World Neurosurg
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Intradural extramedullary metastatic melanoma is a rare entity with only 13 other cases reported in the literature.1 Of these, only 3 have been described in the cervical spine.2-4 Metastatic melanoma to the brain has historically portended a grim prognosis; however, due to the paucity of reported intradural lesions, the clinical course, including surgical findings, is less well known. This video illustrates a case of a 59-year-old man with new left arm pain and numbness found to have cervical intradural extramedullary metastatic melanoma (Video 1). ⋯ Considering its rarity, visualizing the intraoperative resection is important for surgeons who may potentially treat such pathology. Patient consented for the procedures and for publication of the video.
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The American Medical Association and National Institutes of Health have recommended that patient education materials should be written at the sixth-grade reading level to maximize patient comprehension. The objective of the present study was to evaluate the readability of Internet information for the 9 most common spinal surgeries. ⋯ The most accessed online materials for common spinal surgeries, not only exceeded the readability limits recommended by both the American Medical Association and the National Institutes of Health, but they also exceeded the average reading ability of most adults in the United States. Patients, therefore, might not fully comprehend the information from commonly accessed websites regarding surgical spine treatment options.
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Intervertebral fusions in cases of reduced bone density are a tough challenge. From a biomechanical point of view, most current studies have focused on the range of motion or have shown test setups for single-component tests. Definitive setups for biomechanical testing of the primary stability of a 360° fusion using a screw-rod system and cage on osteoporotic spine are missing. The aim of this study was to develop a test stand to provide information about the bone-implant interface under reproducible conditions. ⋯ This setup is suitable for biomechanical testing of cyclical continuous loads on the spine with reduced bone quality or osteoporosis. The embedding method is stable and ensures a purely single-level setup with different trajectories, especially when using the cortical bone trajectory. Optical monitoring provides a very accurate indication of cage movement, which correlates with the macroscopic and radiological results.
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This study aims to demonstrate the efficacy of salvage oblique lumbar interbody fusion (OLIF) surgery for pseudarthrosis after posterior/transforaminal lumbar interbody fusion (PLIF/TLIF). ⋯ The salvage OLIF approach was useful option for pseudarthrosis after PLIF/TLIF. It enabled us to build a rigid anterior support, allowed for extensive curettage of intervertebral scar tissue, and reduced the rate of the complications associated with dealing with posterior scar tissue.
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Previous research in neurosurgery has examined academic productivity for U.S. medical graduates and residents. However, associations between scholarly output and international medical education, residency training, and fellowship training are scarcely documented. ⋯ Neurosurgeon scholarly output was not significantly affected by international training in medical school or residency. Dual fellowship training in both a domestic and an international program was associated with higher academic productivity.