World Neurosurg
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There is a paucity of studies on readmission rates in elderly patients over a period of 360 days after spinal surgery. ⋯ We found that electrocardiographic abnormalities, male sex, low hemoglobin levels, asthma, heart disease, intensive care unit admission, low aspartate aminotransferase level, high body mass index, and high platelet level were risk factors for readmission. As the postoperative observational period became longer, the reasons for readmission tended to be more related to non-surgical site-related problems than to surgical-related problems.
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Dorsal spinal instrumentation with cervical pedicle screws (CPS) and rod constructs is performed for numerous pathologies of the cervical spine, although technically demanding. Screw misplacement is biomechanically disadvantageous and carries the risk of neurovascular sequelae. The aim of this study was to assess the accuracy of patient-specific, template-guided CPS placement from C2 to C7 compared with the freehand technique. ⋯ In a cadaver model, template-guided CPS placement has a significantly greater accuracy than the freehand technique. This accuracy is comparable with navigated techniques reported in the literature.
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Clear cell sarcoma (CCS) is a rare malignant soft tissue tumor with poor prognosis owing to metastasis and insensitive response to chemotherapy and radiotherapy. ⋯ To the best of our knowledge, this is the first case of primary central nervous system CCS. Primary CCS may involve the skull and should be one of the differential diagnoses for intra-extracranial communicating tumors. Further research on biological characteristics and molecular targeted therapy of CCS are needed to improve its poor prognosis.
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Serotonin syndrome (SS) is a common disease entity and could result in death if missed. The incidence of SS is underestimated due to misdiagnosis of many cases, especially the ones with less severe presentation. Many medications have been depicted as the source of SS. We present a case of SS in a patient who received intravenous tramadol and oral gabapentin as pain management after spine surgery. ⋯ Physicians treating spine patients should be alert about SS in patients using both tramadol and gabapentin.
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Parotid adenocarcinoma comprises 10% of all parotid cancers and does not frequently produce distant metastases. The most common site for metastases is the lung, and there have only been 2 reported cases of skeletal metastases. The purpose of this study is to report the first vertebral metastasis from a primary parotid adenocarcinoma. Patient records, imaging, and pathology from a case of vertebral metastasis of a primary parotid adenocarcinoma were reviewed. A literature review of parotid adenocarcinoma metastases was also performed and is presented. ⋯ Distant metastases from a primary parotid adenocarcinoma are rare events, especially metastases to bone. This case represents the first vertebral metastasis from a primary parotid adenocarcinoma.