Division of the Month Neurosugery

Research has long been an integral part of the mission of the Division of Neurosurgery. Divisional members cover all subspecialties of neurosurgery in their clinical practices, and several are active in many areas of neurosurgical research, cutting across clinical and translational themes.

27 March 2024

The Division of Neurosurgery leads in many areas of neurosurgical research, cutting across clinical and translational themes.

Functional neurosurgery 
The Functional Neurosurgery Research Laboratory, led by Principal Investigator Dr. Tejas Sankar along with co-investigator Dr. Cameron Elliott, uses neuroimaging, neurophysiology, and collaborative basic science methods to advance the goal of generating biomarkers for outcome prediction and surgical patient selection across diverse neurological conditions, including Parkinson’s Disease, chronic facial pain, and epilepsy. The laboratory boasts several current and former undergraduate, graduate, and post-doctoral trainees. Selected recent publications include (Divisional Faculty highlighted in bold text):

Ostertag C, Friedman TN, Keough MB, Kerr BJ, Sankar T. Heightened Presence of Inflammatory Mediators in the Cerebrospinal Fluid of Patients with Trigeminal Neuralgia. Pain Rep. 2023 Dec; 8(6): e1117. doi: 10.1097/PR9.0000000000001117

Ishaque AH, Xie H, Danyluk H, Wheatley BM, Broad R, Kong L, Sankar T. Comparison of prognostic scoring systems to predict durable pain relief after microvascular decompression for trigeminal neuralgia. World Neurosurg. 2022 Jan 157:e432-440. doi: 10.1016/j.wneu.2021.10.111.

Danyluk H, Lang S, Monchi O, Sankar T. Pre-operative limbic system functional connectivity distinguishes responders from non-responders to surgical treatment for trigeminal neuralgia. Front Neurol. 2021 Oct 4;12:716500. doi: 10.3389/fneur.2021.716500. eCollection 2021

Kassiri J, Elliott C, Liu N, Mailo J, Rajapakse T, Schmitt L, Wheatley M, Sinclair DB. Neuroimaging in pediatric temporal lobe epilepsy: Does neuroimaging accurately predict pathology and surgical outcome? Epilepsy Res. 2021 Sep;175:106680. doi: 10.1016/j.eplepsyres.2021.106680.

Andrews JC, Roy FD, Ba F, Sankar T. Intraoperative changes in the H-reflex pathway during deep brain stimulation surgery for Parkinson's disease: A potential biomarker for optimal electrode placement. Brain Stimul. 2020 Oct 6;13(6):1765-1773.

Gamma Knife 
The Gamma Knife stereotactic radiosurgery program has a very large clinical throughput, treating patients with both malignant and benign brain disease, and continues to grow and thrive with collaborations from multiple specialties. Led by Dr. Gregory Bowden, the program is a member of the International Radiosurgery Research Foundation (IRRF), which allows for large data sets to be created across multiple centers. In addition, two masters students are affiliated with the program currently. Selected recent publications include:

Das S, Faruqi S, Nordal R, Starreveld Y, Kelly J, Bowden G, Amanie J, Fairchild A, Lim G, Loewen S, Rowe L, Wallace C, Ghosh S, Patel S.

A phase III, multicenter, randomized controlled trial of preoperative versus postoperative stereotactic radiosurgery for patients with surgically resectable brain metastases. BMC Cancer. 2022 Dec 30;22(1):1368. doi: 10.1186/s12885-022-10480-z.

Bowden G, Faramand A, Mallella A, Wei Z, Patel K, Niranjan A, Lunsford LD. Does the Timing of Radiosurgery after Grade 1 Meningioma Resection Affect Long-Term Outcomes? Stereotact Funct Neurosurg. 2021;99(6):506-511. doi: 10.1159/000517427.

Vascular Neurosurgery 
Under the leadership of Dr. Bryce Weir in the 1980s and early 1990s, research into vascular neurosurgery became a major focus of the Division, resulting in highly-cited publications on the pathophysiology and treatment of brain aneurysms, subarachnoid hemorrhage, and subarachnoid hemorrhage-related vasospasm. Vascular neurosurgical research in the Division today is focused largely on generating evidence for various surgical and endovascular treatments through clinical trials. Selected recent publications include:

Boisseau W, Darsaut TE, Fahed R, Comby PO, Drake B, Lesiuk H, Rempel JL, O'Kelly CJ, Chow MMC, Iancu D, Roy D, Weill A, Klink R, Raymond J.

Endovascular Parent Vessel Occlusion versus Flow diversion in the Treatment of Large and Giant Aneurysms: A randomized comparison. World Neurosurg. 2024 Feb 26:S1878-8750(24)00327-9. doi: 10.1016/j.wneu.2024.02.114.

Darsaut TE, Findlay JM, Bojanowski MW, Chalaala C, Iancu D, Roy D, Weill A, Boisseau W, Diouf A, Magro E, Kotowski M, Keough MB, Estrade L, Bricout N, Lejeune JP, Chow MMC, O'Kelly CJ, Rempel JL, Ashforth RA, Lesiuk H, Sinclair J, Erdenebold UE, Wong JH, Scholtes F, Martin D, Otto B, Bilocq A, Truffer E, Butcher K, Fox AJ, Arthur AS, Létourneau-Guillon L, Guilbert F, Chagnon M, Zehr J, Farzin B, Gevry G, Raymond J.

A Pragmatic Randomized Trial Comparing Surgical Clipping and Endovascular Treatment of Unruptured Intracranial Aneurysms.

AJNR Am J Neuroradiol. 2023 Jun;44(6):634-640. doi: 10.3174/ajnr.A7865. Epub 2023 May 11.

Darsaut TE, Magro E, Bojanowski MW, Chaalala C, Nico L, Bacchus E, Klink R, Iancu D, Weill A, Roy D, Sabatier JF, Cognard C, Januel AC, Pelissou-Guyotat I, Eker O, Roche PH, Graillon T, Brunel H, Proust F, Beaujeux R, Aldea S, Piotin M, Cornu P, Shotar E, Gaberel T, Barbier C, Corre ML, Costalat V, Jecko V, Barreau X, Morandi X, Gauvrit JY, Derrey S, Papagiannaki C, Nguyen TN, Abdalkader M, Tawk RG, Huynh T, Viard G, Gevry G, Gentric JC, Raymond J; TOBAS Collaborative Group; List of participating TOBAS centers and physicians.

Surgical treatment of brain arteriovenous malformations: clinical outcomes of patients included in the registry of a pragmatic randomized trial. J Neurosurg. 2022 Sep 9;138(4):891-899. doi: 10.3171/2022.7.JNS22813.

O'Kelly CJ, Rempel J, Ashforth R, Darsaut T, Chow M. The Utility of Superselective Rotational Angiography for Frameless Stereotactic Navigation During Craniotomy for Micro-Arteriovenous Malformation. World Neurosurg X. 2021 Dec 21;13:100116. doi: 10.1016/j.wnsx.2021.100116.

Spine Surgery 
Our spinal neurosurgery group is one of the busiest in the country, and an active contributor to innovative clinical spine research, as well as the body of literature published by the Canadian Spine Outcomes and Research Network (CSORN). Selected recent publications include:

Malhotra AK, Evaniew N, Dea N, Fisher CG, Street JT, Cadotte DW, Jacobs WB, Thomas KC, Attabib N, Manson N, Hall H, Bailey CS, Nataraj A, Phan P, Rampersaud YR, Paquet J, Weber MH, Christie SD, McIntosh G, Wilson JR.

The Effects of Peri-Operative Adverse Events on Clinical and Patient-Reported Outcomes After Surgery for Degenerative Cervical Myelopathy: An Observational Cohort Study from the Canadian Spine Outcomes and Research Network. Neurosurgery. 2024 Mar 11. doi: 10.1227/neu.0000000000002896.

Balas M, Jaja BNR, Harrington EM, Jack AS, Hofereiter J, Malhotra AK, Jaffe RH, He Y, Byrne JP, Wilson JR, Witiw CD.

Earlier Tracheostomy Reduces Complications in Complete Cervical Spinal Cord Injury in Real-World Practice: Analysis of a Multicenter Cohort of 2001 Patients. Neurosurgery. 2023 Dec 1;93(6):1305-1312. doi: 10.1227/neu.0000000000002575.

Krebs B, Nataraj A, McCabe E, Clark S, Sufiyan Z, Yamamoto SS, Zaïane O, Gross DP. Developing a triage predictive model for access to a spinal surgeon using clinical variables and natural language processing of radiology reports. Eur Spine J. 2023 Feb 6. doi: 10.1007/s00586-023-07552-4.

Hockley A, Ge D, Vasquez-Montes D, Moawad MA, Passias PG, Errico TJ, Buckland AJ, Protopsaltis TS, Fischer CR.

Predictors of long-term opioid dependence in transforaminal lumbar interbody fusion with a focus on pre-operative opioid usage.

Eur Spine J. 2020 Jun;29(6):1311-1317. doi: 10.1007/s00586-020-06345-3.