Research that helps physicians effectively treat a wide variety of neurosurgical disorders – ranging from brain tumors to spinal deformity to severe facial pain – was a focus of Mayfield Brain & Spine neurosurgeons in 2024.
Mayfield’s academic activity last year included participation in 12 clinical trials and 17 research studies or registries. Its roster of physicians and providers also published 20 journal articles and delivered 40 lectures. The program demonstrated national research leadership that will improve care for generations to come, and extends the independent practice’s tradition of research and education that serves both patients and treating physicians.
“Leading-edge research and expertise have been hallmarks of Mayfield since our founding in 1937,” said Dr. Vincent DiNapoli, chair of Mayfield’s Board of Directors. “We have built a legacy of excellence in clinical care, education and research, allowing us to serve generations of patients with the best possible neurosurgical care.”
Mayfield experts led or contributed expertise to a variety of studies, including:
Dr. Ronald Warnick led a group of more than 30 collaborators to recommend a personalized approach using Gamma Knife radiosurgery to treat trigeminal neuralgia, the often-misunderstood neurological condition marked by episodic facial pain usually caused by compression of the trigeminal nerve.
The retrospective data study was the largest-ever of its kind, outlining a pathway to pain relief and reduced medication use. The study was featured on the August cover of the Journal of Neurosurgery, the publication of the American Association of Neurological Surgeons.
In the past, patients were treated with a standard dose of radiation and could expect a 90% probability of pain relief and 2% risk of bothersome facial numbness. With the aid of a chart designed as part of the study, physicians can determine a radiation dose and treatment duration for each patient to provide the highest likelihood of rapid pain relief, a reduced need for medication and a long-term reduction of symptoms.
“We believe that our personalized approach to Gamma Knife radiosurgery for trigeminal neuralgia will provide superior outcomes compared to the previous ‘cookie-cutter’ approach that did not take into account differences between patients,” Dr. Warnick said.
In 2024, Dr. Warnick was among the top 15 percent of most-published neurosurgeons and the top 25 percent of most-cited neurosurgeons, according to the physician online networking service Doximity.
For patients with unruptured brain aneurysms, new research led by Dr. Andrew Ringer can help physicians better balance the risks of clotting vs. bleeding from taking blood thinners after aneurysm repair.
In a study published by the Journal of NeuroInterventional Surgery, Dr. Ringer and his collaborators showed that a combination of a coil inserted into a brain aneurysm with a stent in the artery, plus dual anti-platelet therapy – a regimen of blood thinners often called DAPT – can reduce both risks for about six weeks. Dual anti-platelet therapy combines a daily aspirin with a second blood-thinning medication, called a P2Y12 inhibitor.
“Patients with unruptured brain aneurysms face the double risks of a blockage that disrupts blood flow to the brain, called an ischemic event, plus the risk of bleeding, either in the cranial cavity from the aneurysm or from other problems such as ulcers,” Dr. Ringer said. “Our goal is to help treating physicians balance those risks and rewards with a consistent protocol, reducing unnecessary medication use.”
Mayfield served as one of 12 sites across the country, and the only site in Ohio, for a clinical trial related to the use of GammaTile radiation therapy in treatment of brain metastases, or cancer that spreads from other areas of the body, such as the lung or breast.
Dr. DiNapoli, a national leader in the use of GammaTile, contributed to the study that was published in the journal Neuro-Oncology Advances. The study showed no adverse events directly attributable to GammaTile, and concluded that GammaTile is a safe option for treating newly diagnosed brain metastases. Learn more about GammaTile in Dr. DiNapoli’s online Q&A.
The research and education activity extended well beyond formal academic publishing or clinical trials. Mayfield providers and physicians presented several programs to national or regional programs on efforts to increase efficiency in spine surgery, improving patient access and outcomes.
- Mayfield neurosurgeon Dr. Bryan Krueger presented on “AI’s Role in Deformity Correction Planning” at the Winter Clinics for Cranial & Spinal Surgery in March 2024, and at the Herche Lectureship for Surgical Innovation in August. Krueger said using algorithms that analyze huge data sets can help surgeons shape the procedure – by developing patient-specific rods, for example – allowing them to predict and avoid post-operative complications.
- Jody Beckington, a nurse practitioner at Mayfield, presented on “A Nurse Practitioner Evidence-Based Practice Model: Improving Patient Access” at the March 2024 meeting of the American Association of Neurosurgery Nurses. Mayfield has developed NP Spine Clinics at several patient offices, allowing the nurse practitioner to make an initial evaluation and allow the patient to get to the specific level of care they need with an increased efficiency. Beckington also presented in September 2024 on “Spine Postoperative Complications” at the Ohio State Neurosurgical Society annual meeting.
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