World Neurosurg
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Rhabdoid meningioma (RM) and papillary meningioma (PM) are rare variants of World Health Organization grade III meningiomas. In this study, we presented a series of 23 cases from our institution to investigate adverse factors of and appropriate treatment for RM and PM. ⋯ We recommended adjuvant radiation regardless of the extent of resection. Individuals with PM or RM were at increased risk of recurrence and death; appropriate treatment for these patients should be further studied, and close follow-up is needed.
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Some patients experience failed back surgery syndrome after lumbar spine surgery. We report the effect of additional treatments for paralumbar spine and peripheral nerve diseases addressing residual symptoms after surgery. ⋯ Of 74 patients who underwent lumbar spine surgery, 16 (21.6%) required additional surgery. To reduce the incidence of failed back surgery syndrome, concurrent diseases that may be masked by symptoms resulting from severe lumbar spine disease must be ruled out, as these diseases may become apparent after initial lumbar spine surgery.
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Hormonal insufficiency of 1 or more pituitary axes can appear after pituitary surgery. Adrenal axis impairment after surgery can lead to serious consequences if not identified and treated. ⋯ Hypothalamic pituitary adrenal axis insufficiency is common after endoscopic transsphenoidal surgery. Male gender, age greater than 50 years, visual impairment, and intraoperative CSF leak were correlated with late postoperative AI. More than two thirds of patients in whom early AI developed did not require steroids in the long term.
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The biopsy is recognized as the most accurate method to determine the histologic characterization of sellar germ cell tumors. It is difficult to evaluate the prognosis before histologic confirmation. ⋯ Diameter >15 mm, octamer-binding transcription positivity, or NGGCT was associated with a poorer prognosis for patients with sellar GCTs, whereas the combination of chemotherapy and radiotherapy was associated with a better prognosis.
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Spine surgeons are exposed to high amounts of radiation from fluoroscopic procedures during their lifetime. In this study, we evaluated spine surgeons' knowledge of and attitude regarding radiation exposure during spine surgery. ⋯ Future efforts toward implementing educational programs in Latin America focused on safety strategies are needed to minimize intraoperative radiation exposure.