In Situ Real-Time Dosimetric Studies for Spine Stereotactic Body Radiation Therapy in a Cadaver Implanted with Carbon-Fiber and Titanium Instrumentation.

Objective: We sought to compare the dosimetric accuracy of postoperative stereotactic body radiation therapy in a carbon-fiber (CF) versus titanium instrumented spine using a cadaveric model.

Methods: In situ cadaveric implantation of titanium and CF instrumentation and dosimeter chips in a thoracic spine. The cadaver underwent stereotactic body radiation therapy, and a dose of radiation therapy was calculated, measured, and compared.

Postoperative Stereotactic Body Radiotherapy for Spinal Metastasis and Predictors of Local Control.

Background: Spine surgery is indicated for select patients with mechanical instability, pain, and/or malignant epidural spinal cord compression, with or without neurological compromise. Stereotactic body radiotherapy (SBRT) is an option for durable local control (LC) for metastatic spine disease.

Objective: To determine factors associated with LC and progression-free survival (PFS) for patients receiving postoperative stereotactic spine radiosurgery.

Cost Analysis With Use of Expandable Cage or Cement in Single level Thoracic Vertebrectomy in Metastasis.

Study Design: Retrospective case series.

Objective: Patient with metastatic cancer frequently require spinal operations for neural decompression and stabilization, most commonly thoracic vertebrectomy with reconstruction. Objective of the study was to assess economic aspects associated with use of cement versus expandable cage in patients with single level thoracic metastatic disease.

Damned if you monitor, damned if you don't: medical malpractice and intraoperative neuromonitoring for spinal surgery.

Objective: The aim of this study was to identify trends in medical malpractice litigation related to intraoperative neuromonitoring.

Methods: The Westlaw Edge legal research service was queried for malpractice litigation related to neuromonitoring in spine surgery. Cases were reviewed to determine if the plaintiff's assertion of negligence was due to either failure to use neuromonitoring or negligent monitoring.

C1-2 facet disarticulation for correction of iatrogenic cervical kyphosis following occipital-cervical fusion.

The patient is a 69-year-old woman with a history of atlantoaxial instability and cervical pain who underwent an occipital-cervical fusion at an outside hospital. Five days following the procedure she required a PEG tube due to progressive dysphagia. Compared with preoperative imaging, x-ray shows cervical spine hyperextension with a significant decrease in the occipital-C2 angle.

Stereotactic CT image guidance and biplanar fluoroscopy for transoral C2 vertebroplasty and direct anterolateral subaxial vertebroplasty: a surgical technique note on access to the axial and subaxial spine.

Background: Metastatic cervical spine disease can cause compression fractures, cervical spine instability, and pain. Vertebroplasty can stabilize a fracture, reduce the pain associated with a compression fracture, prevent or stop the progression of a fracture, thus avoiding cervical spine fixation, and decreased mobility. Transoral C2 vertebroplasty is less invasive than open fusion surgery, but it poses its own risk of infection and cement leak in this highly sensitive area.

Decreasing External Ventricular Drain-Related Infection Rates with Duration-Independent, Clinically Indicated Criteria for Drain Revision: A Retrospective Study.

Objective: To lower external ventricular drain (EVD)-related infection rates, in April 2013, our institution enacted a major protocol change, switching from routine EVD replacement every 5 days to EVD replacement only when clinically indicated. In the present study, we evaluated the effect of this change on nosocomial EVD-related infections.

Methods: We performed a retrospective cohort study to compare the EVD-related infection rates between 2 groups (group A, elective EVD replacement; group B, clinically indicated EVD replacement).

Intraspinal hypotension syndrome presents as transient quadriplegia.

Intracranial hypotension can be a complication of epidural anaesthesia. Pure clinical spinal hypotension manifesting as acute transient quadriplegia following epidural anaesthesia is a severe, life-threatening complication that have not been described before. This complication can be solved with an epidural blood patch; thus, it should be familiar to doctors across all specialities.

Cavernous Carotid Artery Pseudoaneurysm Following a Radical Cavernous Sinus Resection.

Iatrogenic cavernous carotid pseudoaneurysms are a special group among other intracranial aneurysms. They can occur during the dissection phase of the surgery if the tumor encases a vessel. Complications of their rupture as hemorrhage or stroke are life threatening.

Uncal herniation in a fully conscious patient-The sliding uncus syndrome.

Uncal herniation is accompanied by a decreased level of consciousness. We describe a patient who remained fully alert despite the uncal herniation. The computed tomography (CT) scans allowed us to visualize the uncus and its spatial relation to the cerebral peduncle.