Impact of Adjacent Muscular Anatomic Preservation on Proximal Junctional Kyphosis and Failure.

Background: Surgical intervention is a cornerstone of adult spinal deformity (ASD) management. However, there remain burdens from complications, including proximal junctional kyphosis (PJK) and proximal junctional failure (PJF). Posterior anatomic preservation at the uppermost instrumented vertebra has emerged as an accessible approach to potentially reduce PJK/PJF risk.

Advances and Evolving Challenges in Spinal Deformity Surgery.

Background: Surgical intervention is a critical tool to address adult spinal deformity (ASD). Given the evolution of spinal surgical techniques, we sought to characterize developments in ASD correction and barriers impacting clinical outcomes.

Methods: We conducted a literature review utilizing PubMed, Embase, Web of Science, and Google Scholar to examine advances in ASD surgical correction and ongoing challenges from patient and clinician perspectives.

High-volume facilities are not always low risk: comparing risk-standardized mortality rates versus facility volume as quality measures in surgical neuro-oncology.

Objective: Risk-standardized mortality rates (RSMRs) have recently been shown to outperform facility case volume as a proxy for surgical quality in lung and gastrointestinal cancer. The aim of this study was to investigate RSMR as a surgical quality metric in primary CNS cancer.

Methods: This retrospective observational cohort study used data from the National Cancer Database, a population-based oncology outcomes database sourced from more than 1500 institutions in the United States, and included adult patients 18 years of age and older who were diagnosed with glioblastoma, pituitary adenoma, or meningioma and were treated with surgery.

Does waiting for surgery matter? How time from diagnostic MRI to resection affects outcomes in newly diagnosed glioblastoma.

Objective: Maximal safe resection is the standard of care for patients presenting with lesions concerning for glioblastoma (GBM) on magnetic resonance imaging (MRI). Currently, there is no consensus on surgical urgency for patients with an excellent performance status, which complicates patient counseling and may increase patient anxiety. This study aims to assess the impact of time to surgery (TTS) on clinical and survival outcomes in patients with GBM.

Spinal Metastases from Colorectal Cancer at Mass General Brigham: A Twenty-Year Case Series With Literature Review.

Objective: We present an institutional case series of patients treated for colorectal carcinoma (CRC) spinal metastases to investigate the outcomes between no treatment, radiation, surgery, and surgery/radiation.

Methods: A retrospective cohort of patients with CRC spinal metastases presenting to affiliated institutions between 2001 and 2021 wereidentified. Information related to patient demographics, treatment modality, treatment outcomes, symptom improvement, and survival was collected by chart review.

Single-cell RNA sequencing and spatial transcriptomics reveal cancer-associated fibroblasts in glioblastoma with protumoral effects.

Cancer-associated fibroblasts (CAFs) were presumed absent in glioblastoma given the lack of brain fibroblasts. Serial trypsinization of glioblastoma specimens yielded cells with CAF morphology and single-cell transcriptomic profiles based on their lack of copy number variations (CNVs) and elevated individual cell CAF probability scores derived from the expression of 9 CAF markers and absence of 5 markers from non-CAF stromal cells sharing features with CAFs. Cells without CNVs and with high CAF probability scores were identified in single-cell RNA-Seq of 12 patient glioblastomas.

Impact of extent of resection and adjuvant therapy in diffuse gliomas of the spine.

Background Content: Diffuse gliomas of the spine (DGS)-consisting of intradural intramedullary glioblastoma, astrocytoma, and oligodendroglioma-are exceedingly rare tumors that account for about 2% of primary spinal cord tumors. Much is unknown about their optimal treatment regimen due to a relative lack of clinical outcome data.

Purpose: To provide an updated analysis on treatment and outcomes in DGS.

Idiopathic Intracranial Hypertension: A Comprehensive Overview.

Idiopathic intracranial hypertension (IIH), also called pseudotumor cerebri syndrome, is a disorder defined as elevated intracranial pressure (ICP) of unknown cause. It is a diagnosis of exclusion in most cases, and all other forms of elevated ICP must be ruled out. With its increasing prevalence, it is much more likely for physicians, otolaryngologists included, to encounter this condition.

Neurosurgical Outcomes for Pediatric Central Nervous System Tumors in the United States.

Background: Limited data exist on pediatric central nervous system (CNS) tumors, and the results from the National Cancer Database, the largest multicenter national cancer registry, have not previously been comprehensively reported.

Objective: To capture pediatric neurosurgical outcomes and investigate possible disparities of care.

Methods: The National Cancer Database was queried for pediatric patients who were diagnosed with CNS tumors from 2004 to 2018.

The Relationship Among Surgeon Experience, Complications, and Radiographic Outcomes in Spine Deformity Surgery: The Experience of a Junior Surgeon.

Objective: To examine complication rates and radiographic outcomes in patients undergoing surgery for adult spinal deformity (ASD) by a junior surgeon.

Methods: A study was conducted of a retrospective cohort of patients who underwent an open posterior interbody fusion of the thoracic and/or lumbar regions by a single surgeon for ASD between 2018 and 2022. Patient characteristics, complications, and common radiographic parameters of spinopelvic alignment were collated.

Pituitary adenoma in the elderly: surgical outcomes and treatment trends in the United States.

Objective: Decision-making in how to manage pituitary adenomas (PAs) in the elderly (age ≥ 65 years) can be challenging given the benign nature of these tumors and concerns about surgical morbidity in these patients. In this study involving a large multicenter national registry, the authors examined treatment trends and surgical outcomes in elderly compared to nonelderly patients.

Methods: The National Cancer Data Base (NCDB) was queried for adults aged ≥ 18 years with PA diagnosed by MRI (in observed cases) or pathology (in surgical cases) from 2004 to 2016.

Malignant Pineal Parenchymal Tumors in Adults: A National Cancer Database Analysis.

Background: Limited retrospective data exist on malignant pineal parenchymal tumors (PPTs) in adults, and there are no large previous studies that review clinical outcomes across the 3 treatment arms of surgery, radiotherapy, and chemotherapy. As a result, optimal disease management has yet to be defined.

Objective: To evaluate treatment trends and perform survival analysis in adult PPT.

Effect of facility volume on giant pituitary adenoma neurosurgical outcomes.

Objective: Giant pituitary adenomas (PAs), defined as 4 cm or greater at their maximum diameter, are commonly treated with neurosurgical intervention as the first-line therapy. However, existing studies are from high-volume institutions whose outcomes may not be representative of many cancer centers. In the present study, the authors use a large cancer registry to evaluate demographics, national treatment trends, and outcomes by facility volume to address knowledge gaps for this uncommon tumor.

Interactions Between Anti-Angiogenic Therapy and Immunotherapy in Glioblastoma.

Glioblastoma is the most aggressive brain tumor with a median survival ranging from 6.2 to 16.7 months.