Effective at the time of the most recent meeting of the Executive Committee of the Congress Neurological Surgeons (CNS), we are now a Joint Section of both major neurosurgical organizations. There are two significant effects of this change. The first is that Section membership is now open to CNS members as well as AANS members. This will slightly broaden our membership. The second effect will be on the influence we will have on the education mission of both organizations, particularly as it relates to the Annual Meeting of each organization.
In these rapidly changing times of scrutiny and revolution in reimbursement there will be progressively greater pressure on us as neurosurgeons to justify the decisions we make related to patient care. This is particularly true in areas where controversy continues to exist and practice patterns are at great variance.
Outcome Studies
Along with the other Joint Sections, the Pediatric Section has been challenged by its parent organizations to perform outcome studies to bring a semblance of science to clinical decision making. These studies will require a great deal of time and energy and some money to be successful. The AANS is providing consultative resources to make these a success. Several studies are presently being performed by interested pediatric neurosurgeons, the most compelling being the shunt outcome study comparing short -term outcomes from the implantation of various valves under the direction of James Drake, MD, and John R. W. Kestle, MD.
The section has committed resources to outcome-related projects in three areas:
- Scientific analysis of the data on severe closed head injury in children as they differ form adults. This task is jointly sponsored by the Joint Section on Neurotrauma and Critical Care, as well as the Pediatric Section. It is intended that this take the form of a document either as a “stand-alone” or as annotations to the Adult Severe Head Injury Guidelines. This work is under the direction of Thomas Luerssen, MD.
- With the support of the Section, there will be a National Institutes of Health (NIH)-sponsored consensus conference to be held October 1719, 1996, in Salt Lake City, Utah, under the direction of Marion Walker, MD. The conference will deal with six specific questions about the treatment of hydrocephalus, including how the shunt-dependent patient’s treatment is optimized under managed care. We intend to use this opportunity to generate questions that can be answered using randomized prospective trials.
- Finally, we are exploring the feasibility of performing a study on the indications and outcomes of surgery for tethered cord release following the repair of a patient with a myelomeningocele.
Pediatric Neurosurgery Meetings
The Joint Section on Pediatric Neurological Surgery portion of the AANS meeting in Minneapolis, Minnesota, held April 27 – May 2, 1996, was successful with a full afternoon devoted to Scientific Papers. Harold Hoffman, MD, presented the Special Lecture on the topic of “Separation of Cephalopagus Twins.” The Shulman Award was presented to Seyed M. Emadian, PhD, for his paper “Correla tion of Chromosome 17p Loss with Clinical Outcome in Patients with Primitive Neuroectodermal Tumors.” The Matson Award was given to a team of researchers led by Kent D. Yundt, MD, for their paper entitled “Neonatal Cere bral Blood Flow Inversely Correlates with Long-Term Neurological Outcome in Full-Term Infants Surviving Hypoxic-Ischemic Encephalopathy.”
The 1996 Annual Meeting of the Joint Section on Pediatric Neurological Surgery is scheduled to be held in Charleston, South Carolina, December 10 – 13, 1996.
The primary focus of the activity of the Joint Section on Pediatric Neurological Surgery is on the continuing education of its members, non-member neurological surgeons, the families of the patients we treat, and the community at large. If you see areas which need emphasis or opportunities to fulfill this purpose, please notify one of the members of the Section’s executive committee. We will listen.