{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:17:07Z","timestamp":1782454627411,"version":"3.54.5"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2017,3]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Little is known about optimal treatment if neurolysis for ulnar nerve entrapment at the elbow fails. The authors evaluated the clinical outcome of patients who underwent anterior subcutaneous transposition after failure of neurolysis of ulnar nerve entrapment (ASTAFNUE).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A consecutive series of patients who underwent ASTAFNUE performed by a single surgeon between 2009 and 2014 was analyzed retrospectively. Preoperative and postoperative complaints in the following 3 clinical modalities were compared: pain and\/or tingling, weakness, and numbness. Six-point satisfaction scores were determined on the basis of data from systematic telephonic surveys.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Twenty-six patients were included. The median age was 56 years (range 22\u201379 years). The median duration of complaints before ASTAFNUE was 23 months (range 8\u201378 months). The median interval between neurolysis and ASTAFNUE was 11 months (range 5\u201334 months). At presentation, 88% of the patients were experiencing pain and\/or tingling, 46% had weakness, and 50% had numbness of the fourth and fifth fingers. Pain and\/or tingling improved in 35%, motor function in 23%, and sensory disturbances in 19% of all the patients. Improvement in at least 1 of the 3 clinical modalities was found in 58%. However, a deterioration in 1 of the 3 modalities was noted in 46% of the patients. On the patient-satisfaction scale, 62% reported a good or excellent outcome. Patients with a good\/excellent outcome were a median of 11 years younger than patients with a fair\/poor outcome. No other factor was significantly related to satisfaction score.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n A majority of the patients were satisfied after ASTAFNUE, even though their symptoms only partly resolved or even deteriorated. Older age is a risk factor for a poor outcome. Other factors that affect outcome might play a role, but they remain unidentified. One of these factors might be earlier surgical intervention. The modest results of ASTAFNUE should be mentioned when counseling patients after failure of neurolysis of ulnar nerve entrapment to manage their expectations. Patients, especially those who are elderly, might even consider not undergoing a secondary procedure. A randomized trial that includes a conservative treatment group and groups undergoing one of the several possible surgical procedures is needed to find the definitive answer for this clinical problem.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.11.focus16451","type":"journal-article","created":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T03:38:34Z","timestamp":1488339514000},"page":"E8","source":"Crossref","is-referenced-by-count":8,"title":["Anterior subcutaneous transposition for persistent ulnar neuropathy after neurolysis"],"prefix":"10.3171","volume":"42","author":[{"given":"Jort A. N.","family":"van Gent","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Datema","sequence":"additional","affiliation":[{"name":"Neurology, Leiden University Medical Centre; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justus L.","family":"Groen","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"Pondaag","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Job L. A.","family":"Eekhof","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alrijne Hospital, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn J. A.","family":"Malessy","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16451","series-title":"J Hand Surg Am","first-page":"2141","article-title":"Outcomes of revision surgery for cubital tunnel syndrome","volume":"39","author":"Aleem AW,","year":"2014","unstructured":"Aleem AW, Krogue JD, Calfee RP: Outcomes of revision surgery for cubital tunnel syndrome. J Hand Surg Am 39:2141\u20132149, 2014"},{"key":"b2-focus16451","series-title":"J Bone Joint Surg Br","first-page":"998","article-title":"Anterior submuscular transposition of the ulnar nerve. For post-operative focal neuropathy at the elbow","volume":"86","author":"Bartels RH,","year":"2004","unstructured":"Bartels RH, Grotenhuis JA: Anterior submuscular transposition of the ulnar nerve. For post-operative focal neuropathy at the elbow. J Bone Joint Surg Br 86:998\u20131001, 2004"},{"key":"b3-focus16451","series-title":"Neurosurgery","first-page":"522","article-title":"Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: Part 1","volume":"56","author":"Bartels RH,","year":"2005","unstructured":"Bartels RH, Verhagen WI, van der Wilt GJ, Meulstee J, van Rossum LG, Grotenhuis JA: Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: Part 1. Neurosurgery 56:522\u2013530, 2005"},{"key":"b4-focus16451","series-title":"Muscle Nerve","article-title":"A novel points system to predict the prognosis of ulnar neuropathy at the elbow.","author":"Beekman R,","year":"2016","unstructured":"Beekman R, Zijlstra W, Visser LH: A novel points system to predict the prognosis of ulnar neuropathy at the elbow.. Muscle Nerve [epub ahead of print]2016"},{"key":"b5-focus16451","series-title":"J Hand Surg Am","first-page":"85","article-title":"Technical problems with ulnar nerve transposition at the elbow: findings and results of reoperation","volume":"3","author":"Broudy AS,","year":"1978","unstructured":"Broudy AS, Leffert RD, Smith RJ: Technical problems with ulnar nerve transposition at the elbow: findings and results of reoperation. J Hand Surg Am 3:85\u201389, 1978"},{"key":"b6-focus16451","series-title":"Cochrane Database Syst Rev","first-page":"CD006839","article-title":"Treatment for ulnar neuropathy at the elbow.","volume":"7","author":"Caliandro P,","year":"2012","unstructured":"Caliandro P, La Torre G, Padua R, Giannini F, Padua L: Treatment for ulnar neuropathy at the elbow.. Cochrane Database Syst Rev 7:CD006839, 2012"},{"key":"b7-focus16451","series-title":"J Hand Surg Am","first-page":"544","article-title":"Subcutaneous anterior transposition of the ulnar nerve for failed decompression of cubital tunnel syndrome","volume":"25","author":"Caputo AE,","year":"2000","unstructured":"Caputo AE, Watson HK: Subcutaneous anterior transposition of the ulnar nerve for failed decompression of cubital tunnel syndrome. J Hand Surg Am 25:544\u2013551, 2000"},{"key":"b8-focus16451","series-title":"Clin Neurol Neurosurg","first-page":"150","article-title":"Clinical efficacy of simple decompression versus anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome: A meta-analysis","volume":"126","author":"Chen HW,","year":"2014","unstructured":"Chen HW, Ou S, Liu GD, Fei J, Zhao GS, Wu LJ, : Clinical efficacy of simple decompression versus anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome: A meta-analysis. Clin Neurol Neurosurg 126:150\u2013155, 2014"},{"key":"b9-focus16451","series-title":"J Bone Joint Surg Am","first-page":"213","article-title":"Reoperation for failed decompression of the ulnar nerve in the region of the elbow","volume":"72","author":"Gabel GT,","year":"1990","unstructured":"Gabel GT, Amadio PC: Reoperation for failed decompression of the ulnar nerve in the region of the elbow. J Bone Joint Surg Am 72:213\u2013219, 1990"},{"key":"b10-focus16451","series-title":"Neurosurgery","first-page":"108","article-title":"Simple decompression versus anterior submuscular transposition of the ulnar nerve in severe cubital tunnel syndrome: a prospective randomized study","volume":"56","author":"Gervasio O,","year":"2005","unstructured":"Gervasio O, Gambardella G, Zaccone C, Branca D: Simple decompression versus anterior submuscular transposition of the ulnar nerve in severe cubital tunnel syndrome: a prospective randomized study. Neurosurgery 56:108\u2013117, 2005"},{"key":"b11-focus16451","series-title":"J Hand Surg Eur","first-page":"379","article-title":"Incidence of reoperation and subjective outcome following in situ decompression of the ulnar nerve at the cubital tunnel.","volume":"34","author":"Goldfarb CA,","year":"2009","unstructured":"Goldfarb CA, Sutter MM, Martens EJ, Manske PR: Incidence of reoperation and subjective outcome following in situ decompression of the ulnar nerve at the cubital tunnel.. J Hand Surg Eur 34:379\u2013383, 2009"},{"key":"b12-focus16451","series-title":"Acta Neurochir (Wien)","first-page":"311","article-title":"Comparison of the long-term results of anterior transposition of the ulnar nerve or simple decompression in the treatment of cubital tunnel syndrome\u2014a prospective study","volume":"151","author":"Keiner D,","year":"2009","unstructured":"Keiner D, Gaab MR, Schroeder HW, Oertel J: Comparison of the long-term results of anterior transposition of the ulnar nerve or simple decompression in the treatment of cubital tunnel syndrome\u2014a prospective study. Acta Neurochir (Wien) 151:311\u2013316, 2009"},{"key":"b13-focus16451","series-title":"J Shoulder Elbow Surg","first-page":"634","article-title":"Predictors of surgical revision after in situ decompression of the ulnar nerve","volume":"24","author":"Krogue JD,","year":"2015","unstructured":"Krogue JD, Aleem AW, Osei DA, Goldfarb CA, Calfee RP: Predictors of surgical revision after in situ decompression of the ulnar nerve. J Shoulder Elbow Surg 24:634\u2013639, 2015"},{"key":"b14-focus16451","series-title":"Hand (NY)","first-page":"50","article-title":"Selection of operative procedures for cubital tunnel syndrome","volume":"4","author":"Novak CB,","year":"2009","unstructured":"Novak CB, Mackinnon SE: Selection of operative procedures for cubital tunnel syndrome. Hand (NY) 4:50\u201354, 2009"},{"issue":"269","key":"b15-focus16451","series-title":"Clin Orthop Relat Res","first-page":"193","article-title":"The failed ulnar nerve transposition. Etiology and treatment.","author":"Rogers MR,","year":"1991","unstructured":"Rogers MR, Bergfield TG, Aulicino PL: The failed ulnar nerve transposition. Etiology and treatment.. Clin Orthop Relat Res 269193\u2013200, 1991"},{"key":"b16-focus16451","series-title":"Clin Imaging","first-page":"263","article-title":"MR anatomy and pathology of the ulnar nerve involving the cubital tunnel and Guyon's canal","volume":"40","author":"Shen L,","year":"2016","unstructured":"Shen L, Masih S, Patel DB, Matcuk GR Jr: MR anatomy and pathology of the ulnar nerve involving the cubital tunnel and Guyon's canal. Clin Imaging 40:263\u2013274, 2016"},{"key":"b17-focus16451","series-title":"J Hand Surg Am","first-page":"1551","article-title":"Trends in the surgical treatment of cubital tunnel syndrome: an analysis of the national survey of ambulatory surgery database","volume":"38","author":"Soltani AM,","year":"2013","unstructured":"Soltani AM, Best MJ, Francis CS, Allan BJ, Panthaki ZJ: Trends in the surgical treatment of cubital tunnel syndrome: an analysis of the national survey of ambulatory surgery database. J Hand Surg Am 38:1551\u20131556, 2013"},{"key":"b18-focus16451","series-title":"Br J Plast Surg","first-page":"311","article-title":"Revision anterior submuscular transposition of the ulnar nerve for failed subcutaneous transposition","volume":"57","author":"Vogel RB,","year":"2004","unstructured":"Vogel RB, Nossaman BC, Rayan GM: Revision anterior submuscular transposition of the ulnar nerve for failed subcutaneous transposition. Br J Plast Surg 57:311\u2013316, 2004"},{"key":"b19-focus16451","series-title":"J Res Med Sci","first-page":"745","article-title":"Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial","volume":"17","author":"Zarezadeh A,","year":"2012","unstructured":"Zarezadeh A, Shemshaki H, Nourbakhsh M, Etemadifar MR, Moeini M, Mazoochian F: Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial. J Res Med Sci 17:745\u2013749, 2012"},{"key":"b20-focus16451","series-title":"J Bone Joint Surg Am","first-page":"2591","article-title":"Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials","volume":"89","author":"Zlowodzki M,","year":"2007","unstructured":"Zlowodzki M, Chan S, Bhandari M, Kalliainen L, Schubert W: Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 89:2591\u20132598, 2007"},{"key":"b1-focus16451","series-title":"J Hand Surg Am","first-page":"2141","article-title":"Outcomes of revision surgery for cubital tunnel syndrome","volume":"39","author":"Aleem AW,","year":"2014","unstructured":"Aleem AW, Krogue JD, Calfee RP: Outcomes of revision surgery for cubital tunnel syndrome. J Hand Surg Am 39:2141\u20132149, 2014"},{"key":"b2-focus16451","series-title":"J Bone Joint Surg Br","first-page":"998","article-title":"Anterior submuscular transposition of the ulnar nerve. For post-operative focal neuropathy at the elbow","volume":"86","author":"Bartels RH,","year":"2004","unstructured":"Bartels RH, Grotenhuis JA: Anterior submuscular transposition of the ulnar nerve. For post-operative focal neuropathy at the elbow. J Bone Joint Surg Br 86:998\u20131001, 2004"},{"key":"b3-focus16451","series-title":"Neurosurgery","first-page":"522","article-title":"Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: Part 1","volume":"56","author":"Bartels RH,","year":"2005","unstructured":"Bartels RH, Verhagen WI, van der Wilt GJ, Meulstee J, van Rossum LG, Grotenhuis JA: Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: Part 1. Neurosurgery 56:522\u2013530, 2005"},{"key":"b4-focus16451","series-title":"Muscle Nerve","article-title":"A novel points system to predict the prognosis of ulnar neuropathy at the elbow.","author":"Beekman R,","year":"2016","unstructured":"Beekman R, Zijlstra W, Visser LH: A novel points system to predict the prognosis of ulnar neuropathy at the elbow.. Muscle Nerve [epub ahead of print]2016"},{"key":"b5-focus16451","series-title":"J Hand Surg Am","first-page":"85","article-title":"Technical problems with ulnar nerve transposition at the elbow: findings and results of reoperation","volume":"3","author":"Broudy AS,","year":"1978","unstructured":"Broudy AS, Leffert RD, Smith RJ: Technical problems with ulnar nerve transposition at the elbow: findings and results of reoperation. J Hand Surg Am 3:85\u201389, 1978"},{"key":"b6-focus16451","series-title":"Cochrane Database Syst Rev","first-page":"CD006839","article-title":"Treatment for ulnar neuropathy at the elbow.","volume":"7","author":"Caliandro P,","year":"2012","unstructured":"Caliandro P, La Torre G, Padua R, Giannini F, Padua L: Treatment for ulnar neuropathy at the elbow.. Cochrane Database Syst Rev 7:CD006839, 2012"},{"key":"b7-focus16451","series-title":"J Hand Surg Am","first-page":"544","article-title":"Subcutaneous anterior transposition of the ulnar nerve for failed decompression of cubital tunnel syndrome","volume":"25","author":"Caputo AE,","year":"2000","unstructured":"Caputo AE, Watson HK: Subcutaneous anterior transposition of the ulnar nerve for failed decompression of cubital tunnel syndrome. J Hand Surg Am 25:544\u2013551, 2000"},{"key":"b8-focus16451","series-title":"Clin Neurol Neurosurg","first-page":"150","article-title":"Clinical efficacy of simple decompression versus anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome: A meta-analysis","volume":"126","author":"Chen HW,","year":"2014","unstructured":"Chen HW, Ou S, Liu GD, Fei J, Zhao GS, Wu LJ, : Clinical efficacy of simple decompression versus anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome: A meta-analysis. Clin Neurol Neurosurg 126:150\u2013155, 2014"},{"key":"b9-focus16451","series-title":"J Bone Joint Surg Am","first-page":"213","article-title":"Reoperation for failed decompression of the ulnar nerve in the region of the elbow","volume":"72","author":"Gabel GT,","year":"1990","unstructured":"Gabel GT, Amadio PC: Reoperation for failed decompression of the ulnar nerve in the region of the elbow. J Bone Joint Surg Am 72:213\u2013219, 1990"},{"key":"b10-focus16451","series-title":"Neurosurgery","first-page":"108","article-title":"Simple decompression versus anterior submuscular transposition of the ulnar nerve in severe cubital tunnel syndrome: a prospective randomized study","volume":"56","author":"Gervasio O,","year":"2005","unstructured":"Gervasio O, Gambardella G, Zaccone C, Branca D: Simple decompression versus anterior submuscular transposition of the ulnar nerve in severe cubital tunnel syndrome: a prospective randomized study. Neurosurgery 56:108\u2013117, 2005"},{"key":"b11-focus16451","series-title":"J Hand Surg Eur","first-page":"379","article-title":"Incidence of reoperation and subjective outcome following in situ decompression of the ulnar nerve at the cubital tunnel.","volume":"34","author":"Goldfarb CA,","year":"2009","unstructured":"Goldfarb CA, Sutter MM, Martens EJ, Manske PR: Incidence of reoperation and subjective outcome following in situ decompression of the ulnar nerve at the cubital tunnel.. J Hand Surg Eur 34:379\u2013383, 2009"},{"key":"b12-focus16451","series-title":"Acta Neurochir (Wien)","first-page":"311","article-title":"Comparison of the long-term results of anterior transposition of the ulnar nerve or simple decompression in the treatment of cubital tunnel syndrome\u2014a prospective study","volume":"151","author":"Keiner D,","year":"2009","unstructured":"Keiner D, Gaab MR, Schroeder HW, Oertel J: Comparison of the long-term results of anterior transposition of the ulnar nerve or simple decompression in the treatment of cubital tunnel syndrome\u2014a prospective study. Acta Neurochir (Wien) 151:311\u2013316, 2009"},{"key":"b13-focus16451","series-title":"J Shoulder Elbow Surg","first-page":"634","article-title":"Predictors of surgical revision after in situ decompression of the ulnar nerve","volume":"24","author":"Krogue JD,","year":"2015","unstructured":"Krogue JD, Aleem AW, Osei DA, Goldfarb CA, Calfee RP: Predictors of surgical revision after in situ decompression of the ulnar nerve. J Shoulder Elbow Surg 24:634\u2013639, 2015"},{"key":"b14-focus16451","series-title":"Hand (NY)","first-page":"50","article-title":"Selection of operative procedures for cubital tunnel syndrome","volume":"4","author":"Novak CB,","year":"2009","unstructured":"Novak CB, Mackinnon SE: Selection of operative procedures for cubital tunnel syndrome. Hand (NY) 4:50\u201354, 2009"},{"issue":"269","key":"b15-focus16451","series-title":"Clin Orthop Relat Res","first-page":"193","article-title":"The failed ulnar nerve transposition. Etiology and treatment.","author":"Rogers MR,","year":"1991","unstructured":"Rogers MR, Bergfield TG, Aulicino PL: The failed ulnar nerve transposition. Etiology and treatment.. Clin Orthop Relat Res 269193\u2013200, 1991"},{"key":"b16-focus16451","series-title":"Clin Imaging","first-page":"263","article-title":"MR anatomy and pathology of the ulnar nerve involving the cubital tunnel and Guyon's canal","volume":"40","author":"Shen L,","year":"2016","unstructured":"Shen L, Masih S, Patel DB, Matcuk GR Jr: MR anatomy and pathology of the ulnar nerve involving the cubital tunnel and Guyon's canal. Clin Imaging 40:263\u2013274, 2016"},{"key":"b17-focus16451","series-title":"J Hand Surg Am","first-page":"1551","article-title":"Trends in the surgical treatment of cubital tunnel syndrome: an analysis of the national survey of ambulatory surgery database","volume":"38","author":"Soltani AM,","year":"2013","unstructured":"Soltani AM, Best MJ, Francis CS, Allan BJ, Panthaki ZJ: Trends in the surgical treatment of cubital tunnel syndrome: an analysis of the national survey of ambulatory surgery database. J Hand Surg Am 38:1551\u20131556, 2013"},{"key":"b18-focus16451","series-title":"Br J Plast Surg","first-page":"311","article-title":"Revision anterior submuscular transposition of the ulnar nerve for failed subcutaneous transposition","volume":"57","author":"Vogel RB,","year":"2004","unstructured":"Vogel RB, Nossaman BC, Rayan GM: Revision anterior submuscular transposition of the ulnar nerve for failed subcutaneous transposition. Br J Plast Surg 57:311\u2013316, 2004"},{"key":"b19-focus16451","series-title":"J Res Med Sci","first-page":"745","article-title":"Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial","volume":"17","author":"Zarezadeh A,","year":"2012","unstructured":"Zarezadeh A, Shemshaki H, Nourbakhsh M, Etemadifar MR, Moeini M, Mazoochian F: Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial. J Res Med Sci 17:745\u2013749, 2012"},{"key":"b20-focus16451","series-title":"J Bone Joint Surg Am","first-page":"2591","article-title":"Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials","volume":"89","author":"Zlowodzki M,","year":"2007","unstructured":"Zlowodzki M, Chan S, Bhandari M, Kalliainen L, Schubert W: Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials. J Bone Joint Surg Am 89:2591\u20132598, 2007"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/42\/3\/article-pE8.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/42\/3\/article-pE8.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/42\/3\/article-pE8.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T08:19:56Z","timestamp":1780733996000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/42\/3\/article-pE8.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":40,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2016.11.focus16451","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}