World Neurosurg
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Dumbbell-shaped tumor is a type of inner and outer cervical spinal canal tumor, and most of these are neurogenic. Desmoid tumors are rare, and, to the best of our knowledge, no case of desmoid tumors involving intervertebral foramen formed dumbbell-shaped tumors in the cervical spine have been reported before in English literature. Here we report a case of a desmoid tumor occurring in the cervical spine that is presented as a typical dumbbell-shaped tumor. ⋯ Desmoid tumors in the head and neck may present as cervical dumbbell-shaped tumors. Before the treatment plan was made, thorough examinations, including surgical pathology, were necessary.
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In this study, we present our experiences on the feasibility of rescue permanent Solitaire stent placement for failed mechanical thrombectomy (MT) and our protocol to avoid ineffective stent placement. ⋯ Permanent Solitaire stent placement might be a feasible therapy for patients with MT-failed emergency large artery occlusion. For a successful revascularization, careful antegrade flow assessment before stent detachment is critical.
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Spinal ependymomas are rare, with an incidence of 1 per 100,000. Given the paucity of data for higher grade II and III disease, the management and patterns of care require further investigation. ⋯ Approximately 40% of patients with grade III ependymomas do not receive immediate adjuvant therapy, which may be related to distance from a facility. Patients with this rare tumor may benefit from multidisciplinary care at facilities with a larger volume.
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Recent population-level increases in intravenous drug abuse (IVDA) may contribute to incidence of spinal infection. The aim of this study was to evaluate national trends of spinal infections and evaluate effect of IVDA on outcomes in operative management of spinal infection. ⋯ From 2002 to 2014 in the United States, the incidence of operatively treated spine infections increased 227.9%, and the proportion of cases associated with IVDA significantly increased. Patients with IVDA had a longer mean length of stay and increased inpatient cost of care but were not at increased risk for complication, reoperation, or mortality. These findings are important for surgeons, internists, hospitals, and insurers to ensure proper resource allocation in treating these at-risk patients.
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Progression of scoliosis following completion of growth, and the combination of low mental retardation and the conspicuous sagittal clinical and radiographic abnormalities suggest a secondary genesis of the scoliosis according to a genetic aberration. ⋯ In the presence of dysplastic sacral changes and accompanying elongated conus medullaris in patients with scoliosis, it is always necessary to think of rare chromosome aberrations and to initiate appropriate diagnostics before surgery. The intraoperative neurophysiological monitoring is strongly recommended, owing to a morphologically, and not fully-excludable, tethered cord syndrome.