Paraplegia due to spinal epidural lipoma without spinal dysraphism in an adolescent patient: a case report.

We report the case of a rare lipoma arising in the epidural space of a 14-year-old boy without spinal dysraphism. Lipomas are rare in pediatric soft tissue tumors, accounting for only about 4% of cases. The incidence of an intraspinal epidural lipoma without spinal dysraphism is extremely rare in pediatric patients.

Differences in Demographic and Radiographic Characteristics between Patients with Visible and Invisible T1 Slopes on Lateral Cervical Radiographic Images.

Introduction: The T1 slope is important for cervical surgical planning, and it may be invisible on radiographic images. The prevalence of T1 invisible cases and the differences in demographic and radiographic characteristics between patients whose T1 slopes are visible or invisible remains unexplored.

Methods: This pilot study aimed to evaluate the differences in these characteristics between outpatients whose T1 slopes were visible or invisible on radiographic images.

＜Editors' Choice＞ Surgical outcomes of decompressive laminoplasty with spinous process osteotomy to treat lumbar spinal stenosis.

Decompressive laminoplasty with spinous process osteotomy (LSPO) was developed as a less invasive procedure for lumbar decompression by Weiner et al. There are few reports extensively highlighting the surgical outcomes of LSPO. The purpose of this study was to evaluate the surgical outcomes of LSPO for lumbar spinal stenosis (LSS).

Posterior fusion of the occipital axis in children with upper cervical disorder using both C2 pedicle and laminar screws (C2 hybrid screws).

Introduction: An occipital-cervical surgery for children is challenging for surgeons because of the immature bone quality, extensive anatomical variability, and small osseous structures. Furthermore, occipital-C2 fusion in children results in great stress on the C2 screws. We report a technique that uses both C2 pedicle and bilateral lateral mass screws (C2 hybrid screws) in children with an upper cervical disorder to preserve motion segment and secure strength in those who require occipital-cervical fusion.

Efficacy of Early Fusion With Local Bone Graft and Platelet-Rich Plasma in Lumbar Spinal Fusion Surgery Followed Over 10 Years.

Study Design: Prospective clinical study.

Objective: Many oral surgeons use platelet-rich plasma (PRP) for bone defects, but the efficacy of PRP for spinal arthrodesis remains uncertain. The objective was to compare the efficacy of autologous local bone graft and PRP with local bone graft alone for promotion of bony union in posterolateral lumbar fusion (PLF) surgery, with investigation of the safety of PRP over 10 years.

Intrawound Vancomycin powder as the prophylaxis of surgical site infection after invasive spine surgery with a high risk of infection.

Surgical site infections (SSIs) are one of the most serious complications in spine surgery. We investigated the efficacy of locally administered vancomycin (VCM) powder for prophylaxis on SSI after invasive spine surgery. We retrospectively studied 174 consecutive patients who underwent spine surgery.

Efficacy of intraoperative lumbar subarachnoid drainage for prevention of cerebrospinal fluid leak after spinal cord tumor resection.

Background: Postoperative cerebrospinal fluid (CSF) leakage is a major clinical problem, and prevention of CSF leakage at the surgical site is an important issue. The goal of the study was to evaluate the efficacy of intraoperative lumbar subarachnoid drainage (LSAD) for prevention of CSF leakage after spinal cord tumor resection.

Methods: The subjects were 97 patients with a cervical or thoracic primary intradural spinal cord tumor who underwent surgery at our hospital.

MRI Characteristics of Spinal Ependymoma in WHO Grade II: A Review of 59 Cases.

Study Design: Retrospective multicenter study.

Objective: The goal of this study is to determine the characteristic imaging features of spinal ependymoma in a review of magnetic resonance imaging (MRI) data for a large series of surgically proven cases.

Summary Of Background Data: Common spinal intramedullary neoplasms are mostly ependymomas and comprise 50% to 60% of spinal neuroepithelial tumors in adults.

Factors for a Good Surgical Outcome in Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Thoracic Ossification of the Posterior Longitudinal Ligament: Prospective Single-Center Study.

Background: Surgery for thoracic ossification of the posterior longitudinal ligament (T-OPLL) is still challenging, and factors for good surgical outcomes are unknown.

Objective: To identify factors for good surgical outcomes with prospective and comparative study.

Methods: Seventy-one consecutive patients who underwent posterior decompression and instrumented fusion were divided into good or poor outcome groups based on ≥50% and <50% recovery rates for the Japanese Orthopaedic Association score.

The Feature of Clinical and Radiographic Outcomes in Elderly Patients With Cervical Spondylotic Myelopathy: A Prospective Cohort Study on 1025 Patients.

Study Design: A prospective cohort study.

Objective: The purpose of this study was to compare the surgical outcomes between nonelderly and elderly patients with cervical spondylotic myelopathy (CSM) and to characterize the preoperative symptoms and postoperative residual symptoms in elderly patients.

Summary Of Background Data: Age at the time of surgery influences the surgical outcome.

Surgical intervention for a pediatric isolated intramedullary spinal aneurysm.

Purpose: To report the case of a pediatric patient with intramedullary spinal aneurysm.

Methods: A 9-year-old boy presented with low back pain and subsequent gait disturbance. He had no history of trauma.

Image Diagnostic Classification of Magnetic Resonance T2 Increased Signal Intensity in Cervical Spondylotic Myelopathy: Clinical Evaluation Using Quantitative and Objective Assessment.

Study Design: A prospective imaging study.

Objective: The study investigated whether the classification of increased signal intensity (ISI) using magnetic resonance imaging (MRI) reflects the severity of symptoms in patients with cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Although the ISI on MRI in patients with CSM is observed, the degree of ISI has not been examined.

Optimal Timing of Surgery for Intramedullary Cavernous Hemangioma of the Spinal Cord in Relation to Preoperative Motor Paresis, Disease Duration, and Tumor Volume and Location.

Study Design: Prospective study.

Objective: Investigate factors associated with preoperative motor paresis, recovery, ambulatory status, and intraoperative neurophysiological monitoring (IONM) among patients with no preoperative paresis (N group), complete preoperative motor recovery (CR group), and no complete recovery (NCR group) in patients with intramedullary spinal cavernous hemangioma to determine the optimal timing of surgery.

Methods: The study evaluated 41 surgical cases in our institute.

Rapid Worsening of Symptoms and High Cell Proliferative Activity in Intra- and Extramedullary Spinal Hemangioblastoma: A Need for Earlier Surgery.

Study Design: A retrospective analysis of a prospective database.

Objective: To compare preoperative symptoms, ambulatory ability, intraoperative spinal cord monitoring, and pathologic cell proliferation activity between intramedullary only and intramedullary plus extramedullary hemangioblastomas, with the goal of determining the optimal timing for surgery.

Methods: The subjects were 28 patients (intramedullary only in 23 cases [group I] and intramedullary plus extramedullary in 5 cases [group IE]) who underwent surgery for spinal hemangioblastoma.

Correction of spherical aberration in multi-focal multiphoton microscopy with spatial light modulator.

We demonstrate that high-quality images of the deep regions of a thick sample can be obtained from its surface by multi-focal multiphoton microscopy (MMM). The MMM system incorporates a spatial light modulator to separate the excitation beam into a multi-focal excitation beam and modulate the pre-distortion wavefront to correct spherical aberration (SA) caused by a refractive index mismatch between the immersion medium and the biological sample. When fluorescent beads in transparent epoxy resin were observed using four SA-corrected focal beams, the fluorescence signal of the obtained images was ~52 times higher than that obtained without SA correction until a depth of ~1100 μm, similar to the result for single-focal multiphoton microscopy (SMM).

Risk Factors for Ineffectiveness of Posterior Decompression and Dekyphotic Corrective Fusion with Instrumentation for Beak-Type Thoracic Ossification of the Posterior Longitudinal Ligament: A Single Institute Study.

Background: Thoracic ossification of the posterior longitudinal ligament (T-OPLL) is treated surgically with instrumented posterior decompression and fusion. However, the factors determining the outcome of this approach and the efficacy of additional resection of T-OPLL are unknown.

Objective: To identify these factors in a prospective study at a single institution.

Discrimination between spinal extradural meningioma and both intra and extradural meningioma: Case Report.

Meningiomas are common spinal tumor and mostly located at intradura. Recurrence rate after surgery for extradural meningioma was higher than intradural meningioma. A patient with intra and extradural spinal meningioma was treated and discussed its features and clinical management.

Collaboration with an infection control team for patients with infection after spine surgery.

Background: The risk of infection, including surgical site infection (SSI), after spine surgery has increased due to aging and more immunocompromised hosts. An infection control team (ICT) is responsible for management of health care-associated infections at our institution.

Methods: The study subjects were 40 patients (18 men and 22 women with an average age of 54 years) referred to the ICT after spine surgery since 2010.

Analysis of Incident and Accident Reports and Risk Management in Spine Surgery.

Study Design: A review of accident and incident reports.

Objective: To analyze prevalence, characteristics, and details of perioperative incidents and accidents in patients receiving spine surgery.

Summary Of Background Data: In our institution, a clinical error that potentially results in an adverse event is usually submitted as an incident or accident report through a web database, to ensure anonymous and blame-free reporting.

Resection of Beak-Type Thoracic Ossification of the Posterior Longitudinal Ligament from a Posterior Approach under Intraoperative Neurophysiological Monitoring for Paralysis after Posterior Decompression and Fusion Surgery.

 Prospective clinical study.  Posterior decompression and fusion surgery for beak-type thoracic ossification of the posterior longitudinal ligament (T-OPLL) generally has a favorable outcome. However, some patients require additional surgery for postoperative severe paralysis, a condition that is inadequately discussed in the literature.

Characteristics of Residual Symptoms After Laminoplasty in Diabetic Patients With Cervical Spondylotic Myelopathy: A Prospective Cohort Study.

Study Design: A prospective cohort study.

Objective: The purpose of this study was to compare cervical laminoplasty outcomes between diabetic and nondiabetic patients with cervical spondylotic myelopathy (CSM), and to characterize residual symptoms of diabetic patients.

Summary Of Background Data: Diabetes is one of the most frequent comorbidities in CSM patients.

Self-assembling Peptide Reduces Glial Scarring, Attenuates Posttraumatic Inflammation, and Promotes Neurite Outgrowth of Spinal Motor Neurons.

Study Design: Self-assembling peptide gel (SPG-178) provides new evidence for the role of a scaffold for treatment of the spinal cord through induction of neuroprotective factors.

Objective: To verify the reproducibility of SPG-178 as scaffold after spinal cord injury, we examine the characteristics of SPG-178 and protective effect on neural cells in vitro and in vivo.

Summary Of Background Data: The central nervous system extracellular matrix may play a role in maintenance of the neuronal network by inhibiting axonal growth and suppressing formation of additional inadequate synapses.

Transcranial motor evoked potential waveform changes in corrective fusion for adolescent idiopathic scoliosis.

OBJECTIVE Corrective surgery for spinal deformities can lead to neurological complications. Several reports have described spinal cord monitoring in surgery for spinal deformity, but only a few have included patients younger than 20 years with adolescent idiopathic scoliosis (AIS). The goal of this study was to evaluate the characteristics of cases with intraoperative transcranial motor evoked potential (Tc-MEP) waveform deterioration during posterior corrective fusion for AIS.