Journal Of Neurosurgery Publishing Group Research Articles

Telovelar/Transcerebellomedullary Fissure Approach: Giant Distal Posterior Inferior Cerebellar Artery Aneurysm, Epidermoid Cyst, and Brainstem Cavernoma: 2-Dimensional Operative Video.

The telovelar or transcerebellomedullary fissure approach can provide wide exposure of the cerebellomedullary fissure and fourth ventricle by separating the natural plane between the medulla and cerebellum.1-5. The cerebellar tonsil is attached to the adjacent cerebellum only by the tonsillar peduncle at its superolateral edge.2 The posterior inferior cerebellar artery (PICA) runs in the cerebellomedullary fissure, usually making its caudal and cranial loops.6,7. After widely opening the foramen magnum, the tonsil is gently elevated by shearing the tela choroidea up to the lateral recess from the taenia, where the vein of the inferior cerebellar peduncle courses.8,9. The developed occipital sinus, posterior condylar vein, and anomalies of the vertebral artery and PICA origin can obstruct the exposure. Detailed neuromonitoring is essential for accomplishing the procedure safely.10,11. This exposure can be extended to the lower cerebellopontine angle and can also be applied to the dorsal brainstem surgery.2,12 The patients consented to the procedure and to the publication of their images.Image Credits: Department of Neurosurgery, Tokyo Medical University logo used by permission. Image at 0:10, 1:02, 2:46, 6:22, and 7:10 from Matsushima and Kohno,1 used by permission from Medical View Co., Ltd.Right image at 0:14 and also upper image at 0:46, image at 1:26, and for left and lower right images at 1:54 from Matsushima et al,2 by permission from Journal of Neurosurgery Publishing Group (JNSPG). Left image at 0:14, from Matsushima et al,4 used by permission from the Congress of Neurological Surgeons. Lower image at 0:46 reprinted from Matsushima et al,9 by permission from Elsevier. Left image at 1:06 from Matsushima et al,8 used by permission from the Congress of Neurological Surgeons.Image at top right at 1:54 from Lister et al,6 used by permission from the Congress of Neurological Surgeons. Image in center at 6:56 from Matsushima et al,11 used by permission from Springer Nature. Image at right at 6:56 from Matsushima et al,10 used by permission from JNSPG. Images at 9:48, by year: 1982 article screenshot and figure from Matsushima et al,4 by permission from the Congress of Neurological Surgeons; 1992: article title screenshot from Matsushima et al,3 by permission from the Congress of Neurological Surgeons; 1996: used with permission of McGraw-Hill Health Professions Division, from Microsurgical Anatomy of the Fourth Ventrical, Matshushiam T and Rhoton AL Jr, in Neurosurgery, eds Wilkins and Rengachary, vol 1, 1996, permission conveyed through Copyright Clearance Center, Inc.; 2000: article title screenshot from Mussi et al,5 reused with permission from JNSPG; 2001: article title screenshot from Matsushima, Transcerebellomedullary fissure approach with special reference to methods of dissecting the fissure, J Neurosurg, vol 91, 2001, p. 257-264, by permission from JNSPG; 2021: article title screenshot from Matsushima et al,12 by permission from Springer Nature. Images at 11:05 from Inoue T et al, "Surgical approach to the mesencephalic vascular malformation" [in Japanese], Surg Cereb Stroke, vol 26, 1998, p 288-289, by permission from the Japanese Society on Surgery for Cerebral Stroke. Cadaveric image at 11:56 from Matsushima T et al, "Exposure of the wide interior of the fourth ventricle without splitting the vermis: importance of cutting procedures for the tela choroidea" Neurosurg Rev, vol 35, 2012, p 563-571, used with permission from Springer Nature.

A Classification Proposal for Spinal Vascular Lesions.

A Classification Proposal for Spinal Vascular Lesions.

Humbled to Serve.

Humbled to Serve.

Humbled to Serve.

Humbled to Serve.

Letter: In Memoriam: Paul Farmer and Global Neurosurgery.

To the Editor: On February 21, 2022, in Butaro, Rwanda, Dr Paul Farmer unexpectedly died because of “a cardiac event while he was sleeping.”1 He was aged 62 years at the time. As we honor his life and contributions, it is paramount to reflect on his legacy to fuel a collective impetus for improving the lives of our world's most vulnerable. A few statements from Dr Farmer resonate with this sentiment:“The poorest parts of the world are by and large the places in which one can best view the worst of medicine and not because doctors in these countries have different ideas about what constitutes modern medicine. It's the system and its limitations that are to blame.” “I can't sleep. There's always somebody not getting treatment. I can't stand that.” At Harvard Medical School, the program in Global Surgery and Social Change represents a collaborative initiative between the Harvard Medical School (HMS), Harvard teaching hospitals including Massachusetts General Hospital and Brigham and Women's Hospital, HMS Department of Global Health and Social Medicine, Boston Children's Hospital, and Partners in Health, the latter Dr Farmer cofounded in 1987. HMS offers the Paul Farmer Global Surgery Fellowship which among many attributes trains leaders in policy development and implementation with aim to equilibrate health outcomes for at-risk populations around the world. The fellowship consists of 2 separate tracks—research fellow and research associate. On the first track, a research fellow is a medical school graduate (resident, registrar, or international equivalent) who for 2 years conducts research pertinent to global surgery, anesthesia, and obstetrics and gynecology while providing care and advocating for patients in resource limited settings worldwide. Neurosurgery residents are encouraged to apply to this role as scholarly pursuit during their postgraduate year (PGY)-5 and PGY-6. On the second track, a research associate is a 1-year position for students enrolled in any health-related graduate degree (including MD and MBBS) with aim to jumpstart or further interest in global surgical care. As part of HMS program for Global Surgery and Social Change, the Paul Farmer Global Surgery Fellowship enables young leaders a platform to meaningfully contribute to the vision for a better future for children and adults alike stricken by disease. Recently, a proposal was made to incorporate a “Global Neurosurgery” section or category into neurosurgical journals, with aim to “highlight research regarding strategies for developing sustainable neurosurgical training models, augmenting neurosurgical clinical and research capacity, and strengthening health systems through policy and advocacy.”2 Discourse centering around providing this addition to neurosurgical, including in NEUROSURGERY Publications, involved providing a space where neurotrauma groups around the world could provide pearls of knowledge concerning dealing with the global burden of disease with specific locoregional adaptations to reflect the multifaceted nature of caring for diverse groups. For NEUROSURGERY Publications, specifically, an alternative could be made by the Editorial Board: the creation of an entirely new journal, published electronically, which would still allow print Neurosurgery to be fully operational. In that frame, published works in the new journal would consist of invited manuscripts of a specific preapproved topic in Global Neurosurgery, which when published would be open access. This proposal is similar to that in 1996 which led to the creation of Neurosurgical Focus within the Journal of Neurosurgery Publishing Group. To date, Neurosurgical Focus has had 52 volumes and 322 issues—including 15 issue supplementals. As the leader and most complete window in contemporary neurosurgery, if NEUROSURGERY Publications were to create a new journal on Global Neurosurgery, it would serve as a model for neurosurgical journals and signal to importance of global health and equity. This journal could include volumes which may be read as a textbook, typically consisting of an introductory chapter or “Editorial” into the global health subject of interest, followed by the most up-to-date peer-reviewed information and ending with a “Letter” or “Commentary” on the current state and future directions of a contemporaneous topic of interest decided on by the Editorial Board. In addition, this Global Neurosurgery journal could offer continuing medical education credit to Congress of Neurological Surgeons members, granting constituents the ability to earn up to 3 hours of category I continuing medical education each month. Still, whether incorporating Global Neurosurgery into NEUROSURGERY Publications is finalized in the form of a Category, Section, or Journal; this addition will withstand the test of time while advancing our knowledge and understanding of medicine and technology in resource-constrained settings. Death is to be regarded with remembrance and reflection. Dr Farmer was an introverted leader who stood up for people in their times of need and a humble man who stuck to his family and faith while revitalizing the vision for social justice and global equity. It is our turn to elevate our hero as we further contribute fuel to the vehicle of Global Neurosurgery.

Petrosal Approach for Giant Retrochiasmatic Craniopharyngioma: 2-Dimensional Operative Video.

Microsurgical resection of craniopharyngiomas poses significant challenges, which are amplified with tumors in the retrochiasmatic location and larger size. Traditional pterional trans-sylvian, subfrontal translamia terminalis, or interhemispheric approaches provide narrow surgical corridors with obstructed visualization of the tumor by the prefixed chiasm and slit optic carotid window.1-5 The superior extension of the tumor compressing the hypothalamus and third ventricle are likewise inaccessible. Dissection through these approaches requires crossing and manipulation of the already compromised optic apparatus with surgical instruments. Finally, the basilar artery and its perforating branches are often adherent to the posterior aspect of the tumor, and are invisible. Endonasal endoscopic techniques have been utilized as a surgical approach that accesses the tumor without crossing the optic apparatus; however, these approaches have a significant risk of cerebrospinal fluid leakage and require dissection of the basilar artery and hypothalamus from long distances with lengthy instruments.6-9 Frequently, the surgeon achieves only partial removal. The petrosal approach is ideal for tumors in the retrochiasmatic location.10-13 Advantages include unhindered access to the retrochiasmatic space without crossing the optic nerve and chiasm. The angle of approach allows visualization superiorly to the hypothalamus. Additionally, the approach shortens the distance to the tumor, allowing for delicate bimanual dissection of the tumor, especially at the basilar artery and hypothalamic interfaces. This video demonstrates three cases of retrochiasmatic craniopharyngioma resection through the petrosal approach, highlighting these advantages to optimize patient outcome. The patients and guardians consented for the surgery, photography, and publication of the patient's image. Figures from Al-Mefty et al11 used with permission from the Journal of Neurosurgery Publishing Group. Additional figures republished from Al-Mefty et al.12 "The petrosal approach for the resection of retrochiasmatic craniopharyngiomas," Neurosurgery, 2008, volume 62, issue 5 Suppl 2 (ONS), ONS331-ONS336, by permission of the Congress of Neurological Surgeons.

Online Impact and Presence of a Specialized Social Media Team for the Journal of Neurosurgery: Descriptive Analysis.

BackgroundSocial media use continues to gain momentum in academic neurosurgery. To increase journal impact and broaden engagement, many scholarly publications have turned to social media to disseminate research. The Journal of Neurosurgery Publishing Group (JNSPG) established a dedicated, specialized social media team (SMT) in November 2016 to provide targeted improvement in digital outreach.ObjectiveThe goal of this study was to examine the impact of the JNSPG SMT as measured by increased engagement.MethodsWe analyzed various metrics, including impressions, engagements, retweets, likes, profile clicks, and URL clicks, from consecutive social media posts from the JNSPG’s Twitter and Facebook platforms between February 1, 2015 and February 28, 2019. Standard descriptive statistics were utilized.ResultsBetween February 2015 and October 2016, when a specialized SMT was created, 170 tweets (8.1 tweets/month) were posted compared to 3220 tweets (115.0 tweets/month) between November 2016 and February 2019. All metrics significantly increased, including the impressions per tweet (mean 1646.3, SD 934.9 vs mean 4605.6, SD 65,546.5; P=.01), engagements per tweet (mean 35.2, SD 40.6 vs mean 198.2, SD 1037.2; P<.001), retweets (mean 2.5, SD 2.8 vs mean 10.5, SD 15.3; P<.001), likes (mean 2.5, SD 4.0 vs mean 18.0, SD 37.9; P<.001), profile clicks (mean 1.5, SD 2.0 vs mean 5.2, SD 43.3; P<.001), and URL clicks (mean 13.1, SD 14.9 vs mean 38.3, SD 67.9; P<.001). Tweets that were posted on the weekend compared to weekdays had significantly more retweets (mean 9.2, SD 9.8 vs mean 13.4, SD 25.6; P<.001), likes (mean 15.3, SD 17.9 vs mean 23.7, SD 70.4; P=.001), and URL clicks (mean 33.4, SD 40.5 vs mean 49.5, SD 117.3; P<.001). Between November 2015 and October 2016, 49 Facebook posts (2.3 posts/month) were sent compared to 2282 posts (81.5 posts/month) sent between November 2016 and February 2019. All Facebook metrics significantly increased, including impressions (mean 5475.9, SD 5483.0 vs mean 8506.1, SD 13,113.9; P<.001), engagements (mean 119.3, SD 194.8 vs mean 283.8, SD 733.8; P<.001), and reach (mean 2266.6, SD 2388.3 vs mean 5344.1, SD 8399.2; P<.001). Weekend Facebook posts had significantly more impressions per post (mean 7967.9, SD 9901.0 vs mean 9737.8, SD 19,013.4; P=.03) and a higher total reach (mean 4975.8, SD 6309.8 vs mean 6108.2, SD 12,219.7; P=.03) than weekday posts.ConclusionsSocial media has been established as a crucial tool for the propagation of neurosurgical research and education. Implementation of the JNSPG specialized SMT had a demonstrable impact on increasing the online visibility of social media content.

In Reply: Big Data Research in Neurosurgery: A Critical Look at this Popular New Study Design.

The use of big in neurosurgical research has become increasingly popular. However, using this type of data comes with limitations. This study aimed to shed light on this new approach to clinical research. We compiled a list of commonly used databases that were not specifically created to study neurosurgical procedures, conditions, or diseases. Three North American journals were manually searched for articles published since 2000 utilizing these and other non-neurosurgery-specific databases. A number of data points per article were collected, tallied, and analyzed.A total of 324 articles were identified since 2000 with an exponential increase since 2011 (257/324, 79%). The Journal of Neurosurgery Publishing Group published the greatest total number (n = 200). The National Inpatient Sample was the most commonly used database (n = 136). The average study size was 114 841 subjects (range, 30-4 146 777). The most prevalent topics were vascular (n = 77) and neuro-oncology (n = 66). When categorizing study objective (recognizing that many papers reported more than 1 type of study objective), Outcomes was the most common (n = 154). The top 10 institutions by primary or senior author accounted for 45%-50% of all publications. Harvard Medical School was the top institution, using this research technique with 59 representations (31 by primary author and 28 by senior).The increasing use of data from non-neurosurgery-specific databases presents a unique challenge to the interpretation and application of the study conclusions. The limitations of these studies must be more strongly considered in designing and interpreting these studies.

Big Data Research in Neurosurgery: A Critical Look at this Popular New Study Design.

The use of "big data" in neurosurgical research has become increasingly popular. However, using this type of data comes with limitations. This study aimed to shed light on this new approach to clinical research. We compiled a list of commonly used databases that were not specifically created to study neurosurgical procedures, conditions, or diseases. Three North American journals were manually searched for articles published since 2000 utilizing these and other non-neurosurgery-specific databases. A number of data points per article were collected, tallied, and analyzed.A total of 324 articles were identified since 2000 with an exponential increase since 2011 (257/324, 79%). The Journal of Neurosurgery Publishing Group published the greatest total number (n = 200). The National Inpatient Sample was the most commonly used database (n = 136). The average study size was 114 841 subjects (range, 30-4 146 777). The most prevalent topics were vascular (n = 77) and neuro-oncology (n = 66). When categorizing study objective (recognizing that many papers reported more than 1 type of study objective), "Outcomes" was the most common (n = 154). The top 10 institutions by primary or senior author accounted for 45%-50% of all publications. Harvard Medical School was the top institution, using this research technique with 59 representations (31 by primary author and 28 by senior).The increasing use of data from non-neurosurgery-specific databases presents a unique challenge to the interpretation and application of the study conclusions. The limitations of these studies must be more strongly considered in designing and interpreting these studies.

The 2017 AANS Presidential Address. A world of innovation.

The 2016 scientific meeting of the American Association of Neurological Surgeons (AANS) focused on the theme "A World of Innovation." In his presidential address, 2016 AANS President Frederick Boop compared the historical development of the specialty of neurological surgery with that of the development of global communications. In the early years, general surgeons training in the United States would spend post-residency time abroad learning from surgical masters in Europe and other places. Since Harvey Cushing's day, neurosurgeons from around the world continue to travel abroad, with many now coming to America for training at centers of excellence. Current clinical practice is defined by multi-national, multi-center clinical trials, and the AANS subsidiary NeuroPoint Alliance has positioned itself to serve as an international center for the oversight of such trials. The Neurosurgery Research & Education Foundation and the Journal of Neurosurgery Publishing Group have made it possible for a neurosurgeon anywhere with Internet access to learn relevant surgical anatomy, learn new neurosurgical procedures, and watch masters in the field perform operations via high-definition surgical videos at no cost via learning platforms such as the Rhoton Collection, the Neurosurgical Atlas, and Neurosurgical Focus video supplements. At the same time, patients are now traveling abroad to seek medical specialty care. Although the globalization of health care poses certain threats, it also presents neurosurgeons with a world of opportunities.

Introduction: guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine.

On behalf of the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Section on Disorders of the Spine and Peripheral Nerves, it is with distinct pleasure that I introduce the “Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine.” The initial version of these guidelines was originally published in the June 2005 issue of the Journal of Neurosurgery: Spine.1 The update presented in this issue of the Journal of Neurosurgery: Spine exemplifies the commitment that organized neurosurgery, in cooperation with our orthopedic colleagues, has made to ensure that this vital source of information continues to evolve and reflect the most current evidence on each of the topics covered. In a very real sense these guidelines are a credit to all clinicians involved in the care of disorders of the spine. That is the body of work on which the literature is based, which in turn is the foundation of these guidelines. This work is also a credit to the established infrastructure created by the Guidelines Committee of the AANS and CNS to facilitate the production and dissemination of evidence-based guidelines. In addition, the successful publication of this material would not have been possible without the assistance provided by the staff at the Journal of Neurosurgery Publishing Group. Their expertise in the peer-review process, editorial guidance, and transmission of information have enhanced the overall quality and impact of this effort. I personally want to thank Dr. James T. Rutka, M.D., Ph.D., Editor-in-Chief of the Journal of Neurosurgery: Spine, for his forbearance and attention to this project. As the literature has evolved, so too has the process of guidelines development. As there is no well-accepted standard protocol for updating guidelines, a significant amount of time and effort was expended to establish the methodology. Consensus among members of the expert panel was achieved in accord with a well-defined methodology to minimize bias, maximize integrity, and create a final product consistent with the highest ideals of evidence-based medicine. Among the most important missions of the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves is the generation of highquality evidence that can assist both our membership and the spine community at large in providing the highestquality care for our patients. Just as this work builds on the foundation created by the original 2005 publication, it is anticipated that this document will in time be updated as well. For the moment, however, it reflects an unbiased synthesis of the literature and points toward the quality spine care that we, as clinicians, aspire to provide. It is an honor to present this Guideline Update on behalf of the AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves to the readership of the Journal of Neurosurgery: Spine. This update reflects the highest ideals of the section. It is offered to physicians of all levels who seek a greater understanding of the role lumbar fusion can play in the care of patients with degenerative disease of the lumbar spine. (http://thejns.org/doi/abs/10.3171/2014.4.SPINE14190)

Editorial: Leading transition while maintaining tradition

I am deeply honored to be appointed as the new Editor-in-Chief (EIC) of the Journal of Neurosurgery (JNS). I follow Dr. John Jane Sr., who has served admirably and tirelessly in this role since October 1992, and has implemented numerous transformative changes within the Journal of Neurosurgery Publishing Group (JNSPG) (Fig. 1). As such, the task for me is somewhat daunting; however, I view this task as a tremendous opportunity at a time when the standard operating procedures for publications for associations, such as the American Association of Neurological Surgeons (AANS), are being rewritten, in part, by shifts from print to online publishing. At a time of transition, such as this, it is wise to review salient aspects of the history of the JNS as we prepare to chart a new course for our future. Since its inception in 1944 there have been 6 previous EICs of the JNS (Table 1), all of whom have left indelible marks on the progress and stature of the journal. In addition, we should also remember the insightful and deliberative force of Dr. John F. Fulton, who, in the spring of 1943, in response to a request by Dr. Alfonso Asenjo in Santiago, Chile, worked with the officers of the Harvey Cushing Society (now AANS) to establish the first specialty-specific and international journal devoted to neurosurgery. In the words of Dr. R. Glen Spurling, a major participant in the US military effort during World War II, Dr. Fulton “fathered the JNS.”1 The first issue of the journal was published in January 1944, and the lead article was written by Dr. Gilbert Horrax on the many contributions of Harvey Cushing to the science and practice of neurosurgery throughout his career.4 There were initially 5 members appointed to the Editorial Board. Issues were published bimonthly until 1962, at which time it was necessary to increase the number of issues to 12 per year to accommodate the ever-increasing number of accepted submissions. From its first issue, the JNS has been maintained as an international journal accepting neurosurgical submissions from around the world.1,8 The same holds true to this day, with authors from over 60 countries submitting their best work for peer review in 2012. In this era of bibliometrics, we can indeed be proud of the JNS, which, from 2011 data, has a 5-year Impact Factor (IF) of 3.088, and total citations of 28,800, which is more than any other neurosurgical journal. The proliferation of neurosurgical centers throughout the world and the widespread accessibility of scientific and clinical data have led to an exponential rise in the number of submissions and, consequently, the number of published pages in the JNS over the past 50 years. Whereas in 1963 there were 165 individual papers and 1111 pages of text published in the JNS,1 in 2012 there were 1208 accepted manuscripts from a total of 3604 submissions, and a near 5-fold increase in pages printed at 5106 pages. Obviously, to accommodate such an incredible increase in volume of submissions and Editorial

Honoring the 75th anniversary of the American Association of Neurological Surgeons.

Ever since the Journal of Neurosurgery (JNS) published its first volume in 1944, the journal has reflected the scientific, technical, and clinical evolution of our specialty and parent organization, first called the Harvey Cushing Society and later the American Association of Neurological Surgeons. The JNS has been an uncompromising arbiter of progress in our specialty, and its superb editorial stewardship has led to its recognition as the premier journal in the field. The impact rating of JNS and its wide circulation among neurosurgeons worldwide are two of the many reasons why most of the truly innovative and paradigm-shifting advances in neurosurgery have been published in its pages. As part of the 75th anniversary of the American Association of Neurological Surgeons celebration, the JNS Publishing Group has initiated a project of reviewing papers published over the years that have had the highest impact factor and greatest scientific interest: papers that have heralded new knowledge, new concepts, and new techniques that have been at the heart of modern neurosurgery and its continuing excitement and progress. We hope you will enjoy these articles and the accompanying commentaries. In this issue we present the next paper in this series.

Honoring the 75th anniversary of the American Association of Neurological Surgeons

Ever since the Journal of Neurosurgery (JNS) published its first volume in 1944, the journal has reflected the scientific, technical, and clinical evolution of our specialty and parent organization, first called the Harvey Cushing Society and later the American Association of Neurological Surgeons. The JNS has been an uncompromising arbiter of progress in our specialty, and its superb editorial stewardship has led to its recognition as the premier journal in the field. The impact rating of JNS and its wide circulation among neurosurgeons worldwide are two of the many reasons why most of the truly innovative and paradigm-shifting advances in neurosurgery have been published in its pages. As part of the 75th anniversary of the American Association of Neurological Surgeons celebration, the JNS Publishing Group has initiated a project of reviewing papers published over the years that have had the highest impact factor and greatest scientific interest: papers that have heralded new knowledge, new concepts, and new techniques that have been at the heart of modern neurosurgery and its continuing excitement and progress. We hope you will enjoy these articles and the accompanying commentaries. In this issue we present the next paper in this series.

Honoring the 75th anniversary of the American Association of Neurological Surgeons.

Ever since the Journal of Neurosurgery (JNS) published its first volume in 1944, the journal has reflected the scientific, technical, and clinical evolution of our specialty and parent organization, first called the Harvey Cushing Society and later the American Association of Neurological Surgeons. The JNS has been an uncompromising arbiter of progress in our specialty, and its superb editorial stewardship has led to its recognition as the premier journal in the field. The impact rating of JNS and its wide circulation among neurosurgeons worldwide are two of the many reasons why most of the truly innovative and paradigm-shifting advances in neurosurgery have been published in its pages. As part of the 75th anniversary of the American Association of Neurological Surgeons celebration, the JNS Publishing Group has initiated a project of reviewing papers published over the years that have had the highest impact factor and greatest scientific interest: papers that have heralded new knowledge, new concepts, and new techniques that have been at the heart of modern neurosurgery and its continuing excitement and progress. We hope you will enjoy these articles and the accompanying commentaries. In this issue we present the next paper in this series.

Policy on Conflict of Interest

Relationships between industry and neurosurgeons engaged in both clinical practice and research have become increasingly complicated due to increased utilization of expensive devices in day-to-day neurosurgical practice. The Journal of Neurosurgery Publishing Group (JNSPG) has always had a policy of demanding open disclosure of any real, potential, or even perceived conflict of interest by authors submitting scientific manuscripts. Recently, the editor-in-chief and members of the editorial boards, after much discussion of this issue, decided that this policy of open disclosure should be enhanced and more specifically defined. In addition, we felt that such a policy should be extended to all reviewers of articles submitted for publication to JNSPG journals—both members of the editorial boards and ad hoc reviewers. To clarify, extend, and specify the JNSPG's policy in this respect, the editor and editorial boards developed a task force on “Conflict of Interest.” The task force, after considerable discussion with the full editorial boards, developed the following Conflict of Interest policy as well as the forms that submitting authors, editorial board members, and other reviewers are now required to complete.

Policy on Conflict of Interest

Relationships between industry and neurosurgeons engaged in both clinical practice and research have become increasingly complicated due to increased utilization of expensive devices in day-to-day neurosurgical practice. The Journal of Neurosurgery Publishing Group (JNSPG) has always had a policy of demanding open disclosure of any real, potential, or even perceived conflict of interest by authors submitting scientific manuscripts. Recently, the editor-in-chief and members of the editorial boards, after much discussion of this issue, decided that this policy of open disclosure should be enhanced and more specifically defined. In addition, we felt that such a policy should be extended to all reviewers of articles submitted for publication to JNSPG journals—both members of the editorial boards and ad hoc reviewers. To clarify, extend, and specify the JNSPG's policy in this respect, the editor and editorial boards developed a task force on “Conflict of Interest.” The task force, after considerable discussion with the full editorial boards, developed the following Conflict of Interest policy as well as the forms that submitting authors, editorial board members, and other reviewers are now required to complete.

Policy on Conflict of Interest

Relationships between industry and neurosurgeons engaged in both clinical practice and research have become increasingly complicated due to increased utilization of expensive devices in day-to-day neurosurgical practice. The Journal of Neurosurgery Publishing Group (JNSPG) has always had a policy of demanding open disclosure of any real, potential, or even perceived conflict of interest by authors submitting scientific manuscripts. Recently, the editor-in-chief and members of the editorial boards, after much discussion of this issue, decided that this policy of open disclosure should be enhanced and more specifically defined. In addition, we felt that such a policy should be extended to all reviewers of articles submitted for publication to JNSPG journals-both members of the editorial boards and ad hoc reviewers. To clarify, extend, and specify the JNSPG's policy in this respect, the editor and editorial boards developed a task force on "Conflict of Interest." The task force, after considerable discussion with the full editorial boards, developed the following Conflict of Interest policy as well as the forms that submitting authors, editorial board members, and other reviewers are now required to complete.

Policy on Conflict of Interest.

Relationships between industry and neurosurgeons engaged in both clinical practice and research have become increasingly complicated due to increased utilization of expensive devices in day-to-day neurosurgical practice. The Journal of Neurosurgery Publishing Group (JNSPG) has always had a policy of demanding open disclosure of any real, potential, or even perceived conflict of interest by authors submitting scientific manuscripts. Recently, the editor-in-chief and members of the editorial boards, after much discussion of this issue, decided that this policy of open disclosure should be enhanced and more specifically defined. In addition, we felt that such a policy should be extended to all reviewers of articles submitted for publication to JNSPG journals-both members of the editorial boards and ad hoc reviewers. To clarify, extend, and specify the JNSPG's policy in this respect, the editor and editorial boards developed a task force on "Conflict of Interest." The task force, after considerable discussion with the full editorial boards, developed the following Conflict of Interest policy as well as the forms that submitting authors, editorial board members, and other reviewers are now required to complete.

Honoring the 75th anniversary of the American Association of Neurological Surgeons.

Ever since the Journal of Neurosurgery (JNS) published its first volume in 1944, the journal has reflected the scientific, technical, and clinical evolution of our specialty and parent organization, first called the Harvey Cushing Society and later the American Association of Neurological Surgeons. The JNS has been an uncompromising arbiter of progress in our specialty, and its superb editorial stewardship has led to its recognition as the premier journal in the field. The impact rating of JNS and its wide circulation among neurosurgeons worldwide are two of the many reasons why most of the truly innovative and paradigm-shifting advances in neurosurgery have been published in its pages. As part of the 75th anniversary of the American Association of Neurological Surgeons celebration, the JNS Publishing Group has initiated a project of reviewing papers published over the years that have had the highest impact factor and greatest scientific interest: papers that have heralded new knowledge, new concepts, and new techniques that have been at the heart of modern neurosurgery and its continuing excitement and progress. We hope you will enjoy these articles and the accompanying commentaries. In this issue we present the next paper in this series.