Unplanned readmission after surgical procedures is an important quality metric. Yet, rates and causes have not been evaluated for patients transsphenoidal surgery pituitary tumors.To analyze unplanned 30-day readmissions at a center to encourage the development of effective clinical pathways prevent readmission.A retrospective review adult who underwent lesions Barrow Neurological Institute (January 2011-March 2014) was performed identify within 30 days surgery. Patient demographics, tumor...

The comparative efficacy of microscopic and fully endoscopic transsphenoidal surgery for pituitary adenomas has not been well studied despite the adoption by many centers. influence surgeon experience also examined in this setting. authors therefore compared extent tumor resection (EOR) endocrine outcomes 1 very experienced performing a technique with those less using nonfunctioning concurrent series patients.Post hoc analysis was conducted cohort adult patients prospectively enrolled...

University of Michigan Medical School (UMMS) students attending a seminar on the history and ethics anatomical dissection were fascinated by report room experience in Thailand that relates body donor's status as teacher. The felt they had naturally adopted "body teacher" approach their course, rather than first patient" is encouraged faculty. It was decided to explore question whether other medical shared these perceptions. A questionnaire sent out all UMMS who finished course. One hundred...

Artificial intelligence (AI) is a powerful computational tool that being utilized more frequently in healthcare. AI holds promise within surgical practice, including application the care of challenging patient populations. Complex spine reconstruction requires thorough multi-variable preoperative analysis and then precise enactment plan. Spino-plastics employs vascularized bone grafts (VBGs) to augment spinal fusion these high-risk patients. In this article, we discuss great breadth...

INTRODUCTION: Patients with workers’ compensation (WC) claims are reported to demonstrate poorer surgical outcomes after lumbar spine surgery. However, anterior cervical discectomy and fusion (ACDF) in WC patients remain debatable. METHODS: who underwent 1- 4-level ACDF were retrospectively reviewed from the prospectively maintained Quality Outcomes Database (QOD). After propensity score matching, 1-year patient satisfaction, physical disability (Neck Disability Index [NDI]), pain (visual...

In the summer of 2009, we began full body computed tomography (CT) scanning pre-embalmed cadavers in University Michigan Medical School (UMMS) dissection lab. We theorized that implementing web-based, self-guided clinical cases based on postmortem CT (PMCT) scans would result increased student appreciation for relevance anatomy, knowledge cross-sectional and ability to identify common pathologies scans. The PMCT scan each cadaver was produced as a DICOM dataset, then converted into Quicktime...

OBJECTIVE For a diagnosis of brain death (BD), ancillary testing is performed if patient factors prohibit complete clinical examination and apnea test. The American Academy Neurology (AAN) guidelines identify cerebral angiography (CA), scintigraphy, electroencephalography, transcranial Doppler ultrasonography as accepted tests. CA widely considered the gold standard these, it provides most reliable assessment intracranial blood flow. CT (CTA) noninvasive available study that also capable...

Background We assessed a new robotic visualization platform with novel user-control features and compared its performance to the previous model of operative microscope. Methods In neurosurgery research laboratory, we performed anatomical dissections robotic, exoscopic, endoscopic, fluorescence functionality. Usability functionality were tested in operating room over 1 year. Results The microscope showed higher sensitivity for fluorescein sodium, detail non-fluorescent background,...

Background We examined the biomechanical performance of a three-dimensional (3D)-printed vertebra on pedicle screw insertional torque (IT), axial pullout (APO), and stiffness (ST) testing. Materials methods Seventy-three anatomically identical L5 vertebral body models (146 pedicles) were printed tested for IT, APO, ST using single-threaded screws equivalent diameter (6.5 mm), length (40.0 thread pitch (2.6 mm). Print properties (material, cortical thickness [number shells], cancellous...

After transsphenoidal surgery, delayed hyponatremia (DH) is the leading cause of 30-d unplanned hospital readmissions.To determine impact a DH care pathway on readmissions after surgery.Data from before and implementation were retrospectively reviewed. Patient demographics clinical characteristics compared. Readmission causes, failures, sodium trends, symptoms evaluated.Before implementation, 229 (55%) patients treated (group 1); afterward, 188 (45%) 2). Baseline equivalent between groups,...

Objective and subjective fluoroscopic assessments of a new synthetic spine model.The aim this study was to analyze the performance fidelity human tissue Barrow Biomimetic Spine project aims develop 3-dimensional (3D) printed, model that will one day replace cadaveric in biomechanical research. A crucial component any biomimetic is it performs similarly on standard diagnostic imaging modalities.Numerous L5 vertebral bodies (VBs) were 3D printed with variable shell thicknesses internal...

The Living Spine Model (LSM) is a three-dimensionally printed, surgical training platform developed by neurosurgical residents.To evaluate the face and content validity of this model as tool for open posterior lumbar surgery.Six surgeons with varying experience were asked to complete L3-5 pedicle screw fixation L3-4 laminectomy on an LSM. Face was measured using questionnaire, National Aeronautics Space Administration Task Load Index (NASA TLX) tests. Student's t-test used compare NASA TLX...

Abstract BACKGROUND Overlapping surgeries have recently become a controversial topic. OBJECTIVE To evaluate the effect of overlapping on patient outcomes. METHODS A retrospective analysis all neurosurgical procedures performed at single institution from July 2013 to May 2016 was conducted. Variables extracted electronic medical records included sex, age, procedure type, resident years training, evening case, emergency American Society Anesthesiologists Physical Status Score, illness...

The Schwab osteotomy grading scale-a unified classification system created in 2014 by et al.-is one of many concepts spine surgery that require detailed knowledge 3-dimensional (3D) anatomy. 3D-printed models have demonstrated increasing utility as they more quickly communicate information on complex 3D anatomical relationships than planar imaging or 2-dimensional images. purpose this study was to evaluate the a custom, model help surgical trainees understand and perform scale.Eight...

Retrospective analysis of prospectively collected data.Assess the cost-utility anterior cervical discectomy and fusion (ACDF) performed in ambulatory surgery center (ASC) versus inpatient hospital setting for Medicare privately insured patients at one-year follow-up.Outpatient ACDF has gained popularity due to improved safety reduced costs. Formal studies are lacking, precluding an accurate assessment cost-effectiveness.A total 6504 enrolled Quality Outcomes Database (QOD) undergoing...

Abstract The Anatomical Donations Program at the University of Michigan Medical School (UMMS) has begun a multiphase project wherein interviews donors will be recorded and later shown to medical students who participate in anatomical dissection course. first phase this included surveys both current UMMS concerning their perceptions such program. A five‐question survey administered via Qualtrics software was electronically mailed all UMMS, registered potential requesting information from on...

Abstract In 2004, the University of Michigan Medical School reduced its gross anatomy curriculum. To determine effect this reduction on resident perceptions their clinical preparedness, we surveyed alumni that included residents from original and new shortened curricula. A Likert‐scale survey was sent to four classes alumni. Respondents were compared in old curriculum (OC) (NC) groups, surgical specialty (SS) nonsurgical (NS) subgroups SS NS for differences between OC NC. Mean response...