American Association of Neurological Surgeons, April 26-May 1, 2008

American Association of Neurological Surgeons' 76th Annual Meeting

The American Association of Neurological Surgeons' 76th Annual Meeting took place April 26-May 1 in Chicago, and attracted more than 6,000 attendees from around the world. Topics included advances in basic science and clinical research, including developments that may affect the management of patients with brain tumors and cervical degenerative disc disease.

"One of the most promising studies showed that certain biomarkers in the urine correlate with the stage and progression of brain tumors," said Ghassan K. Bejjani, M.D., of the University of Pittsburgh Medical Center, chair of the meeting's public relations committee. "We need bigger studies to confirm these results. But if the results hold up, this test for brain tumors could be like the prostate-specific antigen test for prostate cancer."

In that study, Edward R. Smith, M.D., of Children's Hospital Boston, and colleagues assessed levels of urinary matrix metalloproteinases (MMPs) and other biomarkers in 28 tumor patients and 23 controls. They found that the levels were elevated in patients, suggesting that urine testing may be a novel method for detecting disease status, progression and therapeutic efficacy.

"Ultimately, we envision that routine sampling of urinary MMPs and other biomarkers may enhance current methods of brain tumor detection and follow-up by facilitating earlier detection of both novel and recurrent disease through non-invasive surveillance for abnormal urinary biomarker profiles," Smith said in a statement. "And most exciting, is that this has real potential to equate to improved patient outcome."

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"Another study, which looked at bariatric surgery patients, confirmed what has always intuitively made sense: that there's a strong link between obesity and lower back pain, and that weight reduction leads to less pain," Bejjani said.

In that study, Paul Khoueir, M.D., of the University of Southern California, and colleagues studied changes in low-back pain scores in 30 patients (mean body mass index, or BMI, 52.5) who underwent bariatric surgery. Six months after surgery, the researchers found that the patients' mean BMI decreased to 38.32 and that their mean reported pain scale decreased by 44 percent.

"Although past research has certainly shown that obesity is a risk factor for poorer outcome in patients undergoing spine surgery, this study provides evidence that substantial weight reduction following bariatric surgery results in moderate reductions in pre-existing back pain within six months of weight loss," Khoueir said in a statement. "And this effect does not appear to be the result of the overall improvement associated with the patients well being."

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Another study, presented by Michael Fehlings, M.D., of the University of Toronto, showed outcomes are significantly better in spinal cord injury patients who receive prompt decompression. "I don't think that's going to change management because we always try to decompress such patients as soon as possible, but now we have evidence to support the idea that early decompression is better," Bejjani said.

In that study, Fehlings and colleagues compared outcomes in 108 patients who received decompression less than 24 hours after their injury and 64 patients who received decompression more than 24 hours after their injury. After six months, they found that 24 percent of patients in the early decompression group experienced at least a two-grade improvement in their American Spinal Injury Association score compared to only 4 percent in the delayed decompression group.

"The initial results from our Surgical Treatment of Acute Spinal Cord Injury Study research suggests that decompression within 24 hours may be associated with improved neurological recovery at one-year follow-up," Fehlings said in a statement. "However, further recruitment of patients with long-term follow-up is necessary to validate these promising results."

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AANS: Surgical Technique Eases Chronic Headache

TUESDAY, April 29 (HealthDay News) -- In patients with chronic headaches that do not respond to conventional treatment, the surgical implantation of a cranial peripheral nerve stimulation system may provide relief, according to research presented this week at the annual meeting of the American Association of Neurological Surgeons in Chicago.

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AANS: Malpractice Suits Affect Practicing Neurosurgeons

TUESDAY, April 29 (HealthDay News) -- Between 2005 and 2007, the number of practicing neurosurgeons increased in states with the worst malpractice environments. But the probable reason -- restrictions in practice to limit liability -- may adversely affect patient care, according to research presented this week at the annual meeting of the American Association of Neurological Surgeons in Chicago.

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AANS: Deep Brain Stimulation Beneficial in Depression

MONDAY, April 28 (HealthDay News) -- Deep brain stimulation may be effective in treating refractory chronic depression, and preoperative depression treatment may benefit patients who undergo surgery for malignant brain tumors, according to two studies presented this week at the annual meeting of the American Association of Neurological Surgeons in Chicago.

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AANS: Novel Agent Effective in Parkinson's Disease

MONDAY, April 28 (HealthDay News) -- In patients with moderate to advanced Parkinson's disease, the use of Spheramine -- a novel cell-based therapy consisting of human retinal pigment epithelial (hRPE) cells that are implanted in the brain region where levodopa created by the cells is thought to convert to dopamine -- is safe and effective, according to preliminary research presented this week at the annual meeting of the American Association of Neurological Surgeons in Chicago.

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