Clinical Outcomes of Decompressive Spine Surgery for Painless Cervical Myelopathy: Analysis of the Michigan Spine Surgery Improvement Collaborative Registry.

Background And Objectives: Although axial neck pain and radicular arm pain are often associated with cervical spondylotic myelopathy (CSM), some patients present or are discovered to have CSM without pain. Little is known regarding the surgical outcomes in these patients. Our objective is to describe the outcomes of decompressive spine surgery in a cohort of patients treated for painless CSM.

Risk Factors of Long-Term Opioid Use After Elective Cervical and Lumbar Spine Surgery: A Michigan Spine Surgery Improvement Collaborative Study.

Background And Objectives: Given the current opioid epidemic and its impact on public health, long-term opioid use after elective spine surgery is a significant concern. Identifying risk factors of long-term opioid use after spine surgery is crucial for developing effective interventions to reduce opioid dependence in this patient population. The objective of this study was to identify risk factors associated with long-term opioid use after elective lumbar and cervical spine surgeries.

Laser Interstitial Thermal Therapy for Intra-Axial Brain Tumors: Everything the Neuroradiologist Should Know.

Laser interstitial thermal therapy (LITT) is a minimally invasive cytoreductive treatment option for patients with intracranial tumors. Utilizing real-time MR thermometry, LITT delivers tailored, targeted, and permanent cytotoxic thermal injury to intra-axial pathology. As a minimally invasive and nonionizing treatment option proved to be an effective, less morbid, and more efficient alternative to surgery, the utility of LITT has rapidly expanded.

Laser interstitial thermal therapy for first-line treatment of insular glioma.

Objective: Insular gliomas pose a significant surgical challenge due to the complex surrounding functional and vascular anatomy. The authors report their experience using a novel framework for the treatment of insular gliomas with laser interstitial thermal therapy (LITT) and provide representative case examples emphasizing indications, rationale, and technical pearls.

Methods: A prospectively gathered institutional database was used to identify patients with newly diagnosed insular gliomas who underwent LITT between 2015 and 2023.

Compressive myelopathy from diffuse spinal dural calcifications in a patient with end-stage renal disease: illustrative case.

Background: Diffuse spinal dural calcification is a rare disorder associated with hyperparathyroidism, including the secondary forms associated with renal failure, osteodystrophy, and chronic hypocalcemia. Here, the authors report a rare case of diffuse dural calcification causing spinal cord compression with myelopathy, requiring decompressive surgery with duraplasty to achieve adequate decompression.

Observations: A 46-year-old male with a history of renal failure on dialysis presented with 2 months of progressive neuropathic pain, lower-extremity weakness, and nonsustained clonus.

Laser interstitial thermal therapy for deep-seated perivascular brain tumors is not associated with distal ischemia.

Purpose: Laser interstitial thermal therapy (LITT) is a minimally invasive cytoreductive treatment option for brain tumors with a risk of vascular injury from catheter placement or thermal energy. This may be of concern with deep-seated tumors that have surrounding end-artery perforators and critical microvasculature. The purpose of this study was to assess the risk of distal ischemia following LITT for deep-seated perivascular brain tumors.

Laser Interstitial Thermal Therapy for First-Line Treatment of Surgically Accessible Recurrent Glioblastoma: Outcomes Compared With a Surgical Cohort.

Background: Laser interstitial thermal therapy (LITT) for glioblastoma (GBM) has been reserved for poor surgical candidates and deep "inoperable" lesions. We present the first reported series of LITT for surgically accessible recurrent GBM (rGBM) that would otherwise be treated with surgical resection.

Objective: To evaluate the use of LITT for unifocal, lobar, first-time rGBM compared with a similar surgical cohort.

Genomic Biomarkers of Meningioma: A Focused Review.

Meningiomas represent a phenotypically and genetically diverse group of tumors which often behave in ways that are not simply explained by their pathologic grade. The genetic landscape of meningiomas has become a target of investigation as tumor genomics have been found to impact tumor location, recurrence risk, and malignant potential. Additionally, targeted therapies are being developed that in the future may provide patients with personalized chemotherapy based on the genetic aberrations within their tumor.

Reducing Superfluous Opioid Prescribing Practices After Brain Surgery: It Is Time to Talk About Drugs.

Background: Opioids are prescribed routinely after cranial surgery despite a paucity of evidence regarding the optimal quantity needed. Overprescribing may adversely contribute to opioid abuse, chronic use, and diversion.

Objective: To evaluate the effectiveness of a system-wide campaign to reduce opioid prescribing excess while maintaining adequate analgesia.

The influence of sagittal spinopelvic alignment on patient discharge disposition following minimally invasive lumbar interbody fusion.

Background: The aim of this study was to investigate the changes to spinopelvic sagittal alignment following minimally invasive (MIS) lumbar interbody fusion, and the influence of such changes on postoperative discharge disposition.

Methods: The Michigan Spine Surgery Improvement Collaborative was queried for all patients who underwent transforaminal lumbar interbody fusion (TLIF)or lateral lumbar interbody fusion (LLIF) procedures for degenerative spine disease. Several spinopelvic sagittal alignment parameters were measured, including sagittal vertical axis (SVA), lumbar lordosis, pelvic tilt, pelvic incidence, and pelvic incidence-lumbar lordosis mismatch.

Oculomotor Schwannomas: A Systematic Review and Report of Two Pediatric Cases Treated with Fractionated Cyberknife Stereotactic Radiotherapy.

Objective: Pediatric oculomotor nerve schwannomas are rare and challenging lesions due to the high morbidity associated with surgical intervention and their proximity to critical structures limiting the opportunity for stereotactic radiosurgery. We aim to report and review the novel use of fractionated Cyberknife (Accuray, Inc., Sunnyvale, California, USA) stereotactic radiotherapy in pediatric patients with oculomotor schwannomas.

Investigation of the aryl hydrocarbon receptor and the intrinsic tumoral component of the kynurenine pathway of tryptophan metabolism in primary brain tumors.

Introduction: There is mounting evidence supporting the role of tryptophan metabolism via the kynurenine pathway (KP) in the pathogenesis of primary brain tumors. Under normal physiological conditions, the KP is the major catabolic pathway for the essential amino acid tryptophan. However, in cancer cells, the KP becomes dysregulated, depletes local tryptophan, and contributes to an immunosuppressive tumor microenvironment.