A history of Colombian neurosurgery: events, persons, and outcomes that have shaped the specialty in the country.

The history of Colombian neurosurgery is a collective legacy of neurosurgeon-scientists, scholars, teachers, innovators, and researchers. Anchored in the country's foundational values of self-determination and adaptability, these pioneers emerged from the Spanish colonial medical tradition and forged surgical alliances abroad. From the time of Colombian independence until the end of World War I, exchanges with the French medical tradition produced an emphasis on anatomical and systematic approaches to the emerging field of neurosurgery. The onset of American neurosurgical expertise in the 1930s led to a new period of exchange, wherein technological innovations were added to the Colombian neurosurgical repertoire. This diversity of influences culminated in the 1950s with the establishment of Colombia's first in-country neurosurgery residency program. A select group of avant-garde neurosurgeons from this period expanded the domestic opportunities for patients and practitioners alike. Today, the system counts 10 recognized neurosurgery residency programs and over 500 neurosurgeons within Colombia. Although the successes of specific individuals and innovations were considered, the primary purpose of this historical survey was to glean relevant lessons from the past that can inform present challenges, inspire new opportunities, and identify professional and societal goals for the future of neurosurgical practice and specialization.

Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations.

Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.

Rehabilitation of Spinal Cord Injury: WFNS Spine Committee Recommendations.

Spinal cord injury (SCI) is accompanied by a significant number of complications associated with damage to the spinal cord, gross functional impairments leading to limited self-care and movement, leading to a high level of disability, social and psychological maladaptation of the patients. Besides, pain and spasticity negatively affect rehabilitation programs. This search was conducted in PubMed/MEDLINE database. All studies published in English language (n = 16,297) were considered for inclusion. Of all studies evaluating rehabilitation in SCI patients (n = 80) were included. Based on the literature review the faculty of the WFNS Spine Committee created statements covering different aspects of the contemporary rehabilitation process of the SCI patients. The prepared statements were subjected to discussions, followed by anonymous voting process by the members of the WFNS Spine Committee. As result of the diccussions and the voting process the statements were modified and published as recommendations of the WFNS Spine Committee. The care for the SCI has gone a long way from the times after the World War II when these patients were considered hopeless in terms of any functional recovery, to the contemporary comprehensive rehabilitation programs. The rehabilitation is important part of the modern comprehencive treatment of SCI patients nowadays. The current manuscript reflects different aspects of the contemporary rehabilitaton process and decision makings, which were discussed by the faculty of the WFNS Spine Committee resulting in issuing of the following recommendations.

Traumatic Spinal Injury: Global Epidemiology and Worldwide Volume.

BACKGROUND: Traumatic spinal injury (TSI) results from injury to bony, ligamentous, and/or neurologic structures of the spinal column and can cause significant morbidity and mortality. The global burden of TSI is poorly understood, so we performed a systematic review and meta-analysis to estimate the global volume of TSI. METHODS: We performed a systematic review through PubMed, Embase, and Cochrane Databases on TSI studies reported from 2000 to 2016. Collected data were used to perform a meta-analysis to estimate the annual incidence of TSI across World Health Organization regions and World Bank income groups using random-effect models. Incorporating global population figures, the annual worldwide volume of TSI was estimated. RESULTS: A total of 102 studies were included in the systematic review and 19 studies in the meta-analysis. The overall global incidence of TSI was 10.5 cases per 100,000 persons, resulting in an estimated 768,473 [95% confidence interval, 597,213-939,732] new cases of TSI annually worldwide. The incidence of TSI was higher in low- and middle-income countries (8.72 per 100,000 persons) compared with high-income countries (13.69 per 100,000 persons). Road traffic accidents, followed by falls, were the most common mechanism of TSI worldwide. Overall, 48.8% of patients with TSI required surgery. CONCLUSIONS: TSI is a major source of morbidity and mortality throughout the world. Largely preventable mechanisms, including road traffic accidents and falls, are the main causes of TSI globally. Further investigation is needed to delineate local and regional TSI incidences and causes, especially in low- and middle-income countries.

Tratamiento de la craneosinostosis / Surgical treatment of craniosynostosis

Las cráneosinostosis deben ser diagnósticadas tempranamente por el médico general o especialista y en lo posible ser intervenidas quirúrgicamente antes del primer año de vida, época de mayor crecimiento del cerebro. Algunos casos como las trigonocefalias que comprometen varias suturas asociadas a hueso frontal pequeño, deben ser intervenidos durante las primeras semanas de vida. Solamente en hospitales universitarios, donde se cuenta con equipos médicos y paramédicos multidisciplinarios y con alta tecnología, podemos tratar estos pacientes. La atención del paciente va más allá del acto quirúrgico, puesto que se requiere un seguimiento y entrenamiento especial; igualmente nuestra labor debe abarcar el núcleo familiar, preparándolo adecuadamente para lograr la rehabilitación también afectiva y social de nuestro paciente con craneosinostosis.

La Unidad de Neurocirugía y sus perspectivas / Neurosurgery unit: perspectives

Las actividades académicas en el campo neuroquirúrgico en la facultad se iniciaron a comienzos de la década de los 80. En febrero de 1980, dos neurocirujanos, los doctores José Mora Rubio y Miguel Gutierrez, iniciaron cursos de Neuroanatomía funcional para el segundo semestre de medicina y, en julio del mismo año, el doctor Mora Rubio, dictó los primeros cursos de Semiología Neurológica para los alumnos de cuarto semestre de la facultad