{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T09:08:20Z","timestamp":1775898500366,"version":"3.50.1"},"reference-count":84,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECT<\/jats:title>\n                    <jats:p>Vertebral fractures are the most common osteoporotic fracture. Bone density testing and medical treatment with bisphosphonates or parathormone are recommended for all patients with an osteoporotic fracture diagnosis. Inadequate testing and treatment of patients presenting with low-impact fractures have been reported in various specialties. Similar data are not available from academic neurosurgery groups. The authors assessed compliance with treatment and testing of osteoporosis in patients with vertebral compression fractures evaluated by the authors\u2019 academic neurosurgery service, and patient variable and health-systems factors associated with improved compliance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Data for patients who underwent percutaneous kyphoplasty for compression fractures was retrospectively collected. Diagnostic and medical interventions were tabulated. Pre-, intra-, and posthospital factors that had been theorized to affect the compliance of patients with osteoporosis-related therapies were tabulated and statistically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Less than 50% of patients with kyphoplasty received such therapies. Age was not found to correlate with other variables. Referral from a specialist rather than a primary care physician was associated with a higher rate of bone density screening, as well as vitamin D and calcium therapy, but not bisphosphonate\/parathormone therapy. Patients who underwent preoperative evaluation by their primary care physician were significantly more likely to receive bisphosphonates compared with those only evaluated by a hospitalist. Patients with unprovoked fractures were more likely to undergo multiple surgeries compared with those with minor trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These results suggest poor compliance with current standard of care for medical therapies in patients with osteoporotic compression fractures undergoing kyphoplasty under the care of an academic neurosurgery service.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.9.focus15375","type":"journal-article","created":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T03:37:25Z","timestamp":1448941045000},"page":"E15","source":"Crossref","is-referenced-by-count":3,"title":["Patient variables and referral paradigms associated with osteoporosis screening and treatment in neurosurgical patients undergoing kyphoplasty"],"prefix":"10.3171","volume":"39","author":[{"given":"Simon","family":"Morr","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and Department of Neurosurgery, Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakeem J.","family":"Shakir","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and Department of Neurosurgery, Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay J.","family":"Lipinski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and Department of Neurosurgery, Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vassilios G.","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and Department of Neurosurgery, Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jody","family":"Leonardo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and Department of Neurosurgery, Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Pollina","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; and Department of Neurosurgery, Kaleida Health, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2A","key":"b1-focus15375","series-title":"Am J Med","first-page":"3S","article-title":"The economic and human costs of osteoporotic fracture","volume":"98","author":"Barrett-Connor","year":"1995"},{"key":"b2-focus15375","series-title":"Lancet","first-page":"1535","article-title":"Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures","volume":"348","author":"Black","year":"1996"},{"key":"b3-focus15375","series-title":"J Clin Densitom","first-page":"102","article-title":"Role of dualenergy X-ray absorptiometry in the diagnosis and treatment of osteoporosis","volume":"10","author":"Blake","year":"2007"},{"key":"b4-focus15375","series-title":"Br J Clin Pharmacol","first-page":"359","article-title":"A systematic review of educational interventions to change behaviour of prescribers in hospital settings, with a particular emphasis on new prescribers","volume":"75","author":"Brennan","year":"2013"},{"key":"b5-focus15375","series-title":"BMJ","first-page":"991","article-title":"Vertebral deformities as predictors of non-vertebral fractures","volume":"309","author":"Burger","year":"1994"},{"key":"b6-focus15375","series-title":"Osteoporos Int","first-page":"559","article-title":"Awareness of osteoporosis and compliance with management guidelines in patients with newly diagnosed low-impact fractures","volume":"12","author":"Castel","year":"2001"},{"key":"b7-focus15375","series-title":"Bone","first-page":"377","article-title":"Costs and health effects of osteoporotic fractures","volume":"15","author":"Chrischilles","year":"1994"},{"key":"b8-focus15375","series-title":"JAMA","first-page":"2077","article-title":"Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial","volume":"280","author":"Cummings","year":"1998"},{"key":"b9-focus15375","series-title":"N Engl J Med","first-page":"767","article-title":"Risk factors for hip fracture in white women","volume":"332","author":"Cummings","year":"1995"},{"key":"b10-focus15375","series-title":"J Bone Miner Res","first-page":"557","article-title":"Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study","volume":"20","author":"Delmas","year":"2005"},{"key":"b11-focus15375","series-title":"J Bone Miner Res","first-page":"712","article-title":"Multiple adjacent vertebral fractures after kyphoplasty in a patient with steroid-induced osteoporosis","volume":"19","author":"Donovan","year":"2004"},{"key":"b12-focus15375","series-title":"N Engl J Med","first-page":"1634","article-title":"Clinical practice. Vertebral fractures","volume":"364","author":"Ensrud","year":"2011"},{"key":"b13-focus15375","series-title":"JAMA","first-page":"637","article-title":"Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial","volume":"282","author":"Ettinger","year":"1999"},{"key":"b14-focus15375","series-title":"J Bone Joint Surg Am","first-page":"1063","article-title":"Treatment of osteoporosis: are physicians missing an opportunity?","volume":"82-A","author":"Freedman","year":"2000"},{"key":"b15-focus15375","series-title":"Osteoporos Int","first-page":"2005","article-title":"Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis","volume":"16","author":"Grafe","year":"2005"},{"key":"b16-focus15375","series-title":"J Spinal Disord Tech","first-page":"238","article-title":"Minimal invasive stabilization of osteoporotic vertebral fractures: a prospective nonrandomized comparison of vertebroplasty and balloon kyphoplasty","volume":"18","author":"Grohs","year":"2005"},{"key":"b17-focus15375","series-title":"J Womens Health Gend Based Med","first-page":"1077","article-title":"Healthcare use among U.S. women aged 45 and older: total costs and costs for selected postmenopausal health risks","volume":"8","author":"Hoerger","year":"1999"},{"key":"b18-focus15375","series-title":"Osteoporos Int","first-page":"38","article-title":"Mortality after osteoporotic fractures","volume":"15","author":"Johnell","year":"2004"},{"key":"b19-focus15375","series-title":"Arch Intern Med","first-page":"1215","article-title":"Vertebral fractures and mortality in older women: a prospective study","volume":"159","author":"Kado","year":"1999"},{"key":"b20-focus15375","series-title":"Osteoporos Int","first-page":"399","article-title":"European guidance for the diagnosis and management of osteoporosis in postmenopausal women","volume":"19","author":"Kanis","year":"2008"},{"issue":"Suppl 2","key":"b21-focus15375","series-title":"Bone","first-page":"S1","article-title":"Epidemiology of vertebral osteoporosis","volume":"13","author":"Kanis","year":"1992"},{"key":"b22-focus15375","series-title":"J Bone Miner Res","first-page":"712","article-title":"Which bone density measurement?","volume":"12","author":"Kleerekoper","year":"1997"},{"key":"b23-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"57","article-title":"Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits","volume":"31","author":"Ledlie","year":"2006"},{"key":"b24-focus15375","series-title":"N Engl J Med","first-page":"1437","article-title":"Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis","volume":"333","author":"Liberman","year":"1995"},{"key":"b25-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"1631","article-title":"Initial outcome and efficacy of \u201ckyphoplasty\u201d in the treatment of painful osteoporotic vertebral compression fractures","volume":"26","author":"Lieberman","year":"2001"},{"key":"b26-focus15375","series-title":"Osteoporos Int","first-page":"414","article-title":"Incidence and direct medical costs of hospitalizations due to osteoporotic fractures in Switzerland","volume":"7","author":"Lippuner","year":"1997"},{"key":"b27-focus15375","series-title":"Pharmacotherapy","first-page":"21S","article-title":"Management of patients with vertebral compression fractures","volume":"19","author":"Lyles","year":"1999"},{"key":"b28-focus15375","series-title":"South Med J","first-page":"457","article-title":"Pain outcome and vertebral body height restoration in patients undergoing kyphoplasty","volume":"99","author":"Machinis","year":"2006"},{"key":"b29-focus15375","series-title":"J Bone Miner Res","first-page":"16","article-title":"Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation","volume":"12","author":"Melton","year":"1997"},{"issue":"Suppl 4","key":"b30-focus15375","series-title":"Osteoporos Int","first-page":"S7","article-title":"Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effectiveness analysis. Introduction","volume":"8","author":"National Osteoporosis Foundation: Osteoporosis","year":"1998"},{"key":"b31-focus15375","series-title":"J Am Geriatr Soc","first-page":"483","article-title":"Diagnosis and treatment of osteoporosis in patients with vertebral compression fractures","volume":"51","author":"Neuner","year":"2003"},{"key":"b32-focus15375","series-title":"CMAJ","first-page":"1423","article-title":"No magic bullets: a systematic review of 102 trials of interventions to improve professional practice","volume":"153","author":"Oxman","year":"1995"},{"issue":"15 Suppl","key":"b33-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"S45","article-title":"Minimally invasive treatments of osteoporotic vertebral compression fractures","volume":"28","author":"Phillips","year":"2003"},{"key":"b34-focus15375","series-title":"J Bone Miner Res","first-page":"1564","article-title":"Consequences of vertebral deformities in older men and women","volume":"15","author":"Pluijm","year":"2000"},{"key":"b35-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"435","article-title":"Kyphoplasty reduction of osteoporotic vertebral compression fractures: correction of local kyphosis versus overall sagittal alignment","volume":"31","author":"Pradhan","year":"2006"},{"key":"b36-focus15375","series-title":"J Bone Miner Res","first-page":"24","article-title":"Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation","volume":"12","author":"Ray","year":"1997"},{"issue":"5 Suppl","key":"b37-focus15375","series-title":"Bone","first-page":"505S","article-title":"The worldwide problem of osteoporosis: insights afforded by epidemiology","volume":"17","author":"Riggs","year":"1995"},{"key":"b38-focus15375","series-title":"Ann Intern Med","first-page":"919","article-title":"Preexisting fractures and bone mass predict vertebral fracture incidence in women","volume":"114","author":"Ross","year":"1991"},{"key":"b39-focus15375","series-title":"J Gen Intern Med","first-page":"17","article-title":"Evaluation and management of osteoporosis following hospitalization for low-impact fracture","volume":"18","author":"Simonelli","year":"2003"},{"key":"b40-focus15375","series-title":"Spine J","first-page":"979","article-title":"Predictors and prevalence of patients undergoing additional kyphoplasty procedures after an initial kyphoplasty procedure","volume":"10","author":"Tatsumi","year":"2010"},{"key":"b41-focus15375","series-title":"Radiology","first-page":"119","article-title":"Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis","volume":"226","author":"Uppin","year":"2003"},{"key":"b42-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"2806","article-title":"Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures","volume":"30","author":"Voggenreiter","year":"2005"},{"issue":"2A","key":"b1-focus15375","series-title":"Am J Med","first-page":"3S","article-title":"The economic and human costs of osteoporotic fracture","volume":"98","author":"Barrett-Connor","year":"1995"},{"key":"b2-focus15375","series-title":"Lancet","first-page":"1535","article-title":"Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures","volume":"348","author":"Black","year":"1996"},{"key":"b3-focus15375","series-title":"J Clin Densitom","first-page":"102","article-title":"Role of dualenergy X-ray absorptiometry in the diagnosis and treatment of osteoporosis","volume":"10","author":"Blake","year":"2007"},{"key":"b4-focus15375","series-title":"Br J Clin Pharmacol","first-page":"359","article-title":"A systematic review of educational interventions to change behaviour of prescribers in hospital settings, with a particular emphasis on new prescribers","volume":"75","author":"Brennan","year":"2013"},{"key":"b5-focus15375","series-title":"BMJ","first-page":"991","article-title":"Vertebral deformities as predictors of non-vertebral fractures","volume":"309","author":"Burger","year":"1994"},{"key":"b6-focus15375","series-title":"Osteoporos Int","first-page":"559","article-title":"Awareness of osteoporosis and compliance with management guidelines in patients with newly diagnosed low-impact fractures","volume":"12","author":"Castel","year":"2001"},{"key":"b7-focus15375","series-title":"Bone","first-page":"377","article-title":"Costs and health effects of osteoporotic fractures","volume":"15","author":"Chrischilles","year":"1994"},{"key":"b8-focus15375","series-title":"JAMA","first-page":"2077","article-title":"Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial","volume":"280","author":"Cummings","year":"1998"},{"key":"b9-focus15375","series-title":"N Engl J Med","first-page":"767","article-title":"Risk factors for hip fracture in white women","volume":"332","author":"Cummings","year":"1995"},{"key":"b10-focus15375","series-title":"J Bone Miner Res","first-page":"557","article-title":"Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study","volume":"20","author":"Delmas","year":"2005"},{"key":"b11-focus15375","series-title":"J Bone Miner Res","first-page":"712","article-title":"Multiple adjacent vertebral fractures after kyphoplasty in a patient with steroid-induced osteoporosis","volume":"19","author":"Donovan","year":"2004"},{"key":"b12-focus15375","series-title":"N Engl J Med","first-page":"1634","article-title":"Clinical practice. Vertebral fractures","volume":"364","author":"Ensrud","year":"2011"},{"key":"b13-focus15375","series-title":"JAMA","first-page":"637","article-title":"Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial","volume":"282","author":"Ettinger","year":"1999"},{"key":"b14-focus15375","series-title":"J Bone Joint Surg Am","first-page":"1063","article-title":"Treatment of osteoporosis: are physicians missing an opportunity?","volume":"82-A","author":"Freedman","year":"2000"},{"key":"b15-focus15375","series-title":"Osteoporos Int","first-page":"2005","article-title":"Reduction of pain and fracture incidence after kyphoplasty: 1-year outcomes of a prospective controlled trial of patients with primary osteoporosis","volume":"16","author":"Grafe","year":"2005"},{"key":"b16-focus15375","series-title":"J Spinal Disord Tech","first-page":"238","article-title":"Minimal invasive stabilization of osteoporotic vertebral fractures: a prospective nonrandomized comparison of vertebroplasty and balloon kyphoplasty","volume":"18","author":"Grohs","year":"2005"},{"key":"b17-focus15375","series-title":"J Womens Health Gend Based Med","first-page":"1077","article-title":"Healthcare use among U.S. women aged 45 and older: total costs and costs for selected postmenopausal health risks","volume":"8","author":"Hoerger","year":"1999"},{"key":"b18-focus15375","series-title":"Osteoporos Int","first-page":"38","article-title":"Mortality after osteoporotic fractures","volume":"15","author":"Johnell","year":"2004"},{"key":"b19-focus15375","series-title":"Arch Intern Med","first-page":"1215","article-title":"Vertebral fractures and mortality in older women: a prospective study","volume":"159","author":"Kado","year":"1999"},{"key":"b20-focus15375","series-title":"Osteoporos Int","first-page":"399","article-title":"European guidance for the diagnosis and management of osteoporosis in postmenopausal women","volume":"19","author":"Kanis","year":"2008"},{"issue":"Suppl 2","key":"b21-focus15375","series-title":"Bone","first-page":"S1","article-title":"Epidemiology of vertebral osteoporosis","volume":"13","author":"Kanis","year":"1992"},{"key":"b22-focus15375","series-title":"J Bone Miner Res","first-page":"712","article-title":"Which bone density measurement?","volume":"12","author":"Kleerekoper","year":"1997"},{"key":"b23-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"57","article-title":"Kyphoplasty treatment of vertebral fractures: 2-year outcomes show sustained benefits","volume":"31","author":"Ledlie","year":"2006"},{"key":"b24-focus15375","series-title":"N Engl J Med","first-page":"1437","article-title":"Effect of oral alendronate on bone mineral density and the incidence of fractures in postmenopausal osteoporosis","volume":"333","author":"Liberman","year":"1995"},{"key":"b25-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"1631","article-title":"Initial outcome and efficacy of \u201ckyphoplasty\u201d in the treatment of painful osteoporotic vertebral compression fractures","volume":"26","author":"Lieberman","year":"2001"},{"key":"b26-focus15375","series-title":"Osteoporos Int","first-page":"414","article-title":"Incidence and direct medical costs of hospitalizations due to osteoporotic fractures in Switzerland","volume":"7","author":"Lippuner","year":"1997"},{"key":"b27-focus15375","series-title":"Pharmacotherapy","first-page":"21S","article-title":"Management of patients with vertebral compression fractures","volume":"19","author":"Lyles","year":"1999"},{"key":"b28-focus15375","series-title":"South Med J","first-page":"457","article-title":"Pain outcome and vertebral body height restoration in patients undergoing kyphoplasty","volume":"99","author":"Machinis","year":"2006"},{"key":"b29-focus15375","series-title":"J Bone Miner Res","first-page":"16","article-title":"Fractures attributable to osteoporosis: report from the National Osteoporosis Foundation","volume":"12","author":"Melton","year":"1997"},{"issue":"Suppl 4","key":"b30-focus15375","series-title":"Osteoporos Int","first-page":"S7","article-title":"Osteoporosis: review of the evidence for prevention, diagnosis and treatment and cost-effectiveness analysis. Introduction","volume":"8","author":"National Osteoporosis Foundation: Osteoporosis","year":"1998"},{"key":"b31-focus15375","series-title":"J Am Geriatr Soc","first-page":"483","article-title":"Diagnosis and treatment of osteoporosis in patients with vertebral compression fractures","volume":"51","author":"Neuner","year":"2003"},{"key":"b32-focus15375","series-title":"CMAJ","first-page":"1423","article-title":"No magic bullets: a systematic review of 102 trials of interventions to improve professional practice","volume":"153","author":"Oxman","year":"1995"},{"issue":"15 Suppl","key":"b33-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"S45","article-title":"Minimally invasive treatments of osteoporotic vertebral compression fractures","volume":"28","author":"Phillips","year":"2003"},{"key":"b34-focus15375","series-title":"J Bone Miner Res","first-page":"1564","article-title":"Consequences of vertebral deformities in older men and women","volume":"15","author":"Pluijm","year":"2000"},{"key":"b35-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"435","article-title":"Kyphoplasty reduction of osteoporotic vertebral compression fractures: correction of local kyphosis versus overall sagittal alignment","volume":"31","author":"Pradhan","year":"2006"},{"key":"b36-focus15375","series-title":"J Bone Miner Res","first-page":"24","article-title":"Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation","volume":"12","author":"Ray","year":"1997"},{"issue":"5 Suppl","key":"b37-focus15375","series-title":"Bone","first-page":"505S","article-title":"The worldwide problem of osteoporosis: insights afforded by epidemiology","volume":"17","author":"Riggs","year":"1995"},{"key":"b38-focus15375","series-title":"Ann Intern Med","first-page":"919","article-title":"Preexisting fractures and bone mass predict vertebral fracture incidence in women","volume":"114","author":"Ross","year":"1991"},{"key":"b39-focus15375","series-title":"J Gen Intern Med","first-page":"17","article-title":"Evaluation and management of osteoporosis following hospitalization for low-impact fracture","volume":"18","author":"Simonelli","year":"2003"},{"key":"b40-focus15375","series-title":"Spine J","first-page":"979","article-title":"Predictors and prevalence of patients undergoing additional kyphoplasty procedures after an initial kyphoplasty procedure","volume":"10","author":"Tatsumi","year":"2010"},{"key":"b41-focus15375","series-title":"Radiology","first-page":"119","article-title":"Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis","volume":"226","author":"Uppin","year":"2003"},{"key":"b42-focus15375","series-title":"Spine (Phila Pa 1976)","first-page":"2806","article-title":"Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures","volume":"30","author":"Voggenreiter","year":"2005"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/39\/6\/article-pE15.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/39\/6\/article-pE15.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/39\/6\/article-pE15.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T08:24:00Z","timestamp":1775895840000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/39\/6\/article-pE15.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":84,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2015.9.focus15375","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12]]}}}