World Neurosurg
-
Case Reports
Modularized Implant Assembly for Spinal Fusion - A Means For Managing Adjacent Level Disease: Technical Report.
The occurrence of adjacent-level disease in spinal fusion is a complex and contentious issue. Through the years, surgeons have developed various approaches to address this problem. While some have avoided fusion altogether, others have advocated for large, multilevel fusion constructs. With the advent of minimally invasive spine surgery, there are now novel approaches to the spine which allow for less onerous and morbid revision surgeries. In this paper, we present the case of a woman who previously underwent a posterior cervical fusion and presented with adjacent-level disease. ⋯ We believe that our case is demonstrative of a new, modularized approach to spinal fusion and suggest a way forward in the treatment of adjacent-level disease.
-
To understand cost distribution in a 90-day episode of care following posterior spinal fusions (PSFs) for adolescent idiopathic scoliosis (AIS). ⋯ Facility costs are a major determinant of overall 90-day costs following PSFs in AIS. Providers should aim at optimizing the co-morbidity burden and constructing accelerated care-pathways to decrease the length of stay and reduce the cost of the entire episode of care.
-
Low-grade gliomas (LGGs) are known to progress to glioblastoma (GBM), decreasing the chances of survival. The tumor necrosis factor receptor CD40 and its ligand CD40L have shown value as biomarkers for GBM. The present study evaluated the role of CD40/CD40L in LGG and GBM in differentiating isocitrate dehydrogenase (IDH) wild-type and IDH-mutant GBM. ⋯ High CD40 expression showed a significant correlation with poor outcomes for both LGG and GBM and was overexpressed in IDH wild-type GBM.