[Thoracic disc herniation].

Contrary to traditional opinion thoracic herniation is more frequent than expected. The disease poses two main challenges: (1) surgical removal and (2) early and correct diagnosis. It is without a doubt that herniated thoracic discs can be difficult to remove.

To biopsy or not to biopsy: a retrospective review of presumed osteoid osteomas treated by radiofrequency ablation.

Objective: First, to determine the frequency and spectrum of osteoid osteoma (OO)-mimicking lesions among presumed OO referred for radiofrequency ablation (RFA). Second, to compare patient sex and age, lesion location, and rates of primary treatment failure for OO based on histopathology results.

Materials And Methods: A retrospective review was performed of all first-time combined CT-guided biopsy/RFA for presumed OO at a single academic center between January 1990 and August 2023.

Evolution of Video Assisted Thoracoscopic Surgery for Thoracic Disc Herniation: Towards Biportal Thoracoscopic Approach.

Objective: This work aims to describe the evolution of the video-assisted Thoracoscopic Surgery (VATS) approach from a multiportal access to a biportal access for thoracic herniated disc surgery. Thoracic disc herniation remains a challenging pathology for spine surgeons. VATS of the thoracic spine was described in the 90s and represented an important technical leap by including minimally invasive options for thoracic pathology.

Elongated morphology of osteoid osteoma is associated with radiofrequency ablation failure in children.

Objective: To compare the frequency of elongated morphology of osteoid osteoma (OO) in children compared to adolescents and to determine if this elongated morphology is associated with radiofrequency ablation treatment failure.

Materials And Methods: Retrospective review of first-time CT-guided radiofrequency ablation performed for presumed OO in patients < 21 years old between 1990 and 2023. Children were considered 0 to 10 years old, and adolescents were considered 11 to 20 years old.

Preparing MSK radiologists of the future.

The future will bring increasing demands for specialty training of MSK radiologists. These will include requirements for further standardization of curriculum, educational methods, and documentation. This will place further burdens (both temporal and financial) on the fellowship programs and may lead to termination of some programs.

Malignant pleural mesothelioma characteristics and outcomes: A SEER-Medicare analysis.

Background: Pleural mesothelioma is rare cancer linked to asbestos exposure. Previous research has indicated that female individuals have better survival than male individuals, but this has never been examined in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database.

Materials And Methods: Malignant pleural mesothelioma cases diagnosed from 1992 to 2015 were queried from the linked SEER-Medicare database.

Antero-lateral transthoracic endoscopic approach for a calcified thoracic disc herniation.

Thoracic disc herniation is one of the most therapeutically challenging spine conditions. A myriad of surgical approaches have been described in the literature, including posterior, anterior, and combined techniques. However, transthoracic and retropleural approaches are currently deemed the most effective techniques to successfully obtain anterior decompression.

Fracture through tracking pin sites following a robotic-assisted total knee arthroplasty.

The use of computer-navigated, robotic-assisted total knee arthroplasty (TKA) is expanding as the result of widespread efforts to improve the precision of implant placement and to restore mechanical, anatomic, and kinematic alignment. The procedure requires placement of femoral and tibial pins to mount the robotic tracking system. Fractures through tracking pin sites following robotic-assisted TKA are rare; only 30 cases have been reported to our knowledge.

Nerve autofluorescence under near-ultraviolet light: cutting-edge technology for intra-operative neural tissue visualization in 17 patients.

Background: Nerve visualization and the identification of other neural tissues during surgery is crucial for numerous reasons, including the prevention of iatrogenic nerve and neural structure injury and facilitation of nerve repair. However, current methods of intra-operative nerve detection are generally expensive, unproven, and/or technically challenging. Recently, we have documented, in both in vivo animal models and ex vivo human tissue, that nerves autofluorescence when viewed in near-ultraviolet light (NUV).

Best Practices: CT-Guided Percutaneous Sampling of Vertebral Discitis-Osteomyelitis and Technical Factors Maximizing Biopsy Yield.

Vertebral discitis-osteomyelitis is an infection of the intervertebral disk and vertebral bodies that may extend to adjacent paraspinal and epidural soft tissues. Its incidence is increasing, likely because of improved treatments and increased life expectancy for patients with predisposing chronic disease and increased rates of IV drug use and intravascular intervention. Because blood cultures are frequently negative in patients with vertebral discitis-osteomyelitis, biopsy is often indicated to identify a causative microorganism for targeted antimicrobial therapy.

Correction to: Revision surgery in thoracic disc herniation.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.

Revision surgery in thoracic disc herniation.

Purpose: Surgical treatment failures or strategies for the reoperation of residual thoracic disc herniations are sparsely discussed. We investigated factors that led to incomplete disc removal and recommend reoperation strategies.

Methods: As a referral centre for thoracic disc disease, we reviewed retrospectively the clinical records and imaging studies before and after the treatment of patients who were sent to us for revision surgery for thoracic disc herniation from 2013 to 2018.

Osteoblastoma of the clavicle at the site of a previous fracture-first case report and review of the literature.

Osteoblastoma is a rare, benign primary tumor of bone, accounting for < 1% of all bone tumors. We report the case of a 27-year-old female who developed pain and swelling five and a half years after a clavicular fracture and was subsequently found to have an osteoblastoma arising at the fracture site. This is the first reported case of an osteoblastoma developing after a fracture, although osteoid osteomas, which are histologically indistinguishable from osteoblastomas, have been reported at prior fracture sites.

Magnetic resonance imaging of the lumbar spine: determining clinical impact and potential harm from overuse.

Background: Lumbar spine magnetic resonance imaging is frequently said to be "overused" in the evaluation of low back pain, yet data concerning the extent of overuse and the potential harmful effects are lacking.

Purpose: The objective of this study was to determine the proportion of examinations with a detectable impact on patient care (actionable outcomes).

Study Design: This is a retrospective cohort study.

The Effect of Computer-Assisted Reporting on Interreader Variability of Lumbar Spine MRI Degenerative Findings: Five Readers With 30 Disc Levels.

Purpose: The aim of this study was to assess differences in interreader variability among radiologists after the implementation of a computer-assisted reporting (CAR) tool for the interpretation of degenerative disc disease on lumbar spine MRI.

Methods: Thirty lumbar spine MRI examinations were selected from the radiology database. Five fellowship-trained musculoskeletal radiologists evaluated each L4-L5 disc in a blinded fashion and reported the findings using a traditional free dictation approach.

Syringo-Subarachnoid Shunt for the Treatment of Persistent Syringomyelia Following Decompression for Chiari Type I Malformation: Surgical Results.

Background: Approximately 30% of patients treated with foramen magnum decompression (FMD) for Chiari I-associated syringomyelia will show persistence, recurrence, or progression of the syrinx.

Objective: This study evaluates the clinical and radiologic outcomes of syringo-subarachnoid shunt (SSS) as the treatment for persistent syringomyelia after FMD.

Methods: Data were collected retrospectively.

Socioeconomic and Demographic Predictors of Missed Opportunities to Provide Advanced Imaging Services.

Purpose: The extent to which racial and socioeconomic disparities exist in accessing clinically appropriate, advanced diagnostic imaging has not been well studied. This study assesses the relationship between demographic and socioeconomic factors and the incidence of imaging missed care opportunities (IMCOs).

Methods: We performed a retrospective review of outpatient CT and MRI appointments at a quaternary academic medical center and affiliated outpatient facilities during a 12-month period.

MR imaging features of hemispherical spondylosclerosis.

Objective: Hemispherical spondylosclerosis (HS) is a rare degenerative entity characterized by dome-shaped sclerosis of a single vertebral body that may pose a diagnostic dilemma. The goal of this study was to describe the MR imaging features of HS.

Materials And Methods: We identified spine radiographs and CT examinations of subjects with HS who also had MR imaging for correlation.

Simultaneous Multislice-Based 5-Minute Lumbar Spine MRI Protocol: Initial Experience in a Clinical Setting.

Background And Purpose: Previous studies have used parallel imaging (PI) techniques to decrease spine magnetic resonance imaging (MRI) protocol acquisition times. Recently developed MRI sequences allow even faster acquisitions. Our purpose was to develop a lumbar spine MRI protocol using PI with GRAPPA (generalized autocalibrating partially parallel acquisition) and a simultaneous multislice (SMS)-based sequence and to evaluate its diagnostic performance compared to a standard lumbar spine MRI protocol.

Improving Radiology Workflow with Automated Examination Tracking and Alerts.

The modern radiology workflow is a production line where imaging examinations pass in sequence through many steps. In busy clinical environments, even a minor delay in any step can propagate through the system and significantly lengthen the examination process. This is particularly true for the tasks delegated to the human operators, who may be distracted or stressed.

Utilization Management of High-Cost Imaging in an Outpatient Setting in a Large Stable Patient and Provider Cohort over 7 Years.

Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist.

Skeletal Radiology: the year in review 2016.

A look back at Skeletal Radiology in 2016 reveals a sizable number of publications that significantly advanced the state of knowledge about diseases of the musculoskeletal system. This review summarizes the content of some of the most intriguing papers of the year.

Updated Outcome and Analysis of Tumor Response in Mobile Spine and Sacral Chordoma Treated With Definitive High-Dose Photon/Proton Radiation Therapy.

Purpose: Treatment of spine and sacral chordoma generally involves surgical resection, usually in conjunction with radiation therapy. In certain circumstances where resection may result in significant neurologic or organ dysfunction, patients can be treated definitively with radiation therapy alone. Herein, we report the outcome and the assessment of tumor response to definitive radiation therapy.