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Objective: To evaluate the short-term surgical outcomes and the reimbursement patterns, after treatment of type 2 odontoid fractures using the anterior or posterior approach., Methods: The National Surgical Quality Improvement Program database was queried for surgically treated patients with type 2 odontoid fractures by the anterior or posterior approach between 2016 and 2020. Propensity score matching with the optimal approach was used to balance the cohorts., Results: A total of 96 patients in the anterior and 352 patients in the posterior surgery group were included in the unmatched analysis. After propensity score matching 1:1, 96 anterior and 96 posterior cases were included in the matched analysis. Operative times were shorter in the anterior group (92.0 vs. 145.0 minutes, P < 0.001). The need for intraoperative or postoperative transfusions was higher in the posterior group (15% vs. 2.1%; P = 0.002). However, there were no significant differences in complications between groups (P > 0.05). Hospital stay was significantly longer in the posterior group (4.5 days vs. 3.0; P = 0.049). Nonroutine discharge was more frequent in the posterior group (55% vs. 40%, P = 0.030). However, the rate of 30-day readmission, reoperation, and mortality did not differ between groups (P > 0.05). Also, the work relative value units were significantly higher in the anterior group (22.7 vs. 20.6, P < 0.001), indicating higher reimbursement trends for this approach., Conclusions: In this matched analysis, the anterior approach for type 2 odontoid fractures was superior to the posterior approach. The anterior approach was associated with significantly shorter operation times, hospital stays, fewer transfusions, nonroutine discharges, and higher reimbursements., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Objective: Neurosurgery is one of the most competitive specialties, and navigating the match process is often challenging for aspiring applicants. Here, we analyze insights from the National Resident Matching Program Director Surveys, illustrating evolving trends in applicant selection for interviews and for the ranking process, and providing a comparison with other specialties., Methods: We evaluated 7 surveys administered from 2012 to 2022. Six biennial surveys reported on factors influencing interview and ranking processes, while all 7 surveys included data about the program director (PD)'s attitude toward United States Medical Licensing Examination (USMLE) test scores., Results: The response rate of PDs decreased over the years. The most cited factor for interviews included specialty-specific recommendation letters (95%), USMLE Step 1 scores (91%), and interest in research (78%). A recent decline in emphasis on USMLE Step 1 scores coincided with a growing reliance on USMLE Step 2 scores. Award in basic science held significant esteem to a subset of programs. Personal characteristics dominated for ranking, with faculty interaction (89%), interpersonal skills (89%), and house staff interaction (85%) being the most important. Yet, PDs reported a difficulty in assessing interpersonal skills through virtual interviews., Conclusions: Our analysis revealed the pervasive importance of specialized endorsements and academic achievements when screening applicants for the interview process. A shift in emphasis toward the USMLE Step 2 became apparent. Personal characteristics, on the other hand, seemed crucial to make a match and rank high among the pool of interviewed applicants. We uncovered difficulties in assessing these characteristics through virtual interviews., (Copyright © 2024. Published by Elsevier Inc.)

Background: The frontal bone is frequently approached during neurosurgical procedures. Feared complications of such surgeries include cerebrospinal fluid leak, among others, and frequently result from a breach of the frontal sinus. For this reason, the sinus should be avoided when possible. The supraorbital notch (SON) is a reliable and easily identifiable surgical landmark and its relation to the frontal sinus has been previously studied. However, the frontal sinus shows significant variability in size and shape between populations., Methods: In the present study, we investigate the frontal sinus dimension and its relation to the SON in the Middle Eastern population., Results: The analysis of a set of computed tomography scans reveals a significant variation in size between genders, and we subsequently provide neurosurgeons in the region with population-targeted, gender-specific risk maps., Conclusions: We finally conclude that a 2-cm margin rostral and lateral to the SON is safest., (Copyright © 2020 Elsevier Inc. All rights reserved.)