Neurosurgery
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Interhospital transfer from community hospitals to centers specialized in managing traumatically injured individuals can strain patients, healthcare systems, and delay appropriate care. The purpose was to compare long-term neurological outcomes in transferred or directly admitted patients with traumatic spinal cord injury (SCI). ⋯ Therapeutic level II.
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Posterior reconstruction of the cervicothoracic junction poses significant biomechanical challenges secondary to transition from the mobile cervical to rigid thoracic spines and change in alignment from lordosis to kyphosis. After destabilization, the objectives of the current investigation were to compare the rod strain and multidirectional flexibility properties of the cervicothoracic junction using a 4-rod vs traditional 2-rod reconstructions. ⋯ Supplemental accessory rods affixed to traditional 2-rod constructs significantly improved stability of Ti alloys and CoCr alloy materials. The 4.0-mm CoCr rods provided greater stability than 3.5-mm Ti rods in flexion-extension, lateral bending, and axial rotation. While rod strain was not significantly reduced by the addition of accessory rods, it was reduced in CoCr rod treatment groups compared with the Ti rods.
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Review
Long-term Survival From Breast Cancer Brain Metastases in the Era of Modern Systemic Therapies.
Median survival for all patients with breast cancer with brain metastases (BCBMs) has increased in the era of targeted therapy (TT) and with improved local control of intracranial tumors using stereotactic radiosurgery (SRS) and surgical resection. However, detailed characterization of the patients with long-term survival in the past 5 years remains sparse. The aim of this article is to characterize patients with BCBM who achieved long-term survival and identify factors associated with the uniquely better outcomes and to find predictors of mortality for patients with BCBM. ⋯ Patients with BCBM can achieve long-term survival. The use of TT and HER2+ disease are associated with long-term survival. The primary cause of death was extracranial disease progression, and none of the patients living ≥5 years died of CNS-related disease.
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Multicenter Study
Clinical and Imaging Outcomes After Trigeminal Schwannoma Radiosurgery: Results From a Multicenter, International Cohort Study.
An international, multicenter, retrospective study was conducted to evaluate the long-term clinical outcomes and tumor control rates after stereotactic radiosurgery (SRS) for trigeminal schwannoma. ⋯ SRS was associated with long-term freedom (10 year) from additional management in 80% of patients. SRS proved to be a valuable salvage option after resection. When used as a primary management for smaller volume tumors, both clinical improvement and prevention of new deficits were optimized.