Abstract:
:OBJECTIVE Disposable supplies constitute a large portion of operating room (OR) costs and are often left over at the end of a surgical case. Despite financial and environmental implications of such waste, there has been little evaluation of OR supply utilization. The goal of this study was to quantify the utilization of disposable supplies and the costs associated with opened but unused items (i.e., "waste") in neurosurgical procedures. METHODS Every disposable supply that was unused at the end of surgery was quantified through direct observation of 58 neurosurgical cases at the University of California, San Francisco, in August 2015. Item costs (in US dollars) were determined from the authors' supply catalog, and statistical analyses were performed. RESULTS Across 58 procedures (36 cranial, 22 spinal), the average cost of unused supplies was $653 (range $89-$3640, median $448, interquartile range $230-$810), or 13.1% of total surgical supply cost. Univariate analyses revealed that case type (cranial versus spinal), case category (vascular, tumor, functional, instrumented, and noninstrumented spine), and surgeon were important predictors of the percentage of unused surgical supply cost. Case length and years of surgical training did not affect the percentage of unused supply cost. Accounting for the different case distribution in the 58 selected cases, the authors estimate approximately $968 of OR waste per case, $242,968 per month, and $2.9 million per year, for their neurosurgical department. CONCLUSIONS This study shows a large variation and significant magnitude of OR waste in neurosurgical procedures. At the authors' institution, they recommend price transparency, education about OR waste to surgeons and nurses, preference card reviews, and clarification of supplies that should be opened versus available as needed to reduce waste.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Zygourakis CC,Yoon S,Valencia V,Boscardin C,Moriates C,Gonzales R,Lawton MTdoi
10.3171/2016.2.JNS152442subject
Has Abstractpub_date
2017-02-01 00:00:00pages
620-625issue
2eissn
0022-3085issn
1933-0693journal_volume
126pub_type
杂志文章abstract::Ischemic stroke remains a leading cause of morbidity and death for which few therapeutic options are available. The development of neuroprotective agents, a once promising field of investigation, has failed to translate from bench to bedside successfully. This work reviews the ischemic cascade, agents targeting steps ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2012.11.JNS12408
更新日期:2013-05-01 00:00:00
abstract::The authors reviewed 70 publications on MR imaging-based targeting techniques for identifying the subthalamic nucleus (STN) for deep brain stimulation in patients with Parkinson disease. Of these 70 publications, 33 presented quantitatively validated results. There is still no consensus on which targeting technique ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/2011.6.JNS101571
更新日期:2011-11-01 00:00:00
abstract::A study of computerized tomography (CT) scans was performed in a consecutive series of 100 patients with ruptured saccular cerebral aneurysms who were admitted, diagnosed, and operated on within 72 hours after subarachnoid hemorrhage (SAH) and treated with calcium antagonists. The aneurysms were in the anterior portio...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.2.0217
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVE:Glioblastoma (GBM) is the most malignant form of astrocytoma. The average survival is 6-10 months in patients with recurrent GBM (rGBM). In this study, the authors evaluated the role of stereotactic radiosurgery (SRS) in patients with rGBMs. METHODS:The authors performed a retrospective review of their brain...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.4.JNS172909
更新日期:2018-10-19 00:00:00
abstract::Symptomatic cysts of the septum pellucidum are rare. Up to 1969, 17 published cases were considered to be symptomatic. In the case report here, a 9-week-old girl was hospitalized because of disproportionate progressive enlargement of the head, lumbar myelomeningocele, and a history of generalized seizures. A giant sep...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.4.0646
更新日期:1981-10-01 00:00:00
abstract:OBJECT:Bioabsorbable polymeric material coils are being used in the endovascular treatment of aneurysms to achieve better thrombus organization than is possible using bare platinum coils. We used immunohistochemical and molecular biological analysis techniques in experimental aneurysms implanted with three different bi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS-07/07/0109
更新日期:2007-07-01 00:00:00
abstract::The avian sarcoma virus-induced glioma model in rats was used to evaluate radiation dose response (survival curves), giving fractionated treatments to the whole head. Groups of 14 to 20 rats received total doses of 2300, 4600, or 5750 rads over 2, 4, or 5 weeks, respectively. Median group survival times were compared ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.1.0068
更新日期:1980-07-01 00:00:00
abstract::The authors have previously advocated a supraorbital approach to tumors of the orbit. In this paper, they describe a technique in which they take advantage of a large frontal sinus as a means of entering the orbit without the necessity of intracranial exposure, as required by the more conventional supraorbital approac...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.5.0811
更新日期:1985-11-01 00:00:00
abstract:OBJECT:In the preceding article, the authors described the Hydrocephalus Outcome Questionnaire (HOQ), a simple, reliable, and valid measure of health status in children with hydrocephalus. In the present study, they present their initial experience in using the HOQ to quantify the health status in a typical cohort of c...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/ped.2004.101.2.0141
更新日期:2004-11-01 00:00:00
abstract::A case is presented of tentorial dural arteriovenous malformation (AVM) associated with visual hallucinations and quadrant hemianopsia. Computerized tomography (CT) and magnetic resonance imaging showed an ischemic region, mainly affecting the white matter of the right occipital lobe, that was defined as an area of in...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.80.3.0552
更新日期:1994-03-01 00:00:00
abstract::OBJECTIVE Access to the third ventricle is a veritable challenge to neurosurgeons. In this context, anatomical and morphometric studies are useful for establishing the limitations and advantages of a particular surgical approach. The transchoroidal approach is versatile and provides adequate exposure of the middle and...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.8.JNS16403
更新日期:2017-07-01 00:00:00
abstract::OBJECTIVE Different surgical routes have been used over the years to achieve adequate decompression of the optic nerve in its canal including, more recently, endoscopic approaches performed either through the endonasal corridor or the transorbital one. The present study aimed to detail and quantify the amount of bone ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2016.8.JNS16566
更新日期:2017-07-01 00:00:00
abstract:OBJECT:Recent advances in neuroradiology have made it possible to dilate vasospastic human cerebral arteries after aneurysmal subarachnoid hemorrhage (SAH), but the time window is short and the success rate for reversal of delayed ischemic neurological deficits (DINDs) varies between 31% and 77%. In a dog model of vaso...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1999.91.1.0051
更新日期:1999-07-01 00:00:00
abstract::Myositis ossificans (MO) is a disorder characterized by the intramuscular proliferation of fibroblasts and osteoblasts, with subsequent deposition of bone and cartilage. A typical clinical presentation involves traumatic injury to a young adult, usually localized to the thigh, buttock, or upper arm, with resultant MO ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2001.95.3.0525
更新日期:2001-09-01 00:00:00
abstract::The authors describe their minimally invasive technique for performing a superficial temporal artery (STA) to middle cerebral artery (MCA) bypass, which relies on an enlarged bur hole (2-2.5 cm) rather than the standard craniotomy. They perform this procedure in a minimally invasive fashion, using CT angiography for i...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/JNS/2008/109/9/0553
更新日期:2008-09-01 00:00:00
abstract::This report describes a large, asymptomatic, subdural skeletal-type condrosarcoma originating from the meninges. Distinction between the mesenchymal and skeletal types of intracranial chondrosarcoma is important since they have different prognoses. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.48.5.0825
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVE:It is well known that larger aneurysm size is a risk factor for poor outcome after surgical treatment of unruptured saccular intracranial aneurysms (USIAs). However, the authors have occasionally observed poor outcome in the surgical treatment of small USIAs and hypothesized that size ratio has a negative imp...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.4.JNS173221
更新日期:2018-09-21 00:00:00
abstract::Experience indicates that stand-alone cages may lack the necessary stability to secure highly unstable motion segments at the lumbosacral junction. The authors have designed a special carbon fiber composite interbody cage that allows additional screw placement in anterior lumbar interbody fusion procedures performed a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2003.98.2.0222
更新日期:2003-03-01 00:00:00
abstract:OBJECT:Patients with gliomas frequently have cognitive deficits, and surgery can exacerbate these deficits. Preoperative assessment is therefore crucial in patients undergoing surgery for glioma in eloquent areas, because the proximity of functional areas increases the risk of permanent postoperative cognitive disturba...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2012.7.JNS12263
更新日期:2012-11-01 00:00:00
abstract::A patient with a subcutaneous sacrococcygeal ependymoma and metastasis to the inguinal lymph nodes is presented and his treatment is described. Previous reports on sacrococcygeal ependymoma are reviewed. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.68.3.0474
更新日期:1988-03-01 00:00:00
abstract::A large, highly ossified craniopharyngioma was diagnosed and surgically treated in a 2-year-old girl. About 20 teeth were macroscopically identified in the operative specimen, some of them totally developed, complete with crown and root. Pathological study established the diagnosis of craniopharyngioma with formation ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.5.0832
更新日期:1981-11-01 00:00:00
abstract::Experimental cerebral vasospasm was produced in the canine basilar artery by an intracisternal injection of fresh autogenous arterial blood, and prostaglandins generated in spastic and nonspastic arteries were assessed by thin-layer chromatography. Prostaglandins synthesized in normal arteries were 6-keto-prostaglandi...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1981.55.5.0779
更新日期:1981-11-01 00:00:00
abstract::OBJECTIVEThe authors' aim in this study was to evaluate placement accuracy and clinical outcomes in patients who underwent implantation of deep brain stimulation devices with the aid of frame-based stereotaxy and intraoperative MRI after induction of general anesthesia.METHODSThirty-three patients with movement disord...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.7.JNS171166
更新日期:2018-12-01 00:00:00
abstract::Recombinant interleukin-2 (rIL-2) is an immunotherapeutic agent with efficacy against certain advanced cancers. The penetration of rIL-2 across the blood-cerebrospinal fluid (CSF) barrier was studied in 12 cancer patients who had no evidence of tumor involvement of the central nervous system. At different times during...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1988.69.1.0029
更新日期:1988-07-01 00:00:00
abstract::In the early days of the war between Iran and Iraq, reports of the sudden deaths of soldiers who previously had survived a penetrating head injury suggested the possibility that a late complication, traumatic aneurysm (TA), could be the cause of this catastrophe. In response, the authors planned a prospective study to...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.5.0769
更新日期:1996-05-01 00:00:00
abstract::A case is reported of a patient in whom an intracranial extracerebral melanoma developed in association with a life-long nevus of Ota. Melanotic pigmentation of the skull, periosteum, and meninges beneath the nevus was found at operation. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.58.2.0280
更新日期:1983-02-01 00:00:00
abstract:OBJECT:The authors studied the microsurgical anatomy of the ophthalmic artery (OphA), paying particular attention to its possibly dangerous anastomoses with the middle meningeal artery (MMA). METHODS:The microsurgical anatomy of the OphA and its anastomoses with the MMA were studied in 14 vessels from seven adult cada...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2007.106.1.142
更新日期:2007-01-01 00:00:00
abstract::Angiograms obtained prior to treatment in 53 cases of deep-seated cerebral arteriovenous malformations (AVM's) were retrospectively analyzed with particular attention to the topography of the AVM nidus and the venous drainage. The location of the lesion was determined by a combination of angiography and computerized t...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1985.63.2.0180
更新日期:1985-08-01 00:00:00
abstract:OBJECT:Surgeries for CNS tumors are frequently performed by general neurosurgeons and by those who specialize in surgical neurooncology. Subspecialization in neurosurgical practice has become common and may improve patient morbidity and mortality rates. However, the potential benefits for patients of having their surge...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.10.JNS132057
更新日期:2015-02-01 00:00:00
abstract::The effect of hypercholesterolemia on vascular responsiveness was studied in isolated rabbit arteries. The arteries of animals maintained on a cholesterol-rich (1%) diet for 6 months had more pronounced intimal lesion than those receiving the diet for 3 months. The aortas were more severely damaged than the carotid or...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.5.0793
更新日期:1989-05-01 00:00:00