World Neurosurg
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Clear cell sarcoma (CCS) is a rare malignant soft tissue tumor with poor prognosis owing to metastasis and insensitive response to chemotherapy and radiotherapy. ⋯ To the best of our knowledge, this is the first case of primary central nervous system CCS. Primary CCS may involve the skull and should be one of the differential diagnoses for intra-extracranial communicating tumors. Further research on biological characteristics and molecular targeted therapy of CCS are needed to improve its poor prognosis.
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Serotonin syndrome (SS) is a common disease entity and could result in death if missed. The incidence of SS is underestimated due to misdiagnosis of many cases, especially the ones with less severe presentation. Many medications have been depicted as the source of SS. We present a case of SS in a patient who received intravenous tramadol and oral gabapentin as pain management after spine surgery. ⋯ Physicians treating spine patients should be alert about SS in patients using both tramadol and gabapentin.
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Dorsal spinal instrumentation with cervical pedicle screws (CPS) and rod constructs is performed for numerous pathologies of the cervical spine, although technically demanding. Screw misplacement is biomechanically disadvantageous and carries the risk of neurovascular sequelae. The aim of this study was to assess the accuracy of patient-specific, template-guided CPS placement from C2 to C7 compared with the freehand technique. ⋯ In a cadaver model, template-guided CPS placement has a significantly greater accuracy than the freehand technique. This accuracy is comparable with navigated techniques reported in the literature.
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There is a paucity of studies on readmission rates in elderly patients over a period of 360 days after spinal surgery. ⋯ We found that electrocardiographic abnormalities, male sex, low hemoglobin levels, asthma, heart disease, intensive care unit admission, low aspartate aminotransferase level, high body mass index, and high platelet level were risk factors for readmission. As the postoperative observational period became longer, the reasons for readmission tended to be more related to non-surgical site-related problems than to surgical-related problems.
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Traumatic brain injury (TBI) is a major health issue in developing nations such as India along with underreporting of TBI data because of a lack of major studies targeting the population with TBI. Various lacunae from field to tertiary centers are responsible for this significant burden of TBIs. We studied the epidemiologic profile of 1150 patients with TBI including the predictors of the outcome of TBIs in a tertiary health care institution in North India to identify the modifiable factors that could be used to improve the outcome and reduce the TBI burden. ⋯ Knowledge about the causes, pattern, and distribution of patients with TBI from this study is helpful in policy making, research, health management, and rehabilitation at the national level in ours and in other nations.