Does Restoration of Lumbar and Segmental Cobb Angle Affect Fusion Outcome in Short-Segment Posterior Lumbar Fusion?

Objective: To study the effect of lumbar lordosis change and pelvic parameters on surgical outcomes such as fusion versus nonfusion (pseudarthrosis), adjacent segment pathology (ASP), and reoperation in patients undergoing 1-level, 2-level, and 3-level posterior lumbar fusion (PLF).

Methods: Adult patients with degenerative spine disease who had undergone PLF between L2 and L5 levels at an academic center between 2010 and 2020 were included. Preoperative and early postoperative lateral standing radiographs of the lumbar spine were used to measure preoperative lumbar Cobb angle, postoperative lumbar Cobb angle, preoperative segmental Cobb angle (measured from the superior end plate of the upper instrumented vertebra to the inferior end plate of the lower instrumented vertebra), postoperative segmental Cobb angle, preoperative pelvic incidence, and pelvic tilt.

Risk Factors of Pulmonary Embolism in Long-Segment Posterior Thoracolumbar Fusion: Scoring System for Prophylactic Inferior Vena Cava Filter Placement.

Objective: To investigate the factors for pulmonary embolism (PE) development and the necessity of inferior vena cava (IVC) filter placement. Specifically, propose a scoring system to identify patient populations who benefit from IVC filter placement.

Methods: A single-institution retrospective cohort study was performed between 2010 and 2022.

Intramedullary Metastases to Conus Medullaris: A Review of the Literature with a Case Illustration.

Intramedullary metastases to the conus medullaris spinalis (IMCM) pose a rare problem in neurosurgical oncology and are usually encountered as a complicated clinical scenario in the setting of advanced systemic malignancy with poor overall survival. Despite the progress in interdisciplinary oncological care, their management remains complicated. We performed a PRISMA-guided literature search to achieve a pooled analysis of all previously reported IMCM cases that contained detailed clinical data on this problem to investigate the currently employed management options and respective outcomes.

The Effect of Interbody Cage Parameters on the Rate of Subsidence in Single-Level Anterior Cervical Discectomy and Fusion (ACDF): A Retrospective Analysis of 98 Patients.

Introduction: Subsidence is a relatively common consequence after anterior cervical discectomy and fusion (ACDF) surgery. This study aimed to identify the effect of radiological and non-radiological risk factors on subsidence after a single-level ACDF surgery with cage and plate.

Methods: This is a retrospective cohort study of patients who underwent ACDF for radiculopathy or myelopathy at an academic center, University of Kentucky Albert Chandler Hospital, Lexington, Kentucky, United States, between January 2010 and January 2020.

Does the Number of Interbody Devices Affect the Fusion Outcome in Short-Segment Posterior Lumbar Fusion?

Introduction: Interbody devices (IBDs) have been shown to improve outcomes when used in posterior lumbar fusion (PLF) surgery; however,the exact extent of their clinical benefit remains a current topic of interest. Our primary objective in this study was to identify whether the use of an IBD at every level of fusion construct would affect fusion outcomes such as adjacent segment pathology (ASP) and pseudarthrosis after one- to three-level PLF surgery.

Methods: This was a single-institution retrospective study.

Utility of Decremental Triggered Electromyogram for Intraoperative Neuromonitoring to Identify Midline in Posterior Myelotomy for Spinal Cord Intramedullary Lesions: Technical Note of a Novel Method.

Background And Importance: Intramedullary spinal cord lesions are eloquent lesions that are surgically resected via posterior midline myelotomy (PMM). This treatment method carries the risk of postoperative neurological deficits. Various intraoperative neuromonitoring techniques have been used to address this concern.

Predicting the Need for Surgery in Patients with Lumbar Disc Herniation: A New Internally Validated Scoring System.

Study Design: Prospective study.

Purpose: To propose a scoring system for predicting the need for surgery in patients with lumbar disc herniation (LDH).

Overview Of Literature: The indications for surgery in patients with LDH are well established.

Spinal Ganglioneuroma: A Systematic Review of the Literature.

Objective: Spinal ganglioneuromas (GNs) are rare benign tumors that often manifest as symptoms related to the compression of neural elements. The preferred treatment for affected patients is surgical resection, which typically improves symptoms and accompanies a low likelihood of tumor recurrence. We conducted a systematic review of reports of GNs involving the spinal cord and nerve roots, examining their clinical presentation, surgical management, and outcomes.

Effect of Body Mass Index on Fusion Outcome After Short-Segment Posterior Lumbar Fusion.

Objective: Obesity is a growing epidemic in the United States. While many adverse effects of obesity on surgical outcome are well studied, a direct correlation among obesity, pseudarthrosis, and adjacent segment pathology is not well defined. In this study we aimed to identify the effect of body mass index (BMI) on pseudarthrosis, adjacent segment pathology (ASP), and reoperation after short-segment (1-3 levels) open posterior lumbar fusion (PLF).

Effect of Obesity on Surgical Outcomes of Lumbar Microdiscectomy: A Retrospective Analysis of 525 Patients.

Introduction: Obesity has been implicated in higher rates of intra-operative complications, as well as increased risk for recurrent herniation and re-operation following lumbar microdiscectomy (LMD). However, the current literature is still controversial about whether obesity adversely affects surgical outcomes, especially a higher re-operation rate. In this study, we have compared surgical outcomes such as recurrence of symptoms, recurrence of disc herniation, and re-operation rates in obese and non-obese patients undergoing one segment LMD.

Influence of clinical and radiological parameters on the likelihood of neurological improvement after surgery for degenerative cervical myelopathy.

Objective: Degenerative cervical myelopathy (DCM) is routinely treated with surgical decompression, but disparate postoperative outcomes are frequently observed, ranging from complete neurological recovery to persistent decline. Although numerous clinical and radiological factors have been independently associated with failure to improve, the relative impact of these proposed risk factors remains obscure. In this study, the authors assess the combined role of clinical and radiographic parameters in contributing to failure to attain neurological improvement after surgery.

Can activated titanium interbody cages accelerate or enhance spinal fusion? a review of the literature and a design for clinical trials.

While spinal interbody cage options have proliferated in the past decade, relatively little work has been done to explore the comparative potential of biomaterial technologies in promoting stable fusion. Innovations such as micro-etching and nano-architectural designs have shown purported benefits in in vitro studies, but lack clinical data describing their optimal implementation. Here, we critically assess the pre-clinical data supportive of various commercially available interbody cage biomaterial, topographical, and structural designs.

Middle Meningeal Artery Embolization Versus Conventional Treatment of Chronic Subdural Hematomas.

Background: Middle meningeal artery (MMA) embolization is an emerging minimally invasive endovascular technique for chronic subdural hematoma (cSDH). Currently, limited literature exists on its safety and efficacy compared with conventional treatment (open-surgical-evacuation-only).

Objective: To compare MMA embolization to conventional treatment.

Safety and Efficacy of the VariLift-C® Cervical Standalone Interbody Fusion Device with Emphasis on Multiple-level and Prior Fusion Cases.

Introduction The VariLift-C is a stand-alone, expandable, cervical interbody fusion device, not requiring the addition of anterior plating. Because of the access and placement technique, as well as not needing a plate, the device could potentially be used preferentially for patients with prior anterior fusions or for multiple, non-contiguous vertebral segments. Methods A retrospective chart review was conducted and all cases of anterior cervical discectomy and fusion (ACDF) using VariLift-C implants by a single surgeon were included.

Hydatid Cyst in the Lumbar Paravertebral Muscle: A Case Report.

A hydatid cyst is a zoonotic disease caused by the worm Echinococcus granulosus. In endemic regions, it is a well-known differential diagnosis of cystic lesions, especially in the liver, lungs, brain, and vertebral column. Primary paravertebral muscle involvement, however, is rarely reported.

Factors Predictive of Adjacent Segment Disease After Lumbar Spinal Fusion.

Objective: Adjacent segment disease (ASD) is a long-term complication of lumbar spinal fusion. This study aims to evaluate demographic and operative factors that influence development of ASD after fusion for lumbar degenerative pathologies.

Methods: A retrospective cohort study was performed on patients undergoing instrumented lumbar fusion for degenerative disorders (spondylolisthesis, stenosis, or intervertebral disk degeneration) with a minimum follow-up of 6 months.

Factors influencing the presence of hemiparesis in chronic subdural hematoma.

Objective: Chronic subdural hematoma (CSDH) has a variety of clinical presentations, including hemiparesis. Hemiparesis is of the utmost importance because it is one of the major indications for surgical intervention and influences outcome. In the current study, the authors intended to identify factors influencing the presence of hemiparesis in CSDH patients and to determine the threshold value of hematoma thickness and midline shift for development of hemiparesis.

Intracranial hypertension after Chiari decompression resolving after removal of a levonorgestrel-releasing intrauterine device: case report.

Levonorgestrel-releasing intrauterine devices (LIUDs) are thought to release this progestin locally in the uterus to limit side effects. Authors here present a case of treatment-refractory hydrocephalus and pseudomeningocele (PMC), both of which fully resolved after LIUD removal.A 35-year-old woman with an implanted LIUD developed symptomatic PMC and hydrocephalus after suboccipital craniectomy for Chiari malformation type I.

Factors Predicting the Need for Surgery of the Opposite Side After Unilateral Evacuation of Bilateral Chronic Subdural Hematomas.

Background: Patients with bilateral chronic subdural hematoma (bCSDH) undergo unilateral evacuation for the large or symptomatic side because the contralateral hematoma is either small or asymptomatic. However, the contralateral hematoma may subsequently grow and require evacuation.

Objective: To characterize factors that predict contralateral hematoma growth and need for evacuation.

Pitting Oedema in a Patient with Lumbar Disc Herniation: Case report of an unusual association.

Oedema refers to the excessive accumulation of fluid within intercellular tissues as a result of disequilibrium between the capillary hydrostatic and oncotic pressure gradients. Lumbar disc herniation (LDH) commonly causes lower back pain and radicular leg pain. We report a 57-year-old female who presented to the neurosurgery clinic of the Bam University of Medical Sciences, Bam, Iran, in 2015 with pain and pitting oedema in the bilateral lower extremities.

Factors predicting reoperation of chronic subdural hematoma following primary surgical evacuation.

OBJECTIVEChronic subdural hematoma (CSDH) is commonly encountered in neurosurgical practice. However, surgical evacuation remains complicated by a high rate of reoperation. The optimal surgical approach to reduce the reoperation rate has not been determined.

Medical Malpractice in Neurosurgery: A Comprehensive Analysis.

Background: Of all specialists, neurosurgeons have the highest probability of facing a medical malpractice claim. Here we report the first specialty-wide review of malpractice claims in neurosurgery performed using a well-established national online legal database.

Methods: The Westlaw legal research service (Thomson Reuters, Eagan, Minnesota, USA) was queried for jury verdicts and settlements related to neurosurgery and medical malpractice between 1985 and 2015.

Subtotal Resection of a Thalamic Glioblastoma Multiforme through Transsylvian Approach.

Glioblastoma multiforme (GBM) is a malignant brain tumor with an ominous prognosis. The standard treatment includes maximal safe resection plus adjuvant therapy. Thalamic GBMs, however, are unfavorable for microsurgical removal because of deep location and proximity to critical structures.

Brain Computed Tomography Angiography as an Ancillary Test in the Confirmation of Brain Death.

Introduction Brain death (BD) is the irreversible termination of the functioning of the brain. The diagnosis should be first made by clinical criteria and confirmed by using paraclinical confirmatory techniques (ancillary tests). While conventional brain angiography remains the standard method of choice, computed tomography angiography (CTA) has emerged as an alternative method.