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Corinna C. Zygourakis, Taemin Oh, Matthew Z. Sun, Igor Barani, James G. Kahn and Andrew T. Parsa

V estibular schwannomas (VSs; also known as acoustic neuromas) are benign tumors that represent approximately 10% of intracranial primary brain tumors. 12 Although they may be asymptomatic, they often present with unilateral hearing loss, tinnitus, imbalance, or vertigo. When they are discovered, VSs are managed in 3 ways: observation (the “wait and scan” approach); Gamma Knife surgery (GKS); or microsurgery. There is a significant body of literature (including many single- and multi-institution studies, as well as meta-analyses) regarding which

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Andrei F. Joaquim, Wellington K. Hsu and Alpesh A. Patel

physical demands that may put his spine at risk for new injury. The spines of high-performance athletes are under unique forces of compression and repetitive and intensive shear, increasing the prevalence of spondylosis. 1 , 8 , 9 Additionally, spine problems may affect the athlete's psychological state, which may lead to early retirement. 8 , 9 Considering the unique aspects involved in the management spinal diseases of professional athletes, we performed a systematic review of papers reporting the outcomes of cervical spine surgery in high-level athletes

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Ross C. Puffer, Ryan Planchard, Grant W. Mallory and Michelle J. Clarke

S urgery has long been an accepted treatment for symptomatic lumbar degenerative disease. Although outcomes at 2 years are similar with surgery and nonoperative measures, some recent studies have suggested that continued medical management beyond 6 weeks without improvement is not cost-effective. 11 , 17 Furthermore, although the upfront costs of operative management are higher, the overall economic impact (e.g., loss of productivity, continued medical evaluation, and treatment) may be higher in patients who are managed conservatively than in those who

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Hillary A. Shurtleff, Dwight Barry, Timothy Firman, Molly H. Warner, Rafael L. Aguilar-Estrada, Russell P. Saneto, John D. Kuratani, Richard G. Ellenbogen, Edward J. Novotny and Jeffrey G. Ojemann

to resection; 30 4) wide ranges of presurgical seizure duration; 28 and 5) variable pathologies. 2 , 28 Because many pediatric studies have focused on different age ranges, some studies have attempted to narrow the developmental scope, but their methods have still varied from each other, making them difficult to compare. Age range samples include patients less than 6 or 7 years at surgery, 19 , 28 3 to 7 years, 6 8 to 159 months, 34 less than 3 years, 20 , 26 or 3 to 36 months. 3 A number of studies 7 , 21 , 22 , 29 , 32 , 37 have focused on temporal

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Gregory W. Poorman, Peter G. Passias, Samantha R. Horn, Nicholas J. Frangella, Alan H. Daniels, D. Kojo Hamilton, Hanjo Kim, Daniel Sciubba, Bassel G. Diebo, Cole A. Bortz, Frank A. Segreto, Michael P. Kelly, Justin S. Smith, Brian J. Neuman, Christopher I. Shaffrey, Virginie LaFage, Renaud LaFage, Christopher P. Ames, Robert Hart, Gregory M. Mundis Jr. and Robert Eastlack

strong negative impact on postsurgery pain and outcome. 14 , 18 Specifically, patients with anxiety and depression have reported higher levels of postsurgery pain and worse long-term outcomes. 11 , 13 Currently there is no protocol for helping patients with depression and anxiety as they undergo cervical spine deformity surgery, whereas attempts at establishing protocols in the lumbar spine surgery population have been better developed. 31 Similar recommendations for the cervical spine were summarized in a review published in the Journal of Orthopedic and Sports

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Sayoa Alvarez de Eulate-Beramendi, Valérie Rigau, Luc Taillandier and Hugues Duffau

D iffuse WHO Grade II glioma (diffuse low-grade glioma [DLGG]) is an infiltrative brain tumor that will inevitably grow and become malignant. 4 As recommended by the European Guidelines, 20 extensive resection should be proposed, even beyond the abnormality visible on FLAIR MR images when possible. 23 Indeed, early and radical surgery has been reported to significantly increase the overall survival. 2 , 9 , 19 Local tumor recurrence is nonetheless usual. In these cases, additional surgery (or surgeries) should be considered because reoperation also has

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Anthony L. Asher, Clinton J. Devin, Brandon McCutcheon, Silky Chotai, Kristin R. Archer, Hui Nian, Frank E. Harrell Jr., Matthew McGirt, Praveen V. Mummaneni, Christopher I. Shaffrey, Kevin Foley, Steven D. Glassman and Mohamad Bydon

of a reduced sample size and, thus, statistical power. The QOD, in contrast, offers the benefits of both paradigms and allows spine surgeons to gain new insight into critical clinical topics. There is extensive literature documenting that patient smoking status is strongly associated with worse outcomes following spine surgery. One study found that rates of readmission, need for intensive care unit admission, length of stay, and total cost following spine surgery were increased for smokers relative to nonsmokers. 4 A separate study demonstrated higher rates of

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Lindsay Tetreault, Ahmed Ibrahim, Pierre Côté, Anoushka Singh and Michael G. Fehlings

C ervical spondylotic myelopathy (CSM) is a progressive degenerative spine disease and the most common cause of spinal cord dysfunction in adults worldwide. 33 , 65 Although generally safe and effective, surgery for the treatment of CSM is associated with complications in 11%–38% of patients. 6 , 15 These include dysphagia, C-5 radiculopathy, wound infection, axial pain, and postoperative kyphosis. Guidelines for the surgical management of CSM are rapidly evolving, and surgeons must consider several variables when selecting a surgical approach. 69

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Justin S. Smith, Eric Klineberg, Virginie Lafage, Christopher I. Shaffrey, Frank Schwab, Renaud Lafage, Richard Hostin, Gregory M. Mundis Jr., Thomas J. Errico, Han Jo Kim, Themistocles S. Protopsaltis, D. Kojo Hamilton, Justin K. Scheer, Alex Soroceanu, Michael P. Kelly, Breton Line, Munish Gupta, Vedat Deviren, Robert Hart, Douglas C. Burton, Shay Bess, Christopher P. Ames and the International Spine Study Group

, surgical treatment may be an option for patients who have unsatisfactory improvement. Multiple recent reports have demonstrated the potential of surgical treatment of ASD to provide significant improvement in pain, disability, and HRQOL. 5 , 6 , 25 , 48 , 49 , 53–57 , 60 However, these procedures are often complex and may be associated with high rates of complications. 4 , 6 , 14 , 15 , 17 , 22 , 39 , 44 , 45 , 50–52 , 55 , 58 , 61 , 63 Previously reported studies of ASD surgery complications have been limited by retrospective design, single-surgeon or single

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Michael E. Sughrue, Tyson Sheean, Phillip A. Bonney, Adrian J. Maurer and Charles Teo

R ecurrence in glioblastoma (GBM) is inevitable. Given that GBMs typically recur focally, 8 and in many cases, resection of all or most of the enhancing portion of the tumor is possible in experienced hands, 5 , 6 repeat resection is often a feasible management strategy. However, there is a paucity of literature to inform decision making for resectable focally recurrent tumor and help clinicians and surgeons decide when surgery is worth the risk. That our opinions and actions inherently change the overall survival (OS) independent of the intervention