Metastatic epidural spinal cord compression approached by MRI: could it predict neurological peril?

Background: Metastatic epidural spinal cord compression (MESCC) are the most serious debilitating morbidities of spine metastases (SpMs) causing devastating neurological damages. We still lack of reliable markers to predict neurological impairment.

Methods: A prospective cohort study collected 164 consecutive patients presenting with MESCC between January 2014-2021, divided in two groups: ambulatory (Frankel D-E) vs non-ambulatory (Frankel A-C).

Meningeal Embolization for Preventing Chronic Subdural Hematoma Recurrence After Surgery: The EMPROTECT Randomized Clinical Trial.

Importance: Middle meningeal artery (MMA) embolization has been proposed as a potential treatment for chronic subdural hematoma (CSDH).

Objective: To assess the efficacy of MMA embolization in reducing the risk of CSDH recurrence at 6 months compared with standard care in patients who underwent an operation and were at high risk of CSDH recurrence.

Design, Setting, And Participants: Multicenter, open-label, randomized clinical trial with blinded end point assessment.

Spinal manifestations of diffuse large B-cell lymphoma.

Background Context: Spinal diffuse large B-cell lymphoma (DLBCL) can be divided into 2 categories: primary non-Hodgkin's lymphoma (PNHL) and metastases from disseminated DLBCL. Prognostic factors of spinal DLBCL metastases seem to differ from those of other spine metastases and PNHL, although the data in the literature remains scarce.

Purpose: This study aims at investigating prognostic factors associated with overall survival (OS) in patients with spine DLBCL metastases.

Surgery for Degenerative Spinal Pathologies in Parkinson's Patients: Low Surgical Benefits for High Risks.

Objective: Lumbar disc herniation, canal stenosis, and cervicarthrosis are degenerative spinal pathologies frequently observed in the aging population of patients with Parkinson disease (PD). Spinal surgery in PD patients remains risky with uncertain functional results. The main issue is to determine whether a surgical procedure should be performed on PD patients with common degenerative spinal pathologies.

F-Naf PET/CT in pseudarthrosis after anterior cervical discectomy and fusion.

Background Context: Pseudarthrosis is a well-known cause of persistent or recurrent pain after anterior cervical discectomy and fusion (ACDF). Numerous radiographic criteria to determine the fusion status has been described in the literature, but their accuracies in clinical practice vary considerably and no 1 single method has proved superior. Fluorine-18 sodium fluoride (F-NaF) positron emission tomography/computed tomography (PET/CT), depicting osteoblastic activity, might be useful to identify pseudarthrosis after ACDF.

Risk of Infective Endocarditis in Patients with Spinal Surgical Site Infection and Bacteremia.

Surgical site infection (SSI) is responsible for significant morbidity, prolonged hospital stays, and increased costs. Infectious endocarditis (IE) is a rare but serious complication of bacteremia, particularly that resulting from SSI. The VIRSTA score predicts the risk of IE and determines the priority of transthoracic echocardiography (TTE) in patients with bacteremia.

Sex Differences in Patient-Rated Outcomes After Lumbar Spinal Fusion for Degenerative Disease: A Multicenter Cohort Study.

Study Design: Heterogeneous data collection through a mix of prospective, retrospective, and ambispective methods.

Objective: To evaluate the effect of biological sex on patient-reported outcomes after spinal fusion surgery for lumbar degenerative disease.

Summary Of Background Data: Current literature suggests sex differences regarding clinical outcome after spine surgery may exist.

Retroperitoneal soft tissue sarcomas: Predictive factors for incomplete resection.

Introduction: Curative management of retroperitoneal sarcoma relies on surgery, and complete monoblock resection is one of the main prognostic factors. The goal of this study was to search predictive factors for incomplete resection.

Methods: All patients undergoing surgery for retroperitoneal sarcoma in two University hospitals between 2010 and 202 were included.

Surgical management of herniated intervertebral disc in children.

Study Design: Retrospective literature review analysis OBJECTIVE: Analyze the risk factors, characteristics, outcome, and follow up of surgical management of disc herniation in children ≤15 years old (y.o) through a review of the literature.

Background: Disc herniation is a rare disease in the pediatric population.

Multicenter external validation of prediction models for clinical outcomes after spinal fusion for lumbar degenerative disease.

Background: Clinical prediction models (CPM), such as the SCOAP-CERTAIN tool, can be utilized to enhance decision-making for lumbar spinal fusion surgery by providing quantitative estimates of outcomes, aiding surgeons in assessing potential benefits and risks for each individual patient. External validation is crucial in CPM to assess generalizability beyond the initial dataset. This ensures performance in diverse populations, reliability and real-world applicability of the results.

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.

Day-case otology: Special attention to the pediatric cochlear implantation procedure.

Objective: Assess the feasibility of cochlear implantation as day-surgery in children and identify variables influencing admission, readmission, and unplanned postoperative consultation.

Methods: This retrospective observational monocentric study was conducted according to the STROBE recommendations. Between January 2017 and July 2022, all medical records of children who underwent cochlear implantation were analyzed.

Are There Still Any Benefits to Drainage for Anterior Cervical Arthrodesis/Arthroplasty by Cervicotomy?

Study Design: A retrospective single-center study between January 2019 and January 2023.

Objective: The role and contribution of drainage in the anterior approach to the cervical spine (cervicotomy) is much debated, motivated primarily by the prevention of retropharyngeal hematoma, so are there still any benefits to drainage?

Background: The anterior approach to the cervical spine is a widespread and common procedure performed in almost all spine surgery departments for the replacement of cervical intervertebral discs and medullar or radicular decompression. The primary endpoint was the occurrence of symptomatic postoperative cervical hematoma.

Enhancing the referral process for surgical management of spinal metastases: insights from a 12-year, bi-institutional study of 533 patients.

Introduction: Delayed surgical management of spinal metastases (SMs) can have detrimental effects on patient survival and quality of life, leading to pain and potential neurological impairment. This study aimed to assess the impact of delayed referral for SMs on clinical outcomes by analyzing patients managed in emergency situations.

Methods: We retrospectively reviewed the data of all patients admitted on either emergency or elective basis who underwent surgery for the treatment of neoplastic spine lesions at our two institutions (tertiary referral neurosurgical units) between January 2008 and December 2019.

Impact of metastatic epidural spinal cord compression (MESCC) and pathological vertebral compression fracture (pVCF) in neurological and survival prognosis.

Background: Metastatic epidural spinal cord compression (MESCC) and pathological vertebral compression fractures (pVCF) are the most serious debilitating morbidities of spine metastases (SpMs) causing devastating neurological damages. The respective impact of these two metastasis-spreading entities on survival and on neurological damage is debated.

Methods: A French prospective cohort study collected 279 consecutive patients presenting with SpMs between January 2017 and 2021.

Two fractions staged Gammaknife radiosurgery for "large" cerebral metastases.

Background: Gammaknife radiosurgery (GKRS) is a valuable option to control cerebral metastases. However, the risk (adverse radiation effect (ARE))-benefit (local control (LC)) ratio switches when the target is too large.

Objective: In order to balance this ratio, two fractions staged GKRS protocol was conducted for "large" cerebral metastases.

Chordoma concurrent with benign notochordal cell tumor of the mobile spine. Should the chordoma part be biopsied? - A stepwise approach for management.

Some evidence suggests that benign notochordal tumors (BNCTs) could be a potential precursor of chordoma. We present an educational rare case of lumbar vertebral BNCTs concomitant with a destructive lesion not reachable on biopsy but thought to be chordoma. We present a stepwise approach for management of these difficult entities based on radiological features.

Natural history of spinal cord metastasis from brain glioblastomas.

Background And Objectives: Spinal cord metastasis arising from an intracranial glioblastoma is a rare and late event during the natural course of the disease. These pathological entities remain poorly characterized. This study aimed to identify and investigate the timeline, clinical and imaging findings, and prognostic factors of spinal cord metastasis from a glioblastoma.

Spinal lesions in multiple myeloma: Primary bone tumors with distinct prognostic factors.

Purpose: Although prognostic factors of spinal multiple myeloma (MM) seem to differ from those of other spine metastases (SpM), the data in the literature remains scarce.

Methods: A prospective population of 361 patients treated for spine MM lesions between January 2014 and 2017.

Results: OS for our series was 59.

Spine Metastasis: Patients With Poor Performance Status (ECOG) Could benefit From Palliative Surgical Care! A Prospective Cohort Study.

Study Design: This study used a French prospective national multi-center database of patients with spine metastasis (SpM).

Objective: The main challenge was to clarify if SpM patients presenting poor ECOG-PS could benefit from a surgical intervention.

Background: Spine metastases (SpM) are debilitating lesions commonly found in the evolution of cancer.