Concussions, classified as a type of mild traumatic brain injury (mTBI), are frequently underdiagnosed due to the subjective nature of symptoms and limitations in existing diagnostic methodologies. Current clinical evaluations, including tools such as the Sport Concussion Assessment Tool 5 (SCAT5), Balance Error Scoring System (BESS), and Vestibular Ocular Motor Screening (VOMS), demonstrate high sensitivity and specificity but often fail to capture the full complexity of concussive injuries. Emerging diagnostic approaches, such as blood biomarkers (for example, glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), S100 calcium-binding protein B (S100B), and tau) and advanced neuroimaging techniques (for example, diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI)), show promise but remain impractical for routine clinical use due to accessibility and standardization challenges. This review examines objective markers, including neuroimaging, electrophysiological measures (for example, Electroencephalography (EEG), Magnetoencephalography (MEG)), and real-time diagnostic tools, as complementary strategies to enhance traditional clinical evaluations. Findings indicate that while clinical assessments remain central to concussion diagnosis, integrating them with advanced imaging and electrophysiological tools can provide more accurate diagnostics and recovery tracking. Biomarkers, although not yet ready for widespread use, hold significant potential for future applications. Further research is required to validate these methods and establish standardized protocols to facilitate their integration into clinical practice.

This meta-analysis aimed to assess the clinical impact of preoperative hair clipping versus no clipping in cranial neurosurgery, addressing an important element of patient-centered care that balances surgical needs with patient comfort. By examining existing evidence, this study seeks to inform neurosurgical practices on preoperative preparation choices that respect both clinical safety and patient preferences. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews, articles from PubMed, Google Scholar, Embase, Scopus, and ScienceDirect, and studies that included adult patients undergoing cranial surgeries were included for data extraction and analysis. Studies were selected based on the presence of preoperative hair clipping or no clipping as a variable. Only comparative studies evaluating clipping versus no clipping were included, and razor-only or noncomparative hair-removal studies were excluded. The primary outcomes compared between these groups included infection rates, reoperation rates, readmission rates, and postoperative complications. Where available, details of perioperative protocols (preoperative Hibiclens/chlorhexidine showers, intraoperative scalp prep, postoperative antibiotic regimens, wound coverage, and timing of hair washing) were extracted. The analysis of studies (n = 22) revealed a higher infection rate in the clipping group compared to the no-clipped group (3% vs. 2%; 95% confidence interval [CI] 2-5% vs. 1-3%), though this difference was not statistically significant (P = 0.10). Reoperation rates were slightly higher in the no-clipping group than the clipping group (1% vs. 0%; 95% CI 0-3% vs. 0-1%), but this difference was also not statistically significant (P = 0.35). No significant difference in readmission rates was observed between the 2 groups (0% vs. 0%; 95% CI 0-3% vs. 0-1%, P = 0.83). Postoperative complications, primarily wound dehiscence, were comparable between the clipping and no-clipping groups (1% vs. 1%; 95% CI 0-2% vs. 0-3%, P = 0.61). This meta-analysis found no statistically significant differences in infection, reoperation, readmission rates, or postoperative complications between patients undergoing cranial neurosurgery with or without hair clipping. These findings suggest that preoperative hair clipping may not be clinically necessary, allowing patient preference to be incorporated without compromising outcomes. Furthermore, variations in perioperative antiseptic, antibiotic, and wound-care practices highlight the need for standardized reporting in future studies.

For patients with spinal care conditions including degenerative disease, deformity, traumatic injury, and complex pain syndromes, care is frequently fragmented across multiple specialists. This process can delay diagnosis, create complexity in communication, and result in inconsistencies in treatment decisions. Multidisciplinary spine clinics have been proposed as one approach to these challenges by bringing key providers together in a coordinated setting. In this narrative review, we examine recent studies comparing multidisciplinary models with traditional fragmented approaches to spine care. Integrated clinics are frequently associated with more consistent decision-making, improved coordination of care, and earlier access to both conservative treatment and surgical evaluation. Several studies indicate lower complication or reoperation rates, although findings vary by patient population and study design. Patient-reported measures of pain, function, satisfaction, and quality of life are generally similar or modestly improved in multidisciplinary settings. Practical advantages include shorter wait times for imaging, improved provider-to-provider communication, and more efficient preoperative preparation. This review addresses a timely gap in the literature by synthesizing evidence within the current context of AI-assisted decision support, value-based care reform, and evolving ERAS protocols, providing an actionable framework for institutions seeking to implement or expand integrated spine care. Clinic infrastructure barriers, reimbursement issues, scheduling demands, and inequitable access continue to limit broader adoption. Future research should prioritize prospective and multicenter studies and explore how tools such as telehealth and artificial intelligence may support and expand multidisciplinary spine care.