World Neurosurg
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Many predictive models for estimating clinical outcomes after spine surgery have been reported in the literature. However, implementation of predictive scores in practice is limited by the time-intensive nature of manually abstracting relevant predictors. In this study, we designed natural language processing (NLP) algorithms to automate data abstraction for the thoracolumbar injury classification score (TLICS). ⋯ We have developed a machine learning NLP model for extracting TLICS features from radiology reports, which we deployed in a web application that can be integrated into clinical practice.
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Esthesioneuroblastoma (ENB) is a rare cancer deriving from the olfactory mucosa. Among the basal or neural genomic subtypes, the basal subtype is associated with poorer survival, poor differentiation, and higher levels of tumor-infiltrating immune cells (TIICs). The immune microenvironment of these ENB subtypes remains unclear. We used an established machine learning algorithm on ENB transcriptomic profiles. ⋯ Basal and neural subtypes display distinct TIIC involvement, which may impact their difference in outcome. These findings provide the framework for further investigation in novel immunomodulation strategies for ENB.
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Transitional lumbosacral vertebra presents in 2 forms based on its origin: sacralization and lumbarization. These patients have 2 options for sacral endplates (upper and lower) and consequently, 2 sets of values for spinopelvic parameters and lumbar lordosis (LL). This study aimed to evaluate these parameters in asymptomatic patients with sacralization and lumbarization and compare them with each other and normative values. ⋯ Upper and lower endplate parameters are comparable in patients with sacralization and lumbarization; therefore, the average spatial position of a sacralized L5 and a lumbarized S1 within the pelvis is similar and either parameter can be used for radiological measurements. Further studies with symptomatic patients are warranted to confirm these results.
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To improve implant stability parameters, including pedicle screw (PS) outer diameter, thread depth, and pitch, by finite element analysis. ⋯ The presently used models are feasible for evaluating the implant stability of PSs. The maximum insertion torque and maximum pullout force of PSs are highly correlated and can be improved by increasing the outer diameter and decreasing pitch. Although with the parameters of the PS, pedicle size and bone mineral density are 2 additional factors to consider for better implant stability.
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The contralateral interhemispheric approach provides a robust path into the mesial frontal lobe and basal ganglia structures.1 The use of gravity to retract the dominant frontal lobe allows the surgeon to avoid injury caused by exposure of the dominant hemisphere. The transfalcine corridor, however, is long and often not well illuminated, necessitating the use of lighted instruments. Within the path of approach lie the anterior cerebral arteries, which must be carefully dissected and preserved. ⋯ The lesion was approached from a contralateral interhemispheric approach and removed completely. The patient's examination improved with removal of the mass lesion. This case demonstrates the utility of this approach for accessing deep corridors within the cerebral cortices.