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首页> 外文期刊>British journal of neurosurgery >The evolution of neurosurgery: How has our practice changed?
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The evolution of neurosurgery: How has our practice changed?

机译：神经外科的演变：我们的做法如何变化？

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Introduction. Neurosurgery is a rapdily evolving speciality and has often taken a lead in adopting new technologies. Advancing technology however is not the only force driving change in this discipline. Other factors include an escalation in patient expectations, an increasing (and ageing) population and the prevailing economic conditions. The aim of our study was to analyse the trends in neurosurgical practice over a 10-year period. Materials and methods. The details of every neurosurgical procedure performed at Wellington Regional Hospital from 2001 to 2011 were prospectively recorded in a relational database. This was then retrospectively interrogated to provide data for this study. Results. Neurosurgical practice has clearly evolved over the last decade. Predictable changes include a trend towards coiling rather than clipping of cerebral aneurysms, an increasing number of tumour resections (particularly for malignant glioma) coupled with the increased use of image guidance and endoscopy. The number of operations on the cervical spine has also increased although overall the number of procedures for spinal degenerative conditions has declined, perhaps reflecting local practice. The rates of craniotomy for trauma and burr holes for chronic subdural haematoma have remained essentially unchanged. We have demonstrated a significant increase in annual case-load that is disproportionate to any change in population size. Collaboration between specialties is increasingly evident. Conclusion. The most important changes have occured in the fields of neuro-oncology, vascular neurosurgery and spinal surgery. Inter-specialty collaboration is establishing itself as a model of care. These data may guide resource allocation for a population increasing both in number and in age.
机译：介绍。神经外科是一种Rapdily演化的专业，经常采用新技术领先。然而，推进技术并不是唯一的力量驾驶这一学科的变化。其他因素包括患者期望的升级，增加（和老化）人口和普遍的经济状况。我们的研究目的是分析10年期间神经外科实践的趋势。材料和方法。从2001年到2011年从惠灵顿地区医院进行的每种神经外科手术的细节都在一个关系数据库中进行了预先记录。然后回顾性地询问此项以提供本研究的数据。结果。在过去十年中，神经外科实践明显发展。可预测的变化包括卷绕趋势而不是脑动脉瘤的剪裁，越来越多的肿瘤切除术（特别是恶性胶质瘤）与增加的图像引导和内窥镜检查的使用增加。宫颈脊柱的作业数量也有所增加，尽管总体而言，脊柱退行性条件的程序数量下降，也许是反映当地的实践。用于慢性硬膜体血肿的创伤和毛刺孔的Craniotmy的速率仍然保持不变。我们已经表现出对年案件负荷的显着增加，这与人口大小的任何变化不成比例。特色之间的合作越来越明显。结论。在神经肿瘤，血管神经外科和脊柱手术领域发生最重要的变化。专业间合作是建立自己作为护理的模式。这些数据可以指导资源分配在数量和年龄的人口中增加。

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