World Neurosurg
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To characterize the intratumoral immune microenvironment and evaluate its clinical implications in patients with primary axial osteosarcoma. ⋯ Our results suggested that the immune microenvironment is of clinically relevant significance in patients with axial osteosarcoma. Specifically, we identified both PD-L1+ TILs and CD8+ TILs as independent favorable prognostic markers.
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Lateral lumbar interbody fusion (LLIF) at the L4-L5 level is a controversial topic in the spine data. The aim of the present study was to compare the rate of nerve-related motor deficits in patients undergoing LLIF with and without L4-L5 involvement. ⋯ The results from the present large study are in line with previous investigations reporting an initial increased risk of new motor deficits for LLIF performed at L4-L5. However, most new motor deficits were transient in nature and had resolved over time.
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To analyze the effects of direct vertebral rotation (DVR) on radiologic outcomes in the treatment of thoracic adolescent idiopathic scoliosis after selective thoracic fusion with pedicle screw instrumentation. ⋯ For correcting single thoracic adolescent idiopathic scoliosis by selective thoracic fusion with pedicle screw instrumentation, the addition of DVR to the surgical procedure showed comparable radiologic outcomes compared with non-DVR procedures.
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Supratentorial cavernous malformations (CMs) can be epileptogenic lesions. However, little is known about clinical comorbidities, medication use, and radiologic features that predict a first seizure presentation without associated CM hemorrhage. ⋯ These prospective data provide possible clues to radiologic factors, clinical comorbidities, and medication influences on seizure presentation in patients with CM. Further multicenter studies would be helpful to determine if disease-modifying agents in addition to epileptic medications or surgery might be helpful.
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The foundation of spine surgery centers on the proper identification, decompression, and stabilization of bony and neural elements. We describe easily reproducible and reliable methods for optimal decompression and release of neural structures to alleviate symptoms and improve patients' quality of life. ⋯ After properly identifying the anatomic structures, each of these techniques provides a consistent, reproducible, and efficient means to decompress the spine under various circumstances. These techniques provide surgical trainees with a framework for approaching surgical decompression.