1
|
Garcia RM, Shlobin NA, Baticulon RE, Ghotme KA, Lippa L, Borba LA, Qureshi M, Thango N, Khan T, Hutchinson P, Rosseau G. Global Neurosurgery: An Overview. Neurosurgery 2024; 95:501-508. [PMID: 39145649 DOI: 10.1227/neu.0000000000003109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/21/2024] [Indexed: 08/16/2024] Open
Abstract
In the following article, we define the practice of global neurosurgery and review the major historical events defining this movement within the larger context of global surgery. The current state of the neurosurgical workforce, disease burden, and ongoing collaborative efforts are highlighted. Ethical practice leading the sustainability is discussed, as well as future targets for the global community as we look beyond the next decade of opportunities to affect the neurosurgical burden of disease.
Collapse
Affiliation(s)
- Roxanna M Garcia
- Department of Neurological Surgery, Northwestern University, Chicago, Illinois, USA
| | - Nathan A Shlobin
- McGaw School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Kemel A Ghotme
- Translational Neuroscience Research Lab, Faculty of Medicine, Universidad de La Sabana, Chía, Colombia
- Pediatric Neurosurgery, Department of Neurosurgery, Fundacion Santa Fe de Bogota & Universidad de La Sabana, Chía, Colombia
| | - Laura Lippa
- Department of Neurosurgery, ASST, Ospedale Maggiore Niguarda, Milan, Italy
| | - Luis A Borba
- Federal University of Parana, Curitiba, Parana, Brazil
| | | | - Nqobile Thango
- Division of Neurosurgery, Neuroscience Institute, University of Cape Town, Red Cross Children's Hospital, Cape Town, South Africa
| | - Tariq Khan
- Northwest School of Medicine, Peshawar, Pakistan
| | - Peter Hutchinson
- Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Gail Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
- Barrow Neurological Institute, Phoenix, Arizona, USA
| |
Collapse
|
2
|
Zhang JF, Strelko O, Komarov O, Kuts-Karpenko V, Forbes JA, Fedorko O, Tomycz LD. Cervical Diastematomyelia: A Case Presentation and Systematic Review. J Neurol Surg Rep 2024; 85:e74-e82. [PMID: 38798790 PMCID: PMC11126352 DOI: 10.1055/a-2319-3444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/29/2024] [Indexed: 05/29/2024] Open
Abstract
Diastematomyelia is a rare congenital disorder characterized by the separation of the spinal cord by an osseocartilaginous or fibrous septum. While diastematomyelia has been reported to be more common in the thoracic and lumbar regions, the true incidence of cervical diastematomyelia is currently unknown. In this study, we conducted the most comprehensive systematic review to date of all other case reports of diastematomyelia to better characterize the incidence of cervical diastematomyelia and provide comprehensive statistics on the clinical characteristics of diastematomyelia generally. Ninety-one articles were included in our study, which comprised 252 males (27.9%) and 651 females (72.0%) (and one patient with unspecified gender). In 507 cases, the vertebral level of the diastematomyelia was described, and we recorded those levels as either cervical ( n = 8, 1.6%), thoracic ( n = 220, 43.4%), lumbar ( n = 277, 54.6%), or sacral ( n = 2, 0.4%). In 719 cases, the type of diastematomyelia was specified as either Type I ( n = 482, 67.0%) or Type II ( n = 237, 33.0%). Our study found that diastematomyelia has been reported in the cervical region in only 1.6% of cases, and we provide comprehensive data that this disorder occurs in female-to-male ratio of approximately 2.6:1 and Type I versus Type II diastematomyelia in an estimated ratio of 2:1.
Collapse
Affiliation(s)
- Jeff F. Zhang
- Department of Neurosurgery, SUNY Upstate Medical University, Syracuse, New York
| | | | - Oleksandr Komarov
- Institute of Postgraduate Education, Bogomolets National Medical University, Kyiv, Ukraine
| | | | - Jonathan A Forbes
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Ostap Fedorko
- Clinical Municipal Communal Emergency Hospital, Lviv, Ukraine
| | - Luke D. Tomycz
- Epilepsy Institute of New Jersey, Jersey City, New Jersey
| |
Collapse
|
3
|
Lu Z, Tshimbombu TN, Abu-Bonsrah N, Kanmouyne US, Hesson D, Edward A, Dewan MC, Ukachukwu AEK, Fuller AT, Groves ML, Rhee DS. Transnational Capacity Building Efforts in Global Neurosurgery: A Review and Analysis of Their Impact and Determinants of Success. World Neurosurg 2023; 173:188-198.e3. [PMID: 36746238 DOI: 10.1016/j.wneu.2023.01.120] [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: 01/12/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neurosurgical capacity building efforts attempt to address the shortage of neurosurgeons and lack of neurosurgical capacity in low- and middle-income countries. This review sought to characterize neurosurgical capacity building efforts in low- and middle-income countries and the challenges they face, and identify factors that predict higher engagement, better training, and performance of high-impact activities. METHODS A scoping review using PubMed and Embase databases was performed and relevant articles were identified. Programs were classified into 6 categories and the activities they performed were classified as having a high-, medium-, or mild impact on capacity. Programs were also classified using the Olivieri engagement and training criteria. RESULTS Fifty-seven articles representing 42 unique efforts were included. The most important determinant of impact was a program's design and intent. Furthermore, 91% of training and twinning programs received high (class 2 or 3) engagement classifications compared to 17% of mission trips and training camps (P < 0.001); 91% of training and twinning programs received high training classifications compared to 64% of mission trips and training camps (P = 0.015); and 91% of training and twinning programs reported performing high-impact activities compared to 29% of mission trips and training camps (P < 0.001). CONCLUSIONS Training and twinning programs are more engaged, offer better training, and are more likely to perform high-impact activities compared to mission trips and training camps, suggesting that these types of programs offer the greatest chance of producing substantial and sustainable improvements to neurosurgical capacity.
Collapse
Affiliation(s)
- Zhuoyan Lu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
| | | | - Nancy Abu-Bonsrah
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Global Surgery Initiative, Baltimore, Maryland, USA
| | | | - Donna Hesson
- Welch Medical Library, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anbrasi Edward
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michael C Dewan
- Department of Neurological Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alvan-Emeka K Ukachukwu
- Duke Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA; Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Mari L Groves
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel S Rhee
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Global Surgery Initiative, Baltimore, Maryland, USA
| |
Collapse
|
4
|
Urgent need for neurological care in Ukraine. Lancet Neurol 2023; 22:202-203. [PMID: 36804088 DOI: 10.1016/s1474-4422(23)00026-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/20/2023] [Indexed: 02/17/2023]
|
5
|
Markosian C, Soroka M, Forbes JA, Tomycz LD. Letter: Capacity Building for Surgical Epilepsy Care in Ukraine. Neurosurgery 2022; 90:e184-e185. [PMID: 35315807 DOI: 10.1227/neu.0000000000001948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Christopher Markosian
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Mariya Soroka
- Epilepsy Institute of New Jersey, Jersey City, New Jersey, USA.,Razom, New York, New York, USA
| | - Jonathan A Forbes
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Luke D Tomycz
- Epilepsy Institute of New Jersey, Jersey City, New Jersey, USA
| |
Collapse
|
6
|
El Refaee E, Zohdi A, Schroeder HWS. Letter: A New Trend of Blended Learning in Neurosurgical Training: Fellowship of Neuroendoscopy. Neurosurgery 2021; 89:E89-E90. [PMID: 33913500 DOI: 10.1093/neuros/nyab134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 12/25/2022] Open
Affiliation(s)
- Ehab El Refaee
- Department of Neurosurgery Cairo University Giza, Egypt.,Department of Neurosurgery University Medicine Greifswald Greifswald, Germany
| | - Ahmed Zohdi
- Department of Neurosurgery Cairo University Giza, Egypt
| | - Henry W S Schroeder
- Department of Neurosurgery University Medicine Greifswald Greifswald, Germany
| |
Collapse
|
7
|
Markosian C, Kurilets I, Tomycz LD. Surgical Clip Ligation of Anterior Communicating Artery Aneurysm in a Resource-Limited Setting. Cureus 2021; 13:e14927. [PMID: 34123626 PMCID: PMC8189529 DOI: 10.7759/cureus.14927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Anterior communicating artery (ACOM) aneurysm clipping with intraoperative measures to ensure total occlusion and avoid ischemic complications is standard in countries such as the United States. However, alternatives need to be considered in resource-limited settings. The clipping of an unruptured, superiorly projecting ACOM aneurysm in a resource-limited setting is presented and special nuances that optimize safety are described. Careful surgical technique, meticulous identification of relevant anatomy, post-ligation inspection of the aneurysm and adjacent vessels, and possibly needle puncture of the aneurysm dome are critical to achieve favorable results.
Collapse
Affiliation(s)
| | - Igor Kurilets
- Neurosurgery, International Neurosurgery Center, Kyiv, UKR
| | - Luke D Tomycz
- Neurosurgery, New Jersey Brain and Spine, Montclair, USA
| |
Collapse
|