Authors: Tarnaris, A.; Arvin, B.; Ashkan, K.

Source: Annals of The Royal College of Surgeons of England, Volume 90, Number 6, September 2008 , pp. 508-512(5)

Publisher: The Royal College of Surgeons of England

Abstract:

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.

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Keywords: NEUROSURGERY; AUDIT; PRACTICE

Document Type: Research article

DOI: http://dx.doi.org/10.1308/003588408X321530

Affiliations: 1: Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK

Publication date: 2008-09-01

More about this publication?

• The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.
  
  The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.
  
  Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database
  
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