The role of medical illustration in the evolution of transsphenoidal pituitary surgery

J Neurosurg 141:491–499, 2024

Medical illustration played a crucial, yet often overlooked, role in the evolution of pituitary surgery. From the late 1800s to the present, many preeminent surgeons, in partnership with their surgical illustrator collaborators, developed and then shifted the paradigm of pituitary surgery, from an open procedure with high mortality and morbidity, to an endonasal approach with high success rates that is widely utilized today. This work aims to highlight the role of surgical illustrators as partners to their physician colleagues, creating artistically accessible road maps that shaped the development of the transsphenoidal approach.

Evolution and Impact of the Brain Trauma Foundation Guidelines

Neurosurgery 89:1148–1156, 2021

The Brain Trauma Foundation (BTF) Guidelines for the Management of Severe Head Injury were the first clinical practice guidelines published by any surgical specialty. These guidelines have earned a reputation for rigor and have been widely adopted around the world. Implementation of these guidelines has been associated with a 50% reduction in mortality and reduced costs of patient care.

Over their 25-yr history the traumatic brain injury (TBI) guidelines have been expanded, refined, and made increasingly more rigorous in conjunction with new clinical evidence and evolving methodologic standards.

Here, we discuss the history and accomplishments of BTF guidelines for TBI as well as their limitations. We also discuss planned changes to future TBI guidelines intended to increase their utility and positive impact in an evolving medical landscape. Perhaps the greatest limitation of TBI guidelines now is the lack of high-quality clinical research as well as novel diagnostics and treatments with which to generate substantially new recommendations.

The microneurosurgical anatomy legacy of Albert L. Rhoton Jr., MD: an analysis of transition and evolution over 50 years

J Neurosurg 129:1331–1341, 2018

Dr. Albert L. Rhoton Jr. was a pioneer of the study of microneurosurgical anatomy. Championing this field over the past half century, he produced more than 500 publications.

In this paper, the authors review his body of work, focusing on approximately 160 original articles authored by Rhoton and his microneuroanatomy fellows.

The articles are categorized chronologically into 5 stages: 1) dawn of microneurosurgical anatomy, 2) study of basic anatomy for general neurosurgery, 3) study for skull base surgery, 4) study of the internal structures of the brain by fiber dissection, and 5) surgical anatomy dealing with new advanced surgical approaches.

Rhoton introduced many new research ideas and surgical techniques and approaches, along with better microsurgery instruments, through studying and teaching microsurgical anatomy, especially during the first stage. The characteristic features of each stage are explained and the transition phases of his projects are reviewed.

 

Instrumentation of the Posterior Thoracolumbar Spine: From Wires to Pedicle Screws

Instrumentation of the Posterior Thoracolumbar Spine- From Wires to Pedicle Screws

Operative Neurosurgery 10:497–505, 2014

Over the past 120 years, spinal stabilization has advanced immensely. An updated review highlighting these advancements has not been performed in the past 20 years.

The objective of this report is to provide a historical assessment of the decades outlining various key innovators, their techniques, and instrumentation.

It is important to provide new generations of surgeons and students with historical evidence of the value of developing new techniques and instrumentation to improve patient care and outcomes.