Spinal extradural arachnoid cysts: a rare entity and review of the literature.

Objective: Spinal extradural arachnoid cysts (SEDC) are rare primary spinal lesions, accounting for less than 1% of all spinal epidural lesions. The literature contains only case reports of this pathology, and treatment remains controversial due to its rarity. Major reported SEDC cases are caused by leaking out of cerebrospinal fluid through a dural defect in the thecal sac forming an extradural cyst.

Three-Dimensional Volumetric Magnetic Resonance Imaging Analysis of Syringomyelia Evolution After Posterior Fossa Decompression for Chiari Malformation Type1.

Objective: This study aims to introduce a method of three-dimensional (3D) volume magnetic resonance imaging (MRI) measurements to evaluate the evolution of syringomyelia (SM) in adults with Chiari malformation type 1 (CM-1) after posterior fossa decompression (PFD), to provide reproducible and accurate measurements.

Methods: Radiologic and clinical data were obtained for 28 patients. MRI 3D syrinx volumes were evaluated by 2 observers using Philips Healthcare Tumor Tracking tool.

Sacrifice of Involved Nerve Root during Surgical Resection of Foraminal and/or Dumbbell Spinal Neurinomas.

Even if usually needed to achieve the gross total resection (GTR) of spinal benign nerve sheath tumors (NSTs), nerve root sacrifice remains controversial regarding the risk of neurological deficit. For foraminal NSTs, we hypothesize that the involved root is poorly functional and thus can be safely sacrificed. All spinal benign NSTs with foraminal extension that underwent surgery from 2013 to 2021 were reviewed.

Pure lumbar foraminal cavernous malformation in a patient with Cowden syndrome-a case report.

Background: Spinal cavernous malformations (CMs) are slow flow venous vascular malformations which can occur in vertebral body, epidural space or intramedullary. Only 7 cases were described confined in foraminal space. Cowden syndrome (CS) is an autosomal dominant genodermatosis that may present and develop vascular malformations, which include CM.

Surgical Treatment of Spinal Meningiomas in the Elderly (≥75 Years): Which Factors Affect the Neurological Outcome? An International Multicentric Study of 72 Cases.

(1) Background: With the increasing life expectancy in the Western world, an increasing number of old patients presents with spinal meningioma. Considering the benign nature of these tumors, the functional outcome remains of great importance, since more people reach old age in general conditions of well-being and satisfactory autonomy. (2) Methods: We conducted an international multicenter retrospective study to investigate demographic, clinical and radiological data in a population of elderly patients (≥75 years of age) undergoing surgery for SM from January 2000 to December 2020 in four European referral centers.

Clipping Test of a Radiculomedullary Artery During Resection of a Dorsal Spinal Meningioma.

Arterial supply of the spinal cord is derived from the anterior spinal artery (ASA) and 2 posterior spinal arteries. In the thoracic spine, a few segmental arteries give origins to radiculomedullary arteries (RMAs) that supply the ASA and posterior spinal arteries. In the lower thoracic spine, the supply is provided by the Adamkiewicz artery.

Predictors of functional outcome after spinal cord surgery: Relevance of intraoperative neurophysiological monitoring combined with preoperative neurophysiological and MRI assessments.

Objectives: To assess the accuracy of intraoperative neurophysiological monitoring (IONM) in predicting immediate and 3-month postoperative neurological new deficit (or deterioration) in patients benefiting from spinal cord (SC) surgery; and to identify factors associated with a higher risk of postoperative clinical worsening.

Methods: Consecutive patients who underwent SC surgery with IONM were included. Pre and postoperative clinical (modified McCormick scale), radiological (lesion-occupying area ratio), and electrophysiological features were collected.

Isolated atlas-duplication as a manifestation of persistent proatlas: a case report.

Purpose: Atlas-duplication is an exceedingly rare dysplasia of the craniocervical junction. To the best of our knowledge, only two cases of atlas-duplication have been reported and these were associated with complete anterior rachischisis and os odontoideum. We aimed to report a case of isolated atlas-duplication of incidental finding and without attributable symptoms which makes it unique.

How was spinal surgery activity maintained during the COVID-19 pandemic? Results of a French multicenter observational study.

Introduction: The French Society of Spinal Surgery (SFCR) offered guidelines during the COVID pandemic. The objective of this work was to report the organization and activity in spinal surgery during the first month of confinement across 6 centers in France. The secondary objective was to monitor the adequacy of our practices within the SFCR guidelines.

The Immune Microenvironment of Chordomas: An Immunohistochemical Analysis.

Chordomas are rare sarcomas that are usually treated by surgery and/or radiotherapy since these are chemo-resistant tumors, but immunotherapy could be a possible option for chordoma patients. However, few reports investigating the composition of the chordoma immune microenvironment exist. We immunohistochemically studied 81 chordomas regarding their immune microenvironment factors and compared them with clinicopathological data.

Autophagic Markers in Chordomas: Immunohistochemical Analysis and Comparison with the Immune Microenvironment of Chordoma Tissues.

Chordomas are notably resistant to chemotherapy. One of the cytoprotective mechanisms implicated in chemoresistance is autophagy. There are indirect data that autophagy could be implicated in chordomas, but its presence has not been studied in chordoma tissues.

Purely Intraforaminal Meningioma in the Cervical Spine.

Meningiomas are mostly benign intradural tumors. Concerning the spine, some of them can extend outside the canal or even develop extradurally but their primary attach is often located in the vertebral canal. Here we present the case of an exceptional purely intraforaminal meningioma mimicking a neurogenic tumor, involving the vertebral artery and presenting with cervicobrachial neuralgia and slight motor deficit.

Prognostic Factors Influencing Survival Rate of Patients Operated for Prostate-Related Metastatic Spinal Cord Compression (MSCC).

Prostate-related metastatic spinal cord compression (MSCC) accounts for 50% of all MSCC cases and constitute an oncological emergency. Metastatic spread has a detrimental impact on patient quality of life and the whole management strategy. We sought to identify the prognostic factors influencing the survival rate of patients operated for prostate-related MSCC.

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study.

Objective: Anderson type II odontoid fractures are severe conditions, mostly affecting elderly people (≥ 70 years old). Surgery can be performed as a primary treatment or in cases of failed conservative management. This study aimed to investigate how duration from injury to surgery, as well as clinical, radiological, and surgical risk factors, may influence the union rate after anterior odontoid screw placement for Anderson type II odontoid fractures.

Patients with Coronavirus 2019 (COVID-19) and Surgery: Guidelines and Checklist Proposal.

The management of patients with novel coronavirus 2019 (COVID-19) represents a new challenge for medical and surgical teams. Each operating room in the world should be prepared thoughtfully, and the development of a protocol and patient route seems mandatory. An adequate degree of protection must be used.

Cysts associated with intramedullary ependymomas of the spinal cord: clinical, MRI and oncological features.

Purpose: Few published articles have explicitly focused on cysts associated with intramedullary (IM) ependymomas. The objective was to assess the clinical, MRI, and oncological results of patients operated for an IM ependymoma associated with a cystic portion.

Methods: During the study period, 23 IM tumors resected were cystic ependymomas.

Clinical and radiographic evaluation of bioactive glass in posterior cervical and lumbar spinal fusion.

Introduction: Spinal surgery of degenerative painful segments is a valuable treatment option in the management of chronic cervical and low back pain. The surgery consists in stabilizing and fusing painful vertebral segment(s). The objective of the study was to report our experience with 45S5 bioactive glass (BAG) to obtain inter-vertebral fusion in the context of posterior spine surgery.