Anti-Nogo-A Antibody Therapy Improves Functional Outcome Following Traumatic Brain Injury.

Background: Traumatic brain injury (TBI) can cause sensorimotor deficits, and recovery is slow and incomplete. There are no effective pharmacological treatments for recovery from TBI, but research indicates potential for anti-Nogo-A antibody (Ab) therapy. This Ab neutralizes Nogo-A, an endogenous transmembrane protein that inhibits neuronal plasticity and regeneration.

Case report and review of literature: Isolated intramedullary spinal neurocysticercosis.

Background: Cases of isolated intramedullary spinal neurocysticercosis are extremely rare. Only 25 cases have been reported before 2022. Due to its rarity, the diagnosis of spinal neurocysticercosis may be missed.

Evaluation of Sagittal Spinopelvic Balance in Spinal Cord Stimulator Patients.

Objective: Spinal cord stimulation (SCS) has become a popular nonopioid pain intervention. However, the treatment failure rate for SCS remains significantly high and many of these patients have poor sagittal spinopelvic balance, which has been found to correlate with increased pain and decreased quality of life. The purpose of this study was to determine if poor sagittal alignment is correlated with SCS treatment failure.

Intraoperative Assessment of Coronal Balance with Long Cassette Radiographs in Adult Thoracolumbar Deformity Correction.

Background: To describe the use of intraoperative anteroposterior long cassette radiographs (APLCRs) to guide kickstand rod application in adult spinal deformity.

Methods: A retrospective chart review was performed to identify patients with adult thoracolumbar and coronal plane deformity undergoing open segmental decompression with spinopelvic fixation and deformity correction between October 2017 and June 2019 who had APLCRs after rod placement. In patients with persistent intraoperative coronal deviations, a kickstand rod was placed.

"The Circle" Predicts Extent of Fusion for Surgical Correction of Cervical Spinal Kyphotic Deformities: Proof of Concept.

Background: Correction of kyphotic deformities of the spine is a common problem faced by spine surgeons. Unfortunately, there are no clear published guidelines available regarding the extent of spinal fusion required to achieve and maintain lasting deformity correction. We aim to share a set of novel radiographic parameters ("the Circle") that can be used as a guideline for determining the extent of fusion required in surgical correction of spinal kyphotic deformity.

Surgical correction of pediatric spinal deformities with coexisting intraspinal pathology: A case report and literature review.

Background: Surgical correction of spinal deformities with coexisting intraspinal pathology (SDCIP) requires special consideration to minimize risks of further injury to an already abnormal spinal cord. However, there is a paucity of literature on this topic. Here, the authors present a pediatric patient with a residual pilocytic astrocytoma and syringomyelia who underwent surgical correction of progressive postlaminectomy kyphoscoliosis.

Improved Functional Outcome After Peripheral Nerve Stimulation of the Impaired Forelimb Post-stroke.

Lack of blood flow to the brain, i.e., ischemic stroke, results in loss of nerve cells and therefore loss of function in the effected brain regions.

Surgical management of atlantoaxial dislocation and cervical spinal cord injury in craniopagus twins.

A case of cervical spinal cord injury in 12-year-old angular craniopagus twins is presented, with a description of the planning and execution of surgical treatment along with subsequent clinical outcome. The injury occurred following a fall from a standing position, resulting in quadriparesis in one of the twins. Imaging revealed severe craniocervical stenosis resulting from a C1-2 dislocation, and T2-weighted hyperintensity of the cervical spinal cord.

Tarik Syndrome: Reversible Postoperative Blindness Secondary to Occipital Seizures.

Background: Postoperative blindness is a devastating surgical complication. Although usually associated with prolonged cardiac and prone spinal operations, it may follow other procedures as well. Postoperative blindness is most commonly caused by a vascular etiology, but it can more rarely be caused by status epilepticus.

Cerebellar Hemorrhage Following an Uncomplicated Lumbar Spine Surgery: Case Report.

Remote cerebellar hemorrhage is rare but potentially fatal complication of cranial and spinal surgeries. The pathophysiology of this condition following spinal surgery is thought to be related to venous bleeding from cerebellar sagging and cerebrospinal fluid (CSF) hypotension. Most reported cases in the literature following spinal surgery involve intraoperative CSF leakage.

Management of Adolescent Idiopathic Scoliosis: Institutional Experience, Integration into Neurosurgical Practice, and Impact on Resident Training.

Objective: Management of adolescent idiopathic scoliosis (AIS) in neurosurgery residency training may have a significant impact on resident experience, even though few trainees are likely to pursue careers in the field of AIS. The impact of this exposure on resident knowledge in adult spinal disease management is the subject of our retrospective analysis.

Methods: An analysis was performed of all adolescent patients undergoing surgical correction of spinal deformity between 2006 and 2016.

Morphologic variations of the second cervical vertebra in Down syndrome compared with age-matched peers.

OBJECTIVEAtlantoaxial instability is an important cause of pain and neurological dysfunction in patients with Down syndrome (DS), frequently requiring instrumented fusion of the upper cervical spine. This study provides a quantitative analysis of C2 morphology in DS patients compared with their peers without DS to identify differences that must be considered for the safe placement of instrumentation.METHODSA retrospective chart review identified age-matched patients with and without DS with a CT scan of the cervical spine.

Reversible postoperative blindness caused by bilateral status epilepticus amauroticus following thoracolumbar deformity correction: case report.

Postoperative vision loss (POVL) is a devastating complication and has been reported after complex spine procedures. Anterior ischemic optic neuropathy and posterior optic neuropathy are the 2 most common causes of POVL. Bilateral occipital lobe seizures causing complete blindness are rare and have not been reported as a cause of POVL after spine surgery with the patient prone.

Biomechanical assessment of a PEEK rod system for semi-rigid fixation of lumbar fusion constructs.

The concept of semi-rigid fixation (SRF) has driven the development of spinal implants that utilize nonmetallic materials and novel rod geometries in an effort to promote fusion via a balance of stability, intra- and inter-level load sharing, and durability. The purpose of this study was to characterize the mechanical and biomechanical properties of a pedicle screw-based polyetheretherketone (PEEK) SRF system for the lumbar spine to compare its kinematic, structural, and durability performance profile against that of traditional lumbar fusion systems. Performance of the SRF system was characterized using a validated spectrum of experimental, computational, and in vitro testing.

The multiple benefits of minimally invasive spinal surgery: results comparing transforaminal lumbar interbody fusion and posterior lumbar fusion.

Minimally invasive transforaminal lumbar interbody fusion (TLIF) offers equivalent postoperative fusion rates compared to posterior lumbar fusion (PLF) and minimizes the amount of iatrogenic injury to the spinal muscles. The objective of this study was to examine the difference in pain perception, stress, mood disturbance, quality of life, and immunological indices throughout the perioperative course among patients undergoing TLIF and PLF. A prospective, nonrandomized descriptive design was used to evaluate these measures among patients undergoing TLIF (n = 17) or PLF (n = 18) at 1 week prior to surgery (T1), the day of surgery (T2), 24 hours postoperatively (T3), and 6 weeks postoperatively (T4).

Clinical outcomes of 90 isolated unilateral facet fractures, subluxations, and dislocations treated surgically and nonoperatively.

Study Design: A retrospective outcomes study.

Objective: The purposes of this study were 1) to identify plausible patient and interventional variables that influence the outcome of unilateral facet injuries and 2) to determine if patients return to normal general health status after unilateral facet injuries.

Summary Of Background Data: The management of unilateral subaxial cervical facet fractures and dislocations lacks agreement on treatment options and the variables that influence outcome.

Thoracic intramedullary cavernous malformation with posttraumatic hematomyelia: case report and literature review.

Although intramedullary spinal cord cavernous malformations are now well described, there have been, to our knowledge, no prior reports focusing on presentation after trauma. We report a patient with a thoracic intramedullary cavernous malformation presenting with hematomyelia and acute neurologic deterioration after spinal chiropractic manipulation. A review of previously published case reports then identifies additional cases of deterioration after spinal cord trauma or exertion.

Occipitocervical fusion with rigid internal fixation: long-term follow-up data in 69 patients.

Object: Instability of the occipitocervical junction may result from degenerative disease, infection, tumor, and trauma. Surgical stabilization involving screw fixation and rigid implants has been found to be biomechanically superior to wire-based implants. To evaluate the long-term results in a large and diverse patient population, the authors prospectively studied a consecutive group of 69 patients.

Immune function, pain, and psychological stress in patients undergoing spinal surgery.

Study Design: This study was an exploratory repeated measures design comparing patients undergoing two magnitudes of surgery in the lumbar spine: lumbar herniated disc repair and posterior lumbar fusion.

Objective: The present study evaluated and compared the effect of perceived pain, perceived stress, anxiety, and mood on natural killer cell activity (NKCA) and IL-6 production among adult patients undergoing lumbar surgery.

Summary Of Background Data: Presurgical stress and anxiety can lead to detrimental patient outcomes after surgery, such as increased infection rates.

Effect of prone positioning systems on hemodynamic and cardiac function during lumbar spine surgery: an echocardiographic study.

Study Design: Prospective randomized study of patients undergoing spine surgery.

Objective: To compare changes in hemodynamic and cardiac function after prone positioning using different prone positioners.

Summary Of Background Data: Prone positioning decreases blood pressure and cardiac function.

Dynamic stabilization in the surgical management of painful lumbar spinal disorders.

Study Design: A literature review.

Objective: To evaluate the mechanisms of action and effectiveness of posterior dynamic stabilization devices in the management of painful spinal disorders.

Summary Of Background Data: Dynamic stabilization may provide pain relief by altering the transmission of abnormal loads across the degenerated disc space.

Obliteration of a tentorial dural arteriovenous fistula causing spinal cord myelopathy using the cranio-orbito zygomatic approach.

Background: Intracranial dural arteriovenous fistulas account for 10 to 15% of all intracranial arteriovenous malformations. Tentorial dural arteriovenous fistulas with spinal medullary venous drainage causing spinal cord myelopathy are very rare, but have been previously described. We describe a case using a cranio-orbito zygomatic approach with intraoperative angiography for the surgical treatment of a tentorial artery dural arteriovenous fistula causing spinal cord myelopathy.