Surgical management of tumors of the cervical spine and craniovertebral junction involving the vertebral artery: A narrative review.

Background: The vertebral artery (VA) is in close proximity to bony structures, nerves and nerve sheaths of the cervical spine and craniovertebral junction (CVJ). These structures can be sources of tumors that are responsible for displacement, encasement and sometimes invasion of the VA. Removing these tumors while minimizing the risk of vascular injury requires thorough knowledge of the vascular anatomy, risk factors of vascular injury, the relationships of each tumor type with the VA, and the different surgical approaches and techniques that result in the best outcomes in terms of vascular control, tumoral exposure and resection.

Vertebral artery stenosis from osteophyte: A systematic review and case series.

Background: Rotational vertebral artery syndrome, also referred to as Bow Hunter's syndrome (BHS), manifests when the vertebral artery (VA) is compressed following head rotation. This compression is often caused by an osteophyte and may lead to symptoms of a posterior stroke. This systematic review aims to shed light on the current management strategies for BHS resulting from osteophytes.

How Does Spino-Pelvic Fixation Affect Post-Operative Compensatory Mechanisms in Adult Spinal Deformity?

Study Design: Retrospective single-center multi-surgeon cohort study.

Objectives: Compare the post-operative changes in the compensatory mechanisms of the sagittal balance according to the type of pelvic fixation: S2-Alar-iliac screws (S2AI) vs iliac screws (IS) in patients with Adult spine deformity (ASD).

Methods: ASD patients who underwent spino-pelvic fixation and remained with a PI-LL >10° mismatch post-operatively were included.

Pneumorrhachis and pneumocephalus resulting from pneumothorax: illustrative case.

Background: Pneumorrhachis and pneumocephalus are rare conditions in which air is found within the spinal canal and brain, respectively. It is mostly asymptomatic and can be located in the intradural or extradural space. Intradural pneumorrhachis should prompt clinicians to search and treat any underlying injury of the skull, chest, or spinal column.

Can Pelvic Incidence Change After Lumbo-Pelvic Fixation for Adult Spine Deformity, and Would the Change be Affected by the Type of Pelvic Fixation?

Study Design: Retrospective review.

Objective: To assess the change in pelvic incidence (PI) after lumbo-pelvic fixation and the differential impact of the type of pelvic fixation: S2-alar-iliac screws (S2AI) versus Iliac screws (IS) on postoperative PI.

Summary Of Background Data: Recent studies suggest that changes occur to the previously assumed fixed PI after spino-pelvic fixation.

Incidence of sacroiliac joint pain after lumbosacral spine fusion: A systematic review.

Objectives: To determine the incidence of sacroiliac joint (SIJ) pain after lumbosacral spinal fusion.

Background: Persistent low back pain is a potential source of disability and poor outcomes following lumbar spine fusion. The SIJ has been described as a potential source.

Using artificial intelligence to quantify dynamic retraction of brain tissue and the manipulation of instruments in neurosurgery.

Purpose: There is no objective way to measure the amount of manipulation and retraction of neural tissue by the surgeon. Our goal is to develop metrics quantifying dynamic retraction and manipulation by instruments during neurosurgery.

Methods: We trained a convolutional neural network (CNN) to analyze microscopic footage of neurosurgical procedures and thereby generate metrics evaluating the surgeon's dynamic retraction of brain tissue and, using an object tracking process, evaluate the surgeon's manipulation of the instruments themselves.

Unusual presentation of a common neurosurgical shunt procedure in an adult patient.

Ventriculoperitoneal shunt surgery is one of the treatments of hydrocephalus. It involves placing a shunt from the cerebral ventricles to the peritoneum serving as a drainage point. Infection and catheter blockage are some of the possible complications resulting from this procedure.

Minimally Invasive Approach for Complete Resection of a Cervical Intramedullary Tumor via a Dorsal Root Entry Zone Using Fixed Tubular Retractor.

We describe the surgical aspects of the resection of a large 2cm intramedullary ependymoma at the C6-7 level associated with an extensive syrinx using a unilateral minimally invasive approach through a fixed tubular retractor. A gross total resection was achieved. Total operative time was 5 hours.

Surgical management of high-grade lumbar spondylolisthesis associated with Hajdu-Cheney syndrome: illustrative case.

Background: Hajdu-Cheney syndrome (HCS) is a rare connective tissue disorder characterized by severe bone demineralization. In the spine, it is associated with the early onset of severe osteoporosis and can cause spondylolisthesis. Spinal instrumentation in the setting of severe osteoporosis is challenging because of poor resistance of vertebrae to biomechanical stress.

Spinal Metastasis in Multiple Primary Malignancies Involving Lung Cancer: Clinical Characteristics and Survival.

Objective: The incidence of multiple primary malignancies (MPM) has increased in recent decades. Our aim was to evaluate incidence, clinical features, and survival in cases of spinal metastases from MPM in which one of the malignancies is lung cancer.

Methods: We retrospectively reviewed an institutional database of lung cancer patients with spinal metastasis and extracted all cases of MPM.

Atlantoaxial wiring hardware failure resulting in intracranial hemorrhage and hydrocephalus: illustrative case.

Background: Atlantoaxial sublaminar wiring has many known complications related to hardware failure, but intracranial hemorrhage is a rare complication.

Observations: A 61-year-old female patient with prior atlantoaxial sublaminar wiring for odontoid fracture nonunion experienced decreased level of consciousness due to a subarachnoid and subdural hemorrhage of the posterior fossa with intraventricular extension and hydrocephalus. Rupture of the sublaminar wire with intramedullary protrusion was the cause of the hemorrhage.

Anterior Longitudinal Ligament Flap Technique: Description of Anterior Longitudinal Ligament Opening During Anterior Lumbar Spine Surgery and Review of Vascular Complications in 189 Patients.

Background: One of the main concerns of anterior lumbar spine approaches are vascular complications. The aim of our study is to provide technical details about a flap technique using the anterior longitudinal ligament (ALL) when approaching the lumbar spine via an anterior corridor. This can help decrease complications by protecting the adjacent vascular structures.

Single-Stage Posterior Approach for the En Bloc Resection and Spinal Reconstruction of T4 Pancoast Tumors Invading the Spine.

Study Design: Retrospective cohort study.

Purpose: This study aimed to evaluate the outcomes of patients who had T4 Pancoast tumors invading the spine and underwent en bloc resection and spinal stabilization through a single-stage posterior approach.

Overview Of Literature: Surgical resection for Pancoast tumors affecting the spine has been successfully performed in two stages involving spinal reconstruction and tumor resection.

CT guided percutaneous vertebroplasty of C2 osteolytic lesion: a case report and technical note.

Vertebroplasty is a minimally invasive treatment option for osteolytic spinal lesions. It provides pain relief and stability with established good results. In this paper, we describe a new CT guided percutaneous vertebroplasty technique using a direct lateral approach between the carotid sheath and the vertebral artery, that can be safely performed under conscious sedation in an outpatient setting.

Spontaneous spinal epidural hematoma related to amphetamine abuse: A case report.

Background: Spontaneous spinal epidural hematoma (SSEH) is a rare condition that is typically associated with hypertension, the use of antithrombotic or sympathomimetic drugs. Here, we report a case of SSEH attributed to the use of amphetamines.

Case Description: A 27-year-old amphetamine user presented with the sudden onset of paraplegia (Frankel A) following amphetamine use.

Impact of obesity on complications and surgical outcomes of adult degenerative scoliosis with long-segment spinal fusion.

Introduction: The relationship between obesity and outcome of spine surgery has been controversial. The impact of obesity on surgical outcomes of patients undergoing long- segment (6 vertebrae or more) spinal fusion have not been studied. This study was designed to define the influence of obesity on the outcomes of patients undergoing long-segment spinal fusion.

Minimally Invasive Resection of an S3 Osteoid Osteoma Using an Intraoperative O-Arm: A Technical Note.

Osteoid osteomas are benign primary bone tumors that typically arise in posterior vertebrae of the spine. For patients with severe pain or those poorly controlled with non-steroidal anti-inflammatory drugs, surgical management is the mainstay of treatment. The recommended surgical treatment option is complete open excision, although minimally invasive CT-guided percutaneous excision and CT-guided radiofrequency ablation have been reported.

Cervical Spine Reconstruction with Chest Tube Technique After Metastasis Resection: A Single-Center Experience.

Background: The silastic tube technique, in which a chest tube is placed into the vertebral body defect and impregnated with polymethyl methacrylate, showed good results in patients with lumbar and thoracic neoplastic diseases. There has been only 1 study about the effectiveness and safety of this technique in patients with cervical metastases. We aimed to report our experience in using this technique to reconstruct the spine after corpectomy for cervical metastasis.

Does the Region of the Spine Involved with Metastatic Tumor Affect Outcomes of Surgical Treatments?

Objective: Spinal metastases occur primarily in the thoracic spine (50%-60%), less commonly in the lumbar (30%-35%), and, infrequently, in the cervical spine (10%-15%). There has been only 1 study with a limited population comparing the postoperative outcome among cervical, thoracic, and lumbar spine metastasis. The aim of this study is to identify whether the region of surgically treated spinal metastasis affects postoperative outcomes.

Minimally Invasive Contralateral Over-the-Top Approach for Lumbar Calcified Foraminal Lesions: A Technical Note.

Background: Various surgical techniques have been described to address intraforaminal/extraforaminal lumbar lesions. They vary from the classic posterior open approaches to minimally invasive techniques with tubular retractors and even endoscopy. These lesions have been approached from either an ipsilateral or a contralateral approach.