Observational studies on the safety and clinical outcomes of PEEK vertebral body replacement cages have not yet been reviewed in a structured manner. A structured literature review was conducted of observational studies dealing exclusively with ACCF treated with PEEK cages according to the PRISMA protocol using the search terms: ‘anterior cervical corpectomy + PEEK cage’. A modified NHLBI Quality Assessment Tool for case series studies was used to objectify the risk of bias. The evidence from the summarised data was classified according to the GRADE criteria. A total of 5 retrospective studies involving 279 patients were identified. The pooled stable fusion rate was 0.88 (95

Abstract Background Chronic subdural hematoma (cSDH) is a common intracranial hemorrhage in elderly patients and is associated with substantial postoperative recurrence rates. Tranexamic acid (TXA) has been proposed as an adjuvant therapy to reduce recurrence by targeting hyperfibrinolysis; however, its efficacy and impact on hematoma volume evolution remain controversial. Methods We performed a retrospective cohort study of adult patients who underwent burr-hole evacuation with subdural drainage for cSDH at a single neurosurgical center between 2012 and 2024. Patients receiving postoperative TXA within 48 h for at least 30 days were compared with patients treated surgically without TXA. Propensity score matching (1:1) was applied to balance baseline characteristics. The primary outcome was revision surgery for recurrent cSDH within 3 months. Secondary outcomes included postoperative hematoma volume evolution and all-cause mortality. Results After matching, 73 patients were included in each group with well-balanced baseline characteristics. Revision surgery within 90 days occurred less frequently in the TXA group compared with controls (8.2% vs. 19.2%; OR 0.40, 95% CI 0.14–1.12; p = 0.042), although the confidence interval marginally crossed unity, indicating limited precision. Median time to revision was 8 days in the TXA group and 11 days in the control group. Mortality was numerically lower in the TXA group, with no deaths observed, compared with one death (1.4%) in the control group. Preoperative, postoperative, and one-month follow-up hematoma volumes were comparable between groups, and no significant difference in absolute volume reduction was detected. Conclusion Postoperative adjuvant TXA therapy after surgical evacuation of cSDH was associated with a lower rate of recurrence requiring revision surgery, without an observed increase in mortality; however, the confidence interval marginally crossed unity, and the findings should be regarded as hypothesis-generating. TXA did not significantly influence short-term hematoma volume reduction. Prospective randomized studies are needed to confirm these findings and define optimal dosing strategies.

Background Chronic subdural hematoma is a persistent, bloody to serous fluid retention in the subdural space between the dura mater and arachnoid mater, usually caused by an initial trauma, and is one of the most common traumatic intracranial hemorrhages in western industrialized nations. In the event of a compressive effect on the brain, the hematoma is usually relieved by means of a burr hole trephination. In view of the high postoperative recurrence rate, conservative treatment methods have been investigated both as a competitor to surgery alone in cases where the indication for surgery is debatable and as a supportive therapy for surgical hematoma relief. Studies on embolization of the middle meningeal artery during surgery as well as studies on postoperative drug therapy using tranexamic acid have shown the most promise. However, there is currently a lack of studies that randomly compare the effectiveness of these two perioperative treatment strategies regarding to their efficacy in avoiding revision surgery and the safety of the respective procedure. Methods TABASCO is a prospective, randomized, two-arm, multicenter, clinical trial designed to determine whether postoperative treatment of chronic subdural hematomas using adjuvant drug therapy with tranexamic acid (test group) is equivalent to postoperative embolization of the arteria meningea media (control group) in terms of postoperative volume reduction of the hematoma and the need for revision surgery of CSDH. Patients over 18 years of age who have undergone surgery for CSDH for the first time no more than 24 h before inclusion in the study will be randomized 1:1 to the test group or control group. The primary endpoint is the postoperative volume decrease of a primarily surgically relieved CSDH quantitatively and regarding to the time course on the affected side in a study period of 3 months postoperatively. The secondary endpoint of this study is to investigate the extent to which the rate of necessary revision surgery can be influenced by the adjuvant therapy procedures over the course of 3 months. The tertiary endpoint is the neurological outcome of the patients included in the study and assigned to the different treatment arms after a total follow-up period of 3 months as well as the complication rate of the adjuvant procedures used. Assuming a risk difference of 8% for rebleeding and surgical revision, with an applied power of 80%, 276 patients (138 per group) will be included in this study. Discussion The TABASCO study will provide clinical evidence as to whether embolization of the middle meningeal artery in addition to surgery is comparable to postoperative drug therapy using tranexamic acid as an adjuvant treatment method for operated chronic subdural hematomas in terms of hematoma volume reduction, revision rate and safety of the procedures. Trial registration German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) DRKS00033515. Registered on 05 Feb 2024.

Introduction Hypoxia-induced autophagy leads to an increase in vasculogenic-mimicry (VM) and the development of resistance of glioblastoma-cells to bevacizumab (BEV). Chloroquine (HCQ) inhibits autophagy, reduces VM and can thus produce a synergistic effect in anti-angiogenic-therapy by delaying the development of resistance to BEV. Purpose We retrospectively compared the combined addition of HCQ+BEV and adjuvant-radiochemotherapy (aRCT) to aRCT alone for recurrent-glioblastoma (rGBM) in regards of overall survival (OS).Methods Between 2006 and 2016, 134 patients underwent neurosurgery for rGBM at our institution. Forty-two patients (Karnofsky-Performance-Score>60%) with primary-glioblastoma underwent repeat-surgery and aRCT for recurrence. Four patients (9.5%) received aRCT+HCQ+BEV. Five patients received aRCT+BEV.Results In rGBM-patients who were treated with aRCT+HCQ+BEV, median OS was 36.57 months and median post-recurrence-survival (PRS) was 23.92 months while median PRS in the control-group was 9.63 months (p=0.022). In patients who received aRCT+BEV, OS and PRS were 26.83 and 12.97 months, respectively.Conclusions Although this study was performed on a small number of highly selected patients, it demonstrates a synergistic effect of HCQ+BEV in the treatment of rGBM which previously could be demonstrated based on experimental data. A significant increase of OS in patients who receive aRCT+HCQ+BEV cannot be ruled out and should be further investigated in randomised-controlled-trials.

We report the case of a 28-year-old female patient who complained of extreme neck pain when giving birth to a child. Magnetic resonance imaging (MRI) of the cervical spine demonstrated an osteolytic lesion at the second cervical vertebral body (C2). In this presentation, we highlight a transoral surgical approach in order to prevent instability of this osteolytic lesion. To the best of our knowledge, this is the first time that such a route of access has been described for this tumor entity. A histopathologic examination led to the diagnosis of epithelioid hemangioendothelioma. During a follow-up period of 33 months, the patient had no complaints.

Primary malignant melanomas of the central nervous system (CNS) are rarely seen entities in the clinical routine. Primary amelanotic melanomas are even rarer. In our literature review, we found only six case reports of primary amelanotic CNS melanomas. Our case report describes the course of a 71-year-old man with a primary amelanotic CNS melanoma with secondary spread to the spine.

OBJECTIVESince 2007, a continuous neurosurgery emergency service has been available in the International Security Assistance Force (ISAF) field hospital in Mazar-e-Sharif (MeS), Afghanistan. The object of this study was to assess the number and range of surgical procedures performed on the spine in the period from 2007 to 2014.METHODSThis is a retrospective analysis of the annual neurosurgical caseload statistics from July 2007 to October 2014 (92 months). The distribution of surgical urgency (emergency, delayed urgency, or elective), patient origin (ISAF, Afghan National Army, or civilian population), and underlying causes of diseases and injuries (penetrating injury, blunt injury/fracture, or degenerative disease) was analyzed. The range and pattern of diagnoses in the neurosurgical outpatient department from 2012 and 2013 were also evaluated.RESULTSA total of 341 patients underwent neurosurgical operations in the period from July 2007 to October 2014. One hundred eighty-eight (55.1%) of the 341 procedures were performed on the spine, and the majority of these surgeries were performed for degenerative diseases (127/188; 67.6%). The proportion of spinal fractures and penetrating injuries (61/188; 32.4%) increased over the study period. These spinal trauma diagnoses accounted for 80% of the cases in which patients had to undergo operations within 12 hours of presentation (n = 70 cases). Spinal surgeries were performed as an emergency in 19.8% of cases, whereas 17.3% of surgeries had delayed urgency and 62.9% were elective procedures. Of the 1026 outpatient consultations documented, 82% were related to spinal issues.CONCLUSIONSCompared to the published numbers of cases from neurosurgery units in the rest of the ISAF area, the field hospital in MeS had a considerably lower number of operations. In addition, MeS had the highest rates of both elective neurosurgical operations and Afghan civilian patients. In comparison with the field hospital in MeS, none of the other ISAF field hospitals showed such a strong concentration of degenerative spinal conditions in their surgical spectrum. Nevertheless, the changing pattern of spine-related diagnoses and surgical therapies in the current conflict represents a challenge for future training and material planning in comparable missions.

ABKÜRZUNGSVERZEICHNIS ACCF Anterior Cervical Corpectomy and Fusion ACDF Anterior Cervical Discectomy and Fusion ASIA American Spinal Injury Association Impairment Scale DTI Diffusion Tensor Imaging ISP Intraspinal Pressure MEP motorisch evozierte Potenziale OLF Ossification of the Ligamentum flavum OPLL Ossification of the posterior longitudinal Ligament SCI Spinal Cord Injury SCIWORET Spinal Cord Injury without radiological Evidence of Trauma SCPP Spinal Cord Perfusion Pressure SLIC Subaxial Cervical Spine Injury Classification SSEP somatosensibel evozierte Potenziale zRMV zervikale Rückenmarkverletzung zSKS zervikale Spinalkanalstenose

We report the case of a 61-year-old male with spindle cell oncocytoma of the hypophysis. On presentation to the Department of Neurosurgery at the German Armed Forces Hospital of Ulm, the patient reported a history of several years of left sixth nerve palsy, right ptosis, increased sensitivity to light, and a bilateral retrobulbar pressure sensation. Pituitary function was normal. A chromophobe non-functioning pituitary adenoma was initially suspected. The diagnosis was established on the basis of examination at a histopathology reference laboratory using immunohistochemistry to identify cell surface markers. During two years of follow-up, there were two clinical recurrences requiring surgery. To our knowledge, this is the 35th documented case of spindle cell oncocytoma of the pituitary gland and the first that was immunohistochemically negative for epithelial membrane antigen (EMA) and S100; and the first that displayed haematogenous metastasis to the right sphenoparietal sinus. The three surgical procedures were associated with massive intraoperative bleeding and thus resulted in subtotal tumor resection. Following surgery for the recurrences, the patient underwent radiotherapy.

ZusammenfassungDas Risikopotenzial eines Patienten mit asymptomatischer zSKS eine zRMV zu erleiden, ist nicht relevant erhöht. Gemessen an der perioperativen Morbidität und Mortalität zervikaler Dekompressions- und Fusionseingriffe sind prophylaktische Operationen für diese Subgruppe nicht zu empfehlen. Bei symptomatischen, insbesondere myelopathischen Patienten mit zSKS steigt einerseits die Sturzgefahr (als Folge der ataktischen Gangstörung), und die Prognose eines zRMV mit zSKS ist erwiesenermaßen schlechter als ohne additive zSKS. Somit sollten symptomatische Patienten mit zSKS insbesondere bei Versagen konservativer Maßnahmen und Progredienz der neurologischen Störungen oder auffälligen elektrophysiologischen Befunden eher einer elektiven Dekompression zugeführt werden. Bei milder zRMV (ASIA >D) kann zunächst ein konservativer Therapieversuch unternommen werden. Bei symptomatischer zRMV (ASIA C oder schlechter) und zusätzlicher zSKS geht der Trend eher hin zu dekomprimierenden Operationen, wenn in der Akut- oder frühen Frühphase nicht eindeutig eine rasche Besserung unter konservativer Therapie ersichtlich ist. Die aktuelle systematisch aufgearbeitete Studienlage zur zRMV favorisiert eine frühe OP (innerhalb von 24 h, bei zRMV mit inkompletter Neurologie sogar < 8 – 12 h). Ob dies auch für die Subgruppe von zRMV mit zSKS gilt, kann mit hochwertigen Studien und eindeutiger Evidenz noch nicht belegt werden. Für eine zervikale Dekompressionsoperation mit Duraerweiterungsplastik finden sich derzeit noch nicht genügend positive Hinweise. Zervikale Myelonverletzungen mit zSKS ziehen sehr häufig Begutachtungen nach sich. In Erwartung dessen sollten Anstrengungen unternommen werden, die initialen Befunde und den Verlauf sowie die durchgeführten Therapien möglichst lückenlos zu dokumentieren.

Zusammenfassung Hintergrund Cages sind als anteriores Fusionsmaterial zur ACCF (Anterior Cervical Corpectomy and Fusion) etabliert, aber in klinischen Studien noch nicht ausreichend vergleichend hinsichtlich des bestgeeigneten Materials untersucht. Patienten und Methoden Retrospektive Analyse von 126 Patienten nach Cage-ACCF (101 PEEK [Polyetheretherketon], 25 Titan) bei zervikaler spondylotischer Myelopathie. Es wurden implantatbedingte Komplikations- und Revisionsraten, radiologische (Sinterung, Fusion, segmentale und regionale Lordose) sowie klinische Parameter (NDI [Neck Disability Index] und EMS [Europäischer Myelopathie Score]) nach 6, 12 und 24 Wochen ausgewertet. Neben deskriptiven Datenanalysen wurden Unterschieds- sowie Zusammenhangshypothesen zwischen Cage-Material sowie den Komplikationen und den jeweiligen klinischen bzw. radiologischen Parametern geprüft. Ergebnisse Signifikant häufiger Schrauben- und Cage-Komplikationen (36 vs. 7,9 % resp. 64 vs. 36,6 %) sowie tendenziell mehr implantatbedingte Revisionen in der Titan-Cage-Gruppe (16 vs. 2,97 %). Signifikant höhere Rate an Fusion Grad I und II in der PEEK-Gruppe nach 6 Monaten (82 vs. 52 %). Keine signifikanten Differenzen oder Korrelationen zwischen den segmentalen und regionalen Lordoseparametern, dem EMS und NDI sowie dem Cage-Material. Durch partielle Korrelationen mit Kontrolle inhomogen verteilter Parameter (Alter, Anteil von Mehrhöhenkorpektomien, mediane Länge der Fusionsstrecke und Überdistraktionsrate) konnten keine signifikanten Korrelationen von Komplikationen, Revisionen sowie klinischen und radiologischen Ergebnissen zum Cage-Material mehr aufgezeigt werden. Schlussfolgerung Mit beiden Cage-Materialien lassen sich signifikante Verbesserungen der klinischen und radiologischen Befunde erreichen. Es lässt sich weder mit dieser Studie noch mit den publizierten Ergebnissen in der Literatur ein klinischer Vorteil eines bestimmten synthetischen Wirbelkörperersatzmaterials nach ACCF mit hoher Evidenz belegen.

Die anteriore zervikale Korporektomie und Fusion (ACCF) ist zur Dekompression der mehrsegmentalen Spinalkanalstenose mit spondylotischer Myelopathie etabliert. Neben auto- und heterologen Knochentransplantaten sowie Titanimplantaten kommen zur Fusion der dekomprimierten Segmente in den letzten Jahren zunehmend auch PEEK(Polyetheretherketon)-Cages zur Anwendung. Die Datenlage in der Literatur zur Anwendungssicherheit und den klinischen sowie radiologischen Ergebnissen ist jedoch noch dünn und widersprüchlich. Die vorliegende Studie stellt die größte bislang publizierte Serie von PEEK-Cage-Fusionen nach ACCF dar.

Background. Anterior cervical corpectomy and fusion (ACCF) has become a standard procedure for patients with spondylotic myelopathy due to multisegmental stenosis of the cervical canal. In addition to the fusion technique using autogenous bone grafts and titanium implants, synthetic polyetheretherketone (PEEK) cages have been used increasingly during the last years. However, limited evidence on the clinical and radiological results of PEEK cages for ACCF exists in the literature. The study presented here is the largest series to date reporting clinical and radiological outcome as well as complication rates after one to three-level ACCF using PEEK cages augmented by an anterior plate-screwosteosynthesis. Materials and methods. Retrospective study on 101 patients after stand-alone PEEK cage-ACCF with a minimum follow-up of 6 months. The number of hardware failures and implant-related surgical revisions were determined. The rate of subsidence and fusion and the course of lordotic alignment were analysed. The neck disability index (NDI) and the European myelopathy score (EMS) were assessed. Results. Screw complications were detected in 8/101 cases and 3 cases of cage dislocation occurred, resulting in an overall implant related revision rate of 2.9% (all revision cases showed cage dislocation). The rate of cage subsidence > 3 mm was 12% and solid fusion was achieved in 82% of the patients. NDI, EMS and lordotic alignment improved significantly. Conclusions. PEEK cages are a safe and effective alternative to titanium cages or autogenous bone graft for ACCF. Further randomized evaluation of different fusion techniques in ACCF is still necessary.

Background Anterior cervical corpectomy and fusion (ACCF) has become a standard procedure for patients with spondylotic myelopathy due to multisegmental stenosis of the cervical canal. Beside the fusion technique using autogenous bone grafts, synthetic cages have been increasingly used in recent years. Published information on the clinical and radiological results of different cage materials for ACCF is still limited. The study presented here is the largest series to date reporting clinical and radiological outcomes and complication rates after one-to three-level ACCF using structural polyetheretherketone (PEEK) or titanium cages augmented by anterior plate-screw osteosynthesis. Materials and Methods Retrospective comparative study on 126 patients after cage ACCF using modular PEEK (n = 101) or distractable titanium (n = 25) cages with a minimum follow-up of 6 months. The numbers of hardware failures and implant-related surgical revisions were determined. The rate of subsidence and fusion and the course of lordotic alignment (segmental and regional Cobb's angles) were analysed. Neck Disability Index (NDI) and European Myelopathy Score (EMS) were assessed. Results Significantly greater number of screw and cage complications were detected in the titanium cage group (36 vs. 7.9% and 64 vs. 36.6%, respectively). Non-significant trend to a higher rate of implant related revision rate in the titanium cage group (16 vs. 2.97%). Significantly greater rate of grade I or II fusion in the PEEK cage group after 6 months (82 vs. 52%). NDI, EMS and lordotic alignment improved significantly in both groups. There were neither significant differences between the two groups nor significant correlations between these clinico-radiological parameters and the cage material. Partial correlations performed with control of parameters showing inhomogenous distribution (patient age, fusion dis-tance, rate of multilevel corpectomy and the rate of intraoperative segmental overdistraction) showed no significant correlations for any of the clinical or radiological outcome parameters and the complications or revisions to the cage material. Conclusion Cages are a safe and effective alternative to autogenous bone graft for ACCF. A significant improvement in clinical and radiological parameters can be achieved with both titanium and PEEK implants. Significant differences between the two cage material groups or significant correlations of clinico-radiological outcome and cage material were not proven. Moreover there is no evidence in the literature for clinical advantages of one special cage material, to date. Therefore further prospective randomised evaluation of different fusion techniques in ACCF is still necessary.

Background and Study Aims Although postnatal surgery can be regarded as the standard of care for open myelomeningocele (MMC), there is no uniform treatment for this condition in Germany. This study assessed the current situation regarding the management of open MMC, a first and essential step toward the development of standards of practice. Patients and Methods In the second half of 2009, we had sent standardized questionnaires to 139 neurosurgery departments and 73 pediatric surgery departments (number of returned questionnaires: 98 and 62, respectively) to identify the principles of MMC management. Newborns with open MMC are treated in 57 of the neurosurgery departments and in 18 of the pediatric surgery departments. Results Overall, 41 of the 57 neurosurgery departments and 16 of the 18 pediatric surgery departments providing care for newborns with MMC perform MMC closure within 24 hours of delivery. In 52 neurosurgery departments and 15 pediatric surgery departments, infants with spina bifida are delivered by planned cesarean section. The diagnostic investigations performed between the time of caesarean delivery and plastic surgical closure vary from none to magnetic resonance imaging of the spine. The criteria underlying the placement of shunts and the time to plastic surgical closure are highly variable. Conclusions The type of treatment that infants with open MMC receive in Germany differs from institution to institution. Clear and consistent guidelines must be established using an interdisciplinary approach to improve treatment and standardize the care provided by surgical specialists for infants with MMC.

Hibernomas are very rare benign soft tissue tumors arising from brown fat. Malignant transformation or metastases are unknown. Males seems to be affected more often. Most patients are aged 20 to 40, but patients with intraosseous hibernomas are older. In children, hibernomas are extremely rare. The tumors grow slowly and have usually been present for a few years on presentation. Hibernomas are typically located on the thigh, neck, axilla or in the peri- und interscapular region. Diagnostic work-up in symptomatic hibernomas usually includes conventional X-ray and magnetic resonance tomography (MRI) with contrast medium. Asymptomatic hibernomas are often found accidentally in the diagnostic work-up of other diseases. Important differential diagnoses are lipomas, well differentiated liposarcomas, rhabdomyomas, granular cell tumors and sebeceous adenomas. Incisional biopsy should be performed to allow definitive histological diagnosis before definitive therapy. According to the literature, histologically preserved hibernomas can be removed with curative intention and marginal resection. After complete tumor removal, local recurrence has not been described. The following article describes the case of a large hibernoma of the proximal arm, involving the axilla, and describes the epidemiology, clinical behavior, diagnostic work-up, therapy and prognosis of this very rare benign fatty soft tissue tumor, on the basis of a review of current literature.

BACKGROUND AND AIM:From July 2007 to October 2014, neurosurgical services have been continuously available in a multinational Role 3 combat support hospital in Mazar-e-Sharif (MeS), Afghanistan. In this paper, we analyze a 7-year operative and outpatient spinal surgery caseload experience. MATERIALS AND METHODS:The overall annual and monthly caseloads were determined. Additionally, the surgical cases were differentiated relating to the strength of the indication, the location of the surgical site, and the origin of the patients. The outpatient caseload and spectrum of the years 2012 and 2013 were also analyzed. RESULTS:A total of 341 surgeries were performed and 188 of them were spinal surgeries (55.1 %). The vast majority of surgeries were performed for degenerative diseases (127/188; 67.6 %). The proportion of fractures and penetrating injuries (61/188; 32.4%) increased over the observation period. Eighty percent of the immediate and urgent surgeries (within 12 h; n = 70) were performed for these indications. 19.8 % of the surgeries were done as an emergency, whereas 17.3 % had delayed urgency, and 62.9 % were elective procedures. Of the 1026 outpatient consultations documented, 82 % of them were related to spinal diseases. CONCLUSIONS:The overall caseload in addition to the distribution of location, strength of indication, and patient origin for MeS are significantly lower than that reported by other International Security Assistance Force (ISAF) nations in eastern and southern Afghanistan. In addition, the rate of elective surgeries and those carried out in civilian Afghan patients is highest in MeS. In comparison with MeS, none of the other ISAF military hospitals shows such a strong concentration of degenerative spinal conditions in their surgical spectrum. Nevertheless, the changing pattern of spine-related diagnoses and surgical therapies in the current conflict represents a challenge for future educational and material planning in comparable missions.

Purpose In recent years, radiofrequency identification has been used for the continuous measurement of intracranial pressure (ICP) in patients with a cerebrospinal fluid (CSF) shunt for hydrocephalus . Unlike ICP monitoring in an inpatient setting, measurements in mobile patients outside the hospital provide ICP data that take into account the everyday activities of each individual patient. Common methods of ICP monitoring and analysis cannot be used for those patients. In addition, ICP measurements in mobile patients require considerably longer observation times than in-hospital monitoring. For this reason, ICP measurements over a period of 7 to 10 days must be analyzed effectively and efficiently. Methods A possible approach is to analyze ICP data graphically. Pathologic changes can be expected to be associated with specific patterns that can be detected graphically (e.g., Lundberg A waves). Patients without pathologic ICP values and without intracranial pathologies usually show an approximately normal distribution of ICP data. By contrast, patients with pathologic ICP values are likely to show major deviations from a normal distribution such as changes in minimum and maximum values and multimodal distributions. Against this background, we present a new graphical method for detecting pathologic conditions. This novel method is based on the distribution of ICP data that is assessed using GNU R, a free software package for statistical computing and graphics. Results A left-skewed distribution indicates CSF shunt overdrainage and a right-skewed distribution suggests CSF shunt underdrainage. In addition, an additive analysis of the number of physiologic ICP values can be helpful in detecting possible causes of CSF shunt overdrainage or underdrainage. The approach presented here shows that patients with hydrocephalus objectively benefited from ICP-guided adjustments of the opening pressure of a shunt valve or the insertion of a valve. This objective improvement was confirmed by the patients' subjective perception of well-being. Conclusions Further investigations should be performed to examine the influence of multimodal ICP distributions and to assess how data analysis is affected by a drift that can occur when a sensor has been in place for an extended period of time.

Seit 2007 steht im Einsatzlazarett der Internationalen Sicherheitsunterstützungstruppe (ISAF) in Mazar-e-Sharif (MeS) ein kontinuierlicher neurotraumatologischer Bereitschaftsdienst zur Verfügung. Es soll eine Einschätzung über Anzahl und Spektrum der wirbelsäulenchirurgischen Eingriffe über den Einsatzzeitraum 2007–2014 getroffen werden.