Differences in the surgical treatment of adult and pediatric brachial plexus injuries among peripheral nerve surgeons.

Objectives: Peripheral nerve surgeons disagree on the optimal timing and treatment of brachial plexus injuries (BPI). This study aims to survey peripheral nerve surgeons on their management of BPI, including disagreement.

Methods: Surgeons responded to a case-based survey involving traumatic and birth injuries leading to BPI involving the upper and lower trunks, and pre- and post-ganglionic injuries.

Pearls and pitfalls of posterior superior iliac spine reference frame placement for spinal navigation: cadaveric series.

Background: Navigation and robotics are important tools in the spine surgeon's armamentarium and use of these tools requires placement of a reference frame. The posterior superior iliac spine (PSIS) is a commonly used site for reference frame placement, due to its location away from the surgical corridor and its ability to provide solid fixation. Placement of a reference frame requires not only familiarity with proper technique, but also command of the relevant anatomy.

Craniocervical instability in patients with Ehlers-Danlos syndrome: controversies in diagnosis and management.

Ehlers-Danlos syndrome (EDS) is a rare hereditary condition that can result in ligamentous laxity and hypermobility of the cervical spine. A subset of patients can develop clinical instability of the craniocervical junction associated with pain and neurological dysfunction, potentially warranting treatment with occipitocervical fixation (OCF). Surgical decision-making in patients with EDS can be complicated by difficulty distinguishing from hypermobility inherent in the disease and true pathological instability necessitating intervention.

Fifty years later: the "rule of Spence" is finally ready for retirement.

Determination of the optimal approach to traumatic atlas fractures with or without transverse atlantal ligament (TAL) injury requires a nuanced understanding of the biomechanics of the atlantoaxial complex. The "rule of Spence" (ROS) was created in 1970 in a landmark effort to streamline management of burst-type atlas fractures. The ROS states that radiographic evidence of lateral mass displacement (LMD) (i.

Spine Image Guidance and Robotics: Exposure, Education, Training, and the Learning Curve.

The use of intraoperative robotics and imaging for spine surgery has been shown to be safe, efficacious, and beneficial to patients, offering accurate placement of instrumentation, decreased operative time and blood loss, and improved postoperative outcomes. Despite these proven benefits, it has yet to be uniformly adopted. One of the major barriers for universal adoption of intraoperative robotics is the learning curve for this complex technology, in conjunction with a lack of formalized training.

Nerve Transfers After Cervical Spine Surgery: Multi-Institutional Case Series and Review of the Literature.

Background: Up to 10% of cervical spine surgeries are complicated by postoperative weakness. Although many patients recover with nonoperative management, some require surgery for restoration of function.

Objective: To present the indications and outcomes of patients undergoing nerve transfers after developing weakness secondary to cervical spine decompression.

Removal of instrumentation for postoperative spine infection: systematic review.

Objective: Currently, no consensus exists as to whether patients who develop infection of the surgical site after undergoing instrumented fusion should have their implants removed at the time of wound debridement. Instrumentation removal may eliminate a potential infection nidus, but removal may also destabilize the patient's spine. The authors sought to summarize the existing evidence by systematically reviewing published studies that compare outcomes between patients undergoing wound washout and instrumentation removal with outcomes of patients undergoing wound washout alone.

Comparison of operator and patient radiation exposure during fluoroscopy-guided vertebroplasty and kyphoplasty: a systematic review and meta-analysis.

Objective: Percutaneous vertebroplasty (PV) and balloon kyphoplasty (BK) are two minimally invasive techniques used to treat mechanical pain secondary to spinal compression fractures. A concern for both procedures is the radiation exposure incurred by both operators and patients. The authors conducted a systematic review of the available literature to examine differences in interventionalist radiation exposure between PV and BK and differences in patient radiation exposure between PV and BK.

SUMO is a pervasive regulator of meiosis.

Protein modification by SUMO helps orchestrate the elaborate events of meiosis to faithfully produce haploid gametes. To date, only a handful of meiotic SUMO targets have been identified. Here, we delineate a multidimensional SUMO-modified meiotic proteome in budding yeast, identifying 2747 conjugation sites in 775 targets, and defining their relative levels and dynamics.

Predictors of Postoperative Visual Outcome After Surgical Intervention for Craniopharyngiomas.

Background: Because of involvement of the optic apparatus, craniopharyngiomas frequently present with visual deterioration. Although visual improvement is a primary goal of surgical intervention, prediction models are lacking.

Methods: We retrospectively reviewed all patients undergoing craniopharyngioma surgery at a single institution (2014-2019).

Predictive factors for overall survival in surgical cases of gliomatosis cerebri from the National Cancer Database.

Gliomatosis Cerebri (GC) is a rare, aggressive, diffusely infiltrating cerebral tumor. Prognostic indicators and management strategies are currently poorly characterized. The National Cancer Database was queried for patients with histologically confirmed GC between 2004 and 2016.