indexed: 04/03/2023] Open
Affiliation(s)
- Woo-Keun Kwon
- Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Se-Hoon Kim
- Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
- Corresponding Author Se-Hoon Kim Department of Neurosurgery, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea
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Lewandrowski KU, Lorio MP. Determination of Work Related to Endoscopic Decompression of Lumbar Spinal Stenosis. J Pers Med 2023; 13:jpm13040614. [PMID: 37109000 PMCID: PMC10143172 DOI: 10.3390/jpm13040614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/19/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Background: Effective 1 January 2017, single-level endoscopic lumbar discectomy received a Category I Current Procedural Terminology (CPT®) code 62380. However, no work relative value units (wRVUs) are currently assigned to the procedure. A physician’s payment needs to be updated to commensurate with the work involved in the modern version of the lumbar endoscopic decompression procedure with and without the use of any implants to stabilize the spine. In the United States, the American Medical Association (AMA) and its Specialty Society Relative Value Scale Update Committee (RUC) proposes to the Centers for Medicare and Medicaid Services (CMS) what wRVUs to assign for any endoscopic lumbar surgery codes. Methods: The authors conducted an independent survey between May and June 2022 which reached 210 spine surgeons using the TypeForm survey platform. The survey link was sent to them via email and social media. Surgeons were asked to assess the endoscopic procedure’s technical and physical effort, risk, and overall intensity without focusing just on the time required to perform the surgery. Respondents were asked to compare the work involved in modern comprehensive endoscopic spine care with other commonly performed lumbar surgeries. For this purpose, respondents were provided with the verbatim descriptions of 12 other existing comparator CPT® codes and associated wRVUs of common spine surgeries, as well as a typical patient vignette describing an endoscopic lumbar decompression surgery scenario. Respondents were then asked to select the comparator CPT® code most reflective of the technical and physical effort, risk, intensity, and time spent on patient care during the pre-operative, peri- and intra-operative, and post-operative periods of a lumbar endoscopic surgery. Results: Of the 30 spine surgeons who completed the survey, 85.8%, 46.6%, and 14.3% valued the appropriate wRVU for the lumbar endoscopic decompression to be over 13, over 15, and over 20, respectively. Most surgeons (78.5%; <50th percentile) did not think they were adequately compensated. Regarding facility reimbursement, 77.3% of surgeons reported that their healthcare facility struggled to cover the cost with the received compensation. The majority (46.5%) said their facility received less than USD 2000, while another 10.7% reported less than USD 1500 and 17.9% reported less than USD 1000. The professional fee received by surgeons was <USD 1000 for 21.4%, <USD 2000 for 17.9%, and <USD 1500 for 10.7%, resulting in a fee less than USD 2000 for 50% of responding surgeons. Most responding surgeons (92.6%) recommended an endoscopic instrumentation carveout to pay for the added cost of the innovation. Discussion and Conclusions: The survey results indicate that most surgeons associate CPT® 62380 with the complexity and intensity of a laminectomy and interbody fusion preparation, considering the work in the epidural space using the contemporary outside-in and interlaminar technique and the work inside the interspace using the inside-out technique. Modern endoscopic spine surgery goes beyond the scope of a simple soft-tissue discectomy. The current iterations of the procedure must be considered to avoid undervaluing its complexity and intensity. Additional undervalued payment scenarios could be created if technological advances continue to replace traditional lumbar spinal fusion protocols with less burdensome, yet no less complex, endoscopic surgeries that necessitate a high surgeon effort in terms of time required to perform the operation and its intensity. These undervalued payment scenarios of physician practices, as well as the facility and malpractice expenses, should be further discussed to arrive at updated CPT® codes reflective of modern comprehensive endoscopic spine care.
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Affiliation(s)
- Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona, Tucson, AZ 85712, USA
- Department of Orthopaedics, Fundación Universitaria Sanitas, Bogotá 111321, Colombia
- Department of Orthopedics at Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-004, Brazil
- Correspondence: ; Tel.: +1-520-204-1495
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Giordan E, Radaelli R, Gallinaro P, Pastorello G, Zanata R, Canova G, Marton E, Del Verme J. Bibliographic Study and Meta-Analysis of Clinical Outcomes of Full-Endoscopic Spine Surgery for Painful Lumbar Spine Conditions. World Neurosurg 2023; 171:e64-e82. [PMID: 36442782 DOI: 10.1016/j.wneu.2022.11.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Full-endoscopic spine surgery (FESS) indications already cover degenerative, infectious, and neoplastic diseases. This study aimed to use a bibliometric search and meta-analysis of the highest-quality studies in the last 20 years to determine the quantity and quality of FESS research, geographic distribution, and the outcomes for lumbar conditions. METHODS Articles on FESS published from 2000 to 2022 were screened and assessed through Web of Science, PubMed, and Scopus. Also, databases were searched for longitudinal studies to pool in a meta-analysis of patients undergoing FESS for lumbar conditions. After stratifying the risk of bias and having collected the studies of the highest quality, we included the proportion of patients with a satisfactory outcome and intraoperative and postoperative adverse events after the analysis of lumbar spine conditions. RESULTS A total of 728 articles were identified by the bibliographic search. Between 2000 and 2021, the published articles increased 21-fold. Most were from China (70.15%), followed by South Korea (19.5%). Most were retrospective (68.3%) and regarding treatment of lumbar disease (86.4%). Fifty studies, including 34,828 patients, were pooled in the meta-analysis. More than 85% of patients experienced satisfactory improvement in each of different lumbar conditions. Major adverse events were <2%; recurrence and postoperative dysesthesia rates were within those reported for open or mini-invasive procedures. CONCLUSIONS This study may fill research gaps on FESS and lead to adequately designed studies. Our meta-analysis showed that FESS for lumbar diseases is a procedure with satisfactory outcomes and low rates of adverse events.
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Affiliation(s)
- Enrico Giordan
- Neurosurgical Department, Aulss2 Marca Trevigiana, Treviso, Italy.
| | | | - Paolo Gallinaro
- Neurosurgical Department, Aulss2 Marca Trevigiana, Treviso, Italy
| | | | - Roberto Zanata
- Neurosurgical Department, Aulss2 Marca Trevigiana, Treviso, Italy
| | - Giuseppe Canova
- Neurosurgical Department, Aulss2 Marca Trevigiana, Treviso, Italy
| | - Elisabetta Marton
- Neurosurgical Department, Aulss2 Marca Trevigiana, Treviso, Italy; Department of Neuroscience, University of Padova, Padova, Italy
| | - Jacopo Del Verme
- Neurosurgical Department, Aulss2 Marca Trevigiana, Treviso, Italy
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Clinical Consequences of Incidental Durotomy during Full-Endoscopic Lumbar Decompression Surgery in Relation to Intraoperative Epidural Pressure Measurements. J Pers Med 2023; 13:jpm13030381. [PMID: 36983563 PMCID: PMC10052087 DOI: 10.3390/jpm13030381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023] Open
Abstract
Background: Seizures, neurological deficits, bradycardia, and, in the worst cases, cardiac arrest may occur following incidental durotomy during routine lumbar endoscopy. Therefore, we set out to measure the intraoperative epidural pressure during lumbar endoscopic decompression surgery. Methods: We conducted a retrospective observational cohort study to obtain intraoperative epidural measurements with an epidural catheter-pressure transducer assembly through the spinal endoscope on 15 patients who underwent lumbar endoscopic decompression of symptomatic lumbar herniated discs and spinal stenosis. The endoscopic interlaminar technique was employed. Results: There were six (40.0%) female and nine (60.0%) male patients aged 49.0667 ± 11.31034, ranging from 36 to 72 years, with an average follow-up of 35.15 ± 12.48 months. Three of the fifteen patients had seizures with durotomy and one of these three had intracranial air on their postoperative brain CT. Another patient developed spinal headaches and diplopia on postoperative day one when her deteriorating neurological function was investigated with a brain computed tomography (CT) scan, showing an intraventricular hemorrhage consistent with a Fisher Grade IV subarachnoid hemorrhage. A CT angiogram did not show any abnormalities. Pressure recordings in the epidural space in nine patients ranged from 20 to 29 mm Hg with a mean of 24.33 mm Hg. Conclusion: Most incidental durotomies encountered during lumbar interlaminar endoscopy can be managed without formal repair and supportive care measures. The intradural spread of irrigation fluid and intraoperatively used drugs and air entrapment through an unrecognized durotomy should be suspected if patients deteriorate in the recovery room. Ascending paralysis may cause nausea, vomiting, upper and lower motor neuron symptoms, cranial nerve palsies, hypotension, bradycardia, and respiratory and cardiac arrest. The recovery team should be prepared to manage these complications.
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12
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Identification of the Magna Radicular Artery Entry Foramen and Adamkiewicz System: Patient Selection for Open versus Full-Endoscopic Thoracic Spinal Decompression Surgery. J Pers Med 2023; 13:jpm13020356. [PMID: 36836589 PMCID: PMC9964931 DOI: 10.3390/jpm13020356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Casually cauterizing the radicular magna during routine thoracic discectomy may have dire consequences. METHODS We performed a retrospective observational cohort study on patients scheduled for decompression of symptomatic thoracic herniated discs and spinal stenosis who underwent a preoperative computed tomography angiography (CTA) to assess the surgical risks by anatomically defining the foraminal entry level of the magna radicularis artery into the thoracic spinal cord and its relationship to the surgical level. RESULTS Fifteen patients aged 58.53 ± 19.57, ranging from 31 to 89 years, with an average follow-up of 30.13 ± 13.42 months, were enrolled in this observational cohort study. The mean preoperative VAS for axial back pain was VAS of 8.53 ± 2.06 and reduced to a postoperative VAS of 1.60 ± 0.92 (p < 0.0001) at the final follow-up. The Adamkiewicz was most frequently found at T10/11 (15.4%), T11/12 (23.1%), and T9/10 (30.8%). There were eight patients where the painful pathology was found far from the AKA foraminal entry-level (type 1), three patients with near location (type 2), and another four patients needing decompression at the foraminal (type 3) entry-level. In five of the fifteen patients, the magna radicularis entered the spinal canal on the ventral surface of the exiting nerve root through the neuroforamen at the surgical level requiring a change of surgical strategy to prevent injury to this important contributor to the spinal cord's blood supply. CONCLUSIONS The authors recommend stratifying patients according to the proximity of the magna radicularis artery to the compressive pathology with CTA to assess the surgical risk with targeted thoracic discectomy methods.
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Saravi B, Ülkümen S, Lang G, Couillard-Després S, Hassel F. Case-matched radiological and clinical outcome evaluation of interlaminar versus microsurgical decompression of lumbar spinal stenosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023:10.1007/s00586-023-07551-5. [PMID: 36729245 DOI: 10.1007/s00586-023-07551-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 01/12/2023] [Accepted: 01/22/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Endoscopic spine surgery is a globally expanding technique advocated as less invasive for spinal stenosis treatment compared to the microsurgical approach. However, evidence on the efficiency of interlaminar full-endoscopic decompression (FED) vs. conventional microsurgical decompression (MSD) in patients with lumbar spinal stenosis is still scarce. We conducted a case-matched comparison for treatment success with consideration of clinical, laboratory, and radiologic predictors. METHODS We included 88 consecutive patients (FED: 36/88, 40.9%; MSD: 52/88, 59.1%) presenting with lumbar central spinal stenosis. Surgery-related (operation time, complications, length of stay (LOS), American Society of Anesthesiologists physical status (ASA) score, C-reactive protein (CRP), white blood cell count, side of approach (unilateral/bilateral), patient-related outcome measures (PROMs) (Oswestry disability index (ODI), numeric rating scale of pain (NRS; leg-, back pain), EuroQol questionnaire (eQ-5D), core outcome measures index (COMI)), and radiological (dural sack cross-sectional area, Schizas score (SC), left and right lateral recess heights, and facet angles, respectively) parameters were extracted at different time points up to 1-year follow-up. The relationship of PROMs was analyzed using Spearman's rank correlation. Surgery-related outcome parameters were correlated with patient-centered and radiological outcomes utilizing a regression model to determine predictors for propensity score matching. RESULTS Complication (most often residual sensorimotor deficits and restenosis due to hematoma) rates were higher in the FED (33.3%) than MSD (13.5%) group (p < 0.05), while all complications in the FED group were observed within the first 20 FED patients. Operation time was higher in the FED, whereas LOS was higher in the MSD group. Age, SC, CRP revealed significant associations with PROMs. We did not observe significant differences in the endoscopic vs. microsurgical group in PROMs. The correlation between ODI and COMI was significantly high, and both were inversely correlated with eQ-5D, whereas the correlations of these PROMs with NRS findings were less pronounced. CONCLUSIONS Endoscopic treatment of lumbar spinal stenosis was similarly successful as the conventional microsurgical approach. Although FED was associated with higher complication rates in our single-center study experience, the distribution of complications indicated surgical learning curves to be the main factor of these findings. Future long-term prospective studies considering the surgical learning curve are warranted for reliable comparisons of these techniques.
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Affiliation(s)
- Babak Saravi
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Centre - Albert-Ludwigs-University of Freiburg, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany. .,Department of Spine Surgery, Loretto Hospital, Freiburg, Germany.
| | - Sara Ülkümen
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Centre - Albert-Ludwigs-University of Freiburg, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany.,Department of Spine Surgery, Loretto Hospital, Freiburg, Germany
| | - Gernot Lang
- Department of Orthopedics and Trauma Surgery, Faculty of Medicine, Medical Centre - Albert-Ludwigs-University of Freiburg, Albert-Ludwigs-University of Freiburg, Hugstetterstrasse 55, 79106, Freiburg, Germany.,Department of Spine Surgery, Loretto Hospital, Freiburg, Germany
| | - Sébastien Couillard-Després
- Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS), Institute of Experimental Neuroregeneration, Paracelsus Medical University, 5020, Salzburg, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Frank Hassel
- Department of Spine Surgery, Loretto Hospital, Freiburg, Germany
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Lin GX, Chen CM, Rui G, Hu BS. Research relating to three-dimensional (3D) printing in spine surgery: a bibliometric analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:395-407. [PMID: 36109389 DOI: 10.1007/s00586-022-07376-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/30/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Although numerous publications on three-dimensional printing (3DP) in spine surgery have been published, bibliometric analysis studies are scarce. Thus, this study aimed to present a bibliometric analysis of the status, hot spots, and frontiers of 3DP in spine surgery and associated research disciplines. METHODS All publications relating to the utilization of 3DP in spine surgery from 1999 to May 9, 2022, were retrieved from the Web of Science. The bibliometric analysis was performed using CiteSpace software, and information on the country, institution, author, journal, and keywords for each publication was collected. RESULTS A total of 270 articles were identified. From 2016 onward, a significant increase in publications on spinal surgery was observed. China was the most productive and influential country (98 publications) and H-index (22), followed by the USA and Australia. The most productive institution was Capital Medical University (9 publications). P. S. D'urso (8 publications, 46 citations) and R. J. Mobbs (8 publications, 39 citations) were the most prolific authors. European Spine Journal contributed the highest number of publications. The eight main clusters were: "rapid prototyping" #0, "3D printed" #1, "spine fusion" #2, "scoliosis" #3, "spine surgery" #4, "patient-specific" #5, "nervous system" #6, and "neuronavigation" #7. The strongest keyword bursts in 3DP in spine surgery were "fixation," "drill template," "instrumentation," "fusion," "complication," and "atlantoaxial instability." CONCLUSION This analysis provides information on research trends and frontiers in the application of 3DP in spine surgery, as well as research and collaboration partners, institutions, and countries.
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Affiliation(s)
- Guang-Xun Lin
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Chien-Min Chen
- Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.,Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan.,College of nursing and health sciences, Dayeh University, Changhua, Taiwan
| | - Gang Rui
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.,The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China
| | - Bao-Shan Hu
- The Third Clinical Medical College, The School of Clinical Medicine, Fujian Medical University, Fuzhou, Fujian, China.
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Li WS, Yan Q, Li GY, Chen WT, Cong L. Global research productivity in the field of discectomy on lumbar disc herniation: A systematic bibliometric analysis. Front Surg 2023; 10:1046294. [PMID: 36798638 PMCID: PMC9927649 DOI: 10.3389/fsurg.2023.1046294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Objective To evaluate the global research productivity in the field of discectomy for lumbar disc herniation (LDH) through bibliometric analysis and mapping knowledge domains. Methods A systematic literature search was performed on the Web of Science (WoS), including the Science Citation Index Expanded (SCIE) database and PubMed. The number of publications, countries of publications, journals of publications, total citation frequency, impact factors of journals, and Institutional sources were analyzed by Microsoft Excel 2019, the Online Analysis Platform of Bibliometrics, and VOSviewer. Hotspots were also analyzed and visualized based on VOSviewer. Results A total of 2,066 papers were identified. The United States ranked first in the number of total citations (7,970). China ranked first in the number of publications (556, 26.9%), which has surpassed the United States in terms of the number of publications published annually since 2016. Wooridul Spine Hospital published the most papers (43). For journals, Spine has published the largest number of papers (289) in this field with the most citation frequencies (6,607). Hotspots could be divided into three clusters: surgery, lumbar disc herniation, and diagnoses. The most recent topic that appeared was symptomatic re-herniation. Conclusions The United States is the most significant contributor to the development of discectomy for LDH. The current research focus of discectomy on LDH was the comparison between surgical approaches and evaluation of current minimally invasive discectomy. At present, minimally invasive techniques, such as endoscopic discectomy, cannot completely replace non-endoscopic discectomy (open discectomy and microdiscectomy) through bibliometric analysis and mapping knowledge domains.
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Affiliation(s)
- Wei-Shang Li
- Department of Orthopedic Surgery, The First Hospital of China Medical University, Shenyang, China
| | - Qi Yan
- Department of Surgery, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Gao-Yu Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wen-Ting Chen
- Disease Control and Prevention Center of China Railway Shenyang Bureau Group Corporation, Shenyang, China
| | - Lin Cong
- Department of Orthopedic Surgery, The First Hospital of China Medical University, Shenyang, China,Correspondence: Lin Cong
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Xie Y, Zhou Q, Wang Y, Feng C, Fan X, Yu Y. Training to be a spinal endoscopic surgeon: What matters? Front Surg 2023; 10:1116376. [PMID: 36950056 PMCID: PMC10025468 DOI: 10.3389/fsurg.2023.1116376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/14/2023] [Indexed: 03/08/2023] Open
Abstract
Objective Spinal endoscopic surgery has been promoted rapidly in the past decade, attracting an increasing number of young, dedicated surgeons. However, it has long been denounced for its long learning curve as a factor impeding the development of this state-of-the-art technique. The aim of the present study was to discover what really matters in the educational process of becoming a spinal endoscopic surgeon. Methods An online survey consisting of 14 compulsory questions was distributed in April and May 2022 through the First Chinese Spinal Endoscopic Surgeons Skills Competition. Reminders were sent to increase response rates. Results Of the 893 emails that were sent, we received 637 responses. A total of 375 (76.7%) surgeons most frequently used endoscopic techniques in their practices. Regardless of their different backgrounds, 284 (75.7%) surgeons thought it would be necessary for a young spinal endoscopic surgeon to perform 300 cases independently in order to become proficient, followed by 500 (n=43, 11.5%), 100 (n=40, 10.7%), and 1,000 (n=8, 2.1%) cases. According to the surgeons, the most difficult aspect of mastering the endoscopic technique is a disparate surgical view (n=255, 68%), followed by adaption to new instruments (n=86, 22.9%) and hand-eye coordination (n=34, 9.1%). The most helpful training method for helping the spinal endoscopic surgeons of younger generations improve is operating on simulation models or cadaver courses (n=216, 57.6%), followed by online or offline theoretical courses (n=67, 17.9%), acquiring opportunities during surgeries (n=51, 13.6%), and frequently participating in surgeries as an assistant (n=41, 10.9%). Conclusion From the perspective of surgeons, to be skilled in spinal endoscopic surgery means overcoming a steep learning curve. However, training systems should be given more attention to make them more accessible to younger surgeons so they can work on simulation models or take cadaver courses.
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Affiliation(s)
- Yizhou Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qun Zhou
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yongtao Wang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chengzhi Feng
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaohong Fan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Correspondence: Yang Yu Xiaohong Fan
| | - Yang Yu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Correspondence: Yang Yu Xiaohong Fan
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Jenkins AS, Moore ML, Pollock JR, Brinkman JC, Verhey J, Chhabra A. The 50 Most Cited Papers Pertaining to American Football: Analysis of Studies From the Past 40 Years. Orthop J Sports Med 2022; 10:23259671221141089. [PMID: 36582927 PMCID: PMC9793059 DOI: 10.1177/23259671221141089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 09/15/2022] [Indexed: 12/24/2022] Open
Abstract
Background Bibliometric citation analyses have been widely used in medicine to help researchers gain foundational knowledge about a topic and identify subtopics of popular interest for further investigations. Purpose To identify the 50 most cited research publications related to American football. Study Design Cross-sectional study. Methods The Clarivate Analytics Web of Science database was used to generate a list of publications relating to football. Articles were filtered by the total number of citations, and the top 50 most cited articles studying the sport of football were selected for this analysis. Articles were analyzed by author, publication year, country of origin, institution affiliation, journal, article type, main research topic area, competitive level, and the level of evidence. A total of 247 articles were reviewed to reach the top 50 articles. Results The most studied topic within the top 50 articles was concussion/chronic traumatic encephalopathy (n = 40). Collegiate football was the most studied level of competition (n = 25). The journal publishing the greatest number of top articles was Neurosurgery. Two institutions, the University of North Carolina at Chapel Hill and Boston University School of Medicine, produced over one-third of top 50 articles (n = 18). Conclusion Our analysis indicated that most of the top 50 publications related to the sport of football focused on concussion and CTE, were observational, and were published during or after 2000. The most studied level of competition was collegiate football.
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Affiliation(s)
- Anna S. Jenkins
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale,
Arizona, USA
| | - Michael L. Moore
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale,
Arizona, USA
| | - Jordan R. Pollock
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale,
Arizona, USA
| | | | - Jens Verhey
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona,
USA
| | - Anikar Chhabra
- Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona,
USA.,Anikar Chhabra, MD, Department of Orthopedic Surgery, Mayo
Clinic Arizona, 5777 E Mayo Boulevard, Phoenix, AZ 85054, USA (
)
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Omar AT, Chan KIP, Ong EP, Dy LF, Go DAD, Paolo Capistrano M, Cua SKN, Diestro JDB, Espiritu AI, Spears J. Neurosurgical research in Southeast Asia: A bibliometric analysis. J Clin Neurosci 2022; 106:159-165. [DOI: 10.1016/j.jocn.2022.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 10/08/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
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余 可. [Brief history, global trends, and Chinese mission of unilateral biportal endoscopy technique]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:1181-1185. [PMID: 36310452 PMCID: PMC9626272 DOI: 10.7507/1002-1892.202207009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/14/2022] [Indexed: 01/24/2023]
Abstract
The current unilateral biportal endoscopy (UBE) technique was originated from Argentina and developed in South Korea, which was rapidly growing and popularizing in China. The adoption of spinal endoscopy, using small cameras placed inside body with continuous water irrigation, providing better surgical field with less tissue dissection and quicker recovery for patients. As with other disciplines, the use of spinal endoscopy in spinal surgery will become increasingly widespread. UBE technique will promote the popularization of spinal endoscopy in China with monoportal endoscopy technique. At the same time, biportal endoscopy has better expansibility, the application of accessory incision may provide solution for more complicated spinal disease. Chinese spine surgeon should better understand the trends in spinal endoscopy, seize the opportunity of the rapidly evolving in spinal healthcare, and to promote the popularization of UBE across the globe.
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Affiliation(s)
- 可谊 余
- 中国医学科学院北京协和医学院北京协和医院骨科(北京 100730)Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100037, P. R. China
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Lin GX, Kotheeranurak V, Chen CM, Hu BS, Rui G. Global research hotspots and trends in the field of spine surgery during the COVID-19 pandemic: A bibliometric and visual analysis. Front Surg 2022; 9:976546. [PMID: 36157412 PMCID: PMC9500354 DOI: 10.3389/fsurg.2022.976546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background The Coronavirus disease-2019 (COVID-19) significantly affected the healthcare and research systems, including spine surgery, throughout the world. A bibliometric analysis allows graphical visualization of the development of an academic field and its frontiers. Since research concerning spine surgery during the COVID-19 pandemic is being constantly upgraded, we conducted a bibliometric analysis of this literature to investigate the current status, research hotspots, and trends in this field. Methods We searched the Web of Science database for literature published (from December 1, 2019, to March 24, 2022) using the terms “COVID-19” OR “2019-nCoV” OR “SARS-CoV-2” AND “spine surgery” OR “spinal surgery” OR “discectomy” OR “decompression” OR “laminectomy” OR “interbody fusion” OR “pedicle screws.” Detailed bibliometric and visual analysis of the number of publications, geographical distribution, institutions, journals, authors, and keywords was done using CiteSpace, VOSviewer, and R-Bibliometrix. Results Of the initially screened 173 articles, we included 84 relevant articles—62 original articles, 10 editorial materials, 8 reviews, and 4 others. The United States, China, Egypt, and Argentina were most actively publishing in the field of spine surgery and COVID-19. The AOSpine International community contributed 7 articles (24 citations). The Hospital for Special Surgery (13.1%) and Johns Hopkins University (13.1%) were institutions with the most publications. Using the Law of Bradford, we found that World Neurosurgery, Global Spine Journal, and European Spine Journal are the core journals in this field, with P. K. Louie being the most influential author. “Elective surgery,” “intensive care,” “telehealth,” “patient satisfaction,” and “follow-up” had the strongest citation bursts. Conclusions During the COVID-19 pandemic, spine surgeons were more concerned with surgical timing, care, treatment, and patient’s quality of life. Accordingly, research hotspots in spine surgery during the pandemic shifted from “early healthcare” to “virus management” and “experience and education.”
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Affiliation(s)
- Guang-Xun Lin
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Vit Kotheeranurak
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Chien-Min Chen
- Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Correspondence: Chien-Min Chen Gang Rui Bao-Shan Hu
| | - Bao-Shan Hu
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Correspondence: Chien-Min Chen Gang Rui Bao-Shan Hu
| | - Gang Rui
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Correspondence: Chien-Min Chen Gang Rui Bao-Shan Hu
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Zhu MT, Li K, Hu BS, Chen CM, Lin GX. Mapping knowledge structure and themes trends in unilateral biportal endoscopic spine surgery: A bibliometric analysis. Front Surg 2022; 9:976708. [PMID: 36157413 PMCID: PMC9489928 DOI: 10.3389/fsurg.2022.976708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background The numerous benefits of unilateral biportal endoscopic (UBE) spine surgery have attracted the attention of many researchers, and a considerable number of relevant clinical studies have been published. However, global research trends in the field of UBE have received little attention. The purpose of this study was to apply bibliometric method to analyze the UBE-related publications to obtain an overview of the research trends in the field of UBE, as well as research hotspots and trends. Methods Web of Science database was searched for articles published until January 31, 2022. CiteSpace was used to analyze the data, which provided graphical knowledge maps. The following factors were applied to all literature: number of publications, distribution, h-index, institutions, journals, authors, and keywords. Results Seventy-three articles were identified. Since 2019, there has been a significant increase in the number of UBE-related publications. The country with the largest number of articles was South Korea (72.6%), followed by China (9.6%), Japan (4.1%), and Egypt (4.1%). South Korea had the highest h-index (16), followed by China (2), Japan (1), and Egypt (1). Leon Wiltse Memorial Hospital was the organization that produced the most papers (12 publications). Heo DH was the most productive author (16 papers) and was the most cited author (35 times). World Neurosurgery published the most papers on UBE (23.3%). The main research hotspots were spinal diseases, decompression, complications, learning curve, and interbody fusion. In addition, the recent concerns were “learning curve,” “interbody fusion,” “management,” and “dural tear.” Conclusions The quantity of publications on UBE research will increase, and South Korea being the major contributor and most prominent country in this field. The findings of our study will provide researchers with practical information on the field of UBE, and identification of mainstream research directions and recent hotspots.
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Affiliation(s)
- Ming-Tao Zhu
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Kunrong Li
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Bao-Shan Hu
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Chien-Min Chen
- Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Guang-Xun Lin
- Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Correspondence: Guang-Xun Lin
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Lin GX, Zhu MT, Kotheeranurak V, Lyu P, Chen CM, Hu BS. Current Status and research hotspots in the field of full endoscopic spine surgery: A bibliometric analysis. Front Surg 2022; 9:989513. [PMID: 36117817 PMCID: PMC9478389 DOI: 10.3389/fsurg.2022.989513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose We aimed to comprehensively analyze the current status, hotspots, and trends in full endoscopic spine surgery (FESS) research using bibliometric analysis and knowledge domain mapping. Methods The Web of Science database was used to screen FESS-related articles published between January 1, 1993 and June 10, 2022. The evaluation involved the following criteria: total number of articles; H-index; and contributions from countries/regions, institutions, journals, and authors. Results A total of 1,064 articles were included. Since 2016, there have been a significant number of publications in the field of FESS. The country/region contributing the largest number of articles was China (37.8%), followed by South Korea (24%), the United States (16.1%), Japan (5.7%), and Germany (5.1%). South Korea (35) had the highest H-index, followed by the United States (27), China (22), Japan (21), and Germany (20). World Neurosurgery (15.7%) published the largest number of FESS-related articles. However, among the top 10 most cited articles, six were published in Spine. The author who contributed the most was S.H. Lee (5.4%), and the largest number of contributions in this field originated from Wooridul Spine Hospital (South Korea; 6.1%). Notably, six of the 10 most published authors in this field were from South Korea. Of the top five productive institutions, three were from South Korea. The keywords with the strongest citation bursts in the field of FESS were “lumbar spine,” “discectomy,” “interlaminar,” “surgical technique,” “follow-up,” “excision,” “thoracic spine,” and “endoscopic surgery.” The 10 clusters generated in this study were: “endoscopic discectomy” (#0), “thoracic myelopathy” (#1), “recurrent lumbar disc herniation” (#2), “low back pain” (#3), “cervical vertebrae” (#4), “lumbar spinal stenosis” (#5), “transforaminal lumbar interbody fusion” (#6), “radiation exposure” (#7), “management” (#8), and “lumbar spine” (#9). Conclusion Global research on FESS is mostly concentrated in a few countries/regions and authors. South Korea has made the largest contribution to the field of FESS. Based on the most cited keyword bursts and clusters, the focus of FESS research was found to include its indications, management, and applications.
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Affiliation(s)
- Guang-Xun Lin
- Department of Orthopedics, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Ming-Tao Zhu
- Department of Neurosurgery, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Vit Kotheeranurak
- Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
| | - Pengfei Lyu
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
- Correspondence: Chien-Min Chen Pengfei Lyu Bao-Shan Hu
| | - Chien-Min Chen
- Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Leisure Industry Management, National Chin-Yi University of Technology, Taichung, Taiwan
- School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Correspondence: Chien-Min Chen Pengfei Lyu Bao-Shan Hu
| | - Bao-Shan Hu
- Department of Orthopedics, the First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- Correspondence: Chien-Min Chen Pengfei Lyu Bao-Shan Hu
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Visconti-Lopez FJ, Solorzano-Salazar DM, Vargas-Fernández R. Neurosurgery Research Productivity in Latin American and Caribbean Countries: A Bibliometric and Visualized Study. World Neurosurg 2022; 165:e401-e411. [PMID: 35724879 DOI: 10.1016/j.wneu.2022.06.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Determine the bibliometric characteristics of scientific articles that address the subject of neurosurgery in Latin America and the Caribbean. METHODS A bibliographic search of original articles published in the Web of Science database up to 2021 was performed, without language restrictions. The terms included in the search strategy were Neurosurgery, neurosurgical procedures, and neurological surgical procedure. Articles according to the inclusion criteria in the Rayyan application were included. Subsequently, a quantitative bibliometric analysis was carried out with the bibliometrix package in R and VOSviewer. RESULTS We identified 882 articles published in 271 journals. The first publication was in 2006, the highest number of publications was in 2021, the annual percentage growth rate was 25.9, and the average number of citations per document was 11.2. The author with the highest number of publications was Teixeira MJ (41 articles), and the University of Sao Paulo had the highest number of articles on this topic. WORLD NEUROSURGERY was the journal with the most publications (120 articles), and the study by Carney et al (2017) was the most cited (1175 citations). The country of corresponding authors with the most publications and the greatest number of total citations was Brazil. Surgery, and Management were the most used keywords plus; however, in the most recent articles Simulation and Guidelines were used. CONCLUSIONS In the past decade, there has been an increase in articles on neurosurgery in Latin America and the Caribbean. Scientific production in neurosurgery must continue to increase in order to promote evidence-based medicine.
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Wang F, Chen K, Lin Q, Ma Y, Huang H, Wang C, Zhou P. Earlier or heavier spinal loading is more likely to lead to recurrent lumbar disc herniation after percutaneous endoscopic lumbar discectomy. J Orthop Surg Res 2022; 17:356. [PMID: 35842677 PMCID: PMC9288683 DOI: 10.1186/s13018-022-03242-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 07/07/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate the clinical features of and risk factors for recurrent lumbar disc herniation (rLDH) after percutaneous endoscopic lumbar discectomy (PELD) in our clinical practice. METHODS A total of 942 consecutive patients who underwent single-level PELD from January 2013 to August 2019 were included. Patients were divided into the recurrence group and the nonrecurrence group. Patient characteristics, radiographic parameters and surgical variables were compared between the two groups. Univariate analysis and multiple logistic regression analysis were adopted to determine the risk factors for recurrence after PELD. RESULTS The prevalence of rLDH was 6.05%. Age, sex, tobacco use, duration of low back pain, body mass index (BMI), occupational lifting, herniated disc type, facet joint degeneration, operation time and time to ambulation were significantly different between the two groups. Univariate analysis showed that age (P < 0.001), sex (P = 0.019), BMI (P = 0.001), current smoking (P < 0.001), occupational lifting (P < 0.001), facet joint degeneration (P = 0.001), operation time (P = 0.002), and time to ambulation (P < 0.001) could be significantly associated with the incidence of rLDH after PELD. Multivariate analysis suggested that an older age (P < 0.001), the male sex (P = 0.017), a high BMI (P < 0.001), heavy work (P = 0.003), grade II facet joint degeneration (P < 0.001) and early ambulation (P < 0.001) were significantly related to rLDH after PELD. CONCLUSIONS An older age, the male sex, a higher BMI, heavy work, grade II facet joint degeneration, and early ambulation are independent significant risk factors for rLDH after PELD. Great importance should be attached to these risk factors to prevent rLDH. We suggest that patients control their weight, avoid heavy work, ambulate at an appropriate time, and perform strengthening rehabilitation exercises to reduce the incidence of rLDH.
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Affiliation(s)
- Fei Wang
- Department of Orthopedic Surgery, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China
| | - Kai Chen
- Department of Orthopedics, Shanghai Changhai Hospital of Naval Medical University, Shanghai, China
| | - Qiushui Lin
- Department of Orthopedics, Shanghai Changhai Hospital of Naval Medical University, Shanghai, China
| | - Yuegang Ma
- Department of Orthopedic Surgery, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China
| | - Hao Huang
- Department of Orthopedic Surgery, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China
| | - Chuanfeng Wang
- Department of Orthopedic Surgery, Tenth Affiliated Hospital of Tongji Medical University, Shanghai, China.
| | - Ping Zhou
- Department of Orthopedic Surgery, Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China.
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Banshal SK, Verma MK, Yuvaraj M. Quantifying global digital journalism research: a bibliometric landscape. LIBRARY HI TECH 2022. [DOI: 10.1108/lht-01-2022-0083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PurposeThe purpose of this paper is to present a comprehensive analysis of the current status and development of the digital journalism field from 1987 to 2021 using the Dimensions database.Design/methodology/approachUsing the Dimensions.ai database, 1734 articles were identified through search strategies which were published from 1987 to 2021. The downloaded results were analysed using specific parameters with the help of bibliometric and science mapping tools: Biblioshiny, VOSviewer and CiteSpace. The key contributions of the present comprehensive bibliometric study of the digital journalism field can be seen in terms of the following aspects: (1) Publication analysis from the perspectives of publication growth, key journals, contributing authors, institutions and countries done through Biblioshiny package. (2) Citation network analysis from the perspective of co-citation structure of papers, authors, countries and institutions done through VOSviewer. (3) Timeline analysis and keywords burst detection to identify hotspots and research trends in digital journalism with the help of CiteSpace.FindingsThe first paper with the keyword digital journalism was published in the year 1989. From 2011 onwards, there has been growth in digital journalism literature. The most popular journal in digital journalism studies is Digital Journalism, Journalism, Journalism Practice, Journalism Studies. Lewis, S.C. has contributed the most number of papers in digital journalism. Further, authors from the countries the USA, Spain, Brazil and UK have contributed immensely. The citation network of authors, institutions and countries contributing to digital journalism studies has also been explored in the study. Through burst analysis, hot topics in digital journalism were identified.Originality/valueThe paper provides a complete overview of the growth of digital journalism literature published from 1987 to 2021. The originality of this work lies in the triangulation of Biblioshiny, VOSviewer and CiteSpace software to present various aspects of bibliometric study. Findings of the study can help the researchers to identify areas as well as journals, authors, institutions working actively in the field of digital journalism.
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Bisphosphates for Osteoporosis: A Bibliometric Analysis of the Most Cited Articles. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:4565069. [PMID: 35646145 PMCID: PMC9132659 DOI: 10.1155/2022/4565069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/27/2021] [Accepted: 04/26/2022] [Indexed: 11/18/2022]
Abstract
Osteoporosis has become a major public health problem and bisphosphates treatment for osteoporosis is a rapidly developing research field. Every year, plenty of studies devoted to the treatment of osteoporosis are published, giving clinicians a new perspective on bisphosphates treatment for osteoporosis. However, the quality of the scientific papers in this area is unclear. The aim of the present study was to characterize the 100 top-cited articles regarding bisphosphates treatment for osteoporosis. This analysis provides an accessible list for practitioners of endocrinology, pharmacy, epidemiology, imaging, surgery, and scientific research to identify the most frequently cited literature and better understand the future direction.
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Surgeons’ Perspective, Learning Curve, Motivation, and Obstacles of Full-Endoscopic Spine Surgery in Thailand: Results From A Nationwide Survey. BIOMED RESEARCH INTERNATIONAL 2022; 2022:4971844. [PMID: 35309165 PMCID: PMC8933085 DOI: 10.1155/2022/4971844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/01/2022] [Indexed: 11/22/2022]
Abstract
Objective To report a nationwide survey of the endoscopic spine surgeons across Thailand. Furthermore, the survey will be focused on the perspective of experience, learning curve, motivations, and obstacles at the beginning of their practices. Materials and Methods The online survey consisting of 16 items was distributed to spine surgeons who are performing endoscopic spine surgery in Thailand via the Google forms web-based questionnaire to investigate participants' demographics, backgrounds, experience in endoscopic spine surgery, motivations, obstacles, and future perspectives. The data was recorded from January 7, 2020 to January 21, 2022. Descriptive statistics were used for analysis. Results A total of 42 surveys were submitted by 6 neurosurgeons (14.3%) and 36 orthopedic surgeons (85.7%). From the surgeons' perspective, the average number of cases that should be performed until one feels confident, consistently good outcomes, and has minimal complications was 27.44 ± 32.46 cases. For surgeons who starting the endoscopic spine practice, at least 3 workshop participation is needed. Personal interest (39 selected responses) and trending marketing or business purpose (25 selected responses) were the primary motivators for endoscopic spine surgery implementation. Lack of support (18 selected responses) and afraid of complications (16 selected responses) were pertinent obstacles to endoscopic spine surgery implementation. Conclusions The trend of endoscopic spine surgery has continued to grow in Thailand, shown by the rate of implementation of endoscopic spine surgery reported by Thai spine surgeons. The number of appropriate cases until one feels confident was around 28 cases. The primary motivator and obstacles were personal interest and lack of support.
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Huang K. Global trends of researches on bone metastasis: A bibliometric and visualization study. Medicine (Baltimore) 2022; 101:e28761. [PMID: 35147101 PMCID: PMC8830846 DOI: 10.1097/md.0000000000028761] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/13/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Bone metastasis (BM) has become an important health problem. In recent years, studies on BM are growing rapidly, but there were no bibliometric studies regarding BM. This study aimed to illustrate the overall knowledge structure and development trends of BM. METHODS Research datasets were acquired from the Web of Science database. The time span was defined as "1980-2020". VOS viewer and Citespace software was provided to analyze the data and generate visualization knowledge maps. Annual trends of publications, distribution, H-index status, co-authorship status, and research hotspots were analyzed. RESULTS Six hundred eighty-two publications met the requirement. USA published most papers (264, 38.7%), and both total citations (13,997) and H-index (57) of USA ranked first. The most productive institution on BM is Amgen Inc. (43). Supportive Care in Cancer (24) published the most papers on BM. "Safety", "skeletal related event", "open label", "management", "health", and "prognosis" are the research hotspots in the recent years. CONCLUSION In this study, we conduct a systematic and comprehensive analysis on the research in BM field. The publication number was rising in recent years stably. USA contributed mostly not only in quality, but also in quantity. Amgen Inc. published the largest number of articles, Supportive Care in Cancer was the most productive journal related to BM. "Safety", "skeletal related event", "open label", "management", "health", and "prognosis" are the research hotspots in recent years. We believe this study can not only show the global research overview in past 40 years but also point the research trend of BM in the future.
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Li WS, Yan Q, Chen WT, Li GY, Cong L. Global Research Trends in Robotic Applications in Spinal Medicine: A Systematic Bibliometric Analysis. World Neurosurg 2021; 155:e778-e785. [PMID: 34500099 DOI: 10.1016/j.wneu.2021.08.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/29/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We systematically evaluated the global research trends in robotic application on the spine through bibliometric analysis and mapping knowledge domains. METHODS A systematic literature search was performed of the PubMed and Web of Science, including the Science Citation Index Expanded, databases. The number, countries, journals, and authors of the publications, total citations, average publication year, and institution sources were analyzed using Microsoft Excel, the Online Analysis Platform of Bibliometrics, and VOSviewer. The hotspots were analyzed and visualized using VOSviewer. RESULTS We identified a total of 2135 publications. The United States ranked first in the number of publications (n = 824; 38.63%) and frequency of citations (n = 29,075). Northwestern University had the highest number of publications (n = 67) and Harvard University the highest number of citations (n = 4198). The Journal of NeuroEngineering and Rehabilitation published the largest number of reports (n = 73), and the most frequently cited journal was Nature (n = 3844 citations). The research hotspots were divided into 3 categories analyzed by VOSviewer: rehabilitation, basic science, and surgery. According to the average publication year, the most recent hotspot was radiation exposure, and the earliest hotspot was radiosurgery. CONCLUSIONS The number of studies of robotic application on the spine has continued to increase. The United States was the greatest contributor to robotic applications on the spine. Robot-assisted rehabilitation for neurological and orthopedic lesions is still a major research hotspot. The range of robotic applications on the spine has expanded from assisted rehabilitation to assisted rehabilitation and surgery.
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Affiliation(s)
- Wei-Shang Li
- Department of Orthopedic Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Qi Yan
- Department of Surgery, University of Texas Health San Antonio, San Antonio, Texas, USA
| | - Wen-Ting Chen
- Disease Control and Prevention Center of China Railway Shenyang Bureau Group Corporation, Shenyang, People's Republic of China
| | - Gao-Yu Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Lin Cong
- Department of Orthopedic Surgery, The First Hospital of China Medical University, Shenyang, People's Republic of China.
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Evaluation of Two Methods (Inside-Out/Outside-In) Inferior Articular Process Resection for Uniportal Full Endoscopic Posterolateral Transforaminal Lumbar Interbody Fusion: Technical Note. Brain Sci 2021; 11:brainsci11091169. [PMID: 34573190 PMCID: PMC8470686 DOI: 10.3390/brainsci11091169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/26/2021] [Accepted: 08/31/2021] [Indexed: 01/14/2023] Open
Abstract
Objective: There is limited literature comparing the uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion outside-in approach (ETLIF (O)) with the inside-out approach (ETLIF (I)). Methods: Radiological evaluation was performed on disc height restoration and coronal wedging angle, and operation time (inferior articular process resection time/total operation time) and clinical evaluation were made. Result: 48 cases of inside-out and 38 cases of outside-in cases were included. Compared to inside-out, the outside-in approach had significantly less operative time required to resect inferior articular process: 36.55 ± 10.37, and total operative time: 87.45 ± 20.14 min compared to 49.83 ± 23.97 and 102.56 ± 36.53 min, respectively, for the inside-out approach, p < 0.05. Compared to the preoperative state, both cohorts achieved significant improvement of VAS and ODI at post-operative 1 week, 3 months and at final follow up. Both cohorts achieved statistically significant increased disc height with 5.00 ± 2.87 mm, 5.49 ± 2.33 mm and statistically significant improvement in coronal wedge angle with 1.76 ± 1.63°, 3.24 ± 2.92° in the inside-out and outside-in approaches respectively. Conclusions: Complete removal of inferior articular process is the key part of endoscopic fusion with two methods that can be applied: an inside-out approach or an outside-in approach. Comparing both techniques, the outside-in approach has a shorter operative time required for inferior articular process resection and total length of operation with similar good clinical and radiological outcomes.
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Yu Y, Jiang Y, Xu F, Mao Y, Yuan L, Li C. A novel vertebral trench technique (VTT) involving transforaminal endoscopic lumbar foraminotomy (TELF) for very highly up-migrated lumbar disc herniation above L5. BMC Musculoskelet Disord 2021; 22:693. [PMID: 34391400 PMCID: PMC8364045 DOI: 10.1186/s12891-021-04548-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Percutaneous endoscopic lumbar discectomy (PELD) has become popular for the treatment of symptomatic lumbar disc herniation (LDH). The very highly up-migrated lumbar disc herniation (VHUM-LDH) is difficult to remove under PELD. The purpose of this research is to investigate the feasibility, clinical efficacy and operative nuances of a novel VTT involving TELF for this type of herniation. METHODS Eleven patients with very highly up-migrated LDH who underwent VTT involving TELF discectomy from May 2016 to May 2019 were included in this study. The operative time, length of hospital stay, and postoperative complications were recorded. Pre-and postoperative radiologic findings were investigated. All the patients were followed more than 1 year. The visual analogue score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores and modified MacNab criteria were used to assess surgical efficacy. RESULTS All the 11 patients underwent successful surgery. We compared the VAS, ODI, and JOA scores before and after surgery. The differences were statistically significant (P < 0.05). According to the modified MacNab criteria, 10 patients were assessed as "excellent", 1 patient was assessed as "good" at the last follow up. CONCLUSION The novel VTT involving TELF discectomy is a supplement to the traditional PELD. This technique enables the endoscope with working cannula to get closer the sequestrated nucleus pulposus without irritating the exiting nerve root, and facilitates the nucleus pulposus be removed successfully under direct visualization. The VTT involving TELF discectomy can be a safe, effective and feasible surgical procedure for the treatment of LDH with very highly up-migrated.
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Affiliation(s)
- Yong Yu
- Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Ye Jiang
- Department of Neurosurgery, Minhang Hospital, Fudan University, Shanghai, 201199, China
| | - Fuling Xu
- Department of Neurosurgery, Minhang Hospital, Fudan University, Shanghai, 201199, China
| | - Yuhang Mao
- Department of Neurosurgery, Minhang Hospital, Fudan University, Shanghai, 201199, China
| | - Lutao Yuan
- Department of Neurosurgery, Minhang Hospital, Fudan University, Shanghai, 201199, China
| | - Chen Li
- Department of Neurosurgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
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Yin M, Xu C, Ma J, Ye J, Mo W. A Bibliometric Analysis and Visualization of Current Research Trends in the Treatment of Cervical Spondylotic Myelopathy. Global Spine J 2021; 11:988-998. [PMID: 32869687 PMCID: PMC8258815 DOI: 10.1177/2192568220948832] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
STUDY DESIGN Bibliometric analysis. OBJECTIVE Cervical spondylotic myelopathy (CSM) has become the most common cause of spinal cord dysfunction. Many topics of CSM still remain controversial. This study aimed to illustrate the overall knowledge structure and development trends of CSM. METHODS Research data sets were acquired from the Web of Science database and the time span was defined as "2000 to 2019." VOS viewer and Citespace software was used to analyze the data and generate visualization knowledge maps. Annual trends of publications, distribution, H-index status, co-authorship status, and research hotspots were analyzed. RESULTS A total of 2367 publications met the requirement. The largest number of articles was from the United States, followed by Japan, China, Canada, and India. The highest H-index was found for articles from the United States. The highest number of articles was published in Spine. The cooperation between the countries, institutes, and authors were relatively weak. Cervical sagittal alignment, predictive factor, diffusion tensor imaging, and the natural history of CSM may become a frontier in this research field. CONCLUSION The number of publications showed an upward trend with a stable rise. Most of the publications are limited to a few countries and institutions with relatively weak interaction. The United States, Canada, Japan, China, and India have made significant contributions to the field of CSM. The United States is the country with the highest productivity, not only in quality but also in quantity. Cervical sagittal alignment, predictive factor, diffusion tensor imaging, and the natural history of CSM are the research hotspots in the recent years.
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Affiliation(s)
- Mengchen Yin
- LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Mengchen Yin and Chongqing Xu are co–first authors of this article, contributing equally to the design and drafting of the manuscript
| | - Chongqing Xu
- LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Mengchen Yin and Chongqing Xu are co–first authors of this article, contributing equally to the design and drafting of the manuscript
| | - Junming Ma
- LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jie Ye
- LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen Mo
- LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Wen Mo, Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Ahmad T, Murad MA, Nasir S, Musa TH, Baig M, Hui J. Trends in hepatitis A research indexed in the Web of Science: a bibliometric analysis over the period from 1985 to 2019. Hum Vaccin Immunother 2021; 17:3221-3229. [PMID: 33945397 DOI: 10.1080/21645515.2021.1914804] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE A bibliometric analysis was conducted to build an all-inclusive view of the status of research on hepatitis A virus (HAV) for facilitating researchers, health professionals, and policymakers to understand the characteristics of research output in this particular domain. METHODS A comprehensive search was conducted in the Web of Science database. The obtained data were exported into Microsoft Excel 2019, OriginPro 2018 and VOSviewer software for windows. RESULTS From 1985 to 2019, a total of 5,950 studies on HAV were published, with an overall h-index of 105, and 90,350 total citations. The most cited article on HAV was "Classification of chronic viral hepatitis: a need for reassessment" authored by Scheuer in the Journal of Hepatology with a total of 1,121 citations. The most cited article on HAV vaccine was "A controlled trial of a formalin-inactivated hepatitis A vaccine in healthy children" by Werzberger et al. in the New England Journal of Medicine with 401 citations. The most frequent year of publication was 2019 (n = 250). The largest number of studies were funded by the United States Department of Health Human Services (n = 199). The organization with the highest number of publications was the United States Centers for Disease Control and Prevention (n = 228). The United State of America (n = 1,500) was the country with the most publications. 'Vaccine' was the leading journal with 299 publications. CONCLUSIONS The highest numbers of studies were published in developed countries. There is a clear need for interdisciplinary research approaches to evaluate and intervene in HAV endemic areas.
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Affiliation(s)
- Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Manal Abdulaziz Murad
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saima Nasir
- Allama Iqbal Open University, Islamabad, Islamic Republic of Pakistan
| | - Taha Hussein Musa
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jin Hui
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
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Zhao T, Shen J, Zheng B, Huang Y, Jin M, Morizane K, Shao H, Chen X, Zhang J. The 100 Most-Cited Publications in Endoscopic Spine Surgery Research. Global Spine J 2021; 11:587-596. [PMID: 32677522 PMCID: PMC8119913 DOI: 10.1177/2192568220934740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN A bibliometric review of the literature. OBJECTIVE Our objective was to identify and analyze the 100 most-cited publications in the field of endoscopic spine surgery (ESS). METHODS In order to determine the top cited 100 articles, a 3-step approach was employed. First, the 100 most-cited ESS studies were identified using the key phrase "endoscopic spine surgery." Then, 8 keywords were identified from the 100 studies of step 1 were used to conduct a second round searching in all databases of the Web of Science. Finally, when the results of the first and second steps were overlapped, duplicated studies were removed. The 100 top-cited articles were used for further analysis. RESULTS The citation number of the top 100 most-cited articles ranged from 44 to 236 with a mean value of 84.4. The most productive periods were from 2001 to 2010. The majority of publications came from Spine and Neurosurgery, where Spine holds the largest number of 35 articles, followed by Neurosurgery with 13 articles. Overall, 10 countries contributed to the 100 articles, with the most productive country being the United States, followed by Germany and Korea. CONCLUSION This bibliometric study is meant to produce a list of intellectual milestones in the field of ESS. This article's identification of the most influential articles in the field of ESS gives us a unique and comprehensive insight into the development of ESS in the past several decades.
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Affiliation(s)
- Tingxiao Zhao
- Zhejiang Provincial People’s
Hospital, Hangzhou, Zhejiang, China,Hangzhou Medical College People’s Hospital, Hangzhou, Zhejiang,
China,Bengbu Medical College, Bengbu, Anhui, China,These authors contribute equally to this study
| | - Jianjian Shen
- Cixi People’s Hospital, Ningbo, Zhejiang, China,These authors contribute equally to this study
| | - Biao Zheng
- Hangzhou Yuhang Orthopedics Hospital, Hangzhou, Zhejiang,
China,These authors contribute equally to this study
| | - Yazeng Huang
- Zhejiang Provincial People’s
Hospital, Hangzhou, Zhejiang, China,Hangzhou Medical College People’s Hospital, Hangzhou, Zhejiang,
China,Bengbu Medical College, Bengbu, Anhui, China
| | - Mengran Jin
- Zhejiang Provincial People’s
Hospital, Hangzhou, Zhejiang, China,Hangzhou Medical College People’s Hospital, Hangzhou, Zhejiang,
China
| | | | - Haiyu Shao
- Zhejiang Provincial People’s
Hospital, Hangzhou, Zhejiang, China,Hangzhou Medical College People’s Hospital, Hangzhou, Zhejiang,
China
| | - Xinji Chen
- Zhejiang Provincial People’s
Hospital, Hangzhou, Zhejiang, China,Hangzhou Medical College People’s Hospital, Hangzhou, Zhejiang,
China
| | - Jun Zhang
- Zhejiang Provincial People’s
Hospital, Hangzhou, Zhejiang, China,Hangzhou Medical College People’s Hospital, Hangzhou, Zhejiang,
China,Jun Zhang, Department of Orthopedics,
Zhejiang Provincial People’s Hospital, Shangtang Road 158#, Hangzhou, Zhejiang,
310014, China.
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35
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Lewandrowski KU, Hellinger S, De Carvalho PST, Freitas Ramos MR, Soriano-SáNchez JA, Xifeng Z, Calderaro AL, Dos Santos TS, Ramírez León JF, de Lima E SilvA MS, Dowling Á, DataR G, Kim JS, Yeung A. Dural Tears During Lumbar Spinal Endoscopy: Surgeon Skill, Training, Incidence, Risk Factors, and Management. Int J Spine Surg 2021; 15:280-294. [PMID: 33900986 DOI: 10.14444/8038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Incidental dural tears during lumbar endoscopy can be challenging to manage. There is limited literature on their appropriate management, risk factors, and the clinical consequences of this typically uncommon complication. MATERIALS AND METHODS To improve the statistical power of studying durotomy with lumbar endoscopy, we performed a retrospective survey study among endoscopic spine surgeons by email and chat groups on social media networks, including WhatsApp and WeChat. Descriptive and correlative statistics were done on the surgeons' recorded responses to multiple-choice questions. Surgeons were asked about their clinical experience with spinal endoscopy, training background, the types of lumbar endoscopic decompression they perform by approach, the decompression instruments they use, and incidental durotomy incidence with routine lumbar endoscopy. RESULTS There were 689 dural tears in 64 470 lumbar endoscopies, resulting in an incidental durotomy incidence of 1.07%. Seventy percent of the durotomies were reported by 20.4% of the surgeons. Eliminating these 19 outlier surgeons yielded an adjusted durotomy rate of 0.32. Endoscopic stenosis decompression (54.8%; P < .0001), rather than endoscopic discectomy (44.1%; 41/93), was significantly more associated with durotomy. Medium-sized dural tears (1-10 mm) were the most common (52.2%; 48/93). Small pinhole durotomies (less than 1 mm) were the second most common type (46.7%; 43/93). Rootlet herniations were seen by 46.2% (43/93) of responding surgeons. The posterior dural sac injury during the interlaminar approach (57%; 53/93) occurred more frequently than traversing nerve-root injuries (31.2%) or anterior dural sac (23.7%; 22/93). Exiting nerve-root injuries (10.8%;10/93) were less common. Over half of surgeons did not attempt any repair or closure (52.2%; 47/90). Forty percent (36/90) used sealants. Only 7.8% (7/90) of surgeons attempted an endoscopic repair or sutures (11.1%; 10/90). DuralSeal was the most commonly used brand of commercially available sealant used (42.7%; 35/82). However, other sealants such as Tisseal (15.9%; 13/82), Evicel (2.4%2/82), and additional no-brand sealants (38; 32/82) were also used. Nearly half of the patients (48.3%; 43/89) were treated with 24-48 hours of bed rest. The majority of participating surgeons (64%; 57/89) reported that the long-term outcome was unaffected. Only 18% of surgeons reported having seen the development of a postoperative cerebrospinal fluid (CSF)-fistula (18%;16/89). However, the absolute incidence of CSF fistula was only 0.025% (16/64 470). Severe radiculopathy with dysesthesia; sensory loss; and motor weakness in association with an incidental durotomy were reported by 12.4% (11/89), 3.4% (3/89), and 2.2% (2/89) of surgeons, respectively. CONCLUSIONS The incidence of dural tears with lumbar endoscopy is about 1%. The incidence of durotomy is higher with the use of power drills and the interlaminar approach. Stenosis decompression that typically requires the more aggressive use of these power instruments has a slightly higher incidence of dural tears than does endoscopic decompression for a herniated disc. Most dural tears are small and can be successfully managed with mechanical compression with Gelfoam and sealants. Two-thirds of patients with incidental dural tears had an entirely uneventful postoperative course. The remaining one-third of patients may develop a persistent CSF leak, radiculopathy with dysesthesia, sensory loss, or motor function loss. Patients should be educated preoperatively and reassured. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, Arizona.,Department of Neurosurgery, UNIRIO, Rio de Janeiro, Brazil
| | | | | | - Max Rogério Freitas Ramos
- Orthopedics and Traumatology, Federal University of the Rio de Janeiro State UNIRIO, Brazil.,Orthopedic Clinics, Gaffrée Guinle University Hospital, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Zhang Xifeng
- The Chinese PLA General Hospital, Beijing, China
| | - André Luiz Calderaro
- Centro Ortopedico Valqueire, Departamento de Full Endoscopia da Coluna Vertebral, Rio de Janeiro, Brazil
| | | | - Jorge Felipe Ramírez León
- Reina Sofía Clinic and Center of Minimally Invasive Spine Surgery, Bogotá, Colombia.,Spine Surgery Program, Universidad Sanitas, Bogotá, Colombia
| | | | - Álvaro Dowling
- Endoscopic Spine Clinic, Santiago, Chile.,Department of Orthopaedic Surgery, USP, Ribeirão Preto, Brazil
| | - Girish DataR
- Center for Endoscopic Spine Surgery, Sushruta Hospital for Orthopaedics and Traumatology, Miraj, Sangli, Maharashtra, India
| | - Jin-Sung Kim
- Seoul Saint Mary's Hospital, Seocho-gu, Seoul, Republic of Korea
| | - Anthony Yeung
- University of New Mexico School of Medicine, Albuquerque, New Mexico.,Desert Institute for Spine Care, Phoenix, AZ
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Ahmad T, Hua L, Khan M, Nabi G, Khan S, Çinar İÖ, Jalal S, Baig M, Jin H, Wang X. Global Research Trends in Pediatric Trauma From 1968 to 2021: A Bibliometric Analysis. Front Pediatr 2021; 9:762531. [PMID: 34778152 PMCID: PMC8581173 DOI: 10.3389/fped.2021.762531] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 09/30/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction: Every year, millions of children die from preventable causes worldwide. According to World Health Organization, injuries are the leading cause of disability and death among all age groups below 60 years. Aim: This study aimed to evaluate the global research outcomes and trends, and some key bibliometric indicators in pediatric trauma. Methods: A descriptive bibliometric analysis study was designed. On June 14, 2021, an electronic search was performed in the Web of Science Core Collection database using the potential searching keywords "Pediatric AND Trauma" in the title field without any limitations. The search was performed using the Boolean search query method. The data were downloaded in plaintext and comma-separated values format. The required graphs were generated using OriginPro 2018. Furthermore, the data were transferred to HistCite™ software for bibliometric analysis. In addition, the obtained data were plotted for network visualization mapping using VOSviewer software version 1.6.15 for windows. Results: A total of 2,269 documents were included in the final analysis. The included documents were authored by 7,894 authors and published in 395 research and academic journals, mainly in the English language (n = 2,222). The main document types were articles (n = 1,276, citations = 18,244), and meeting abstracts (n = 331, citations = 19). Pediatric (n = 2,269) and trauma (n = 2,257) were the most widely used keywords. The most productive year was 2019 (n = 184, citations = 527). The most prolific author was Upperman JS (n = 29, citations = 202). The most attractive journals in pediatric trauma research were The Journal of Trauma and Acute Care Surgery (n = 290, citations = 5,199) and the Journal of Pediatric Surgery (n = 256, citations = 5,088). The most active institute was the University of California System (n = 110). The most dominant country was the United States of America (USA) (n = 1,620, citations = 22,983). The USA and Canada had the highest total link strength, 103 and 70, respectively. Conclusion: This study provides a comprehensive overview of research output in pediatric trauma. The USA continues to dominate scientific research and funding in pediatric trauma. Findings of the current study will help the researchers and clinicians to understand the recent achievements and research frontiers. Collaborative research initiative needs to be established between institutions in developed and developing countries and among researchers.
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Affiliation(s)
- Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Linlin Hua
- Department of Advanced Medical Research, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Muhammad Khan
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, Mansehra, Pakistan
| | - Ghulam Nabi
- Key Laboratory of Animal Physiology, Biochemistry and Molecular Biology of Hebei Province, College of Life Sciences, Hebei Normal University, Shijiazhuang, China
| | - Suliman Khan
- Department of Advanced Medical Research, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - İlgün Özen Çinar
- Department of Public Health Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
| | | | - Sajid Jalal
- Department of Pathophysiology, College of Basic Medical Sciences, Dalian Medical University, Dalian, China
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Xiaoyan Wang
- Department of Child Healthcare, Hubei Maternal and Children's Hospital, Wuhan, China
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Huang Z, Wu L, Wang W, Zhou Y, Zhang X, Huang Y, Pan X, Wu C. Unraveling the publication trends in inhalable nano-systems. JOURNAL OF NANOPARTICLE RESEARCH : AN INTERDISCIPLINARY FORUM FOR NANOSCALE SCIENCE AND TECHNOLOGY 2021; 24:10. [PMID: 35018138 PMCID: PMC8739024 DOI: 10.1007/s11051-021-05384-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/06/2021] [Indexed: 05/02/2023]
Abstract
UNLABELLED Nano-systems (size range: 1 ~ 1000 nm) have been widely investigated as pulmonary drug delivery carriers, and the safety of inhaled nano-systems has aroused general interests. In this work, bibliometric analysis was performed to describe the current situation of related literature, figure out the revolutionary trends, and eventually forecast the possible future directions. The relevant articles and reviews from 2001 to 2020 were retrieved from the Web of Science Core Collection. The documents were processed by Clarivate Analytic associated with Web of Science database, Statistical Analysis Toolkit for Informetric, bibliometric online platform and VOSviewer, and the data were visualized. The bibliometric overview of the literature was described, citation analysis was performed, and research hotspots were showcased. The bibliometric analysis of 3362 documents of interest indicated that most of the relevant source titles were in the fields of toxicology, pharmacy, and materials science. The three research hotspots were the biological process of inhalable nano-systems in vivo, the manufacture of inhalable nano-systems, and the impact of nano-systems on human health in the environment. Toxicity and safety have always been the keywords. The USA was the major contributing country, and international collaboration and co-authorship were common phenomena. The general situation and development trend of literature of inhalable nano-systems were summarized. It was anticipated that bibliometrics analysis could provide new ideas for the future research of inhalable nano-systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11051-021-05384-1.
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Affiliation(s)
- Zhengwei Huang
- College of Pharmacy, Jinan University, Guangzhou, 510006 People’s Republic of China
| | - Linjing Wu
- College of Pharmacy, Jinan University, Guangzhou, 510006 People’s Republic of China
| | - Wenhao Wang
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, 510006 People’s Republic of China
| | - Yue Zhou
- College of Pharmacy, Jinan University, Guangzhou, 510006 People’s Republic of China
| | - Xuejuan Zhang
- College of Pharmacy, Jinan University, Guangzhou, 510006 People’s Republic of China
| | - Ying Huang
- College of Pharmacy, Jinan University, Guangzhou, 510006 People’s Republic of China
| | - Xin Pan
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou, 510006 People’s Republic of China
| | - Chuanbin Wu
- College of Pharmacy, Jinan University, Guangzhou, 510006 People’s Republic of China
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38
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Montenegro TS, Hines K, Partyka PP, Harrop J. Reference accuracy in spine surgery. J Neurosurg Spine 2020; 34:22-26. [PMID: 32977312 DOI: 10.3171/2020.6.spine20640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/01/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The references list is an important part of a scientific article that serves to confirm the accuracy of the authors' statements. The goal of this study was to evaluate the reference accuracy in the field of spine surgery. METHODS Four major peer-reviewed spine surgery journals were chosen for this study based on their subspecialty clinical impact factors. Sixty articles per journal were selected from 12 issues each of The Spine Journal, Spine, and Journal of Neurosurgery: Spine, and 40 articles were selected from 8 issues of Global Spine Journal, for a total of 220 articles. All the articles were published in 2019 and were selected using computer-generated numbers. From the references list of each article, one reference was again selected by using a computer-generated number and then checked for citation or quotation errors. RESULTS The results indicate that 84.1% of articles have a minor citation error, 4.5% of articles have a major citation error, 9.5% of articles have a minor quotation error, and 9.1% of articles have a major quotation error. Journal of Neurosurgery: Spine had the fewest citation errors compared with the other journals evaluated in this study. Using chi-square analysis, no association was determined between the occurrence of errors and potential markers of reference mistakes. Still, statistical significance was found between the occurrence of citation errors and the spine journals tested. CONCLUSIONS In order to advance medical treatment and patient care in spine surgery, detailed documentation and attention to detail are necessary. The results from this study illustrate that improved reference accuracy is required.
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Affiliation(s)
- Thiago S Montenegro
- 1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
| | - Kevin Hines
- 1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
| | - Paul P Partyka
- 2School of Osteopathic Medicine, Rowan University, Stratford, New Jersey; and
- 3Department of Biomedical Engineering, Rowan University, Glassboro, New Jersey
| | - James Harrop
- 1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania
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Chung AS, Wang JC. The Rationale for Endoscopic Spinal Surgery. Neurospine 2020; 17:S9-S12. [PMID: 32746511 PMCID: PMC7410389 DOI: 10.14245/ns.2040104.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/10/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Andrew S Chung
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jeffrey C Wang
- Department of Orthopedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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40
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Quillo-Olvera J, Quillo-Reséndiz J, Quillo-Olvera D, Barrera-Arreola M, Kim JS. Ten-Step Biportal Endoscopic Transforaminal Lumbar Interbody Fusion Under Computed Tomography-Based Intraoperative Navigation: Technical Report and Preliminary Outcomes in Mexico. Oper Neurosurg (Hagerstown) 2020; 19:608-618. [DOI: 10.1093/ons/opaa226] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 05/23/2020] [Indexed: 12/13/2022] Open
Abstract
Abstract
BACKGROUND
The principal advantage of intraoperative spinal navigation is the ease of screw placement. However, visualization and the integration of navigation can be explored with the use of navigation-guided full-endoscopic techniques.
OBJECTIVE
To describe the stepwise intraoperative navigation-assisted unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) technique and to present our preliminary results in a Mexican population.
METHODS
A 10-step summary of the UBE-TLIF operative technique was described, and the clinical and radiological results are presented and analyzed.
RESULTS
A total of 7 patients were treated. We observed the value of integrating navigation and endoscopic visualization when decompression had to be performed.
CONCLUSION
Together, intraoperative navigation and direct visualization through the endoscope may be a useful surgical tool for surgeons with experience in endoscopic spinal surgery.
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Affiliation(s)
- Javier Quillo-Olvera
- The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Department of Neurosurgery, Spine Clinic at Hospital Star Médica, Querétaro City, Mexico
| | - Javier Quillo-Reséndiz
- The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Department of Neurosurgery, Spine Clinic at Hospital Star Médica, Querétaro City, Mexico
| | - Diego Quillo-Olvera
- The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Department of Neurosurgery, Spine Clinic at Hospital Star Médica, Querétaro City, Mexico
| | - Michelle Barrera-Arreola
- The Brain and Spine Care, Minimally Invasive Spine Surgery Group, Department of Neurosurgery, Spine Clinic at Hospital Star Médica, Querétaro City, Mexico
| | - Jin-Sung Kim
- Department of Neurosurgery, Seoul St. Mary's Hospital, Spine Center, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Shin Y, Sunada H, Shiraishi Y, Hosokawa M, Koh Y, Tei R, Aketa S, Motoyama Y, Yonezawa T, Nakase H. Navigation-assisted full-endoscopic spine surgery: a technical note. JOURNAL OF SPINE SURGERY 2020; 6:513-520. [PMID: 32656389 DOI: 10.21037/jss-2019-fess-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Full-endoscopic spine surgery (FESS) necessitates the use of X-ray fluoroscopy for intraoperative guidance and orientation. However, the two-dimensional X-ray fluoroscopic images do not provide real-time guidance. The authors developed a new real-time three-dimensional (3D) navigation technique for FESS that entails the use of intraoperative cone beam computed tomography (CBCT) in a hybrid operating room (OR). Methods A total of 23 patients undergoing FESS using real-time 3D navigation system were enrolled. Preoperative and intraoperative CBCT data were registered in the navigation system. The 3D navigation was used to intraoperatively determine the trajectory and obtain position information. The feasibility and usefulness of the navigation system were retrospectively analyzed. Results Twenty patients had lumbar spine disease, whereas three patients had cervical spine disease. The 3D navigation was successfully used for intraoperative guidance and provided accurate information in all patients. X-ray fluoroscopy was not required in any of the patients. No complications associated with the use of 3D navigation system were encountered. Conclusions The use of real-time 3D navigation system in the hybrid OR was found to be safe and effective in providing intraoperative guidance for FESS.
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Affiliation(s)
- Yasushi Shin
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Hiromu Sunada
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Yuki Shiraishi
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Makoto Hosokawa
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Yumi Koh
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Rinsei Tei
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Shuta Aketa
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Yasushi Motoyama
- Department of Neurosurgery, Nara Medical University, Nara, Japan
| | - Taiji Yonezawa
- Department of Neurosurgery, Osaka Police Hospital, Osaka, Japan
| | - Hiroyuki Nakase
- Department of Neurosurgery, Nara Medical University, Nara, Japan
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Kim JS, Yeung A, Lokanath YK, Lewandrowski KU. Is Asia truly a hotspot of contemporary minimally invasive and endoscopic spinal surgery? JOURNAL OF SPINE SURGERY 2020; 6:S224-S236. [PMID: 32195430 DOI: 10.21037/jss.2019.12.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background The purpose of this study was to analyze the training in relation to practice patterns of surgeons in Asia who perform lumbar endoscopic spinal surgery in comparison to surgeons the world over. The authors solicited responses to an online survey sent to spine surgeons. Methods Pearson Chi-Square measures, Kappa statistics, and linear regression analysis of agreement or disagreement were performed by analyzing the distribution of variances of responses in relation to surgeons' training using statistical package SPSS Version 25.0. Results A total of 430 surgeons accessed the survey. The completion rate was 67.4%. Analyzing the responses of 292 surveys submitted by 97 neurosurgeons (33.2%), 161 orthopaedic surgeons (55.1%), and 34 surgeons of other postgraduate training (11.6%) showed that only 14.0% (41/292) of surgeons had completed a fellowship. Ninety-one of the 292 respondents were from Asian countries/regions. A statistically significantly higher percentage of Asian surgeons (96.7%) compared to non-Asian surgeons (81.6%) indicated that they perform modern minimally invasive (MIS) and endoscopic spinal (ES) surgery (P=0.001). Spinal endoscopy was employed by 70.3% of Asian versus 55.2% of non-Asian surgeons (P=0.015). Endoscopic decompression techniques requiring advanced training was employed nearly twice as high by the Asian surgeons than by non-Asian. Conclusions Training requirements for MIS and ES surgery and implementation of privileges vary in different parts of the world. While industry-sponsored weekend cadaver workshops have remained the mainstay of training aspiring endoscopic spinal surgeons in North America and Europe leaving many of them to become autodidacts.
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Affiliation(s)
- Jin-Sung Kim
- Spine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Anthony Yeung
- Interdisciplinary Center for Spine Health, University of New Mexico School of Medicine, Albuquerque, NM, USA.,Desert Institute for Spine Care, Phoenix, AZ, USA
| | - Yadhu K Lokanath
- Spine Center, Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kai-Uwe Lewandrowski
- Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USA
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