Document Detail


Evolution in practice: how has British neurosurgery changed in the last 10 years?
MedLine Citation:
PMID:  18765031     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Neurosurgery is a fast-evolving surgical subspecialty driven by technological advances, socio-economic factors and patient expectations. In this study, we have compared the work-load volume in a single institution in the years of 1994 and 2004 and commented on the possible reasons for the changes and the impacts they may have for the future. PATIENTS AND METHODS: A retrospective, log-book review of all operations performed in the years 1994 and 2004 in a single, tertiary, neurosurgical centre was performed. RESULTS: Neurosurgical practice has evolved over this period. Current practice has moved away from clipping of aneurysms and towards coil embolisation performed by interventional radiologists. Electrode stimulation of deep brain regions for movement disorders is the current practice, whereas 10 years ago the same disorders were dealt with by lesioning of the relevant regions. In spinal neurosurgery, instrumentation is increasingly favoured currently. In the field of neuro-oncology, current practice favours minimal access to the target area by the use of stereotactic localisation. CONCLUSIONS: Changes were most pronounced in the subspecialties of vascular, functional and spinal neurosurgery within this 10-year period. Knowledge of such dynamics is valuable in health resource management as well as planning for neurosurgical training programmes.
Authors:
A Tarnaris; B Arvin; K Ashkan
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  90     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-03     Completed Date:  2008-12-30     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  508-12     Citation Subset:  IM    
Affiliation:
Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK. andrew.tarnaris@uclh.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Craniotomy / statistics & numerical data
Great Britain
Humans
Middle Aged
Nervous System Neoplasms / surgery
Neurosurgery / trends*
Neurosurgical Procedures / statistics & numerical data,  trends*
Retrospective Studies
Spinal Diseases / surgery
Trauma, Nervous System / surgery
Vascular Diseases / surgery
Young Adult
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