Neurosurgery
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Currently, little is known about the prognostic value of tumor growth rate (TGR) in spinal giant cell tumors of bone (GCTB). ⋯ These data support the use of TGR as a reliable predictive tool for clinically relevant outcomes and response to denosumab therapy of spinal GCTB, which may be helpful in guiding prognostic risk stratification and therapeutic optimization of patients.
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Most professional spine societies have enacted formal guidelines for spine surgeons providing expert witness services. However, there is significant heterogeneity in existing recommendations, with most societies providing information that is limited in detail and scope. ⋯ There remains a paucity in expert witness guidelines provided by professional spine societies. Although existing recommendations are useful, there is a lack of standardized and comprehensive materials for spine surgeons providing expert witness testimony to reference. Moving forward, joint committees comprising surgeons, attorneys, and patient stakeholders may help improve the guidelines.
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Intraventricular metastases (IVMs) are uncommon, and their optimal management remains debatable. ⋯ SRS is an effective treatment option for IVMs, with a local IVM control rate comparable with SRS for parenchymal brain metastases. Leptomeningeal spread and hydrocephalus in patients with IVM occur in a minority of patients, but these patients warrant careful follow-up to detect these changes.