Impact of Dialysis on 30-Day Outcomes After Spinal Fusion Surgery for Pathologic Fractures: Insights from a National Quality Registry.

Background: Patients with chronic renal failure undergoing hemodialysis have been shown to have poor overall health, osteoporosis, and altered bone metabolism. However, the impact of hemodialysis on patient outcomes after spinal fusion remains unknown. We sought to assess the effect of dialysis on 30-day perioperative and postoperative outcomes after cervical and lumbar fusion for pathologic compression fractures.

Reporting Methodology of Neurosurgical Studies Utilizing the American College of Surgeons-National Surgical Quality Improvement Program Database: A Systematic Review and Critical Appraisal.

Background: Use of large databases such as the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) has become increasingly common in neurosurgical research.

Objective: To perform a critical appraisal and evaluation of the methodological reporting for studies in neurosurgical literature that utilize the ACS-NSQIP database.

Methods: We queried Ovid MEDLINE, EMBASE, and PubMed databases for all neurosurgical studies utilizing the ACS-NSQIP.

Periodic focal epileptiform discharges.

Objective: To report intraoperative periodic focal epileptiform discharges (PFEDs) during awake craniotomy using high-density electrocorticography (HD-ECoG).

Methods: We retrospectively analyzed 81 patients undergoing awake craniotomy between 9/29/2016 and 7/5/2018. Intraoperative HD-ECoG was performed with direct electrocortical stimulation (DECS) for functional brain mapping.

Trends in the utilization of radiotherapy for spinal meningiomas: insights from the 2004-2015 National Cancer Database.

OBJECTIVERecent studies have reported on the utility of radiosurgery for local control and symptom relief in spinal meningioma. The authors sought to evaluate national utilization trends in radiotherapy (including radiosurgery), investigate possible factors associated with its use in patients with spinal meningioma, and its impact on survival for atypical tumors.METHODSUsing the ICD-O-3 topographical codes C70.

Outcomes following surgical versus endovascular treatment of spinal dural arteriovenous fistula: a systematic review and meta-analysis.

Although surgical resection is associated with a complete cure in most cases of spinal dural arteriovenous fistulas (SDAVF), there has been an increasing trend towards embolisation. We performed a systematic review and meta-analysis comparing surgical resection with endovascular treatment in terms of success of treatment, rate of recurrence and complications. A literature search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Vitamin D and bone metabolism in breast cancer patients in Karachi, Pakistan.

Breast cancer is one of the common types of malignancy worldwide and in Pakistan. The heterogeneous disease itself and its complex treatment leads to various bone-affecting complications that make breast cancer patients more vulnerable to bone fractures. Vitamin D deficiency among these women worsens the condition and promotes breast cancer growth.

Degenerative Lumbar Spondylolisthesis: Definition, Natural History, Conservative Management, and Surgical Treatment.

Degenerative lumbar spondylolisthesis is one of the most common causes of low back pain and is defined as displacement of one vertebra over subjacent vertebra, associated with degenerative changes, without an associated disruption or defect in the vertebral ring. Undersetanding natural history of degenerative spondylolisthesis is important to tailor an individualized management plan for each patient. A trial of conservative therapy may be considered for patients with low-grade spondylolisthesis presenting with radiculopathy and/or pseudoclaudication.

Primary Central Nervous System Tumors: Comparing Two National Cancer Registries.

Objective: The National Cancer Database (NCDB) and the SEER (Surveillance Epidemiology and End Results) program are the 2 largest cancer registries in the United States. However, considerable differences exist between them regarding the sampling frame as well as the participating facility characteristics. In this study, NCDB and SEER are compared for primary central nervous system (CNS) tumors with the aims of discussing the implications for researchers and evaluating the generalizability of both databases.

Impact of 1p/19q codeletion status on extent of resection in WHO grade II glioma: Insights from a national cancer registry.

Objective: Traditionally, extent of resection (EOR) has been seen as a surgical parameter that can predict survival outcomes of surgically managed WHO grade II gliomas. The aim of this study was to evaluate if such an influence was potentially affected by 1p/19q codeletion status based on a national cancer registry.

Patient And Methods: All adults diagnosed with grade II gliomas between the years 2004 to 2014 were queried from the National Cancer Database (NCDB).

A comparison of minimally invasive transforaminal lumbar interbody fusion and decompression alone for degenerative lumbar spondylolisthesis.

OBJECTIVEThe optimal minimally invasive surgery (MIS) approach for grade 1 lumbar spondylolisthesis is not clearly elucidated. In this study, the authors compared the 24-month patient-reported outcomes (PROs) after MIS transforaminal lumbar interbody fusion (TLIF) and MIS decompression for degenerative lumbar spondylolisthesis.METHODSA total of 608 patients from 12 high-enrolling sites participating in the Quality Outcomes Database (QOD) lumbar spondylolisthesis module underwent single-level surgery for degenerative grade 1 lumbar spondylolisthesis, of whom 143 underwent MIS (72 MIS TLIF [50.

Predictive model for long-term patient satisfaction after surgery for grade I degenerative lumbar spondylolisthesis: insights from the Quality Outcomes Database.

OBJECTIVESince the enactment of the Affordable Care Act in 2010, providers and hospitals have increasingly prioritized patient-centered outcomes such as patient satisfaction in an effort to adapt the "value"-based healthcare model. In the current study, the authors queried a prospectively maintained multiinstitutional spine registry to construct a predictive model for long-term patient satisfaction among patients undergoing surgery for Meyerding grade I lumbar spondylolisthesis.METHODSThe authors queried the Quality Outcomes Database for patients undergoing surgery for grade I lumbar spondylolisthesis between July 1, 2014, and June 30, 2016.

Spinal cord high-grade infiltrating gliomas in adults: clinico-pathological and molecular evaluation.

Primary high-grade infiltrating gliomas of the spinal cord are rare, with prior series including limited numbers of cases and reporting poor outcomes. Additionally, the molecular profile of high-grade infiltrating gliomas of the spinal cord has not been well characterized. We identified 13 adult patients whose surgery had been performed at our institution over a 26-year-period.

Evaluating the Role of Adjuvant Radiotherapy in the Management of Sacral and Vertebral Chordoma: Results from a National Database.

Background: Chordomas are slow-growing but locally invasive tumors. The standard of care consists of surgical resection and radiotherapy (RT) when complete resection is not possible. The reported data has reached equivocal results regarding the effect of adding RT to increase patient survival.

Should Multilevel Posterior Cervical Fusions Involving C7 Cross the Cervicothoracic Junction? A Systematic Review and Meta-Analysis.

Background: Current literature remains inconclusive as to whether multilevel posterior cervical fusions (PCFs) involving the C7 vertebra should cross the cervicothoracic junction (CTJ). The objective of this systematic review was to assess the differences in clinical outcomes, fusion, and reoperation rates, between patients undergoing multilevel PCFs ending at C7 and those undergoing PCF crossing the CTJ.

Methods: A systematic review of literature from 4 databases on crossing the CTJ was conducted.

Assessing the Difference in Clinical and Radiologic Outcomes Between Expandable Cage and Nonexpandable Cage Among Patients Undergoing Minimally Invasive Transforaminal Interbody Fusion: A Systematic Review and Meta-Analysis.

Background: Minimally invasive transforaminal interbody fusion (MIS-TLIF) has been shown to have excellent outcomes for surgical management of degenerative disc disease. However, the challenge is in addressing coronal imbalance and restoring lumbar lordosis and sagittal alignment. Use of expandable cages in MIS-TLIF has been hypothesized to circumvent this disadvantage.

Need for arthrodesis following facetectomy for spinal peripheral nerve sheath tumors: an institutional experience and review of the current literature.

Objective: Spinal peripheral nerve sheath tumors (PNSTs) are a group of rare tumors originating from the nerve and its supporting structures. Standard surgical management typically entails laminectomy with or without facetectomy to gain adequate tumor exposure. Arthrodesis is occasionally performed to maintain spinal stability and mitigate the risk of postoperative deformity, pain, or neurological deficit.

Assessing the differences in outcomes between general and non-general anesthesia in spine surgery: Results from a national registry.

Objectives: Endotracheal/general anesthesia is one of the most commonly used anesthetic techniques when performing thoracic and lumbar surgeries. However, spinal and epidural (non-general) anesthesia have been increasingly employed for lumbar decompressions (LD) and lumbar fusion recently. The objective of this study was to investigate the outcomes of general and non-general anesthesia in patients undergoing posterior lumbar fusion (PLF) and LD using a national registry.

Recurrence of a complex anterior skull base tumour managed with an uncommon surgical approach.

A well 74 -year-old woman presented to routine ophthalmology clinic instituted following treatment of a frontoethmoidal sarcoma initially excised in 1989 and diagnosed then as a sinus mucosal melanoma. At review in ophthalmology clinic, a reduction in right visual fields was noted. CT scan showed recurrence of a mass now involving the frontoethmoidal region, frontal sinus and abutting the cribiform plate.

Vitamin D Intoxication In 7-Month-Old Infant With Recommended Daily Intake Of Vitamin D.

Over the past decade there is increased use of vitamin D supplementation because of its benefits on bone health. It is a fat-soluble vitamin and cannot be excreted from the body. There is need for monitoring 25-hydroxyvitamin D levels in infants and children who receive long-term vitamin D supplementation at or above the upper level intake that is currently recommended.

Assessing the Performance of National Surgical Quality Improvement Program Surgical Risk Calculator in Elective Spine Surgery: Insights from Patients Undergoing Single-Level Posterior Lumbar Fusion.

Introduction: The American College of Surgeons-National Surgical Quality Improvement Program Surgical Risk Calculator is a tool developed to use 21 individual patient characteristics to make predictions for occurrence of 13 general and 2 procedure-specific outcomes. The goal of this study was to evaluate the performance of the Surgical Risk Calculator in predicting outcomes in patients receiving posterior lumbar fusion.

Methods: American College of Surgeons-National Surgical Quality Improvement Program Participant Use File for 2015 was queried for patients with age ≥18 years undergoing single-level posterior lumbar fusion (PLF) surgery.

Ischemic Optic Neuropathy Following Spine Surgery: Case Control Analysis and Systematic Review of the Literature.

Study Design: Case-control analysis and systematic literature review.

Objective: To illustrate the prognosis and perioperative risk factors associated with this condition.

Summary Of Background Data: Ischemic optic neuropathy (ION) is the most common pathological diagnosis underlying postoperative vision loss.

Is Teriparatide Beneficial to Spinal Fusion Surgery in the Older Patient?: A Narrative Review.

Since FDA approval in 2002, teriparatide has gained popularity as an anabolic therapy for the treatment of osteoporosis. Animal studies have suggested a role for teriparatide in spine surgery. Several recent studies have demonstrated adjunctive use of teriparatide in osteoporotic patients undergoing spine fusions improves fusion rates, decreases time to union, and decreases osteoporosis-related complications such as proximal junctional kyphosis.

Reassessing the impact of intraoperative electrocorticography on postoperative outcome of patients undergoing standard temporal lobectomy for MRI-negative temporal lobe epilepsy.

Objective: Almost 30% of the patients with suspected temporal lobe epilepsy (TLE) have normal results on MRI. Success rates for resection of MRI-negative TLE are less favorable, ranging from 36% to 76%. Herein the authors describe the impact of intraoperative electrocorticography (ECoG) augmented by opioid activation and its effect on postoperative seizure outcome.

Clinical presentation, natural history and outcomes of intramedullary spinal cord cavernous malformations.

Objective: There is a paucity of literature investigating the clinical course of patients with spinal intramedullary cavernous malformations (ISCMs). We present a large case series of ISCMs to describe clinical presentation, natural history and outcomes of both surgical and conservative management.

Methods: We retrospectively reviewed the clinical course of patients diagnosed with ISCMs at our institution between 1995 and 2016.