{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T12:10:02Z","timestamp":1732623002078,"version":"3.28.2"},"reference-count":43,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Deep brain stimulation (DBS) is a common procedure in neurosurgery used for the treatment of Parkinson\u2019s disease (PD) and essential tremor (ET) among other disorders. Lower urinary tract dysfunction is a common complication in PD, and this study aimed to evaluate the risk factors of postoperative urinary retention (POUR) after DBS surgery in patients with PD compared with patients with ET. Understanding the risk factors associated with this complication may help in the development of strategies to minimize its occurrence and improve patient outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The study was a retrospective analysis of patients who underwent DBS surgery for PD and ET at the University of Florida between 2010 and 2021. The surgical technique used has been described in previous articles and included a two-stage procedure, with stage 1 involving burr hole placement, microelectrode recording, and electrode implantation and stage 2 involving the placement of an implantable pulse generator (IPG). Data were collected on patient characteristics and surgical details and analyzed using univariate and mixed-linear models. Post hoc propensity score matching was used to confirm the association between subthalamic nucleus (STN)\u2013DBS and POUR.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The study included 350 patients (153 with PD and 197 with ET) who underwent 1086 DBS surgeries (lead implantations, IPG placement, and IPG replacements). The POUR rates were 16.6% (79\/477), 5.2% (19\/363), and 0.4% (1\/246) for stage 1, stage 2, and IPG replacement procedures, respectively. Optimal mixed-effects logistic modeling revealed history of urinary retention (OR 9.3, p = 0.004), male sex (OR 2.7, p = 0.011), having an electrode placed or connected for the first time (OR 2.2, p = 0.014), anesthesia time (OR 1.5 for each 30-minute increase, p &lt; 0.0001), preoperative opioid use (OR 1.4 for each additional 10 morphine milligram equivalents, p = 0.032), and Charlson Comorbidity Index (OR 1.4 per comorbidity, p = 0.017) to be significant risk factors for POUR. Having an electrode in the STN was found to be protective of POUR (propensity score\u2013matched analysis: OR 0.2, p = 0.010).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Most risk factors found to increase the risk of POUR in DBS are not modifiable but are still important to consider in preoperative planning. Opioid use reduction and shorter anesthesia time may be modifiable risk factors to weigh against their alternative. Targeting the STN during DBS may result in decreased rates of POUR. This highlights the potential for STN-targeted DBS in reducing POUR risk in PD and ET patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.11.jns231668","type":"journal-article","created":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T01:46:31Z","timestamp":1706924791000},"page":"221-229","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors for postoperative urinary retention after deep brain stimulation surgery: the role of the subthalamic nucleus"],"prefix":"10.3171","volume":"141","author":[{"given":"Ken","family":"Porche","sequence":"first","affiliation":[{"name":"College of Medicine, University of Florida;"},{"name":"Lillian S. Wells Department of Neurosurgery, University of Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodeania","family":"Peart","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Silva","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Mampre","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"},{"name":"Lillian S. Wells Department of Neurosurgery, University of Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vyshak","family":"Chandra","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"},{"name":"Lillian S. Wells Department of Neurosurgery, University of Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasheedat","family":"Zakare-Fagbamila","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"},{"name":"Lillian S. Wells Department of Neurosurgery, University of Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Foote","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"},{"name":"Lillian S. Wells Department of Neurosurgery, University of Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin D.","family":"Hilliard","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"},{"name":"Lillian S. Wells Department of Neurosurgery, University of Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Robicsek","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Florida;"},{"name":"Department of Anesthesiology, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Parkinsonism Relat Disord","first-page":"77","article-title":"Multi-organ autonomic dysfunction in Parkinson disease","volume":"17","author":"Jain S","year":"2011","unstructured":"Jain S. Multi-organ autonomic dysfunction in Parkinson disease. Parkinsonism Relat Disord. 2011;17(2):77\u201383."},{"issue":"3","key":"b2","series-title":"J Neural Transm (Vienna)","first-page":"443","article-title":"Bladder and bowel dysfunction in Parkinson\u2019s disease","volume":"115","author":"Sakakibara R","year":"2008","unstructured":"Sakakibara R, Uchiyama T, Yamanishi T, Shirai K, Hattori T. Bladder and bowel dysfunction in Parkinson\u2019s disease. J Neural Transm (Vienna). 2008;115(3):443\u2013460."},{"issue":"5","key":"b3","series-title":"Neurourol Urodyn","first-page":"551","article-title":"A guideline for the management of bladder dysfunction in Parkinson\u2019s disease and other gait disorders","volume":"35","author":"Sakakibara R","year":"2016","unstructured":"Sakakibara R, Panicker J, Finazzi-Agro E, Iacovelli V, Bruschini H. A guideline for the management of bladder dysfunction in Parkinson\u2019s disease and other gait disorders. Neurourol Urodyn. 2016;35(5):551\u2013563."},{"issue":"5","key":"b4","series-title":"J Neurosurg","first-page":"1421","article-title":"Perioperative complications of deep brain stimulation among patients with advanced age: a single-institution retrospective analysis","volume":"135","author":"Wakim AA","year":"2021","unstructured":"Wakim AA, Mattar JB, Lambert M, Ponce FA. Perioperative complications of deep brain stimulation among patients with advanced age: a single-institution retrospective analysis. J Neurosurg. 2021;135(5):1421\u20131428."},{"issue":"5","key":"b5","series-title":"Mov Disord","first-page":"573","article-title":"Short-term effect of a single levodopa dose on micturition disturbance in Parkinson\u2019s disease patients with the wearing-off phenomenon","volume":"18","author":"Uchiyama T","year":"2003","unstructured":"Uchiyama T, Sakakibara R, Hattori T, Yamanishi T. Short-term effect of a single levodopa dose on micturition disturbance in Parkinson\u2019s disease patients with the wearing-off phenomenon. Mov Disord. 2003;18(5):573\u2013578."},{"issue":"3","key":"b6","series-title":"Neuroscience","first-page":"871","article-title":"Effects of subthalamic nucleus stimulation on the micturation reflex in cats","volume":"120","author":"Sakakibara R","year":"2003","unstructured":"Sakakibara R, Nakazawa K, Uchiyama T, Yoshiyama M, Yamanishi T, Hattori T. Effects of subthalamic nucleus stimulation on the micturation reflex in cats. Neuroscience. 2003;120(3):871\u2013875."},{"issue":"3","key":"b7","series-title":"Neurourol Urodyn","first-page":"265","article-title":"Effects of high frequency deep brain stimulation on urine storage and voiding function in conscious minipigs","volume":"23","author":"Dalmose AL","year":"2004","unstructured":"Dalmose AL, Bjarkam CR, S\u00f8rensen JC, Djurhuus JC, J\u00f8rgensen TM. Effects of high frequency deep brain stimulation on urine storage and voiding function in conscious minipigs. Neurourol Urodyn. 2004;23(3):265\u2013272."},{"issue":"4","key":"b8","series-title":"J Urol","first-page":"1388","article-title":"Effects of subthalamic nucleus stimulation on urodynamic findings in patients with Parkinson\u2019s disease","volume":"169","author":"Finazzi-Agr\u00f2 E","year":"2003","unstructured":"Finazzi-Agr\u00f2 E, Peppe A, D\u2019Amico A,  Effects of subthalamic nucleus stimulation on urodynamic findings in patients with Parkinson\u2019s disease. J Urol. 2003;169(4):1388\u20131391."},{"issue":"1","key":"b9","series-title":"Ann Neurol","first-page":"118","article-title":"Effect of subthalamic deep brain stimulation on the function of the urinary bladder","volume":"55","author":"Seif C","year":"2004","unstructured":"Seif C, Herzog J, van der Horst C,  Effect of subthalamic deep brain stimulation on the function of the urinary bladder. Ann Neurol. 2004;55(1):118\u2013120."},{"issue":"6","key":"b10","series-title":"Eur Urol Focus","first-page":"1775","article-title":"Effects of deep brain stimulation on lower urinary tract function in neurological patients","volume":"8","author":"Sartori AM","year":"2022","unstructured":"Sartori AM, Kiss B, Mordasini L,  Effects of deep brain stimulation on lower urinary tract function in neurological patients. Eur Urol Focus. 2022;8(6):1775\u20131782."},{"issue":"Pt 1","key":"b11","series-title":"Brain","first-page":"132","article-title":"Improved sensory gating of urinary bladder afferents in Parkinson\u2019s disease following subthalamic stimulation","volume":"131","author":"Herzog J","year":"2008","unstructured":"Herzog J, Weiss PH, Assmus A,  Improved sensory gating of urinary bladder afferents in Parkinson\u2019s disease following subthalamic stimulation. Brain. 2008;131(Pt 1):132\u2013145."},{"issue":"2","key":"b12","series-title":"J Neurosurg","first-page":"583","article-title":"Urinary incontinence following deep brain stimulation of the globus pallidus internus: case report","volume":"132","author":"Liu FT","year":"2019","unstructured":"Liu FT, Lang LQ, Zhou RY,  Urinary incontinence following deep brain stimulation of the globus pallidus internus: case report. J Neurosurg. 2019;132(2):583\u2013585."},{"key":"b13","series-title":"Front Neurosci","first-page":"917","article-title":"Subthalamic stimulation inhibits bladder contraction by modulating the local field potential and catecholamine level of the medial prefrontal cortex","volume":"14","author":"Yamamoto T","year":"2020","unstructured":"Yamamoto T, Sakakibara R, Uchiyama T, Kuwabara S. Subthalamic stimulation inhibits bladder contraction by modulating the local field potential and catecholamine level of the medial prefrontal cortex. Front Neurosci. 2020;14:917."},{"issue":"5","key":"b14","series-title":"Spine J","first-page":"701","article-title":"Considering healthcare value and associated risk factors with postoperative urinary retention after elective laminectomy","volume":"20","author":"Cremins M","year":"2020","unstructured":"Cremins M, Vellanky S, McCann G, Mancini M, Sanzari L, Yannopoulos A. Considering healthcare value and associated risk factors with postoperative urinary retention after elective laminectomy. Spine J. 2020;20(5):701\u2013707."},{"issue":"9","key":"b15","series-title":"Spine J","first-page":"1533","article-title":"Risk factors and associated complications for postoperative urinary retention after lumbar surgery for lumbar spinal stenosis","volume":"18","author":"Golubovsky JL","year":"2018","unstructured":"Golubovsky JL, Ilyas H, Chen J, Tanenbaum JE, Mroz TE, Steinmetz MP. Risk factors and associated complications for postoperative urinary retention after lumbar surgery for lumbar spinal stenosis. Spine J. 2018;18(9):1533\u20131539."},{"issue":"suppl 1","key":"b16","series-title":"Eur J Orthop Surg Traumatol","first-page":"S205","article-title":"Lumbar spine surgery in patients 80 years of age or older: morbidity and mortality","volume":"25","author":"Balabaud L","year":"2015","unstructured":"Balabaud L, Pitel S, Caux I,  Lumbar spine surgery in patients 80 years of age or older: morbidity and mortality. Eur J Orthop Surg Traumatol. 2015;25(suppl 1):S205\u2013S212."},{"issue":"4","key":"b17","series-title":"Spine Deform","first-page":"703","article-title":"Postoperative management factors affect urinary retention following posterior spinal fusion for adolescent idiopathic scoliosis","volume":"8","author":"Knight BA","year":"2020","unstructured":"Knight BA, Bayne AP, Zusman N, Barney N, Yang S. Postoperative management factors affect urinary retention following posterior spinal fusion for adolescent idiopathic scoliosis. Spine Deform. 2020;8(4):703\u2013709."},{"issue":"1","key":"b18","series-title":"J Neurosurg Spine","first-page":"32","article-title":"Preoperative prediction of postoperative urinary retention in lumbar surgery: a comparison of regression to multilayer neural network","volume":"36","author":"Porche K","year":"2021","unstructured":"Porche K, Maciel CB, Lucke-Wold B,  Preoperative prediction of postoperative urinary retention in lumbar surgery: a comparison of regression to multilayer neural network. J Neurosurg Spine. 2021;36(1):32\u201341."},{"issue":"3","key":"b19","series-title":"Spine J","first-page":"399","article-title":"Enhanced recovery after surgery (ERAS) for open transforaminal lumbar interbody fusion: a retrospective propensity-matched cohort study","volume":"22","author":"Porche K","year":"2022","unstructured":"Porche K, Samra R, Melnick K,  Enhanced recovery after surgery (ERAS) for open transforaminal lumbar interbody fusion: a retrospective propensity-matched cohort study. Spine J. 2022;22(3):399\u2013410."},{"key":"b20","series-title":"Surg Neurol Int","first-page":"61","article-title":"The incidence and risk factors for postoperative urinary retention in neurosurgical patients","volume":"4","author":"Alsaidi M","year":"2013","unstructured":"Alsaidi M, Guanio J, Basheer A,  The incidence and risk factors for postoperative urinary retention in neurosurgical patients. Surg Neurol Int. 2013;4:61."},{"issue":"11","key":"b21","series-title":"Eur Spine J","first-page":"3868","article-title":"Pre-operative prediction of post-operative urinary retention in lumbar surgery: a prospective validation of machine learning model","volume":"32","author":"Porche K","year":"2023","unstructured":"Porche K, Maciel CB, Lucke-Wold B,  Pre-operative prediction of post-operative urinary retention in lumbar surgery: a prospective validation of machine learning model. Eur Spine J. 2023;32(11):3868\u20133874."},{"key":"b22","series-title":"J Neurol Sci","first-page":"120190","article-title":"Deep brain stimulation for the treatment of tremor","volume":"435","author":"Chandra V","year":"2022","unstructured":"Chandra V, Hilliard JD, Foote KD. Deep brain stimulation for the treatment of tremor. J Neurol Sci. 2022;435:120190."},{"issue":"5","key":"b23","series-title":"Anesthesiology","first-page":"1139","article-title":"Postoperative urinary retention: anesthetic and perioperative considerations","volume":"110","author":"Baldini G","year":"2009","unstructured":"Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology. 2009;110(5):1139\u20131157."},{"issue":"4","key":"b24","series-title":"Am J Surg","first-page":"374","article-title":"Factors influencing postoperative urinary retention in patients undergoing surgery for benign anorectal disease","volume":"159","author":"Petros JG","year":"1990","unstructured":"Petros JG, Bradley TM. Factors influencing postoperative urinary retention in patients undergoing surgery for benign anorectal disease. Am J Surg. 1990;159(4):374\u2013376."},{"issue":"6","key":"b25","series-title":"J Am Coll Surg","first-page":"663","article-title":"Patient-controlled analgesia and postoperative urinary retention after hysterectomy for benign disease","volume":"179","author":"Petros JG","year":"1994","unstructured":"Petros JG, Alameddine F, Testa E, Rimm EB, Robillard RJ. Patient-controlled analgesia and postoperative urinary retention after hysterectomy for benign disease. J Am Coll Surg. 1994;179(6):663\u2013667."},{"issue":"2","key":"b26","series-title":"Surg Gynecol Obstet","first-page":"172","article-title":"Patient-controlled analgesia and postoperative urinary retention after open appendectomy","volume":"177","author":"Petros JG","year":"1993","unstructured":"Petros JG, Mallen JK, Howe K, Rimm EB, Robillard RJ. Patient-controlled analgesia and postoperative urinary retention after open appendectomy. Surg Gynecol Obstet. 1993;177(2):172\u2013175."},{"issue":"6","key":"b27","series-title":"Surg Gynecol Obstet","first-page":"497","article-title":"Factors influencing urinary tract retention after elective open cholecystectomy","volume":"174","author":"Petros JG","year":"1992","unstructured":"Petros JG, Rimm EB, Robillard RJ. Factors influencing urinary tract retention after elective open cholecystectomy. Surg Gynecol Obstet. 1992;174(6):497\u2013500."},{"issue":"4","key":"b28","series-title":"Am J Surg","first-page":"431","article-title":"Factors influencing postoperative urinary retention in patients undergoing elective inguinal herniorrhaphy","volume":"161","author":"Petros JG","year":"1991","unstructured":"Petros JG, Rimm EB, Robillard RJ, Argy O. Factors influencing postoperative urinary retention in patients undergoing elective inguinal herniorrhaphy. Am J Surg. 1991;161(4):431\u2013434."},{"issue":"4","key":"b29","series-title":"J Stat Softw","first-page":"1","article-title":"GA: a package for genetic algorithms in R","volume":"53","author":"Scrucca L","year":"2013","unstructured":"Scrucca L. GA: a package for genetic algorithms in R. J Stat Softw. 2013;53(4):1\u201337."},{"issue":"1","key":"b30","series-title":"R J","first-page":"187","article-title":"On some extensions to GA package: hybrid optimisation, parallelisation and islands evolution","volume":"9","author":"Scrucca L","year":"2017","unstructured":"Scrucca L. On some extensions to GA package: hybrid optimisation, parallelisation and islands evolution. R J. 2017;9(1):187\u2013206."},{"issue":"3","key":"b31","series-title":"Ann Transl Med","first-page":"45","article-title":"Variable selection in logistic regression model with genetic algorithm","volume":"6","author":"Zhang Z","year":"2018","unstructured":"Zhang Z, Trevino V, Hoseini SS,  Variable selection in logistic regression model with genetic algorithm. Ann Transl Med. 2018;6(3):45."},{"issue":"2","key":"b32","series-title":"Biometrika","first-page":"297","article-title":"Regression and time series model selection in small samples","volume":"76","author":"Hurvich CM","year":"1989","unstructured":"Hurvich CM, Tsai CL. Regression and time series model selection in small samples. Biometrika. 1989;76(2):297\u2013307."},{"issue":"3","key":"b33","series-title":"Biometrika","first-page":"499","article-title":"Bias of the corrected AIC criterion for underfitted regression and time series models","volume":"78","author":"Hurvich CM","year":"1991","unstructured":"Hurvich CM, Tsai CL. Bias of the corrected AIC criterion for underfitted regression and time series models. Biometrika. 1991;78(3):499\u2013509."},{"issue":"1-2","key":"b34","series-title":"Biometrika","first-page":"28","article-title":"The generalisation of student\u2019s problems when several different population variances are involved","volume":"34","author":"Welch BL","year":"1947","unstructured":"Welch BL. The generalisation of student\u2019s problems when several different population variances are involved. Biometrika. 1947;34(1-2):28\u201335."},{"issue":"6","key":"b35","series-title":"Biometrics","first-page":"110","article-title":"An approximate distribution of estimates of variance components","volume":"2","author":"Satterthwaite FE","year":"1946","unstructured":"Satterthwaite FE. An approximate distribution of estimates of variance components. Biometrics. 1946;2(6):110\u2013114."},{"key":"b36","series-title":"The Elements of Statistical Learning: Data Mining, Inference, and Prediction","first-page":"219","article-title":"Model assessment and selection","author":"Hastie T","year":"2009","unstructured":"Hastie T, Tibshirani R, Friedman J. Model assessment and selection. In: The Elements of Statistical Learning: Data Mining, Inference, and Prediction. Springer; 2009:219-259."},{"issue":"8","key":"b37","series-title":"J Stat Softw","first-page":"1","article-title":"MatchIt: nonparametric preprocessing for parametric causal inference","volume":"42","author":"Ho D","year":"2011","unstructured":"Ho D, Imai K, King G, Stuart EA. MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw. 2011;42(8):1\u201328."},{"issue":"15","key":"b38","series-title":"Expert Opin Pharmacother","first-page":"1847","article-title":"The challenge of pain in the pharmacological management of Parkinson\u2019s disease","volume":"20","author":"Jost WH","year":"2019","unstructured":"Jost WH, Buhmann C. The challenge of pain in the pharmacological management of Parkinson\u2019s disease. Expert Opin Pharmacother. 2019;20(15):1847\u20131854."},{"issue":"3","key":"b39","series-title":"Neurol Int","first-page":"61","article-title":"Chronic pain treatment strategies in Parkinson\u2019s disease","volume":"12","author":"Edinoff A","year":"2020","unstructured":"Edinoff A, Sathivadivel N, McBride T,  Chronic pain treatment strategies in Parkinson\u2019s disease. Neurol Int. 2020;12(3):61\u201376."},{"issue":"Pt 12","key":"b40","series-title":"Brain","first-page":"3366","article-title":"Subthalamic stimulation modulates cortical control of urinary bladder in Parkinson\u2019s disease","volume":"129","author":"Herzog J","year":"2006","unstructured":"Herzog J, Weiss PH, Assmus A,  Subthalamic stimulation modulates cortical control of urinary bladder in Parkinson\u2019s disease. Brain. 2006;129(Pt 12):3366\u20133375."},{"key":"b41","series-title":"Neuropsychiatr Dis Treat","first-page":"3727","article-title":"Effect of deep brain stimulation on female Parkinsonian patients with lower urinary tract symptoms","volume":"17","author":"Liang F","year":"2021","unstructured":"Liang F, Tang Y, Bi K,  Effect of deep brain stimulation on female Parkinsonian patients with lower urinary tract symptoms. Neuropsychiatr Dis Treat. 2021;17:3727\u20133733."},{"issue":"3","key":"b42","series-title":"Eur Urol","first-page":"607","article-title":"Effect of thalamic deep brain stimulation on lower urinary tract function","volume":"53","author":"Kessler TM","year":"2008","unstructured":"Kessler TM, Burkhard FC, Z\u2019Brun S,  Effect of thalamic deep brain stimulation on lower urinary tract function. Eur Urol. 2008;53(3):607\u2013612."},{"issue":"10","key":"b43","series-title":"Mov Disord","first-page":"1553","article-title":"Acute urinary retention in two patients after subthalamic nucleus deep brain stimulation (STN-DBS) for the treatment of advanced Parkinson\u2019s disease","volume":"24","author":"Fritsche HM","year":"2009","unstructured":"Fritsche HM, Ganzer R, Schlaier J, Wieland WF, Brawanski A, Lange M. Acute urinary retention in two patients after subthalamic nucleus deep brain stimulation (STN-DBS) for the treatment of advanced Parkinson\u2019s disease. Mov Disord. 2009;24(10):1553\u20131554."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/1\/article-p221.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/1\/article-p221.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/141\/1\/article-p221.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T11:47:19Z","timestamp":1732621639000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/141\/1\/article-p221.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":43,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2023.11.jns231668","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"type":"print","value":"0022-3085"},{"type":"electronic","value":"1933-0693"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}