Circumferential Correction of Severe Thoracolumbar Kyphosis by Utilizing an Articulating Rod and Lateral Interbody Device: A Technical Note.

Background: Surgical management of severe thoracolumbar kyphosis (TLK) is challenging due to the necessity of achieving adequate sagittal realignment without increasing operative risk or compromising hardware integrity. Performing large corrective maneuvers during deformity correction may increase the risk of neurological complications, especially when correcting hyperkyphosis in the distal thoracolumbar spine. The present article describes the first use of a custom-made articulating rod to manipulate a patient's severe TLK into extension in combination with the expandable lateral interbody device to achieve circumferential deformity correction.

Neurosurgical Approach to Neurocysticercosis in Adults: A Comprehensive Systematic Review of Clinical and Imaging Insights.

Background And Objectives: Neurocysticercosis (NCC), caused by larval cysts of Taenia solium , presents a significant health challenge worldwide with diverse clinical presentations and varying management approaches. Untreated NCC can lead to increased intracranial pressure and/or hydrocephalus, with possible death. This review provides comprehensive neurosurgical insight into the heterogeneity of NCC.

Smartphone accelerometers as tools to study the effect of socioeconomic disparities in neurosurgical outcomes: a multi-institutional retrospective analysis.

Objective: Smartphones and wearable devices can be effective tools to objectively assess patient mobility and well-being before and after spine surgery. In this retrospective observational study, the authors investigated the relationship between these longitudinal perioperative patient activity data and socioeconomic and demographic correlates, assessing whether smartphone-captured metrics may allow neurosurgeons to distinguish intergroup patterns.

Methods: A multi-institutional retrospective study of patients who underwent spinal decompression with and without fusion between 2017 and 2021 was conducted.

Machine Learning Models Leveraging Smartphone-Based Patient Mobility Data Can Accurately Predict Functional Outcomes After Spine Surgery.

The development of adjacent segment disease or the progression of spondylosis following the surgical treatment of spinal stenosis and spondylolisthesis is well documented and can lead to subsequent functional decline after a successful index surgery. The early detection of negative inflection points during patients' functional recovery can improve timely intervention. In this study, we developed machine learning (ML) models to predict the occurrence of post-operative decline in patient mobility.

GLUT1 overexpression in CAR-T cells induces metabolic reprogramming and enhances potency.

The intensive nutrient requirements needed to sustain T cell activation and proliferation, combined with competition for nutrients within the tumor microenvironment, raise the prospect that glucose availability may limit CAR-T cell function. Here, we seek to test the hypothesis that stable overexpression (OE) of the glucose transporter GLUT1 in primary human CAR-T cells would improve their function and antitumor potency. We observe that GLUT1OE in CAR-T cells increases glucose consumption, glycolysis, glycolytic reserve, and oxidative phosphorylation, and these effects are associated with decreased T cell exhaustion and increased Th differentiation.

Intraparenchymal Chordoma in the Brain Stem: A Review of Surgical Management and Case Highlight.

We present a rare case of an intraparenchymal chordoma in the brain stem of a 69-year-old male with a history of multiple chordoma recurrences. Chordomas are uncommon tumors that originate from notochordal remnants, with intraparenchymal presentations in the brain stem being particularly rare. A 69-year-old male with a history of clival chordoma three years after primary endoscopic resection and adjuvant proton-beam radiotherapy and a recurrence one year postoperatively for which he underwent a second surgery, presented with severe headaches, weakness, diaphoresis, and difficulty ambulating.

The role of emboli detection studies in acute inpatient vertebral artery dissection.

Background: Prompt diagnosis and treatment of vertebral artery dissection (VAD) is critical for preventing stroke. The use of emboli detection studies (EDS) using Doppler ultrasonography is an emerging method that has been proposed to predict stroke risk and guide subsequent treatment. Limited data exists on the predictive value of this emerging modality in the posterior circulation.

Novel Combination of Lateral Interbody Fusion and Endoscopic Ipsi-Contra Decompression for Severe Stenosis From Lumbar Spondylolisthesis: A Case Report.

Minimally invasive surgical approaches to the spine that leverage indirect decompression are gaining increasing popularity. While there is excellent literature on the value of indirect decompression, there are limitations to this procedure. Specifically, in patients with severe stenosis and neurogenic claudication, there is a concern among many surgeons regarding the adequacy of indirect decompression alone.

Utilizing tubular retractors in colloid cyst resection: A single surgeon experience.

Background: Colloid cysts are intracranial lesions originating from abnormalities in the primitive neuroepithelium folding of the third ventricle. Various surgical approaches have been explored for the management of colloid cysts, each carrying its own set of advantages and limitations. Tubular retractors developed recently alleviate retraction pressure through radial distribution, potentially offering benefits for colloid cyst resection.

Surgical Management of Brain Metastasis from Esophageal Cancer: A Systematic Review and Single-Center Experience.

Background: Brain metastases from esophageal cancer (BMEC) are rare and aggressive, with limited literature on optimal treatment modalities and a standard of care yet to be established. The objective of this study was to systematically review existing literature and perform a retrospective analysis of our institution's patients to evaluate the influence of different treatment modalities on patient outcomes.

Methods: A systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and a retrospective review of our institutional experience with BMEC were both conducted.

Surgical Management of Thoracolumbar Adjacent Segment Disease: Techniques and Outcomes in 107 Patients Undergoing Surgical Intervention.

Background: Adjacent segment disease (ASD) is a known sequela of thoracolumbar instrumented fusions. Various surgical options are available to address ASD in patients with intractable symptoms who have failed conservative measures. However, the optimal treatment strategy for symptomatic ASD has not been established.

FOXO1 is a master regulator of memory programming in CAR T cells.

A major limitation of chimeric antigen receptor (CAR) T cell therapies is the poor persistence of these cells in vivo. The expression of memory-associated genes in CAR T cells is linked to their long-term persistence in patients and clinical efficacy, suggesting that memory programs may underpin durable CAR T cell function. Here we show that the transcription factor FOXO1 is responsible for promoting memory and restraining exhaustion in human CAR T cells.

Determining Differences in Perioperative Functional Mobility Patterns in Lumbar Decompression Versus Fusion Patients Using Smartphone Activity Data.

Background And Objectives: Smartphone activity data recorded through high-fidelity accelerometry can provide accurate postoperative assessments of patient mobility. The "big data" available through smartphones allows for advanced analyses, yielding insight into patient well-being. This study compared rate of change in functional activity data between lumbar fusion (LF) and lumbar decompression (LD) patients to determine preoperative and postoperative course differences.

Single-Position Lateral Approach for Revision Thoracolumbar Corpectomy With Delayed Ipsilateral Kidney Atrophy: Technical Note and Discussion of Complications.

Improvements in navigation technology have enabled surgeons to safely offer single-position fusion surgeries, demonstrating shorter operating times and reduced length of stay (LOS) as compared to traditional lateral and prone dual-position surgeries. However, no studies to date describe revision thoracolumbar corpectomy with simultaneous posterior rod removal and replacement in the lateral position. Furthermore, this is the first reported complication of delayed ipsilateral kidney atrophy following lateral lumbar surgery.

Inosine Induces Stemness Features in CAR T cells and Enhances Potency.

Adenosine (Ado) mediates immune suppression in the tumor microenvironment and exhausted CD8 CAR T cells mediate Ado-induced immunosuppression through CD39/73-dependent Ado production. Knockout of CD39, CD73 or A2aR had modest effects on exhausted CAR T cells, whereas overexpression of Ado deaminase (ADA), which metabolizes Ado to inosine (INO), induced stemness features and potently enhanced functionality. Similarly, and to a greater extent, exposure of CAR T cells to INO augmented CAR T cell function and induced hallmark features of T cell stemness.

The Use of Carbon Fiber-Reinforced Instrumentation in Patients with Spinal Oncologic Tumors: A Systematic Review of Literature and Future Directions.

Introduction: Metastatic spine tumors affect over 30% of patients who have been diagnosed with cancer. While techniques in surgical intervention have undoubtedly evolved, there are some pitfalls when spinal instrumentation is required for stabilization following tumor resection. However, the use of carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implants has become increasingly popular due to improved radiolucency and positive osteobiologic properties.

Size matters - From the working channel to the wavelength of light: Optimizing visualization in endoscopic spine surgery.

Background: Minimally invasive surgery bases many of its benefits on decreasing tissue disruption. Endoscopic spine surgery has continued to push the boundaries to accomplish successful clinical outcomes through the evolution of the endoscope and working channel. As the indications for endoscopic spine surgery increase, a more profound discussion of cannula size selection for endoscopic spine surgery is required.