Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in...Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in published guidelines.The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.Methods:This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.Results:The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews.Overall,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons.Other notable factors include delay in transferring patients to the trauma center,delay in availability of necessary equipment,and scarce medical personnel.Conclusion:In the perspective of neurosurgeons,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.展开更多
Epilepsy surgery has been accepted as an effective treatment in drug-resistant focal epilepsy.However,the number of epilepsy neurosurgeons is not enough in China compared with the huge demand.The content of epilepsy n...Epilepsy surgery has been accepted as an effective treatment in drug-resistant focal epilepsy.However,the number of epilepsy neurosurgeons is not enough in China compared with the huge demand.The content of epilepsy neurosurgeon cultivation includes surgery itself as well as presurgical evaluation.In this article,we review not only different categories of epilepsy surgeries but also the presurgical evaluation approaches including non-invasive methods,such as semiology analysis,high-resolution structural and functional imaging techniques,scalp electroencephalography monitoring as well as invasive methods,such as electrocorticography(ECoG)and stereotactic electroencephalography(SEEG).We also discuss the importance of learning each method briefly.In addition,we suggest that epilepsy neurosurgeons should have a solid structural and functional anatomy basis as it plays pivotal role in localizing epileptogenic zone.Epilepsy neurosurgeons should also be familiar with the staged presurgical evaluation starting from the most preliminary examinations and progressing to more complex and invasive methods.During the diagnosis and therapeutic procedures,collaboration between epilepsy neurosurgeons and other specialists is essential.At last,the necessity of epilepsy neurosurgeon cultivation has been emphasized.展开更多
基金funded by Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences(grant number 98-01-38-41413)。
文摘Purpose:The median time from the event leading to the spinal cord injury(SCI)to the time of decompressive surgery is estimated to be 6.9 days in Iran,which is much longer than the proposed ideal time(less than 24 h)in published guidelines.The current qualitative study aimed to determine the reasons for the observed decompression surgery delay in Iran from the perspective of neurosurgeons.Methods:This qualitative study is designed to perform content analysis on the gathered data from face-to-face semi-structured interviews with 12 Iranian neurosurgeons.Results:The findings of the current study suggest that patient-related factors constitute more than half of the codes extracted from the interviews.Overall,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the main factors causing delayed spinal cord decompression in Iranian patients from the perspective of neurosurgeons.Other notable factors include delay in transferring patients to the trauma center,delay in availability of necessary equipment,and scarce medical personnel.Conclusion:In the perspective of neurosurgeons,the type of injury,presence of polytrauma,and surgeons’’wrong attitude are the leading reasons for delayed decompressive surgery of individuals with SCI in Iran.
基金supported by grants from the National Natural Science Foundation of China(No.81171218)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding(code:XMLX201304code:ZYLX201305).
文摘Epilepsy surgery has been accepted as an effective treatment in drug-resistant focal epilepsy.However,the number of epilepsy neurosurgeons is not enough in China compared with the huge demand.The content of epilepsy neurosurgeon cultivation includes surgery itself as well as presurgical evaluation.In this article,we review not only different categories of epilepsy surgeries but also the presurgical evaluation approaches including non-invasive methods,such as semiology analysis,high-resolution structural and functional imaging techniques,scalp electroencephalography monitoring as well as invasive methods,such as electrocorticography(ECoG)and stereotactic electroencephalography(SEEG).We also discuss the importance of learning each method briefly.In addition,we suggest that epilepsy neurosurgeons should have a solid structural and functional anatomy basis as it plays pivotal role in localizing epileptogenic zone.Epilepsy neurosurgeons should also be familiar with the staged presurgical evaluation starting from the most preliminary examinations and progressing to more complex and invasive methods.During the diagnosis and therapeutic procedures,collaboration between epilepsy neurosurgeons and other specialists is essential.At last,the necessity of epilepsy neurosurgeon cultivation has been emphasized.
