Heterotopic Bone Formation 20 Years After Gunshot Wound to the Cervical Spine: A Rare Cause of Progressive Cervical Myelopathy in a Previously Asymptomatic Patient.

Background: Gunshot wounds are the most common etiology of penetrating spine injuries and have been increasing in incidence in civilian populations. Although these injuries typically result in severe neurologic deficits, operative intervention remains is controversial and is usually reserved for patients with neurologic deterioration, a persistent externalized cerebrospinal fluid fistula, mechanical instability, metallic toxicity, or a bullet location at high risk of migration.

Case Description: A previously asymptomatic patient who had sustained a gunshot wound to the cervical spine 20 years previously presented with new-onset progressive myelopathy and radiculopathy secondary to heterotopic ossification (HO) surrounding the retained bullet fragments near the left lateral masses of C5-T1.

Reductions in length of stay, narcotics use, and pain following implementation of an enhanced recovery after surgery program for 1- to 3-level lumbar fusion surgery.

OBJECTIVELumbar fusion is typically associated with high degrees of pain and immobility. The implementation of an enhanced recovery after surgery (ERAS) approach has been successful in speeding the recovery after other surgical procedures. In this paper, the authors examined the results of early implementation of ERAS for lumbar fusion.

Epidemiology and etiology of secondary piriformis syndrome: A single-institution retrospective study.

Piriformis syndrome (PS) is a rare etiology of extra-spinal sciatica in which pathologies associated with or around the piriformis muscle (PM) irritate the adjacent sciatic nerve (SN), however, there is scarcity in the literature regarding its exact etiologies, thus, we performed a retrospective study to elucidate the epidemiology of PS and assess various causes of the syndrome. Our study included patients assessed at our institution who presented with sciatica of non-spinal origin between May 2014 and December 2015. Radiology reports of all patients who received pelvic MRI were examined for positive findings involving PM and SN.

Primary spinal cord glioblastoma multiforme treated with temozolomide.

Since virtually no trials have evaluated the effectiveness of temozolomide (TMZ) in the treatment of spinal cord (SC) glioblastoma multiforme (GBM), we conducted a systematic review to evaluate its efficacy. Primary SC GBM is rare. Its management remains unclear, even though treatment guidelines have been established since 2005 for its cranial counterpart.

The role of stereotactic radiosurgery in the treatment of intramedullary spinal cord neoplasms: a systematic literature review.

Advances in imaging technology and microsurgical techniques have made microsurgical resection the treatment of choice in cases of symptomatic intramedullary tumors. The use of stereotactic radiosurgery (SRS) for spinal tumors is a recent development, and its application to intramedullary lesions is debated. We conducted a literature search through PubMed's MeSH system, compiling information regarding intramedullary neoplasms treated by SRS.

A prospective, randomized trial comparing expansile cervical laminoplasty and cervical laminectomy and fusion for multilevel cervical myelopathy.

Background: Controversy exists as to the best posterior operative procedure to treat multilevel compressive cervical spondylotic myelopathy.

Objective: To determine clinical, radiological, and patient satisfaction outcomes between expansile cervical laminoplasty (ECL) and cervical laminectomy and fusion (CLF).

Methods: We performed a prospective, randomized study of ECL vs CLF in patients suffering from cervical spondylotic myelopathy.

Leiomyosarcoma metastases to the spine. Case series and review of the literature.

Leiomyosarcoma is a rare malignant smooth-muscle tumor that rarely metastasizes to bone. It is extremely uncommon for osseous metastasis to be the initial presentation of leiomyosarcoma or to be the initial manifestation of recurrence in patients with a history of leiomyosarcoma. The authors have treated four cases of metastatic leiomyosarcoma with the lesion initially presenting in the spine, and a fifth case of disseminated leiomyosarcoma that involved the spine.