World Neurosurg
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Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed primary non-Hodgkin lymphoma of the spine and can induce spinal compression. Reports of lymphoma arising in bone adjacent to metallic prostheses are increasing. However, to our knowledge, DLBCL arising from a scar after lumbar fusion surgery has not been reported previously. ⋯ This case highlights the need to consider malignancy in the differential diagnosis and carefully examine surgical specimens in revision surgery. Further understanding of the role of metal implants in the development of lymphoma is required.
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Comparative Study
Identifying disparities in care in treating glioblastoma: A retrospective cohort study of patients treated at a safety-net versus private hospital setting.
Patients of lower socioeconomic status (SES) may experience barriers to their oncologic care, but current data conflict over whether SES affects the prognosis of patients with glioblastoma (GB). ⋯ Although GB patients at our SNH received less adjuvant treatment compared with PH, outcomes were similar. Access to multidisciplinary care staffed by academic physicians may play an important role in overcoming socioeconomic barriers to treatment availability and quality at SNHs.
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Case Reports
Spinal cοrd compression secondary to a brοwn tumοr as a first manifestation of primary hyperparathyroidism.
Brown tumors (BTs) represent the typical nonmalignant lesions of hyperparathyroidism. Mandibles, ribs, and large bones are the most usual localization of BT. The diagnosis of these tumors requires biological and radiologic assessments. Their treatment is essentially based on parathyroidectomy. ⋯ The brown tumor, when localized at the level of the spine, can be life-threatening and must be managed as soon as possible.
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Knowledge of the anatomy of the foramen transversarium (FT) is essential for performing surgical procedures on the cervical spine. The aim of the present study was to analyze the characteristics of the FT anatomy of the lower cervical spine and its anatomic variations using computed tomography (CT) in a Brazilian population. ⋯ We determined the morphometric features of the FT using CT images. Anatomic variations were observed that justify their study before performing cervical surgical procedures.
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Anterior cervical diskectomy and fusion (ACDF) is the main surgical treatment of cervical radiculopathy. Controversy exists about the need to resect the posterior longitudinal ligament (PLL) to directly decompress the nerve roots, or if it is sufficient to indirectly decompress with diskectomy and graft placement. The objective of this study was to determine the effect of PLL resection after ACDF. ⋯ ACDF leads to a high rate of success in improvement of preoperative radiculopathy. Excision of PLL during surgery leads to 3.8 times greater odds of improvement in this symptom, with no significant difference in the complication rate.