Management and Outcome of Recurring Low-Grade Intramedullary Astrocytomas.

Intramedullary astrocytomas (IMAs) are the second most frequent intramedullary tumors in adults. Low-grade IMAs (LG-IMA, WHO grade I and II) carry a better prognosis than high-grade IMAs (HG-IMAs). However, adjuvant treatment of LG-IMAs by radiotherapy (RT) and/or chemotherapy (CT) as well as treatment of tumor recurrences remains controversial.

A Staged Approach for Surgical Management of Basilar Invagination.

Background And Objectives: Patients with basilar invagination (BI) can be treated with several surgical options, ranging from simple posterior decompression to circumferential decompression and fusion. Here, we aimed at examining the indications and outcomes associated with these surgical strategies to devise a staged algorithm for managing BI.

Methods: We conducted a retrospective cohort study in 2 neurosurgical centers and included patients with a BI, as defined by a position of the dens tip at least 5 mm above the Chamberlain line.

Upper end of the central canal of the human spinal cord: Quantitative anatomical study and 3D modeling.

The upper end of the central canal of the human spinal cord has been repeatedly implicated in the pathogenesis of various diseases, yet its precise normal position in the medulla oblongata and upper cervical spinal cord remains unclear. The purpose of this study is to describe the anatomy of the upper end of the central canal with quantitative measurements and a three-dimensional (3D) model. Seven formalin-embalmed human brainstems were included, and the central canal was identified in serial axial histological sections using epithelial membrane antigen antibody staining.

Spinal Anterior Dural Dissection: Moving From Differential to Unifying Diagnosis.

Background And Objectives: Cerebrospinal fluid (CSF) collections extending longitudinally at the anterior aspect of the spinal dura have been reported in association with various conditions and under multiple names. The aim of this study was to report cases associated with brachial amyotrophy (BA) and examine its relationship with other clinical variants.

Methods: We conducted a retrospective cohort study including patients who presented with a motor deficit of the upper limbs and an anterior interdural CSF collection on spinal MRI.

Laminoplasty with tented duraplasty for Hirayama disease.

Background: Hirayama disease (HD) is a characterized by progressive amyotrophy of the upper limbs due to a forward displacement of the cervical dura during neck flexion.

Methods: Unlike other treatment options aiming at preventing cervical flexion (e.g.

Long-Term Outcomes after Incomplete Resection of Intramedullary Grade II Ependymomas: Is Adjuvant Radiotherapy Justified?

Ependymomas are the most common intramedullary tumors in adults. While gross total resection is the aim of surgery, tumor infiltration might limit resection. In cases of subtotal removal, the necessary adjuvant management remains unclear.

Bevacizumab in real-life patients with recurrent glioblastoma: benefit or futility?

Purpose: Angiogenesis plays a key role in glioblastoma, but most anti-angiogenic therapy trials have failed to change the poor outcome of this disease. Despite this, and because bevacizumab is known to alleviate symptoms, it is used in daily practice. We aimed to assess the real-life benefit in terms of overall survival, time to treatment failure, objective response, and clinical benefit in patients with recurrent glioblastoma treated with bevacizumab.

Surgical Management after Chiari Decompression Failure: Craniovertebral Junction Revision versus Shunting Strategies.

Revision surgery after posterior fossa decompression for Chiari malformation is not uncommon and poses both strategic and technical challenges. We conducted a single-center retrospective cohort study including all adult patients who underwent revision surgery after posterior fossa decompression for Chiari type I malformation between 2010 and 2019. Among 311 consecutive patients operated on for Chiari malformation at our institution, 35 patients had a least one revision surgery with a mean follow-up of 70.

Surgical management of pituicytomas: a single-center case series.

Objective: Pituicytomas (PT) are rare benign sellar and/or supra sellar tumors which surgical treatment might be challenging, owing to the hypervascularity of the tumor. Here, we report our experience with PTs, describe their clinical and radiological features, and propose an optimal therapeutic strategy.

Methods: This is a retrospective single-center study, reporting the clinical manifestations, radiological characteristics, histopathological features, treatment strategies and long-term outcomes of four patients who have been treated for a PT at Bicêtre University Hospital in Paris, France, over the past 7 years.

Cognitive versus virtual reality simulation for evaluation of technical skills in neurosurgery.

Objective: Simulation is gaining momentum as a new modality of medical training, particularly in acute care settings such as surgery. In the present study, the authors aimed to compare individual cognitive skills with manual abilities as assessed by virtual reality (VR) simulation among neurosurgical residents.

Methods: Participants were asked to complete a multiple-choice questionnaire assessing their surgical abilities regarding three basic neurosurgical procedures (endoscopic third ventriculostomy, cranial meningioma, and lumbar laminectomy).

Fear Avoidance Beliefs and Outcome After Surgery for Degenerative Lumbar Spine.

Study Design: This was a prospective cohort study.

Objective: The aim of this study is to question the influence of fear avoidance beliefs on functional outcome following surgery for degenerative lumbar spine.

Background: Fear avoidance beliefs are well-studied modifiers of low back pain.

Reintervention rate of arachnolysis versus shunting for nonforaminal syringomyelia.

Objective: Surgical treatment for nonforaminal syringomyelia related to spinal arachnoiditis is still controversial. The authors sought to assess respective outcomes and rates of reintervention for shunting and spinal cord untethering (arachnolysis) in spinal arachnoiditis with syringomyelia.

Methods: This retrospective cohort study was conducted at a single reference center for syringomyelia.

Management of Chiari malformation type I and syringomyelia during pregnancy and delivery.

Objective: Although a recurrent question in clinical practice, the management of Chiari malformation type I (CMI) and/or syringomyelia during pregnancy and delivery is still debated. The aim of this study was to investigate the modalities of delivery and anesthesia in women presenting with CMI and/or syringomyelia at a national reference center, and to question their potential role in the natural history of these conditions.

Study Design: We conducted a retrospective cohort study using a standardized questionnaire, a customized clinical severity score and data from medical records.

Transsphenoidal resection for pituitary adenoma in elderly versus younger patients: a systematic review and meta-analysis.

Introduction: Pituitary adenomas (PA) are common intracranial tumors. In the context of the aging of the population, the question is whether postsurgical outcomes are comparable to the younger ones. The primary objective of the present study was to review published resection and recurrence rates after transsphenoidal resection.

High-grade gliomas in adolescents and young adults highlight histomolecular differences from their adult and pediatric counterparts.

Background: Considering that pediatric high-grade gliomas (HGGs) are biologically distinct from their adult counterparts, the objective of this study was to define the landscape of HGGs in adolescents and young adults (AYAs).

Methods: We performed a multicentric retrospective study of 112 AYAs from adult and pediatric Ile-de-France neurosurgical units, treated between 1998 and 2013 to analyze their clinicoradiological and histomolecular profiles. The inclusion criteria were age between 15 and 25 years, histopathological HGG diagnosis, available clinical data, and preoperative and follow-up MRI.

Active mechanosensory feedback during locomotion in the zebrafish spinal cord.

The investigation of mechanosensory feedback to locomotion has been hindered by the challenge of recording neurons in motion. Genetic accessibility and optical transparency of zebrafish larvae provide means to revisit this question. Glutamatergic Rohon-Beard (RB) and GABAergic CSF-contacting neurons (CSF-cNs) are spinal mechanosensory neurons.

Bioluminescence Monitoring of Neuronal Activity in Freely Moving Zebrafish Larvae.

The proof of concept for bioluminescence monitoring of neural activity in zebrafish with the genetically encoded calcium indicator has been previously described (Naumann ., 2010) but challenges remain. First, bioluminescence signals originating from a single muscle fiber can constitute a major pitfall.

Operative and Perioperative Durations in O-Arm vs C-Arm Fluoroscopy for Lumbar Instrumentation.

Background: Intraoperative 3-dimensional fluoroscopy (eg, O-arm) has been shown to improve accuracy of pedicle screw placement over 2-dimensional fluoroscopy (C-arm), but its effect on surgery duration remains unclear.

Objective: To compare the durations of operative and perioperative times between O-arm and C-arm procedures for degenerative lumbar disorders.

Methods: We analyzed 198 patients representing 987 pedicle screws treated in a single center by 4 different surgeons between 2013 and 2015.

Mechanosensory neurons control the timing of spinal microcircuit selection during locomotion.

Despite numerous physiological studies about reflexes in the spinal cord, the contribution of mechanosensory feedback to active locomotion and the nature of underlying spinal circuits remains elusive. Here we investigate how mechanosensory feedback shapes active locomotion in a genetic model organism exhibiting simple locomotion-the zebrafish larva. We show that mechanosensory feedback enhances the recruitment of motor pools during active locomotion.

Predicting sagittal deformity after surgery for intramedullary tumors.

Object: Spinal deformity after surgery for intramedullary tumors is a potentially serious complication that may require subsequent fusion. The aim of this study was to determine whether there were risk factors that could be used to predict postoperative sagittal deformity.

Methods: The authors conducted a retrospective study of patients harboring an intramedullary tumor who had undergone surgery at a single center between 1985 and 2011.

Intradural extramedullary spinal metastases of non-neurogenic origin: a distinct clinical entity or a subtype of leptomeningeal metastasis? A case-control study.

Background: Leptomeningeal metastases from carcinoma are still poorly understood.

Objective: To better define the management of unique intradural extramedullary spinal metastases (IESM) from solid cancers of non-neurogenic origin, in particular regarding leptomeningeal metastasis (LM).

Methods: We conducted a retrospective, multicenter, case-control study including 11 patients with IESM matched with 11 patients with LM.