Neurosurgeons Unveil Choosing Wisely® List, Identifying Five Unnecessary Tests or Procedures

Encourage physician and patient conversations about their treatment options

Washington, DCThe American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) today released a list of specific tests or procedures that are commonly ordered, but not always necessary, in neurosurgery. As part of Choosing Wisely®, an initiative of the ABIM Foundation, the list identifies five targeted, evidence-based recommendations that can support physicians in working with their patients to make wise choices about their care.

Neurosurgery’s list includes the following five recommendations:

  1. Don’t administer steroids after severe traumatic brain injury.
  2. Don’t obtain imaging (plain radiographs, magnetic resonance imaging, computed tomography [CT], 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 (SAH) or genetic disorders that may predispose to aneurysm formation.
  5. Don’t routinely use seizure prophylaxis in patients following ischemic stroke.

“Neurosurgeons are committed to identifying the right treatment, for the right patient, at the right time to help eliminate unnecessary procedures, optimize outcomes, and reduce healthcare costs,” said AANS president, Robert E. Harbaugh, MD.  “Participating in the Choosing Wisely initiative is a key step in this process.”

The AANS and CNS Choosing Wisely list was developed after months of careful consideration and review by the organizations’ Joint Guidelines Committee, Quality Improvement Workgroup and seven clinical subspecialty sections. The recommendations reflect the most current evidence about management and treatment options for patients facing disorders of the brain and spine.

CNS president, Daniel K. Resnick, MD, noted, “A broad range of neurosurgeons, from across the spectrum of our specialty, reviewed the evidence and contributed to these recommendations. We anticipate that these will help neurosurgeons and their patients make informed decisions by promoting conversations about the most appropriate tests and treatments, and avoiding care whose potential harm may outweigh the benefits.”

Today, the AANS and CNS are joining more than 100 national and state medical specialty societies, regional health collaboratives and consumer partners in promoting conversations about appropriate care. With the release of these new lists, the Choosing Wisely campaign will have covered more than 300 tests and procedures that the specialty society partners say are overused and inappropriate, and that physicians and patients should discuss.

The campaign also continues to reach millions of consumers nationwide through a stable of consumer and advocacy partners, led by Consumer Reports—the world’s largest independent product-testing organization—which has worked with the ABIM Foundation to distribute patient-friendly resources for consumers and physicians to engage in these important conversations. To learn more about Choosing Wisely and to view the complete lists and additional detail about the recommendations and evidence supporting them, visit

About the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons: The American Association of Neurological Surgeons (AANS) founded in 1931, and the Congress of Neurological Surgeons (CNS), founded in 1951, are the two largest scientific and educational associations for neurosurgical professionals in the world. These groups represent over 8,000 neurosurgeons worldwide. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves. For more information, please visit or, read our blog, follow us on Twitter or connect with us on Facebook.

Media contact: Katie Orrico — (202) 446-2024