Hypoglossal schwannomas: A systematic review of the literature.

Background: Schwannomas of the hypoglossal nerve are rare and account for a very small percentage of non-vestibular schwannomas.

Objectives: In this systematic review of the literature, we examined the epidemiology, symptomatology, management, and outcomes of patients with hypoglossal schwannomas.

Methods: The electronic database Pubmed was searched for all reports of hypoglossal schwannomas with descriptions of symptoms, management, and outcome characteristics.

Successful Novel Treatment of a Paraspinal Primitive Neuroectodermal Tumor with Predominantly Glial Differentiation: A 3-Year Follow-Up After Surgery, Intensity-Modulated Radiation Therapy and Oral Temozolomide.

Background: Paraspinal masses are a relatively uncommon but diverse group of lesions that can be neoplastic or non-neoplastic. Peripheral primitive neuroectodermal tumors of the lumbar paraspinal region with diffuse and strong glial differentiation have never been reported before.

Case Description: We report a primary paraspinal primitive neuroectodermal tumor with overwhelming glial differentiation in a 23-year-old female patient who presented with intractable right lower extremity pain.

Rate of Return to Military Active Duty After Single and 2-Level Anterior Cervical Discectomy and Fusion: A 4-Year Retrospective Review.

Background: Over the years of rigorous of military service, military personnel may experience cervical spondylosis and radiculopathy. Given the frequency of this occurrence, the capacity to return to unrestricted full duty in the military after anterior cervical discectomy and fusion (ACDF) is worthy of analysis.

Objective: To identify the rate of return to full, unrestricted active duty after single and 2-level anterior cervical discectomy, and fusion surgery in military personnel.

Dermoid cysts of the conus medullaris: Clinical review, case series and management strategies.

Background: The management of dermoid cysts can be tedious as they have a tendency to recur, and respond poorly to chemotherapy and radiation. Management is especially difficult for tumors involving highly eloquent areas such as the conus medullaris.

Objective: We aim to provide a summary of the pathology, clinical presentation, and operative management strategies of dermoid cysts involving the conus medullaris.

Hypoglossal Schwannoma of Neck: Case Report and Review of Literature.

Background: Schwannomas are benign, slow-growing neoplasms of the myelin-producing Schwann cells of peripheral nervous system that most commonly affect sensory nerves. Hypoglossal schwannomas, tumors of purely motor nerves, comprise <5% of all head and neck schwannomas. Since the first description of a hypoglossal schwannoma in 1933, there have been few case reports of extracranial origins.

Spinal Cord Compression Secondary to Epidural Fibrosis Associated with Percutaneously Placed Spinal Cord Stimulation Electrodes: Case Report and Review of the Literature.

Spinal cord stimulation is a safe method for treating chronic pain syndromes. Spinal cord stimulators can be placed either surgically by creating a laminectomy defect for paddle leads or percutaneously by inserting electrodes. They are usually not associated with major complications.

Epidural spinal cavernous hemangioma and hybrid vascular subtype.

Aim: To demonstrate less common pathologies of purely epidural spinal tumors that should be considered when noted on MRI prior to surgery. To expand the differential diagnosis of purely epidural spinal tumors and comment on their surgical implications.

Material And Methods: We report on two patients from our institution with rare pathology.

AlloDerm for duraplasty in Chiari malformation: superior outcomes.

Background: Autologous pericranium, fascia lata (either as autograft or allograft), bovine pericardium (DuraGuard), fetal bovine tissue (Durepair), processed collagen matrix (DuraGen), and synthetic fabrics (e.g., synthetic Goretex graft) have all been used for duraplasty in Chiari decompression surgery, and no consensus exists as to the optimal material.

Hemorrhagic intramedullary hemangioblastoma of the cervical spinal cord presenting with acute-onset quadriparesis: case report and review of the literature.

Context: Hemangioblastomas of the spinal cord are uncommon vascular tumors. Patients commonly present with subtle neurologic findings that are thought to represent growth of the lesion over time. Hemorrhage of an intramedullary hemangioblastoma presenting as acute neurologic deficit is an extremely rare occurrence.

Rate of return to military active duty after single level lumbar interbody fusion: a 5-year retrospective review.

Background: Lumbar interbody fusion has been extensively studied in the civilian population; however, data regarding its efficacy in the military are lacking.

Objective: To identify the rate of return to unrestricted active military duty after single-level lumbar interbody fusion surgery.

Methods: The surgical database at a single tertiary care military treatment facility was queried for active-duty patients who underwent a single-level lumbar interbody fusion over a 5-year period.

Progressive vertebral body osteolysis after cervical disc arthroplasty.

Study Design: Case report.

Objective: To review the management of a patient with progressive osteolysis of the vertebral body after undergoing cervical arthroplasty for management of a refractory radiculopathy.

Summary Of Background Data: Since the Food and Drug Administration's (FDA) approval of cervical arthroplasty devices in 2007, many surgeons have incorporated this technology into clinical practice.

Can surgery improve neurological function in penetrating spinal injury? A review of the military and civilian literature and treatment recommendations for military neurosurgeons.

Object: Penetrating spinal injury (PSI), although an infrequent injury in the civilian population, is not an infrequent injury in military conflicts. Throughout military history, the role of surgery in the treatment of PSI has been controversial. The US is currently involved in 2 military campaigns, the hallmark of both being the widespread use of various explosive devices.

Arthroplasty in the military: a preliminary experience with ProDisc-C and ProDisc-L.

Object: The introduction of cervical and lumbar arthroplasty has allowed for management of cervical radiculopathy and lumbar degenerative disease in patients with the preservation of motion at the affected segment. While the early clinical outcomes of this technology appear promising, it remains unclear what activity limitations should be imposed after surgery in patients with these implants. This is of particular interest in military personnel, who may be required to return to a rigorous level of activity after surgery.

Management of unilateral cervical radiculopathy in the military: the cost effectiveness of posterior cervical foraminotomy compared with anterior cervical discectomy and fusion.

Object: To review the cost effectiveness for the management of a unilateral cervical radiculopathy with either posterior cervical foraminotomy (PCF) or anterior cervical discectomy and fusion (ACDF) in military personnel, with a particular focus on time required to return to active-duty service.

Methods: Following internal review board approval, the authors conducted a retrospective review of 38 cases in which patients underwent surgical management of unilateral cervical radiculopathy. Nineteen patients who underwent PCF were matched for age, treatment level, and surgeon to 19 patients who had undergone ACDF.

Spinal tumors in children.

Pediatric spine tumors encompass a diverse group of pathologic diagnoses that differ markedly based on the location and age of the child. Children can be affected by primary and metastatic tumors, making the differential diagnosis and treatment options extensive. This article discusses the features of spinal tumors in children based primarily on location: extradural, intradural-extramedullary, and intramedullary tumors.

Long-term maintenance of cervical alignment after occipitocervical and atlantoaxial screw fixation in young children.

Object: Despite decades of surgical experience, the long-term consequences of occipitocervical (OC) and atlantoaxial (C1-2) fusions in children are unknown. The purpose of this study was to determine the long-term effects of these fusions on growth and alignment of the maturing cervical spine.

Methods: A retrospective chart review was conducted for patients 6 years of age or younger (mean 4.

Atlantoaxial transarticular screw fixation: a review of surgical indications, fusion rate, complications, and lessons learned in 67 pediatric patients.

Object: In this, the second of two articles regarding C1-2 transarticular screw fixation, the authors discuss their surgical experience in treating patients 16 years of age and younger, detailing the rate of fusion, complication avoidance, and lessons learned in the pediatric population.

Methods: The authors retrospectively reviewed 67 consecutive patients (23 girls and 44 boys) younger than 16 years of age in whom at least one C1-2 transarticular screw fixation procedure was performed. A total of 127 transarticular screws were placed in these 67 patients whose mean age at time of surgery was 9 years (range 1.

Atlantoaxial transarticular screw fixation: a review of surgical indications, fusion rate, complications, and lessons learned in 191 adult patients.

Object: In this, the first of two articles regarding C1-2 transarticular screw fixation, the authors assessed the rate of fusion, surgery-related complications, and lessons learned after C1-2 transarticular screw fixation in an adult patient series.

Methods: The authors retrospectively reviewed 191 consecutive patients (107 women and 84 men; mean age 49.7 years, range 17-90 years) in whom at least one C1-2 transarticular screw was placed.

Spinal meningiomas: surgical management and outcome.

Advances in imaging and surgical technique have improved the treatment of spinal meningiomas; these include magnetic resonance imaging, intraoperative ultrasonography, neuromonitoring, the operative microscope, and ultrasonic cavitation aspirators. This study is a retrospective review of all patients treated at a single institution and with a pathologically confirmed diagnosis of spinal meningioma. Additionally the authors analyze data obtained in 556 patients reported in six large series in the literature, evaluating surgical techniques, results, and functional outcomes.

Cavernous hemangioma of the skull presenting with subdural hematoma. Case report.

Cavernous hemangioma of the calvaria is a very rare disease, and patients usually present with headaches or a visible skull deformity. Few reports of patients presenting with intradiploic or epidural hemorrhages are found in the literature. No case of an intradural hemorrhage from a cavernous hemangioma of the skull has been reported to date.

False-negative magnetic resonance angiography with extracranial internal carotid artery stenosis: a report of two cases and review of the literature.

Magnetic resonance angiography (MRA) is increasingly used as a noninvasive means to assess internal carotid artery (ICA) stenosis. When used alone, however, MRA may not be sufficiently accurate in certain settings to determine whether ICA disease meets surgical criteria. Although MRA has been recognized to overestimate the degree of stenosis, the authors present two cases in which it severely underestimated arterial stenosis.