A novel lesion severity index to predict 90-day postoperative survival in brain metastasis patients.

Introduction: Brain metastasis patients require granular surgical risk evaluation. The authors aimed to improve prognostication for brain metastasis patients by creating the Metastatic Brain Lesion Score (MBLS).

Methods: This is a retrospective cohort study of patients undergoing craniotomy for brain metastasis between Jan 1, 2014 and Sept 30, 2021 at a large tertiary referral center.

Ultra-low-field portable MRI for assessing ventricular size in pediatric hydrocephalus: a feasibility study.

Objective: Hydrocephalus, characterized by abnormal CSF accumulation, poses diagnostic and management challenges, especially in pediatric patients. Timely and accurate diagnosis is crucial for effective treatment. The aim of this study was to investigate the feasibility of using ultra-low-field portable MRI (pMRI) as a supplementary tool for assessing ventricular caliber and radiographic features of hydrocephalus, rather than as a stand-alone diagnostic modality.

Mutant prion protein enhances NMDA receptor activity, activates PKC, and triggers rapid excitotoxicity in mice.

Neuronal hyperexcitability precedes synapse loss in certain neurodegenerative diseases, yet the synaptic membrane interactions and downstream signaling events remain unclear. The disordered amino terminus of the prion protein (PrPC) has been implicated in aberrant signaling in prion and Alzheimer's disease. To disrupt neuronal interactions and signaling linked to the amino terminus, we CRISPR-engineered a knockin mouse expressing mutant PrPC (G92N), generating an N-linked glycosylation site between 2 functional motifs.

Cost-Effectiveness Analyses of Bone Morphogenetic Protein 2 (rhBMP-2) in Spinal Fusion: A Systematic Review.

Study DesignSystematic Review Study.ObjectivesThe objective of this study is to assess the cost-effectiveness and cost-utility of rhBMP-2 in spine surgeries.MethodsPubMed, MEDLINE, OVID and CENTRAL (Cochrane Central Register of Controlled Trials) databases were systematically searched for studies reporting the use of rhBMP-2 for spinal procedures in comparison to autograft and/or allograft and alternative graft materials under consideration of cost-effectiveness, cost-benefit, cost minimization, and/or cost-utility analysis.

A prospective evaluation of cellular bone matrix for posterolateral lumbar fusion.

Introduction: Autograft bone is the gold standard graft used in posterolateral lumbar intertransverse fusion (PLF) but can be limited by supply and donor site morbidity. Cadaveric cellular allografts represent an alternative source of graft material that avoids these limitations.

Objective: To assess the safety and efficacy of ViviGenCellular Bone Matrix in comparison to autograft bone in PLF.

Intradural Extramedullary Small Cell Lung Cancer Metastasis Resection: 2-Dimensional Operative Video.

The presented surgical video (Video 1) demonstrates the resection of an intradural extramedullary metastasis in a 62-year-old female patient with a history of metastatic small cell lung cancer (SCLC). SCLC commonly metastasizes to the central nervous system. However, the vast majority of such metastases are to the brain.

Reduced Opioid Use Among Patients Who Received Liposomal Bupivacaine Brachial Plexus Block for Total Shoulder Arthroplasty.

Purpose This retrospective cohort explores the efficacy of regional shoulder blocks using Exparel™ in patients undergoing total shoulder arthroplasty (TSA)/reverse total shoulder arthroplasty (RSA) to reduce total opioid prescription, refills, and length of stay in the acute care setting. Methods Patients who underwent TSA/RSA by a single surgeon in a three-year period were evaluated. Patients in the case group received liposomal bupivacaine 1.

COVID-19 Vaccine Related Cervical Radiculitis and Parsonage-Turner Syndrome: Case Report and Review of the Literature.

Parsonage-Turner Syndrome, or neuralgic amyotrophy, is an acute-onset upper limb and shoulder girdle palsy that can occur in a post-viral, post-surgical or idiopathic setting. There have also been some reported cases of the syndrome occurring following vaccinations. The pathophysiology of neuralgic amyotrophy is not completely understood and many of the commonly used diagnostic imaging modalities we use to try and diagnose this syndrome are inaccurate and misleading.

Resection of intradural intramedullary subependymoma of the cervicothoracic spine: 2-dimensional operative video.

This video presents the case of a 44-year-old male with a 2-year history of pain in the left upper extremity that had worsened over the course of the last 6 months with associated weakened grip strength and had extended into his right arm. T2-weighted sagittal and axial MRI demonstrated an expansive nonenhancing solid intramedullary lesion extending from C5 to T1. The patient underwent a C5-T1 laminectomy and laminoplasty with near-complete resection of the intradural intramedullary subependymoma.

Epileptic versus neuro-oncological focus of management in pediatric patients with concurrent primary brain lesion and seizures: a systematic review.

Objective: Seizures can be a debilitating manifestation of underlying neoplastic intracranial pathology. Existing literature offers a paucity of scientific consensus regarding risk factors, seizure semiology, operative techniques, and tumor characteristics in pediatric patients with a concurrent diagnosis of primary intracranial neoplasm and seizures. To address the limited evidence in current literature, the authors systematically reviewed published literature on current clinical characteristics and management strategies for patients presenting concurrently with seizures and a newly diagnosed brain lesion, while aiming to synthesize a potential management protocol or set of recommendations for these patients.

Long-Term Functional Outcome Following Neurosurgical Intervention for Suspected Abusive Head Trauma.

Background: The purpose of this study was to evaluate the long-term functional and neurodevelopmental outcomes in pediatric patients who underwent neurosurgical intervention following suspected abusive head trauma (AHT).

Methods: We performed a single-center retrospective review (January 1, 2007, to December 31, 2019) of patients aged less than three years who had intracranial injury suspicious for AHT and received a neurosurgical procedure. Long-term functional outcome was measured using the Pediatric Cerebral Performance Category (PCPC), Pediatric Overall Performance Category (POPC), and the Mullen Scales of Early Learning (MSEL).

Supratotal Surgical Resection for Low-Grade Glioma: A Systematic Review.

Low-grade gliomas (LGGs) are optimally treated with up-front maximal safe surgical resection, typically defined as maximizing the extent of tumor resection while minimizing neurologic risks of surgery. Supratotal resection of LGG may improve outcomes beyond gross total resection by removing tumor cells invading beyond the tumor border as defined on MRI. However, the evidence regarding supratotal resection of LGG, in terms of impact on clinical outcomes, such as overall survival and neurologic morbidities, remains unclear.

The Effects of Nicotine- and Cigarette-Related Products on Osteogenesis, Bone Formation, and Bone Mineralization: A Systematic Review.

Background: Many clinicians associate nicotine as the causative agent in the negative and deleterious effects of smoking on bone growth and spine fusion. Although nicotine is the primary driver of physiological addiction in smoking, isolated and controlled use of nicotine is one of the most effective adjuncts to quitting smoking.

Objective: To explore the relationship between nicotine and noncombustion cigarette products on bone growth.

Occult pediatric skull fracture and implications for delay in diagnosis: illustrative case.

Background: After being struck in the left side of the head by a thin metal rod, a 10-year-old, previously healthy male presented to an urgent care clinic with a subcentimeter scalp laceration in the midline parietal area and a normal neurological exam. Evaluation included skull radiographs, which did not demonstrate a definitive fracture. Following laceration repair, the patient was discharged to home.

Rehabilitation and functional outcomes in internally braced and standard ACL reconstructions.

Purpose: The purpose of this study was to compare surgical outcomes in patients who underwent ACL reconstruction, with and without internal bracing, at 1-3, 4-7, and 8-12 months of postoperative physical therapy. Previous studies show that ACL reconstruction with internal bracing allows earlier and more aggressive rehabilitation. Therefore, it was hypothesized that patients with internal bracing would display superior surgical recovery compared to ACL reconstruction alone after adjusting for length of physical therapy.

The influence of preoperative rotator cuff cross-sectional area and strength on postoperative outcomes in reverse shoulder arthroplasty.

Background: Although preoperative function and range of motion (ROM) are determinants of postoperative outcome following reverse shoulder arthroplasty (RSA), there is limited data on the influence of preoperative rotator cuff status. The purpose of this study was to evaluate the relationship between preoperative rotator cuff physiologic cross-sectional area (PCSA) and strength on postoperative RSA outcome.

Methods: A retrospective review was conducted on 53 primary RSAs from a multicenter database performed between 2015 and 2019 using a 135° humeral neck-shaft angle.

Factors Associated with Internal Rotation After Reverse Shoulder Arthroplasty: A Narrative Review.

Reverse shoulder arthroplasty (RSA) leads to improvement in pain and function with a durable outcome in most cases. While improvement in forward flexion and to a lesser degree external rotation is predictably seen after RSA, restoration of internal rotation (IR) is much less predictable. The purpose of this review was to provide a narrative of the modifiable factors, including prosthetic design and surgical factors, that may impact postoperative IR after RSA.

Dysregulation of the EphrinB2-EphB4 ratio in pediatric cerebral arteriovenous malformations is associated with endothelial cell dysfunction in vitro and functions as a novel noninvasive biomarker in patients.

We investigated (1) EphrinB2 and EphB4 receptor expression in cerebral AVMs, (2) the impact of an altered EphrinB2:EphB4 ratio on brain endothelial cell function and (3) potential translational applications of these data. The following parameters were compared between AVM endothelial cells (AVMECs) and human brain microvascular endothelial cells (HBMVECs): quantified EphrinB2 and EphB4 expression, angiogenic potential, and responses to manipulation of the EphrinB2:EphB4 ratio via pharmacologic stimulation/inhibition. To investigate the clinical relevance of these in vitro data, Ephrin expression was assessed in AVM tissue (by immunohistochemistry) and urine (by ELISA) from pediatric patients with AVM (n = 30), other cerebrovascular disease (n = 14) and control patients (n = 29), and the data were subjected to univariate and multivariate statistical analyses.

Dual Lewis Acid/Photoredox-Catalyzed Addition of Ketyl Radicals to Vinylogous Carbonates in the Synthesis of 2,6-Dioxabicyclo[3.3.0]octan-3-ones.

A combined Lewis acid/photoredox catalyst system enabled the intramolecular umpolung addition of ketyl radicals to vinylogous carbonates in the synthesis of 2,6-dioxabicyclo[3.3.0]octan-3-ones.