Survival, fusion, and hardware failure after surgery for spinal metastatic disease.

Objective: Decompression with instrumented fusion is commonly employed for spinal metastatic disease. Arthrodesis is typically sought despite limited knowledge of fusion outcomes, high procedural morbidity, and poor prognosis. This study aimed to describe survival, fusion, and hardware failure after decompression and fusion for spinal metastatic disease.

The impact of age on approach-related complications with navigated lateral lumbar interbody fusion.

Objective: Age is known to be a risk factor for increased complications due to surgery. However, elderly patients can gain significant quality-of-life benefits from surgery. Lateral lumbar interbody fusion (LLIF) is a minimally invasive procedure that is commonly used to treat degenerative spine disease.

Robotic-Assisted Spinal Surgery: Current Generation Instrumentation and New Applications.

In contrast to other surgical fields, robotics is relatively new to spinal surgery. The initial focus for spinal robotics has been on accurate pedicle screw placement, which early studies have shown to be successful. Beyond pedicle screw placement, however, newer generation spinal robots have the capability of navigation, which can impact other aspects of a spinal procedure.

Spinal dural arteriovenous fistula formation after scoliosis surgery: case report.

Spinal dural arteriovenous fistulas are diagnostically challenging lesions, and they are not well described in patients with a history of a spinal deformity correction. The authors present the challenging case of a 74-year-old woman who had previously undergone correction of a spinal deformity with subsequent revision. Several years after the last deformity operation, she developed a progressive myelopathy with urinary incontinence over a 6-month period.

Analysis of Outcomes Between Traditional Open versus Mini-Open Approach in Surgical Treatment of Spinal Metastasis.

Objective: The treatment of spinal metastasis carries significant surgical morbidity, and decompression and stabilization are often necessary. Less invasive techniques may reduce risks and postoperative pain. This study describes the differences between a mini-open (MO) procedure and a traditional open surgery (OS) for symptomatic spinal metastasis, and reports differences in outcome for similar patients undergoing each procedure.

Lumbar Arthroplasty Core Herniation Presenting With Cauda Equina Syndrome: Case Report of a Rare Complication.

Background: Treatment failures of artificial disc implantation are well-described, but posterior herniation of the arthroplasty core is rare. We present a case of posterior herniation of the arthroplasty core resulting in cauda equina syndrome in a 36-yr-old woman. Preoperative imaging studies including computed tomography (CT), magnetic resonance imaging (MRI), and CT Myelogram were performed; only the CT Myelogram demonstrated the severe compression well.

Resource utilization and indications for helicopter transport of head-injured children.

Introduction: Helicopter emergency medical services (HEMS) have provided benefit for severely injured patients. However, HEMS are likely overused for the transportation of both adult and pediatric trauma patients. In this study, we aim to evaluate the degree of overuse of helicopter as a mode of transport for head-injured children.

Delayed Presentation of Cerebral Air Embolism from a Left Atrial-Esophageal Fistula: A Case Report and Review of the Literature.

Air embolism developing from an atrial-esophageal fistula that was created as a complication from an atrial ablation procedure is a rare, yet usually fatal diagnosis. Neurologic manifestations such as meningitis, altered mental status, seizures, strokes, transient ischemic attacks (TIAs), psychiatric changes, and coma can ensue. Imaging of the brain might reveal infarcts, cerebral edema, as well as signs of pneumocephalus.

Congenital Agenesis of the C6 Pedicle Leading to Misdiagnosis of a Traumatically Jumped Facet: A Case Report.

This case report discusses the rare issue of an atrophic cervical pedicle at the C6 level in a patient found unconscious with a jumped facet and an unknown mechanism of injury. A means to discern between traumatic jumped facets versus congenital anomalies is addressed, including missing pedicles, which is encountered at the C6 level in this case. A literature review revealed that the most common level where this occurs is at the C6 level.

Safety and cost effectiveness of early discharge following microscopic trans-sphenoidal resection of pituitary lesions.

Background: Inpatient hospitalization following trans-sphenoidal resection of a pituitary neoplasm has traditionally involved a hospital stay of 2 days or more. It has been the policy of the senior pituitary neurosurgeon (GSA) since February 2008 to allow discharge home on postoperative day (POD) 1 if thirst mechanism is intact and the patient is tolerating oral hydration. The goal of this study was to evaluate the safety and cost-effectiveness of this practice.