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Management of pediatric odontoid fractures is tricky and controversial. C188-9 research buy This study will enrich world literature with intricacies of anterior odontoid screw (OS) fixation in the pediatric population learned over the last decade.

In this retrospective study, all patients with pediatric odontoid fracture who underwent anterior odontoid screw fixation from January 2010 to December 2019 were included and evaluated for surgical outcome.

Thirteen patients were included in this study (mean age, 15 years; range, 6-18 years; male/female, 112; type II, 10; type IIA, 1; type III, 2). Common causes of injury were motor vehicle accidents (61.5%) followed by fall from height (38.5%) and all were acute fractures (2-30 days). Five patients had neurologic deficits. Accurate placement of screw was achieved in 92.3% of patients, including all 9 patients who used intraoperative O-arm. K wire migration during bicortical drilling resulted in neurovascular injury, with 1 mortality (7.7%). The remaining 12 patients were availab wire to avoid cranial migration. Intraoperative O-arm guidance is useful.

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), and intracranial hemorrhage (ICH) may complicate the post-operative course of patients undergoing craniotomy. While prophylaxis with unfractionated heparin (UFH) has been shown to reduce VTE rates, twice-daily (BID) and three-times-daily (TID) UFH dosing regimens have not been compared in neurosurgical procedures. The objective of this study was to explore the association between UFH dosing regimen and rates of VTE and ICH in craniotomy patients.

A retrospective chart review was conducted for 159 patients at Northwestern University receiving 5000 units/0.5 mL UFH injections either BID (n= 132) or TID (n= 27). General linear regression models were run to predict rates of DVT, PE, and reoperation due to bleeding from UFH dosing regimen while controlling for age at surgery, sex, VTE history, craniotomy for tumor resection, surgery duration, length of stay, reoperation, infections, and IDH/MGMT mutations.

Receiving UFH TID was significantly associated with a lower rate of PE when compared with receiving UFH BID (β= -0.121, P= 0.044; TID rate= 0%, BID rate=10.6%). UFH TID also showed a trend toward lower rates ofDVT (β= -0.0893, P= 0.295; TID rate= 18.5%, BID rate= 21.2%) when compared with UFH BID. UFH TID showed no significant difference in rate of reoperation forbleeding when compared to UFH BID (β= -0.00623, P=0.725; TID rate= 0%, BID rate= 0.8%).

UFH TID dosing is associated with lower rates of PE when compared with BID dosing in patients undergoing craniotomy.

UFH TID dosing is associated with lower rates of PE when compared with BID dosing in patients undergoing craniotomy.

Radiation therapy is a common treatment for meningiomas. Volume changes of meningiomas in response to radiation are not well characterized. This study seeks to quantify the volume change of meningiomas following radiation.

Data were collected from a retrospective single-institution database of cases from 2005-2015. Tumors were measured using T1-weighted post-contrast magnetic resonance imaging. Volumes were calculated using the ABC/2 ellipsoidal approximation.

A total of 63 patients fit the inclusion criteria; 37 patients (59%) received radiation following resection, 19 (30%) received radiation alone, 4 (6%) received radiation following a biopsy, and 3 (5%) had unknown surgical status. A total of 39 patients (62%) had skull base meningiomas; 43 tumors were World Health Organization (WHO) grade I, and 12 tumors were WHO grade II. Thirteen patients received radiosurgery, 43 received radiotherapy, and 7 received an unknown number of treatments. Eight patients did not attain local control and were excluded from volume analyses. WHO grade I meningiomas saw an average of 33% ± 19% decrease in tumor volume; WHO grade II tumor volumes decreased by an average 30% ± 23%. Radiosurgery saw an average volume decrease of 34% ± 13%, while radiotherapy resulted in volume decrease of 31% ± 21%. For those who achieved local control, there was an average decrease in tumor size of 30% ± 19%, 30% ± 22%, and 41% ± 19% over 0.5-1.5, 2.5-3.5, and >5 years, respectively.

Meningiomas treated with radiation exhibit nonlinear decrease in size over time. The greatest decrease in tumor volume occurs within the first year and begins to plateau 5 years post-radiation treatment.

Meningiomas treated with radiation exhibit nonlinear decrease in size over time. The greatest decrease in tumor volume occurs within the first year and begins to plateau 5 years post-radiation treatment.

To assess organizational and technical difficulties of neurosurgical procedures during the coronavirus disease 2019 (COVID-19) pandemic and their possible impact on survival and functional outcome and to evaluate virological exposure risk of medical personnel.

Data for all urgent surgical procedures performed in the COVID-19 operating room were prospectively collected. Preoperative and postoperative variables included demographics, pathology, Karnofsky performance status (KPS) and neurological status at admission, type and duration of surgical procedures, length of stay, postoperative KPS and functional outcome comparison, and destination at discharge. We defined 5 classes of pathologies (traumatic, oncological, vascular, infection, hydrocephalus) and 4 surgical categories (burr hole, craniotomy, cerebrospinal fluid shunting, spine surgery). Postoperative SARS-CoV-2 infection was checked in all the operators.

We identified 11 traumatic cases (44%), 4 infections (16%), 6 vascular events (24%), 2 hydrocepg the COVID-19 pandemic. Personal protective equipment affects maneuverability, dexterity, and duration of interventions without affecting survival and functional outcome.

Among the interbody fusions, lateral lumbar interbody fusion allows access to the lumbar spine through the major psoas muscle, which offers several advantages to the spine surgeon. However, some of its drawbacks cause surgeons to avoid using it as a daily practice. Therefore, to address some of these challenges, we propose the prone transpsoas technique, differing mainly from the traditional technique on patient position-moving from lateral to prone decubitus, theoretically enhancing the lordosis and impacting the psoas morphology.

Twenty-four consecutive patients were invited to have magnetic resonance imaging examinations in 3 different positions (prone, dorsal, lateral). Two observers measured the following parameters vertebral body size, psoas diameter, psoas anterior border distance, plexus distance, total lumbar lordosis, distal lumbar lordosis, and proximal lumbar lordosis. Values of P < 0.05 were deemed significant.

The prone position yielded a significant increase in the lumbar lordosis, both in L1-S1 (57° vs.