Azam Basheer MD Journal Club 8.20.14

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This document discusses the results of an objective but not blinded study that found 81 positive cases out of 71 total cases, with 17 excluded and 2 total, resulting in a ratio of positive cases to total cases of 1.14 and a ratio of positive plus excluded to total of 0.44, yielding an overall ratio of 2.61. The document expresses thanks at the end.

81
71
17
2
394
 81/71 = 1.14
 172/394 =
0.44
 1.14/0.44 = 2.61

This document outlines information about sphenoid wing meningiomas (SWM), including: - Background on SWM classification and locations of hyperostosis - Causes of hyperostosis including tumor cell activity and bone stimulation - Presentation of SWM such as headaches, visual changes, and nerve deficits - Workup involving imaging like CT/MRI and surgical planning considerations - Treatment including options for medical management or surgical resection via approaches like pterional or orbitozygomatic to remove tumor and resect bone

Basilar approaches Azam Basheer MD 9-2-14Azam Basheer

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This document discusses surgical approaches for clipping posterior circulation aneurysms, specifically basilar apex aneurysms. It describes the trans-sylvian and subtemporal approaches. For the trans-sylvian approach, the temporal lobe is retracted to expose the carotid-oculomotor triangle and allow dissection along the posterior communicating artery to the basilar bifurcation. For the subtemporal approach, a subtemporal craniotomy is performed and the temporal lobe is lifted to divide the tentorium and expose perforators along the posterior wall for large or posteriorly projecting aneurysms. Both approaches require opening cisterns, releasing arachnoid membranes, and careful dissection of critical structures to access the basilar apex aneurysm for

Jc ppt 12 7-16- meta-analysis azam basheerAzam Basheer

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Arthoplasty vs ACDF Azam Basheer MD CNS AANS 2013Azam Basheer

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This study compared adjacent segment motion in 17 patients who underwent either anterior cervical fusion (ACDF) or cervical arthroplasty (AD) at C5-C6. Using bi-planar fluoroscopy, the researchers found that while total neck motion was similar, ACDF patients exhibited greater rotation at the non-operated C3-C4 and C6-C7 segments compared to AD patients. ACDF patients also demonstrated increased medial-lateral facet shear at C3-C4 and C4-C5. The study suggests ACDF may be associated with increased motion at adjacent segments compared to AD, but longer-term studies are needed to determine if this leads to adjacent segment disease.

Spine Motion Azam Basheer MD CNS AANS 2013Azam Basheer

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This study analyzed cervical spine motion in 11 patients who underwent anterior cervical fusion surgery between the C5-C6 vertebrae. Motion analysis was performed using bi-planar fluoroscopy and clinical measures including neck disability, pain, and quality of life scores were assessed. During neck rotation, increased rotation between the C3-C4 vertebrae correlated with worse clinical outcomes, while increased rotation between C4-C5 correlated with better outcomes. The findings suggest that increased mobility at the level adjacent to the fusion site is healthier, while increased mobility two levels above may indicate a compensatory unhealthy state and potentially increased risk of adjacent segment disease.

Post Op Urinary Retention Azam Basheer MD AANS-CNS 2013Azam Basheer

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This study examined the incidence and risk factors for post-operative urinary retention (POUR) in 137 neurosurgery patients. The overall incidence of POUR was 39.4%. Male gender, anesthesia time over 200 minutes, older age (over 60), and spinal surgery were significant risk factors for POUR based on multivariate regression analysis. Specifically, 18% of patients required re-insertion of an indwelling urinary catheter, with males, older patients, and those with longer anesthesia times more likely to require re-insertion.

Azam Basheer MD Journal Club 3.11.14 (1)Azam Basheer

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This document summarizes a journal club presentation on the short-term cost-effectiveness of spine surgery relative to non-operative care for spinal stenosis and spinal stenosis with spondylolisthesis. The presentation assessed data from the Spine Patient Outcomes Research Trial (SPORT), which compared surgical and non-surgical treatments for various spinal conditions. SPORT involved over 2,500 patients across 13 sites and measured health outcomes, costs, and quality-adjusted life years (QALYs) over 2 years. Surgery was found to improve health outcomes but at a higher initial cost compared to non-operative care.

Spine Motion Lab MANS 2013 Azam Basheer MDAzam Basheer

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This study analyzed 3D in vivo cervical spine motion in 17 patients who underwent either anterior cervical discectomy and fusion (ACDF) or cervical arthroplasty (AD) at C5-C6. Motion at adjacent segments was greater for ACDF patients compared to AD patients during neck extension and rotation. Facet shear was also greater for ACDF patients. For 11 ACDF patients, increased rotation at C3-C4 correlated with worse clinical outcomes, while increased rotation at C4-C5 correlated with better outcomes. The findings provide insights into biomechanical factors that may contribute to adjacent segment disease.

Neurotransmission Azam Basheer MDAzam Basheer

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The document discusses neurotransmission and the resting potential of neurons. It explains that the resting potential is caused by an uneven distribution of ions like potassium and sodium maintained by ion pumps. Any change that affects ion channels can alter the resting potential, causing depolarization or hyperpolarization. When voltage-gated sodium channels open during an action potential, sodium rushes into the cell, reversing the potential until potassium channels open and sodium channels close, returning the potential to normal. Action potentials propagate along axons via this mechanism. Neurotransmitters are then discussed, including acetylcholine, biogenic amines, and their functions and receptors.

SI joint Fusion Azam Basheer MDAzam Basheer

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The document discusses the sacroiliac joint (SIJ), including its anatomy, biomechanics, evaluation, and treatment options for SIJ pain. Key points include: - The SIJ is a synovial joint between the sacrum and ilium bones that allows limited motion. It is innervated by lumbar and sacral nerve roots and plays a role in stress relief and force transmission. - Evaluation of SIJ pain is challenging due to its anatomy. History, physical exam maneuvers like Patrick's test, and image-guided injections are used to diagnose SIJ pain. - Treatment options for SIJ pain include conservative care, injections, denervation, and fusion surgery. Per

Upper C-spine Fractures Azam BasheerAzam Basheer

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This document discusses upper C-spine fractures, including epidemiology, anatomy, common injuries, and management approaches. It provides details on the anatomy of the upper cervical spine and ligaments. Common injuries discussed include atlanto-occipital dislocations, occipital condyle fractures, C1 fractures such as Jefferson fractures, C2 fractures including odontoid fractures. Odontoid fractures are classified using the Anderson and D'Alonzo system. Non-surgical and surgical management approaches are outlined for different upper cervical spine fractures and injuries.

POUR.FLOMAX MANS 5.29.14Azam Basheer

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This study aimed to determine if the drug Flomax (tamsulosin) could reduce rates of postoperative urinary retention (POUR) in male neurosurgery patients undergoing spine surgery. 95 patients were randomized to receive either Flomax or a placebo for 2 days before and after surgery. The overall rate of POUR was similar between the two groups, with 36% in the Flomax group and 28% in the placebo group developing POUR. Foley catheters were reinserted in similar rates between groups as well. The study found that Flomax did not provide significant benefits in reducing POUR for these patients.

POUR AANS 1226 presentation A. Bashee[1]Azam Basheer

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This document reports on a study examining the incidence and risk factors of postoperative urinary retention (POUR) in neurosurgical patients. The study found that the overall incidence of POUR was 39.4% in a cohort of 137 neurosurgical patients. Male patients, those over 60 years old, and those undergoing spine surgery were at highest risk. Patients who developed POUR had longer hospital stays. The results suggest POUR is common in neurosurgery and identifying risk factors could help reduce its occurrence and negative impacts.