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2. Procedures performed during neurosurgery residency in Europe

Author

Stienen, M. N., Freyschlag, C. F., Schaller, K., Meling, T., Al-Amin, A., Al-Mahfoudh, R., Amelot, A., Arvidsson, L., Athanasiou, A., Avellan, C. I. A., Bauchet, L., Berilazic, L., Bolger, C., Bourdillon, P., Boviatsis, S., Bozinov, O., Branco, P., Braunsdorf, W., Cahill, J., Clusmann, H., Conrad, J., Cordier, D., Cristino, N., Djilvesi, D., Duerinck, J., Dumot, C., Durak, M. A., Eisenring, C. V., Esposito, G., Finiels, P. -J., Flaskas, T., Fuentes, S., Ganau, M., Georgiadis, I., Georgiopoulos, M., Giakoumettis, D., Gilis, N., Gradil, C., Grau, S. J., Grin, A., Hadjigeorgiou, G., Halatsch, M. -E., Hecht, N., Holling, M., Ilic, R., Iken, L., Santos, N. I., Jacquesson, T., Jalloh, I., Jelaca, B., Kaestner, S., Kalasauskas, D., Kaliyev, A., Kleiber, J. -C., Konczalla, J., Kothbauer, K. F., Kovacevic, V., Krajcinovic, N., Krieg, S. M., Kamarainen, O. -P., Lapcic, M., Lapras, C., Ljungqvist, J., W. B., Lo, Lubrano, V., Majovsky, M., Manet, R., Marchi, F., Medetov, Y., Meling, T. R., Melloni, I., Melot, A., Mertens, P., Metcalfe, S., Moerkve, S. H., Mora, A. R., Musabelliu, E., Naushahi, M. J., Nurzhan, A., Omerhodzic, I., Paldor, I., Pallud, J., Papanastassiou, V., Papic, V., Paschalis, T., Payer, M., Peerdeman, S. M., Peruzzi, P., Segerlind, J. P., Posti, J. P., Proust, F., Regli, L., Rinne, J., Roche, P. -H., Rocka, S., Rotermund, R., Rutherford, S. A., Ratsep, T., Ruter, A., Saarenpaa, I. M., Samanci, M. Y., Samardzic, M., Sampron, N., Sandvik, U., Scerrati, A., Schneider, M., Schul, D. B., Sengul, G., Simon, E., Sinha, S., Solheim, O., Spatola, G., Spektor, S., Sundblom, J., Syrmos, N. C., Teo, M., Thomson, S., Tonchev, N., Tosic, L., Vandertop, W. P., von der Brelie, C., Vuk, A., Walkden, J., Wendel, C., Yaqout, M., Yusupova, M., Zollino, G., University of Zurich, Surgical clinical sciences, Neuroprotection & Neuromodulation, Neurosurgery, IOO, and ANS - Systems & Network Neuroscience

Subjects
Adult, Male, Neurosurgery/education, medicine.medical_specialty, Certification, Caseload, Europe, Neurosurgery, Residency, Training program, Working hour restriction, 610 Medicine & health, Neurosurgical Procedures, NO, 03 medical and health sciences, 10180 Clinic for Neurosurgery, 0302 clinical medicine, Surveys and Questionnaires, Germany, Medicine, Humans, Child, Greece, business.industry, Female sex, Internship and Residency, Mean age, Surgical procedures, Middle Aged, Current analysis, United Kingdom, Original Article - Neurosurgery Training, ddc:616.8, 030220 oncology & carcinogenesis, Surgery, Female, Neurology (clinical), France, business, 030217 neurology & neurosurgery, Switzerland, Demography
Abstract

Background In a previous article (10.1007/s00701-019-03888-3), preliminary results of a survey, aiming to shed light on the number of surgical procedures performed and assisted during neurosurgery residency in Europe were reported. We here present the final results and extend the analyses. Methods Board-certified neurosurgeons of European Association of Neurosurgical Societies (EANS) member countries were asked to review their residency case logs and participate in a 31-question electronic survey (SurveyMonkey Inc., San Mateo, CA). The responses received between April 25, 2018, and April 25, 2020, were considered. We excluded responses that were incomplete, from non-EANS member countries, or from respondents that have not yet completed their residency. Results Of 430 responses, 168 were considered for analysis after checking in- and exclusion criteria. Survey responders had a mean age of 42.7 ± 8.8 years, and 88.8% were male. Responses mainly came from surgeons employed at university/teaching hospitals (85.1%) in Germany (22.0%), France (12.5%), the United Kingdom (UK; 8.3%), Switzerland (7.7%), and Greece (7.1%). Most responders graduated in the years between 2011 and 2019 (57.7%). Thirty-eight responders (22.6%) graduated before and 130 responders (77.4%) after the European WTD 2003/88/EC came into effect. The mean number of surgical procedures performed independently, supervised or assisted throughout residency was 540 (95% CI 424–657), 482 (95% CI 398–568), and 579 (95% CI 441–717), respectively. Detailed numbers for cranial, spinal, adult, and pediatric subgroups are presented in the article. There was an annual decrease of about 33 cases in total caseload between 1976 and 2019 (coeff. − 33, 95% CI − 62 to − 4, p = 0.025). Variables associated with lesser total caseload during residency were training abroad (1210 vs. 1747, p = 0.083) and female sex by trend (947 vs. 1671, p = 0.111), whereas case numbers were comparable across the EANS countries (p = 0.443). Conclusion The final results of this survey largely confirm the previously reported numbers. They provide an opportunity for current trainees to compare their own case logs with. Again, we confirm a significant decline in surgical exposure during training between 1976 and 2019. In addition, the current analysis reveals that female sex and training abroad may be variables associated with lesser case numbers during residency.

Published
2020
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5. The World Federation of Neurosurgical Societies Young Neurosurgeons Survey (Part I): Demographics, Resources, and Education

Author

Gnanakumar, S, Abou El Ela Bourquin, B, Robertson, FC, Solla, DJF, Karekezi, C, Vaughan, K, Garcia, RM, Hassani, FD, Alamri, A, Höhne, J, Mentri, N, Stienen, M, Laeke, T, Moscote-Salazar, LR, Al-Ahmari, AN, Al-Jehani, H, Nicolosi, F, Samprón, N, Adelson, PD, Servadei, F, Esene, IN, Al-Habib, A, Kolias, AG, and World Federation of Neurosurgical Societies Young Neurosurgeons

Abstract

BACKGROUND: Providing a comprehensive and effective neurosurgical service requires adequate numbers of well-trained, resourced, and motivated neurosurgeons. The survey aims to better understand 1) the demographics of young neurosurgeons worldwide; 2) the challenges in training and resources that they face; 3) perceived barriers; and 4) needs for development. METHODS: This was a cross-sectional study in which a widely disseminated online survey (April 2018-November 2019) was used to procure a nonprobabilistic sample from current neurosurgical trainees and those within 10 years of training. Data were grouped by World Bank income classifications and analyzed using χ2 tests because of its categorical nature. RESULTS: There were 1294 respondents, with 953 completed responses included in the analysis. Of respondents, 45.2% were from high-income countries (HICs), 23.2% from upper-middle-income countries, 26.8% lower-middle-income countries, and 4.1% from low-income countries. Most respondents (79.8%) were male, a figure more pronounced in lower-income groups. Neuro-oncology was the most popular in HICs and spinal surgery in all other groups. Although access to computed tomography scanning was near universal (98.64%), magnetic resonance imaging access decreased to 66.67% in low-income countries, compared with 98.61% in HICs. Similar patterns were noted with access to operating microscopes, image guidance systems, and high-speed drills. Of respondents, 71.4% had dedicated time for neurosurgical education. CONCLUSIONS: These data confirm and quantify disparities in the equipment and training opportunities among young neurosurgeons practicing in different income groups. We hope that this study will act as a guide to further understand these differences and target resources to remedy them.

Published
2020

14. The Impact of Multiple Intracranial Aneurysms on Outcome Following Acute Aneurysmal Subarachnoid Hemorrhage

Author

Roethlisberger, M., additional, Achermann, R., additional, Schatlo, B., additional, Stienen, M., additional, Fung, C., additional, Burkhardt, J., additional, Schoeni, D., additional, D'Alonzo, D., additional, Valsecchi, D., additional, Maduri, R., additional, Ferrari, A., additional, Seule, M., additional, Corniola, M., additional, Marbacher, S., additional, Bijlenga, P., additional, Mariani, L., additional, Guzman, R., additional, and Zumofen, D.W., additional

Published
2017
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15. Chirurgie du rachis lombaire minimalement invasive : passé et présent d'une technique pleine d'avenir

Author

Corniola, Marco Vincenzo, Stienen, M N, Tessitore, Enrico, Schaller, Karl Lothard, and Gautschi, O P

Subjects
musculoskeletal diseases, Spine surgery, Minimal invasive, musculoskeletal system, ddc:616.8
Abstract

In the early twentieth century, the understanding of spine biomechanics and the advent of surgical techniques of the lumbar spine, led to the currently emerging concept of minimal invasive spine surgery, By reducing surgical access, blood loss, infection rate and general morbidity, functional prognosis of patients is improved. This is a real challenge for the spine surgeon, who has to maintain a good operative result by significantly reducing surgical collateral damages due to the relatively traumatic conventional access.

Published
2015

21. Call for uniform neuropsychological assessment after aneurysmal subarachnoid hemorrhage: Swiss recommendations

Author

Zweifel-Zehnder, A E, Stienen, M N, Chicherio, C, Studerus-Germann, A, Bläsi, S, Rossi, S, Gutbrod, K, Schmid, N, Beaud, V, Mondadori, C, Brugger, P, Sacco, L, Müri, R, Hildebrandt, G, Fournier, J Y, Keller, E, Regli, L, Fandino, J, Mariani, L, Raabe, A, Daniel, R T, Reinert, M, Robert, T, Schatlo, B, Bijlenga, P, Schaller, K, Monsch, A U, Zweifel-Zehnder, A E, Stienen, M N, Chicherio, C, Studerus-Germann, A, Bläsi, S, Rossi, S, Gutbrod, K, Schmid, N, Beaud, V, Mondadori, C, Brugger, P, Sacco, L, Müri, R, Hildebrandt, G, Fournier, J Y, Keller, E, Regli, L, Fandino, J, Mariani, L, Raabe, A, Daniel, R T, Reinert, M, Robert, T, Schatlo, B, Bijlenga, P, Schaller, K, and Monsch, A U

Abstract

BACKGROUND In a high proportion of patients with favorable outcome after aneurysmal subarachnoid hemorrhage (aSAH), neuropsychological deficits, depression, anxiety, and fatigue are responsible for the inability to return to their regular premorbid life and pursue their professional careers. These problems often remain unrecognized, as no recommendations concerning a standardized comprehensive assessment have yet found entry into clinical routines. METHODS To establish a nationwide standard concerning a comprehensive assessment after aSAH, representatives of all neuropsychological and neurosurgical departments of those eight Swiss centers treating acute aSAH have agreed on a common protocol. In addition, a battery of questionnaires and neuropsychological tests was selected, optimally suited to the deficits found most prevalent in aSAH patients that was available in different languages and standardized. RESULTS We propose a baseline inpatient neuropsychological screening using the Montreal Cognitive Assessment (MoCA) between days 14 and 28 after aSAH. In an outpatient setting at 3 and 12 months after bleeding, we recommend a neuropsychological examination, testing all relevant domains including attention, speed of information processing, executive functions, verbal and visual learning/memory, language, visuo-perceptual abilities, and premorbid intelligence. In addition, a detailed assessment capturing anxiety, depression, fatigue, symptoms of frontal lobe affection, and quality of life should be performed. CONCLUSIONS This standardized neuropsychological assessment will lead to a more comprehensive assessment of the patient, facilitate the detection and subsequent treatment of previously unrecognized but relevant impairments, and help to determine the incidence, characteristics, modifiable risk factors, and the clinical course of these impairments after aSAH.The need for clinically applicable skin substitutes continues to be a matter of fact. Hypothetically, a labora

Published
2015

22. Neurosurgical resident train ing in the Czech Republic.

Author

Netuka, D., Stienen, M. N., Ringel, F., Gempt, J., Demetriades, A. K., and Schaller, K.

Subjects
*SURGICAL education, *NEUROSURGERY, *NEUROSURGEONS, *CRANIOTOMY, *SPINAL surgery, *TRAINING
Abstract

Introduction: Resident train ing is es sential to be able to off er high-quality medical care. Neurosurgical train ing in its traditional form is cur rently chal lenged by law-enforced work ing hour restrictions and general re-structur ing within Europe. We aimed to evaluate the cur rent situation of resident train ing in the Czech Republic. Methods: An electronic survey was sent to European neurosurgical trainees between 06/ 2014 and 03/ 2015. The responses of Czech trainees were compared to those of trainees from other European countries. Logistic regres sion analysis was used to as sess the effect size of the relationship between a trainee from the Czech Republic and the outcomes (e. g. satisfaction, work ing time). Results: Of n = 532 responses, 22 were from Czech trainees (4.14%). In a multivariate analysis, Czech trainees were as likely as non-Czech European trainees to be satisfied with clinical lectures given at their teach ing facility (OR 1.84; 95% CI 0.77- 4.43; p = 0.170). The satisfaction rate with hands-on operat ing room exposure was nonsignifi cantly higher than in other European countries (OR 3.22; 0.72- 14.39; p = 0.125). Approximately 100% of Czech trainees vs. 88.7% of trainees from other European countries performed a surgical procedure as the primary surgeon within the fi rst year of train ing (Pearson Chi2 test 2.28; p = 0.131). They were about 4-times as likely to begin with their own cranial cases within 36 months of train ing (OR 3.69; 1.04- 13.07; p = 0.042). Czech trainees were 52-times as likely to perform on average ≥ 4 peripheral nerve interventions per month (OR 52.05; 11.46- 236.31; p < 0.001), but less likely to operate ≥ 10 burr hole trepanations (OR 0.13; 0.02- 0.97; p = 0.047) and the exposure was balanced regard ing craniotomies and spine procedures. About 72% of Czech trainees adhered to the weekly limit of 48 h as requested from the European Work ing Time Directive 2003/ 88/ EC, and this was better than the international comparison (OR 0.26; 0.09- 0.75; p = 0.013). Conclusion: Most theoretical and practical aspects of neurosurgical train ing are rated similarly by Czech trainees when compared to the situation of trainees from other European countries. They adhered better to the 48 h week as requested by the European WTD 2003/ 88/ EC. [ABSTRACT FROM AUTHOR]

Published
2018
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24. Call for Uniform Psychosocial Assessment after Aneurysmal Subarachnoid Hemorrhage: Swiss Recommendations

Author

Stienen, M., primary, Zweifel-Zehnder, A., additional, Chicherio, C., additional, Studerus-Germann, A., additional, Bläsi, S., additional, Rossi, S., additional, Gutbrod, K., additional, Schmid, N., additional, Beaud, V., additional, Mondadori, C., additional, Brugger, P., additional, Sacco, L., additional, Müri, R., additional, Hildebrandt, G., additional, Fournier, J., additional, Keller, E., additional, Regli, L., additional, Fandino, J., additional, Mariani, L., additional, Raabe, A., additional, Daniel, R., additional, Reinert, M., additional, Robert, T., additional, Schatlo, B., additional, Bijlenga, P., additional, Schaller, K., additional, and Monsch, A., additional

Published
2015
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27. Decompressive Hemicraniectomy in Aneurysmal Subarachnoid Hemorrhage—Insights from a Swiss National Database (Swiss SOS)

Author

Stienen, M., primary, Corniola, M.-V., additional, Smoll, N., additional, Burkhardt, J.-K., additional, Fung, C., additional, Schöni, D., additional, Röthlisberger, M., additional, Bervini, D., additional, Valsecchi, D., additional, Arrighi, M., additional, Maduri, R., additional, Danura, H., additional, Fathi, A.-R., additional, Keller, E., additional, Regli, L., additional, Fandino, J., additional, Hildebrandt, G., additional, Guzman, R., additional, Schatlo, B., additional, Schaller, K., additional, and Bijlenga, P., additional

Published
2015
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28. Clinical and Radiological Characteristics of Aneurysmal Subarachnoid Hemorrhage in Older Adults

Author

Röthlisberger, M., primary, Zumofen, D., additional, Schatlo, B., additional, Stienen, M., additional, Sailer, M., additional, Fung, C., additional, Burkhardt, J., additional, Tok, S., additional, D'Alonzo, D., additional, Marbacher, S., additional, Hiroki, D., additional, Dell-Kuster, S., additional, Achermann, R., additional, Corniola, M., additional, Bervini, D., additional, Fathi, A., additional, Daniel, R., additional, Hildebrandt, G., additional, Regli, L., additional, Reinert, M., additional, Raabe, A., additional, Fandino, J., additional, Bijlenga, P., additional, Schaller, K., additional, Keller, E., additional, Mariani, L., additional, and Guzman, R., additional

Published
2015
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29. Incidence, Therapy, and Outcome of Aneurysmal Subarachnoid Hemorrhage. The Swiss Study on Aneurysmal Subarachnoid Hemorrhage (Swiss SOS)

Author

Schatlo, B., primary, Fung, C., additional, Stienen, M., additional, Fathi, A., additional, Fandino, J., additional, Smoll, N., additional, Tok, S., additional, Daniel, R., additional, Zumofen, D., additional, Burkhard, J., additional, Dan-Ura, H., additional, Röthlisberger, M., additional, Reinert, M., additional, Winkler, K., additional, Ahlborn, P., additional, Mendes-Pereira, V., additional, D́Alonzo, D., additional, Seule, M., additional, Kerkeni, H., additional, Bervini, D., additional, Sailer, M., additional, Kuhlen, D., additional, Remonda, L., additional, Rohde, V., additional, Mostaguir, K., additional, Marbacher, S., additional, Valsecchi, D., additional, Corniola, M., additional, Schöni, D., additional, Woernle, C., additional, Regli, L., additional, Levivier, M., additional, Hildebrandt, G., additional, Mariani, L., additional, Beck, J., additional, Guzman, R., additional, Raabe, A., additional, Bijlenga, P., additional, Keller, E., additional, and Schaller, K., additional

Published
2015
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33. Computed Tomography Angiography Spot Sign as a Predictor for Outcome for Patients with Intracerebral Hemorrhage and Aneurysmal Subarachnoid Hemorrhage

Author

Burkhardt, J., primary, Neidert, M., additional, Stienen, M., additional, Schöni, D., additional, Fung, C., additional, Röthlisberger, M., additional, Corniola, M., additional, Bervini, D., additional, Maduri, R., additional, Valsecchi, D., additional, Tok, S., additional, Schatlo, B., additional, Schaller, K., additional, Bozinov, O., additional, and Regli, L., additional

Published
2015
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43. Aneurysmatische Subarachnoidalblutung

Author

Gautschi, O P, Stienen, M N, Cadosch, D, Fournier, J Y, Hildebrandt, G, Seule, M A, University of Zurich, and Gautschi, O P

Subjects
10021 Department of Trauma Surgery, 610 Medicine & health, 2700 General Medicine, General Medicine
Published
2010
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46. Building on the concept for marine biological valuation with respect to translating it to a practical protocol: Viewpoints derived from a joint ENCORA-MARBEF initiative

Author

Derous, S., Austen, M., Claus, S., Daan, N., Dauvin, Jean-Claude, Deneudt, K., Depestele, J., Desroy, N., Heessen, H., Hostens, K., Marboe, A.H., Lescrauwaet, A.K., Moreno, M., Moulaert, I., Paelinckx, D., Rabaut, M., Rees, H., Ressurreição, A., Roff, J., Talhadas Santos, P., Speybroeck, J., Willem, E., Stienen, M., Tatarek, A., Hofstede R., Ter, Vincx, M., Zarzycki, T., Degraer, S., Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Laboratoire d’Océanologie et de Géosciences (LOG) - UMR 8187 (LOG), Centre National de la Recherche Scientifique (CNRS)-Université du Littoral Côte d'Opale (ULCO)-Université de Lille-Institut national des sciences de l'Univers (INSU - CNRS), Synthèses sélective organique et produits naturels (SSOPN), Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), Gent University, Department of Biology, and Institut national des sciences de l'Univers (INSU - CNRS)-Université du Littoral Côte d'Opale (ULCO)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD [France-Nord])

Subjects
ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2007

48. Is Intracranial Aneurysm Rupture Related to Solar Activity?

Author

Stienen, M., primary, Smoll, N., additional, Battaglia, M., additional, Schatlo, B., additional, Woernle, C., additional, Fung, C., additional, Röthlisberger, M., additional, Daniel, R., additional, Fathi, A., additional, Hildebrandt, G., additional, Schaller, K., additional, and Bijlenga, P., additional

Published
2014
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50. Introducing a nationwide registry: the Swiss study on aneurysmal subarachnoid haemorrhage (Swiss SOS)

Author

Schatlo, B, Fung, C, Fathi, A-R, Sailer, M, Winkler, K, Daniel, R T, Bijlenga, P, Ahlborn, P, Seule, M, Zumofen, D, Reinert, M, Woernle, C, Stienen, M, Levivier, M, Hildebrandt, G, Mariani, L, Bernays, R, Fandino, J, Raabe, A, Keller, E, Schaller, K, Schatlo, B, Fung, C, Fathi, A-R, Sailer, M, Winkler, K, Daniel, R T, Bijlenga, P, Ahlborn, P, Seule, M, Zumofen, D, Reinert, M, Woernle, C, Stienen, M, Levivier, M, Hildebrandt, G, Mariani, L, Bernays, R, Fandino, J, Raabe, A, Keller, E, and Schaller, K

Abstract

BACKGROUND: Aneurysmal subarachnoid haemorrhage (aSAH) is a haemorrhagic form of stroke and occurs in a younger population compared with ischaemic stroke or intracerebral haemorrhage. It accounts for a large proportion of productive life-years lost to stroke. Its surgical and medical treatment represents a multidisciplinary effort. Due to the complexity of the disease, the management remains difficult to standardise and quality of care is accordingly difficult to assess. OBJECTIVE: To create a registry to assess management parameters of patients treated for aSAH in Switzerland. METHODS: A cohort study was initiated with the aim to record characteristics of patients admitted with aSAH, starting January 1st 2009. Ethical committee approval was obtained or is pending from the institutional review boards of all centres. In the study period, seven Swiss hospitals (five university [U], two non-university medical centres) harbouring a neurosurgery department, an intensive care unit and an interventional neuroradiology team so far agreed to participate in the registry (Aarau, Basel [U], Bern [U], Geneva [U], Lausanne [U], St. Gallen, Zürich [U]). Demographic and clinical parameters are entered into a common database. DISCUSSION: This database will soon provide (1) a nationwide assessment of the current standard of care and (2) the outcomes for patients suffering from aSAH in Switzerland. Based on data from this registry, we can conduct cohort comparisons or design diagnostic or therapeutic studies on a national level. Moreover, a standardised registration system will allow healthcare providers to assess the quality of care.

Published
2012

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