World Neurosurg
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Cervical spondylotic myelopathy (CSM) is a degenerative disease that represents the most common spinal cord disorder in adults. The best treatment option has remained controversial. We performed a prospective study to evaluate the clinical, radiographic, and neurophysiologic outcomes for anterior cervical corpectomy in the treatment of CSM. ⋯ Single- and multilevel corpectomy are valid and safe options in the treatment of CSM. In the present prospective study, a statistically significant improvement in the mJOA score and neurophysiologic parameters was observed for both moderate and severe forms of CSM.
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Intraventricular metastatic brain tumors account for a small, but challenging, fraction of metastatic brain tumors (0.9%-4.5%). Metastases from renal cell carcinoma (RCC) account for a large portion of these intraventricular tumors. Although patient outcomes have been assumed to be poor, these have not been reported in a modern series with a multimodality treatment paradigm of radiotherapy (RT), resection, and cerebrospinal fluid (CSF) diversion. We have presented the first case series of patients with intraventricular metastatic tumors from RCC. ⋯ Despite the relatively limited overall survival for this population with metastatic cancer, comparable to contemporary parenchymal brain metastasis cohorts, reasonable local central nervous system control was achieved in most patients using a paradigm of focal RT and resection, where indicated. Finally, CSF diversion was not required even in patients presenting with hydrocephalus.
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Racial disparities, such as differential treatment and provider bias, negatively affect quality of life for minority patients. However, literature evaluating racial/ethnic differences in the treatment of primary spinal cord tumors (SCTs), a rare condition relying primarily on neurosurgical care, is lacking. ⋯ African Americans were less likely to receive surgical intervention for treatment of primary SCTs compared with whites. Hispanic patients faced longer hospital stays. These disparities may be attributed to compromised access, provider attitudes and biases, communication barriers, or historical distrust in the medical community: issues that health care reform should address.