Expandable, But at What Cost? Failure Patterns in Corpectomy Cages from 373 Real-World Adverse Events.

Study Design: Cross-sectional study.

Objective: This study aimed to analyze the failure patterns of expandable corpectomy cages.

Summary Of Background Data: Expandable corpectomy cages offer significant advantages for anterior column reconstruction but introduce unique mechanical complexities.

Composite RAI, Malnutrition, and Anemia Model Superiorly Predicts 30-Day Morbidity and Mortality After Surgery for Adult Spinal Deformity.

This study examines the composite influence of frailty, malnutrition, and anemia on postoperative outcomes for patients with adult spinal deformity (ASD). In this retrospective cohort study using the 2011-2022 NSQIP database, we utilized CPT and ICD codes to identify ASD patients who underwent PSF. Subjects were stratified based on frailty status.

Artificial intelligence applications in the screening and classification of glioblastoma.

Glioblastoma is the most aggressive primary brain tumor, with poor prognosis following initial identification. Current diagnostic methods, including neuroimaging and molecular pathology, face several limitations in tumor delineation, differentiation of progression from treatment effects, and classification of tumor grade. Artificial intelligence (AI) and machine learning (ML) have been increasingly investigated for its potential in addressing such challenges.

Cognitive Performance in Early Neuronal Synuclein Disease with Hyposmia but without Motor Disability: Association with Dopamine Deficiency and Isolated Rapid Eye Movement Sleep Behavior Disorder.

Objective: To determine the impact of dopamine deficiency and isolated rapid eye movement (REM) sleep behavior disorder (iRBD) on cognitive performance in early neuronal α-synuclein disease (NSD) with hyposmia but without motor disability.

Methods: Using Parkinson's Progression Markers Initiative baseline data, cognitive performance was assessed with a cognitive summary score (CSS) derived from robust healthy control (HC) norms. Performance was examined for participants with hyposmia in early NSD-Integrated Staging System (NSD-ISS), either stage 2A (cerebrospinal fluid α-synuclein seed amplification assay [SAA]+, dopamine transporter scan [DaTscan]-) or 2B (SAA+, DaTscan+).

The hidden cost of robotic spine surgery: real-world adverse events cause 58-minute delays and undermine economic viability.

Background Context: Robotic spine surgery has experienced substantial market growth with global projections exceeding $1.2 billion by 2026. Manufacturers prominently promote enhanced screw placement accuracy, reduced radiation exposure, and improved surgical efficiency as primary value propositions.

Mind the Gap: Social media analysis of 38,609 posts highlights discrepancies between clinical focus and patient priorities in neurosurgical care.

Objective: To analyze social media discussions among cranial neurosurgical patients to identify prevalent concerns, emotional patterns, and quality of life impacts that may not be fully captured in traditional clinical assessments.

Methods: We analyzed 38,609 neurosurgery-related posts from Reddit using natural language processing and the Valence Aware Dictionary and sEntiment Reasoner (VADER) sentiment analysis tool. Posts were categorized into clinical domains (symptoms, conditions, procedures, treatments, complications, quality of life, and clinical course), with sentiment scores calculated for each category.

Assessing combined effects of risk analysis index-revised (RAI-rev), malnutrition, and anemia on morbidity and mortality after spine surgery for metastatic spinal tumors.

Purpose: This study evaluates the combined effects of frailty, anemia, and malnutrition on outcomes in spinal metastases patients.

Methods: We conducted a retrospective cohort study using the 2011-2022 NSQIP database. Adult patients undergoing spinal surgery for spinal metastases were identified using CPT and ICD codes and stratified based on Risk Analysis Index-revised (RAI-rev) frailty status; frail patients were subdivided based on anemia and malnutrition status.

Race, Region, and Reimbursement: Sociodemographic Variations in Medicare Payments for Spine Surgery in the United States, 2014-2022.

Study Design: Retrospective.

Objective: Assess whether Medicare adjustments adequately correct for systemic population-level payment variations.

Summary Of Background Data: Medicare currently uses payment adjustments for spine surgery, including clinical risk, geography, and socioeconomic status.

MOSAIC: A Multi-Feature Genomic Instability Score Independently Predicts Sarcoma Survival in 2138 Patients.

Objectives: While genomic profiling has identified prognostic markers in sarcoma, clinical risk stratification remains largely histology-based. The combined impact of multiple genomic instability features on survival remains poorly understood. This study evaluated the prognostic utility of a novel Measure Of Sarcoma Aggregate Instability Complex (MOSAIC) Score.

Precision Oncology in Non-small Cell Lung Cancer: A Comparative Study of Contextualized ChatGPT Models.

Objectives: The growing adoption of Large Language Models (LLMs) in medicine has raised important questions about their potential utility for clinical decision support within oncology. This study aimed to evaluate the effects of various contextualization methods on ChatGPT's ability to provide National Comprehensive Cancer Network (NCCN) guideline-aligned recommendations on managing non-small cell lung cancer (NSCLC).

Methodology: GPT-4o, base GPT-4, and GPT-4 models contextualized with prompts and PDF documents were asked to identify preferred chemotherapies for twelve advanced lung cancers given molecular profiles derived from the 2024 NCCN Clinical Practice Guidelines in Oncology for NSCLC.

Beyond the Clinic: A Social Media Network Analysis of 5466 Posts Reveals the Interconnected Challenges Facing Sarcoma Patients.

Objectives: Social media platforms have increasingly been investigated as a source of patient perspectives that may not emerge in clinical settings. This study aimed to explore how disease status, treatment, and the patient experience interconnect for sarcoma patients posting on a major social media platform.

Methods: We conducted a systematic thematic analysis of 5466 posts across 7 health-related subreddits using a framework of 6 major categories: physical symptoms, disease status, treatments, psychosocial impact, support systems, and daily life impact.

Prevalence of Artificial Intelligence-Generated Text in Neurosurgical Publications: Implications for Academic Integrity and Ethical Authorship.

Introduction: With the rapid proliferation of artificial intelligence (AI) tools, important questions about their applicability to manuscript preparation have been raised. This study explores the methodological challenges of detecting AI-generated content in neurosurgical publications, using existing detection tools to highlight both the presence of AI content and the fundamental limitations of current detection approaches.

Methods: We analyzed 100 randomly selected manuscripts published between 2023 and 2024 in high-impact neurosurgery journals using a two-tiered approach to identify potential AI-generated text.

Subtype-Specific Patterns of Tumor Purity and Mutation Load Suggest Treatment Implications: A Cross-Sectional Analysis of 7494 Soft Tissue and Bone Sarcomas (MSK Cohort).

Objectives: Sarcomas are complex mesenchymal malignancies whose molecular characteristics can significantly influence treatment strategies. This study aimed to investigate the relationship between tumor purity, mutation load, and clinical characteristics across sarcoma subtypes, focusing on potential implications for therapeutic stratification.

Methods: This study analyzed the molecular characteristics of 7494 sarcoma cases from the Soft Tissue and Bone Sarcoma (MSK, Nat Commun 2022) data set using available case analysis.

Advances in Coccygectomy: A Comprehensive Review Evaluating Surgical Techniques for Coccygodynia.

Background: Coccygodynia presents significant challenges in diagnosis and treatment. While coccygectomy has emerged as a crucial intervention for refractory cases, significant heterogeneity exists in surgical techniques. Traditional approaches are increasingly complemented by novel methods, necessitating a comprehensive review of current surgical options.

The Association Between Clival Axial Angle and Distal Junctional Failure After Craniocervical Fusion.

Study DesignRetrospective Cohort.ObjectivesCraniovertebral instability can arise from various congenital or acquired conditions, but definitive management often requires craniocervical fusion. This study evaluates whether postoperative clivo-axial angle (CXA) can predict distal junctional failure in patients undergoing craniocervical fusion.

Indocyanine Green as a Marker for Tissue Ischemia in Spinal Tumor Resections and Extended Revisions: A Technical Note.

The increasing complexity of spinal oncology procedures, particularly in en-bloc tumor resections, creates challenges in tissue perfusion assessment due to extended operative times and extensive surgical dissection. Real-time visualization of tissue perfusion can be achieved with ICG using commercially available handheld imaging systems, offering potential advantages in spinal oncology cases. This study assessed the utility of ICG in analyzing soft-tissue viability during complex spine procedures extending beyond 7.

Evidence for alpha-synuclein aggregation in older individuals with hyposmia: a cross-sectional study.

Background: Synuclein pathology in neurodegenerative diseases, such as Parkinson's disease (PD) and Dementia with Lewy bodies (DLB), begins years before motor or cognitive symptoms arise. Alpha-Synuclein seed amplification assays (α-syn SAA) may detect aggregated synuclein before symptoms occur.

Methods: Data from the Parkinson Associated Risk Syndrome Study (PARS) have shown that individuals with hyposmia, without motor or cognitive symptoms, are enriched for dopamine transporter imaging (DAT) deficit and are at high risk to develop clinical parkinsonism or related synucleinopathies.

Racial/Ethnic Disparities in Perception of Health Literacy and Barriers to Care Among Cervical Stenosis Patients.

Study DesignCross-Sectional Survey.ObjectiveThis study aimed to assess racial disparities in self-reported barriers to care, health literacy, and health status within a large cohort of cervical stenosis patients.MethodsThis cross-sectional study used ICD-9 and ICD-10 codes to identify cervical stenosis patients recorded in the NIH All of Us Research Program between 2017 and 2022.

Staged Screening Identifies People with Biomarkers Related to Neuronal Alpha-Synuclein Disease.

Objective: Remote identification of individuals with severe hyposmia may enable scalable recruitment of participants with underlying alpha-synuclein aggregation. We evaluated the performance of a staged screening paradigm using remote smell testing to enrich for abnormal dopamine transporter single-photon emission computed tomography imaging (DAT-SPECT) and alpha-synuclein aggregation.

Methods: The Parkinson's Progression Markers Initiative (PPMI) recruited participants for the prodromal cohort who were 60-years and older without a Parkinson's disease diagnosis.

Impact of dopamine deficiency and REM sleep behavior disorder on cognition in early neuronal synuclein disease with hyposmia.

Objectives: To determine the impact of dopamine deficiency and isolated REM sleep behavior disorder (iRBD) on cognitive performance in early neuronal alpha-synuclein disease (NSD) with hyposmia.

Methods: Using Parkinson's Progression Markers Initiative baseline data, cognitive performance was assessed with a cognitive summary score (CSS) developed by applying regression-based internal norms derived from a robust healthy control (HC) group. Performance was examined for participants with hyposmia classified as NSD-Integrated Staging System (NSD-ISS) Stage 2, either Stage 2A (CSF alpha-synuclein seed amplification assay [SAA]+, SPECT dopamine transporter scan [DaTscan]-) or 2B (SAA+, DaTscan+).

From "invisible" to "audible": Features extracted during simple speech tasks classify patient-reported fatigue in multiple sclerosis.

Background: Fatigue is a major "invisible" symptom in people with multiple sclerosis (PwMS), which may affect speech. Automated speech analysis is an objective, rapid tool to capture digital speech biomarkers linked to functional outcomes.

Objective: To use automated speech analysis to assess multiple sclerosis (MS) fatigue metrics.

Validation of Parkinson's Disease Ascertainment in the Veterans Administration Electronic Medical Record.

Background: Electronic medical record (EMR)-based studies hold great potential for epidemiologic investigations of Parkinson's disease (PD) causal factors and phenomenology, but diagnostic misclassification may obscure or bias inferences.

Objectives: The aims were to determine the validity of PD diagnostic codes in the Veterans Administration (VA) national electronic medical databases and develop recommendations for maximizing ascertainment accuracy.

Methods: We investigated a cohort of 146,776 veterans who utilized VA healthcare between 1999 and 2021.