The American Association of Neurological Surgeons and Congress of Neurological Surgeons released a list of neurosurgical tests or procedures that are commonly ordered, but not always necessary, as part of the Choosing Wisely campaign.
The campaign is an initiative of the ABIM Foundation to encourage and engage physicians in managing healthcare resources more efficiently by promoting conversations about appropriate care.
The list of recommendations for neurosurgical procedures includes:
1. Don't administer steroids after severe traumatic brain injury.
2. Don't obtain imaging — plain radiographs, magnetic resonance imaging, computed tomography or other advanced imaging — of the spine in patients with non-specific acute low back pain and without red flags.
3. Don't routinely obtain CT scanning of children with mild head injuries.
4. Don't routinely screen for brain aneurysms in asymptomatic patients without a family or personal history of brain aneurysms, subarachnoid hemorrhage or genetic disorders that may predispose to aneurysm formation.
5. Don't routinely use seizure prophylaxis in patients following ischemic stroke.