Abstract:
:Although the expectation of monetary compensation has been associated with failures in lumbar discectomy, the issue has not been investigated in patients undergoing cervical disc surgery. The authors analyzed the relationship between economic forms of secondary gain and surgical outcome in a group of patients with a common pay scale, retirement plan, and disability program. All procedures were performed at the Portsmouth Naval Medical Center between 1993 and 1995; active-duty military servicepersons treated for cervical radiculopathy were prospectively included. Clinical, demographic, and financial factors were analyzed to determine which were predictive of outcome. Financial data were used to create a compensation incentive, which is proportional to the patient's rank, years of service, potential disability, retirement eligibility, and base pay and reflects the monetary incentive of disability. The results of cervical surgery were compared to a previously reported companion population of patients treated for lumbar disc disease. A good outcome was defined as a return to active duty, whereas a referral for disability was considered a poor surgical result. A 100% follow-up rate was obtained for 269 patients who underwent 307 cervical operations. Only 16% (43 of 269) of patients who underwent cervical operation received disability, whereas 24.7% (86 of 348) of patients who underwent lumbar discectomy obtained a poor result (p = 0.0082). Although economic forms of secondary gain were not associated with a poor outcome in cervical disease, both the rank (p = 0.002) and duration (p = 0.03) of an individual's military career were significant factors (p = 0.02). Of the medical variables tested, multilevel surgery (p = 0.03) and revision operations at the same level (p = 0.03) were associated with referral for medical discharge. Secondary gain in the form of economic compensation influences outcome in lumbar but not cervical disc surgery patients; the increased rate of disability referral in patients who underwent lumbar discectomy may reflect an expectation of economic compensation. Social factors that are independent of the anticipation of economic compensation seem to influence the outcome in cervical disc surgery patients.
journal_name
Neurosurg Focusjournal_title
Neurosurgical focusauthors
Kaptain GJ,Shaffrey CI,Alden TD,Young JN,Whitehill Rdoi
10.3171/foc.1998.5.2.9subject
Has Abstractpub_date
1998-08-15 00:00:00pages
e6issue
2issn
1092-0684pii
050206journal_volume
5pub_type
杂志文章abstract::Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.7.FOCUS19441
更新日期:2019-10-01 00:00:00
abstract::The widespread use of fusion procedures in the management of spinal disorders has led investigators to explore the use of growth and differentiation factors in such procedures. As an adjuvant to allograft bone or as a replacement for harvested autograft, bone morphogenetic proteins (BMPs) appear to improve fusion rate...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2001.10.4.4
更新日期:2001-04-15 00:00:00
abstract::The histological appearance of a meningioma is an important predictor of tumor behavior and is frequently a factor in decisions concerning therapy. The relationship between histological features and prognosis is formalized in grading schemes such as those published by the World Health Organization (WHO), most recently...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC-07/10/E3
更新日期:2007-01-01 00:00:00
abstract:OBJECT:The purpose of this study was to evaluate the performance of a resorbable polylactide film in the sheep posterior spine in the presence of a combined laminectomy and durotomy defect. METHODS:A resorbable polylactide film was used to cover the combined defects in the eight sheep used in this study. Two surgical ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2004.16.3.3
更新日期:2004-03-15 00:00:00
abstract::Acute ischemic stroke is now considered a neurological emergency for which there are new therapies. Neurosurgeons and neurologists need to remain apprised of advances in this field. The authors discuss approved and emerging therapies for patients suffering from acute ischemic stroke, based on a review of recent public...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2000.8.5.2
更新日期:2000-05-15 00:00:00
abstract:Objective:Treatment advances have resulted in improved survival for many cancer types, and this, in turn, has led to an increased incidence of metastatic disease, specifically to the vertebral column. Surgical decompression and stabilization prior to radiation therapy have been shown to improve functional outcomes, but...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.5.FOCUS16162
更新日期:2016-08-01 00:00:00
abstract::The aim of this study is to review the clinical outcome of patients treated for spinal dural arteriovenous malformations and investigate the presence of pretreatment indicators of outcome after short- and midterm follow-up. The authors retrospectively reviewed the records of 65 consecutive patients treated either surg...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2012.2.FOCUS1218
更新日期:2012-05-01 00:00:00
abstract::For decades, lumbar disc herniation and lumbar stenosis have been treated surgically via traditional open techniques. With recent emphasis on minimally invasive approaches in spine surgery, a number of new techniques has been introduced that are aimed at treating these 2 common pathological conditions. Currently the m...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/FOC/2008/25/8/E11
更新日期:2008-01-01 00:00:00
abstract::Optical imaging of intrinsic signals (OIS) is a well-established neuroimaging modality by which functional cortical activity is mapped by detecting activity-related changes in cortical light reflectance. Light reflectance changes are detected by a charged-coupled device camera that captures images of the exposed corte...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.4.2
更新日期:2002-10-15 00:00:00
abstract::Complex posterior circulation aneurysms are formidable lesions with an abysmal natural history. Their management continues to present a challenge to both endovascular and open microsurgical approaches. Affording an expansive, combined supra- and infratentorial exposure, the petrosal approaches are well suited for thes...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2012.6.FOCUS12131
更新日期:2012-08-01 00:00:00
abstract::Tentorial dural arteriovenous fistulae (TDAVFs) are complex lesions with the arteriovenous fistula located between the leaves of the tentorium cerebelli. While a large portion of dural arteriovenous fistulae are treated endovascularly, TDAVF may require additional microsurgical treatment given their high risk of hemor...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.1.FocusVid.15420
更新日期:2016-01-01 00:00:00
abstract::This paper describes some of the more common patterns in neurobehavioral deficits and their underlying neuroanatomical basis in myelomeningocele (MMC). Patients with MMC can face a lifetime of specific organ system dysfunction, chief among them spinal cord malformations, orthopedic issues, hydrocephalus, and urologica...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.7.FOCUS19445
更新日期:2019-10-01 00:00:00
abstract::OBJECTIVEPituitary adenomas occur in a heterogeneous patient population with diverse perioperative risk factors, endocrinopathies, and other tumor-related comorbidities. This heterogeneity makes predicting postoperative outcomes challenging when using traditional scoring systems. Modern machine learning algorithms can...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.8.FOCUS18268
更新日期:2018-11-01 00:00:00
abstract::Aquaporin-4 (AQP4) channels play an important role in brain water homeostasis. Water transport across plasma membranes has a critical role in brain water exchange of the normal and the diseased brain. AQP4 channels are implicated in the pathophysiology of hydrocephalus, a disease of water imbalance that leads to CSF a...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/2016.7.FOCUS16191
更新日期:2016-09-01 00:00:00
abstract::Cellular therapy has been evaluated in small animals, subhuman primates, and now humans for the potential repair of brain injury due to stroke. Experimental striate stroke models have proven useful for the purpose of evaluating different treatment paradigms. Early clinical trials involving neuronal transplantation in ...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2002.13.5.2
更新日期:2002-11-15 00:00:00
abstract::OBJECTIVE In this study the authors describe the technical considerations and feasibility of transforaminal discectomy and foraminoplasty for the treatment of lumbar radiculopathy in patients who have herniated discs at the thoracolumbar junction. METHODS After institutional review board approval, charts from 3 consec...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.10.FOCUS15372
更新日期:2016-02-01 00:00:00
abstract::Arteriovenous fistulae of the internal maxillary artery are exceedingly rare, with less than 30 cases reported in the literature. Most of these lesions are congenital, iatrogenic, or posttraumatic. The most common presentation of internal maxillary artery fistulae is pulsatile tinnitus and headache. Because these lesi...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2019.1.FocusVid.18479
更新日期:2019-01-01 00:00:00
abstract:OBJECT:Some patients develop communicating hydrocephalus after meningioma surgery, and this can develop into a serious clinical condition. However, this has rarely been addressed in the literature. Therefore, the authors sought to determine predictive patient variables for the occurrence of postoperative hydrocephalus ...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2011.3.FOCUS117
更新日期:2011-05-01 00:00:00
abstract:OBJECT:This review summarizes the continuous study of low-power laser radiation treatment of a severely injured peripheral nerve. Laser phototherapy was applied as a supportive factor for accelerating and enhancing axonal growth and regeneration after injury or a reconstructive peripheral nerve procedure. In nerve cell...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/FOC.2009.26.2.E8
更新日期:2009-02-01 00:00:00
abstract::The authors detail the life and career of Dr. J. Lawrence Pool, as well as his significant contributions to the field of cerebrovascular neurosurgery. The discipline of cerebrovascular neurosurgery is a young and dynamic field, which underwent rapid and substantial growth during the middle of the twentieth century. As...
journal_title:Neurosurgical focus
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2006-06-15 00:00:00
abstract:OBJECT:Hemangiopericytomas represent a small subset of meningeal tumors. Despite their relatively uncommon nature, they are aggressive tumors known for recurrence. Resection is the standard treatment in most, although regrowth and metastases are common even after resection. The authors evaluate the role of stereotactic...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.2003.14.5.15
更新日期:2003-05-15 00:00:00
abstract::Shunt systems with differential pressure valves are prone to the complications of overdrainage. A programmable valve permits adjustment of the opening pressure of the valve. In this paper the authors report the incidence of subdural fluid collections in a randomized trial of programmable compared with conventional val...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/foc.1999.7.4.2
更新日期:1999-10-15 00:00:00
abstract::In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2018.1.FocusVid.17572
更新日期:2018-01-01 00:00:00
abstract::Germ line and somatic mutations in the neurofibromatosis Type 2 (NF2) tumor suppressor gene predispose individuals to tumors of the nervous system, including schwannomas and meningiomas. Since identification of the NF2 gene more than a decade ago, a large body of information has been collected on the nature and conseq...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:10.3171/foc.2005.19.5.7
更新日期:2005-11-15 00:00:00
abstract::Deep brain stimulation (DBS) has been reported to have beneficial effects in severe, treatment-refractory cases of obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). In this report, the authors present the first case in which DBS was used to treat the neuropsychiatric symptoms of Kleefstra syndrome, a rar...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.3.FOCUS1528
更新日期:2015-06-01 00:00:00
abstract:OBJECT:A variety of anterior, posterior, and combined approaches exist to decompress the spinal cord, restore sagittal alignment, and avoid kyphosis, but the optimal surgical strategy remains controversial. The authors compared the anterior and posterior approach used to treat multilevel cervical spondylotic myelopathy...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2010.1.FOCUS09253
更新日期:2010-03-01 00:00:00
abstract::OBJECTIVE Many reports have successfully demonstrated that cervical disc arthroplasty (CDA) can preserve range of motion after 1- or 2-level discectomy. However, few studies have addressed the extent of changes in segmental mobility after CDA or their clinical correlations. METHODS Data from consecutive patients who u...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2016.10.FOCUS16411
更新日期:2017-02-01 00:00:00
abstract::Iatrogenic intervertebral disc space infection is encountered following microsurgical discectomy, percutaneous laser disc decompression, automated percutaneous lumbar nucleotomy operations, and discography. The purpose of this paper is to present a case report and review the literature on the uncommon origins of pyoge...
journal_title:Neurosurgical focus
pub_type: 杂志文章,评审
doi:
更新日期:2004-06-15 00:00:00
abstract::OBJECTIVE The long-term effects on adjacent-segment pathology after nonfusion dynamic stabilization is unclear, and, in particular, changes at the adjacent facet joints have not been reported in a clinical study. This study aims to compare changes in the adjacent facet joints after lumbar spinal surgery. METHODS Patie...
journal_title:Neurosurgical focus
pub_type: 杂志文章
doi:10.3171/2015.10.FOCUS15456
更新日期:2016-01-01 00:00:00
abstract::The contemporary management of projectile head injuries owes much to the lessons neurosurgeons have distilled from their experiences in war. Through early investigation and an increasingly detailed account of wartime clinical experience, neurosurgeons--including the field's early giants--began to gain a greater unders...
journal_title:Neurosurgical focus
pub_type: 历史文章,杂志文章
doi:10.3171/2010.2.FOCUS1038
更新日期:2010-05-01 00:00:00