Early versus late construct failure in spine metastatic disease: implications for surgical strategy and oncologic outcome.

Purpose: This study aimed to identify variables that portend early construct failure requiring surgical revision in patients undergoing instrumented fusion for spine metastases.

Methods: A detailed retrospective chart review was performed. Demographic, surgical, and oncologic variables were collected and analyzed via independent samples t-testing, chi-square testing, and Kaplan-Meier method with log-rank testing.

Identification of Distinct Visual Scan Paths for Pathologists in Rare-Element Search Tasks.

Background: The search for rare elements, like mitotic figures, is crucial in pathology. Combining digital pathology with eye-tracking technology allows for the detailed study of how pathologists complete these important tasks.

Objectives: To determine if pathologists have distinct search characteristics in domain- and nondomain-specific tasks.

Use of Magnetic Resonance Imaging for Postoperative Radiation Therapy Planning in Patients with Carbon Fiber-Reinforced Polyetheretherketone Instrumentation.

Purpose: Carbon fiber-reinforced polyetheretherketone (CFR-PEEK) instrumentation is being used more frequently in the spinal oncology landscape. Better visualization with this material allows for more precise postoperative stereotactic body radiation therapy (SBRT) planning using either computed tomography (CT)-myelography or magnetic resonance imaging (MRI) studies. We compared the dosimetric planning equivalencies and outcomes.

The effect of radiotherapy, chemotherapy, and immunotherapy on fusion rate in spinal surgery using osteobiologics for patients with metastatic spinal disease: a systematic review.

Objective: To evaluate the impact that adjuvant therapies like radiotherapy, chemotherapy, and immunotherapy have on osteobiologic properties and bony regeneration in patients with metastatic spine disease (MSD) undergoing spinal fusion surgery.

Methods: PubMed and ClinicalTrials.gov searches were performed.

Intradural Extramedullary Small Cell Lung Cancer Metastasis Resection: 2-Dimensional Operative Video.

The presented surgical video (Video 1) demonstrates the resection of an intradural extramedullary metastasis in a 62-year-old female patient with a history of metastatic small cell lung cancer (SCLC). SCLC commonly metastasizes to the central nervous system. However, the vast majority of such metastases are to the brain.

Management of Refractory Cancer Pain with Intrathecal Drug Delivery and Spinal Cord Stimulation.

Background: Intrathecal pumps (ITPs) are indicated for refractory cancer pain and decrease systemic opioid requirements. While not yet indicated for cancer pain, spinal cord stimulators (SCSs) are used off-label for cancer pain, with increasing evidence of their efficacy.

Materials And Methods: A retrospective chart review was conducted of patients who underwent both ITP and at least SCS trial for cancer pain.

A Basal Ganglia model for understanding working memory functions in healthy and Parkinson's conditions.

Unlabelled: Working memory (WM) is considered as the scratchpad for reading, writing, and processing information necessary to perform cognitive tasks. The Basal Ganglia (BG) and Prefrontal Cortex are two important parts of the brain that are involved in WM functions, and both structures receive projections from dopaminergic nuclei. In this modelling study, we specifically focus on modelling the WM functions of the BG, the WM deficits in Parkinson's disease (PD) conditions, and the impact of dopamine deficiency on different kinds of WM functions.

Modeling hippocampal spatial cells in rodents navigating in 3D environments.

Studies on the neural correlates of navigation in 3D environments are plagued by several issues that need to be solved. For example, experimental studies show markedly different place cell responses in rats and bats, both navigating in 3D environments. In this study, we focus on modelling the spatial cells in rodents in a 3D environment.

Disease Control and Toxicity Outcomes after Stereotactic Ablative Radiation Therapy for Recurrent and/or Metastatic Cancers in Young-Adult and Pediatric Patients.

Background: Pediatric patients with metastatic and/or recurrent solid tumors have poor survival outcomes despite standard-of-care systemic therapy. Stereotactic ablative radiation therapy (SABR) may improve tumor control. We report the outcomes with the use of SABR in our pediatric solid tumor population.

Machine Learning in Spine Oncology: A Narrative Review.

Study Design: Narrative Review.

Objective: Machine learning (ML) is one of the latest advancements in artificial intelligence used in medicine and surgery with the potential to significantly impact the way physicians diagnose, prognose, and treat spine tumors. In the realm of spine oncology, ML is utilized to analyze and interpret medical imaging and classify tumors with incredible accuracy.

A lateralized motor network in order to understand adaptation to visuomotor rotation.

The functional asymmetry between the two brain hemispheres in language and spatial processing is well documented. However, a description of difference in control between the two hemispheres in motor function is not well established. Our primary objective in this study was to examine the distribution of control in the motor hierarchy and its variation across hemispheres.

MIS technique for separation surgery in lumbar spine metastatic disease.

Around 40% of cancer patients present with spinal metastases (SM), the lumbar spine being the second most involved site (15%-30%) after the thoracic (60%-80%). Since the development of separation surgery, minimally invasive surgery (MIS) has increasingly been applied to approach SM, mirroring benefits yielded in the degenerative realm. Moreover, preoperative embolization potentially enhances local control for certain radioresistant histologies.

Thoracic root-related intradural extramedullary cavernoma presenting with subarachnoid hemorrhage: illustrative case.

Background: Just 5% of all cavernomas are located in the spine. Thoracic root-related subtypes are the rarest, with a total of 14 cases reported in the literature to date. Among them, only 4 presented with subarachnoid hemorrhage (SAH).

Real-time ultrasound guidance in the endoscopic endonasal resection of a retro-odontoid pannus: Technical note and case illustration.

Background And Objectives: Odontoidectomy is a surgical procedure indicated in the setting of various pathologies, with the main goal of decompressing the ventral brain stem and spinal cord as a result of irreducible compression at the craniovertebral junction. The endoscopic endonasal approach has been increasingly used as an alternative to the transoral approach as it provides a straightforward, panoramic, and direct approach to the odontoid process. In addition, intraoperative ultrasound (US) guidance is a technique that can optimize safety and surgical outcomes in this context.

Implementation of IT supported standardization of individualized hydrocortisone management for treatment of patients with adrenal insufficiency.

Objectives: Hydrocortisone stress dosing guidelines for children with adrenal insufficiency (AI) recommend a wide range of acceptable stress doses. This has led to variability in dosing recommendations resulting in confusion among endocrine, non-endocrine providers and patient families. This quality improvement project sought to standardize documentation and hydrocortisone stress dosing within our pediatric endocrine division to optimize communication regarding AI management.

Vertebral Compression Fracture After Spine Stereotactic Body Radiotherapy: The Role of Vertebral Endplate Disruption.

Background And Objectives: Vertebral compression fracture (VCF) is a common, but serious toxicity of spinal stereotactic body radiotherapy (SBRT). Several variables that place patients at high risk of VCF have previously been identified, including advanced Spinal Instability Neoplastic Score (SINS), a widely adopted clinical decision criterion to assess spinal instability. We examine the role of tumoral endplate (EP) disruption in the risk of VCF and attempt to incorporate it into a simple risk stratification system.

Resection of intradural intramedullary subependymoma of the cervicothoracic spine: 2-dimensional operative video.

This video presents the case of a 44-year-old male with a 2-year history of pain in the left upper extremity that had worsened over the course of the last 6 months with associated weakened grip strength and had extended into his right arm. T2-weighted sagittal and axial MRI demonstrated an expansive nonenhancing solid intramedullary lesion extending from C5 to T1. The patient underwent a C5-T1 laminectomy and laminoplasty with near-complete resection of the intradural intramedullary subependymoma.

A phenomenological model of whole brain dynamics using a network of neural oscillators with power-coupling.

We present a general, trainable oscillatory neural network as a large-scale model of brain dynamics. The model has a cascade of two stages - an oscillatory stage and a complex-valued feedforward stage - for modelling the relationship between structural connectivity and functional connectivity from neuroimaging data under resting brain conditions. Earlier works of large-scale brain dynamics that used Hopf oscillators used linear coupling of oscillators.