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Neurosurgery Outcomes 2017

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NEUROSURGERY OUTCOMES 2017 NEUROSURGERY OUTCOMES 2017 1 TABLE OF CONTENTS WELCOME 2 VOLUMES & OUTCOMES 6 PROGRAMS 12 CONGENITAL MALFORMATIONS / FETAL SURGERY ............................................... 15 CRANIOFACIAL.............................................................................. 17 EPILEPSY ....................................................................................20 FUNCTIONAL NEUROSURGERY................................................................22 HYDROCEPHALUS ...........................................................................24 SKULL BASE SURGERY ........................................................................27 TRAUMA ...................................................................................29 TUMOR ....................................................................................30 VASCULAR ..................................................................................32 PATIENT STORIES 34 LUKE: TUBEROUS SCLEROSIS COMPLEX .........................................................36 EVERETT: SPINA BIFIDA .......................................................................37 MATTHEW: CRANIOSYNOSTOSIS ..............................................................38 FACULTY & PUBLICATIONS 40 FACULTY & STAFF DIRECTORY .................................................................42 SELECTED PUBLICATIONS.....................................................................43 CONTACT US ...............................................................................44 2 NEUROSURGERY OUTCOMES 2017 WELCOME Dear colleagues, parents and friends, It is my true privilege to introduce you to the Neurosurgery Division at Texas Children’s Hospital®. /RFDWHGLQ+RXVWRQ7H[DVDQGDFDGHPLFDOO\DIÀOLDWHGZLWK%D\ORU&ROOHJHRI0HGLFLQH Texas Children’s Hospital is the largest pediatric hospital in the United States and is ranked #4 nationally by U.S. News & World Report, an extraordinary distinction FRQVLGHULQJLWVIRXQGLQJRQO\LQ:HDUHRQHRIÀYHKRVSLWDOVLWHVWKDWFRPSULVHWKH 1HXURORJLFDO6XUJHU\5HVLGHQF\SURJUDPDW%D\ORU&ROOHJHRI0HGLFLQHXQGHU'U'DQLHO <RVKRUFKDLURIQHXURVXUJHU\$W7H[DV&KLOGUHQ·V+RVSLWDOZHDUHRQHRIQLQHVXUJLFDO GLYLVLRQVZLWKLQWKH'HSDUWPHQWRI6XUJHU\PDGHXSRIQHDUO\SHGLDWULFVSHFLDOW\ surgeons, under the leadership of Dr. Larry Hollier, Jr., surgeon-in-chief. ,DUULYHGLQ+RXVWRQLQ0D\DIWHUQHDUO\\HDUVZRUNLQJDWDVLQJOHLQVWLWXWLRQLQ1HZ<RUN7KHKRVSLWDO·VUDQNLQJ VL]HVFRSHDQGYLVLRQIRUJURZWKRYHUWKHQH[WGHFDGHZHUHRQO\SDUWRIZKDWDWWUDFWHGPHWRWKLVRSSRUWXQLW\ 7KHPRVWLPSRUWDQWUHDVRQZDVWRMRLQDQRXWVWDQGLQJWHDPRIVL[IXOOWLPHSHGLDWULFQHXURVXUJHRQVZKRZHUHPDNLQJ LQFUHGLEOHVWULGHVLQWUHDWPHQWIRUFKLOGUHQZLWKQHXURORJLFDOGLVRUGHUV7KLVLVDJURXSRIGHYRWHGFDULQJDFDGHPLFDOO\ SURGXFWLYHDQGVNLOOHGFOLQLFLDQVUHQRZQHGIRUH[FHOOHQFHLQFUDQLRIDFLDOHQGRVFRSLFHSLOHSV\IHWDOIXQFWLRQDO hydrocephalus, spine, trauma, tumor and vascular pediatric neurosurgery. Every faculty member is innovating in a VSHFLÀFDUHDRIH[SHUWLVHZLWKWKHJRDORIOHDYLQJSHGLDWULFQHXURVXUJHU\EHWWHUWKDQWKH\IRXQGLW,WKDVEHHQDQ KRQRUIRUPHWRIROORZWKHJUHDWOHJDF\RI'U7RP/XHUVVHQZKREXLOWWKLVLQFUHGLEO\VWURQJWHDPDQGVHUYLFHKHUH over the last decade. We are extremely excited about the next phase of neurosurgery at Texas Children’s. Our collective vision is to be the SULPDU\GHVWLQDWLRQIRULQQRYDWLYHKLJKTXDOLW\DWWHQWLYHZRUOGFODVVQHXURVXUJLFDOFDUHIRUFKLOGUHQWRWUDLQWKHIXWXUH OHDGHUVRIRXUVSHFLDOW\DQGWRLQYHVWLJDWHWKHFRQGLWLRQVIRUZKLFKZHKDYHXQLTXHDFFHVVDQGLQVLJKW*LYHQWKHULFK FOLQLFDOH[SHULHQFHIRUWUDLQHHVZLWKDSSUR[LPDWHO\RSHUDWLRQVSHUIRUPHGDQQXDOO\ZHKDYHDKLJKO\VRXJKWDIWHU $&31)DFFUHGLWHGRQH\HDUSRVWUHVLGHQF\IHOORZVKLSLQSHGLDWULFQHXURVXUJHU\2XUHOHYHQIHOORZVKLSJUDGXDWHVKROG prestigious academic positions in neurosurgery departments across the country. :HDUHGHOLJKWHGWRVKDUHRXUUHFHQWH[SHULHQFHVDQGRXWFRPHVZLWK\RXLQWKLVRYHUYLHZRIRXUSURJUDP:HORRN IRUZDUGWRFRQWLQXLQJWRVHUYH\RXDQGZRUNZLWK\RXLQWKH\HDUVWRFRPH Sincerely, Howard L. Weiner, M.D., F.A.C.S., F.A.A.P., F.A.A.N.S. Chief of Neurosurgery, Texas Children’s Hospital Professor and Vice Chairman, Department of Neurosurgery, Baylor College of Medicine NEUROSURGERY OUTCOMES 2017 3 Legacy Tower, Texas Children’s newest building, opens in 2018. The expansion includes new high-intensity surgical operating rooms and a neurological intensive care unit. 4 NEUROSURGERY OUTCOMES 2017 TEXAS CHILDREN’S HOSPITAL Texas Children’s Hospital® is one of the nation’s largest and most comprehensive With a staff of more than specialty pediatric hospitals, with more than 2.4 million patient encounters in 2017. 13,500 employees and Texas Children’s mission is to create a healthier future for children and women more than 2,000 board- throughout our global community by leading in patient care, education and FHUWLÀHGSK\VLFLDQVSHGLDWULF research. Renowned worldwide for its expertise and breakthrough developments subspecialists, pediatric in clinical care and research, Texas Children’s Hospital is ranked #4 nationally by U.S. News & World Report. surgical subspecialists and dentists, Texas Children’s Texas Children’s Hospital is located near downtown Houston in the Texas offers more than 40 Medical Center, the largest medical center in the world. The medical center subspecialties, programs campus includes more than 600 licensed beds; the Wallace Tower for outpatient and services. Physicians are visits; the Feigin Tower for pediatric research; and Texas Children’s Pavilion for employees of Baylor College Women for comprehensive OB/GYN care. Located nearby is the Jan and Dan ® of Medicine, not Texas Duncan Neurological Research Institute at Texas Children’s Hospital, a basic Children’s Hospital. Because research institute dedicated to solving childhood neurological diseases. In 2018, the new Legacy Tower will be completed to increase capacity for critical and they practice at Texas surgical care. Children’s Hospital, they may be referred to as “our Texas Children’s Hospital® West Campus and Texas Children’s Hospital® The team” or “Texas Children’s Woodlands bring specialty pediatric care, including acute and critical care beds, physicians” throughout 24/7 pediatric emergency centers, surgical suites and more than 20 subspecialty this report. clinics, to a rapidly expanding population of children west and north of Houston. Texas Children’s also operates Texas Children’s® Health Plan, the nation’s ÀUVW+02IRUFKLOGUHQDQG7H[DV&KLOGUHQ·V® Pediatrics, the largest pediatric network in the nation. Texas Children’s® Health Centers, Specialty Care and Urgent Care locations provide enhanced access to care throughout the Greater Houston community. Texas Children’s Health Plan partners with the State of Texas to form STAR Kids, a Medicaid-managed care plan for children with disabilities and complex medical needs offering streamlined management and coordination of care. ACADEMIC AFFILIATION 7H[DV&KLOGUHQ·V+RVSLWDOLVDIÀOLDWHGZLWK%D\ORU&ROOHJHRI0HGLFLQH® in the areas of pediatrics, pediatric surgery and obstetrics and gynecology. Baylor is ranked by U.S. News & World Report as one of the nation’s top 10 medical schools for pediatrics. Currently and throughout our 63 year partnership, Texas Children’s Hospital serves as Baylor’s primary pediatric training site. The collaboration between Texas Children’s Hospital and Baylor is one of the WRSÀYHVXFKSDUWQHUVKLSVIRUSHGLDWULFUHVHDUFKIXQGLQJIURPWKH1DWLRQDO Institutes of Health. NEUROSURGERY OUTCOMES 2017 5 TEXAS CHILDREN’S NEUROSCIENCE CENTER 7H[DV&KLOGUHQ·V1HXURVFLHQFH&HQWHULVPDGHXSRIWKUHHUHQRZQHGDQGLQWHJUDWHG components – Neurology, Neurosurgery and the Jan and Dan Duncan Neurological Research Institute®. One of the largest pediatric neurology programs in the country, the Neuroscience Center receives more than 30,000 clinic visits and performs more than 1,000 surgeries each year. It is a comprehensive destination for children suffering from common neurological conditions like epilepsy and muscular dystrophy to more complex and UDUHGLVRUGHUVOLNHOLVVHQFHSKDO\DQG5HWWV\QGURPH%\FRPELQLQJFOLQLFDOFDUHZLWK HDV\DFFHVVWRVXUJHU\ZHDUHDEOHWRVWUHDPOLQHWUHDWPHQWIRUSDWLHQWVDQGWKHLU families. Experts in pediatric neurology, neurosurgery, neurophysiology, neurological critical care and genetics deliver complete care in 13 clinics. In 2017, U.S. News & World Report ranked Texas Children’s Hospital fourth in the nation for pediatric neurology and neurosurgery. Neuroscience team members are also active participants and consultants in the hospital’s Level 1 Trauma Center and in research efforts at the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s Hospital. The ZRUOG·VÀUVWEDVLFUHVHDUFKLQVWLWXWHGHGLFDWHGWRFKLOGKRRGQHXURORJLFDOGLVHDVHVWKH15,LVFRPPLWWHGWRSURYLGLQJ VFLHQWLVWVZLWKDZRUOGFODVVWHFKQRORJ\LQIUDVWUXFWXUHFDUHIXOO\GHVLJQHGWRIRVWHUFROODERUDWLRQDPRQJEDVLFIDFXOW\ DQGFOLQLFLDQVFLHQWLVWVZLWKWKHJRDORIDFFHOHUDWLQJWKHSDFHRIGLVFRYHULHVDQGGHYHORSLQJWUHDWPHQWVIRUFKLOGKRRG neurological diseases. PIONEERS IN PEDIATRIC NEUROSURGICAL CARE In 1975, Dr. William R. Cheek established a full-time pediatric Neurosurgery Division at Texas Children’s Hospital, and ZDVWKHÀUVWFKLHIRIVHUYLFH$WWKDWWLPH'U&KHHNZDVDOVRWKHDFWLQJKHDGRIWKH'LYLVLRQRI1HXURORJLFDO6XUJHU\DW Baylor College of Medicine. A graduate of Baylor College of Medicine, Dr. Cheek completed his neurosurgical residency WUDLQLQJDWWKH&ROXPELD8QLYHUVLW\1HXURORJLFDO,QVWLWXWHLQ+HZDVDGLVWLQJXLVKHGOHDGHULQWKHÀHOGVHUYLQJ as president of the American Society of Pediatric Neurosurgeons and chair of the AANS/CNS Section on Pediatric Neurological Surgery. Dr. Cheek recruited pediatric neurosurgeons Dr. Jack Laurent
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  • Beyond Crayons

    Beyond Crayons

    THE JEFFRAS’ PROGRAM THAT PROMOTES A HEALTHY SCHOOL ENVIRONMENT FOR STUDENTS WITH SPINA BIFIDA SECTION 504 PLAN Background Plan Objectives & Goals Spina Bifida is the most common permanently Successful integration of a child with Spina Bifida disabling birth defect in the United States. Spina into school sometimes requires changes in school Bifida occurs when the spine of the baby fails to equipment or the curriculum. In adapting the school close. This creates an opening, or lesion, on the setting for the child with Spina Bifida, architectural spinal column. This takes place during the first factors should be considered. Section 504 of the month of pregnancy when the spinal column and Rehabilitation Act of 1973 requires programs that brain, or neural tube, is formed. This happens before receive federal funding to make their facilities most women even know they are pregnant. Because accessible. This can occur through structural of the opening on the spinal column, the nerves in changes (for example, adding elevators or ramps) or the spinal column may be damaged and not work through schedule and location changes (for properly. This results in some degree of paralysis. example, offering a course on the ground floor). The higher the lesion is on the spinal column, the greater the paralysis. Surgery to close the spine is The Student has a recognized disability, Spina Bifida, generally done within hours after birth. Surgery helps that requires the accommodations and modifications to reduce the risk of infection and to protect the set out in this plan to ensure that the student has the spinal cord from greater damage.