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Taylor E. Purvis, C. Rory Goodwin, Camilo A. Molina, Steven M. Frank and Daniel M. Sciubba

and also previously published randomized trials. 17 , 20 , 23 Statistical Analysis Linear regression was used to test the association between preoperative risk factors and percentage decrease in Hb concentrations while controlling for the following potential confounding factors: age, sex, ASA class, CCI score, surgical group, preoperative Hb level, nadir Hb level < 7 g/dL, PRBC transfusion, units of PRBC transfused, estimated blood loss (EBL), crystalloid fluid volume, and length of stay (LOS). Logistic regression was used to test the effect of percentage ΔHb on

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Kaisorn L. Chaichana, Courtney Pendleton, Daniel M. Sciubba, Jean-Paul Wolinsky and Ziya L. Gokaslan

findings offer useful insights into the care of patients with MESCC. Nevertheless, prospective and higher-volume studies are needed to provide better data to guide clinical decision-making. Conclusions Recent studies have supported the efficacy of decompressive surgery at maintaining the ability to walk for patients with MESCC from solid primary tumors. These studies, however, have grouped patients with distinct types of primary cancers all into the same study population. Studies identifying differences between patients with different primary cancers remain few and

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Surgical management of giant presacral schwannoma: systematic review of published cases and meta-analysis

Presented at the 2019 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves

Zach Pennington, Erick M. Westbroek, A. Karim Ahmed, Ethan Cottrill, Daniel Lubelski, Matthew L. Goodwin and Daniel M. Sciubba

the bibliographies of included articles to identify additional reports. All articles were screened by two reviewers (Z.P. and E.M.W.) with conflicts adjudicated by a third reviewer (A.K.A.). Studies meeting criteria for full-text review were then evaluated for the endpoints of interest, which included patient age and sex, presenting symptoms, surgical approach, EOR, intraoperative EBL and operative duration, maximal tumor dimension and tumor volume, morphology, postoperative complications, follow-up duration, and local recurrence. In cases in which maximal tumor

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Rafael De la Garza-Ramos, Amit Jain, Khaled M. Kebaish, Ali Bydon, Peter G. Passias and Daniel M. Sciubba

A dult spinal deformity (ASD) is a common spinal disorder in patients over 60 years of age, with studies suggesting prevalence as high as 68%. 17 Although corrective surgery achieves better outcomes in terms of leg pain and disability compared with nonoperative treatment, 15 , 19 complication rates range from 37% to 78% in the literature. 1 , 3 , 9 , 18 Risk factors for complication development include age over 65 years, longer constructs, female sex, revision procedures, and having surgery performed by a low-volume surgeon or at a low-volume hospital

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A. Karim Ahmed, Zachary Pennington, Camilo A. Molina, Yuanxuan Xia, C. Rory Goodwin and Daniel M. Sciubba

both neoadjuvant therapy to reduce the tumor volume in sensitive pathologies, 15 , 23 , 24 , 30 , 34 and current 3D printing technologies, which produce unparalleled representations of unique patient anatomy during surgical planning. 16 , 19 , 39 The aim of this work is to describe two cases of this multidisciplinary planning for en bloc resection of primary cervical malignancies. Multidisciplinary Management All primary spine tumors receive multidisciplinary management at our institution beginning with imaging, biopsy, and staging of the lesion. 15 , 17 , 21 , 30

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Erick M. Westbroek, Zach Pennington, A. Karim Ahmed, Yuanxuan Xia, Christine Boone, Philippe Gailloud and Daniel M. Sciubba

demonstrated intraoperative embolization to be safe when performed at high-volume centers. 8 , 10 Even at high-volume centers, complete embolization is often impossible, such as in cases in which a tumor-feeding vessel shares a common origin with a radiculomedullary artery. One outstanding question in the literature is how the degree of tumor embolization impacts intraoperative blood loss. The purpose of this study was to evaluate this endpoint, specifically, to determine whether intraoperative blood loss was correlated with the extent of preoperative tumor embolization. As

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Paul E. Kaloostian, Jennifer E. Kim, Ali Bydon, Daniel M. Sciubba, Jean-Paul Wolinsky, Ziya L. Gokaslan and Timothy F. Witham

system implementation that was not existent at the time of those encounters. Average hourly drain output before symptom onset was 9.2 ml per hour, or a daily average of 221 ml per day. The total volume of intraoperative CSF loss was not recorded, but all CSF leaks were repaired immediately upon detection. Intracranial Hemorrhage All 8 patients were symptomatic postoperatively. Symptom onset ranged from immediately after surgery to postoperative Day 3, and symptoms included headache (n = 1), aphasia (n = 1), seizure (n = 1), and altered mental status (n = 4). No

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Daniel M. Sciubba, R. Morgan Stuart, Matthew J. McGirt, Graeme F. Woodworth, Amer Samdani, Benjamin Carson and George I. Jallo

-hospital mortality rates after ventriculoperitoneal shunt procedures in the United States, 1998 to 2000: relation to hospital and surgeon volume of care. J Neurosurg (Pediatrics 2) 100 : 90 – 97 , 2004 Smith ER, Butler WE, Barker FG II: In-hospital mortality rates after ventriculoperitoneal shunt procedures in the United States, 1998 to 2000: relation to hospital and surgeon volume of care. J Neurosurg (Pediatrics 2) 100: 90–97, 2004 47. Vinchon M , Lemaitre MP , Vallee L , Dhellemmes P : Late shunt infection: incidence

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Ryan M. Kretzer, Daniel M. Sciubba, Carlos A. Bagley, Jean-Paul Wolinsky, Ziya L. Gokaslan and Ira M. Garonzik

construct. The patient was discharged in stable condition 4 days after completion of the staged surgical procedure. F ig . 5 Postoperative anteroposterior x-ray film showing the spinal construct. F ig . 6 Postoperative axial (A) and volume-rendered sagittal (B) and coronal (C) reconstructed CT scans showing bilateral crossing T-1 translaminar screws. Discussion Although transpedicular screw fixation offers the benefits of known stability and high rates of fusion, the pedicular anatomy in the high thoracic spine makes PS placement at these levels

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Camilo A. Molina, Rachel Sarabia-Estrada, Ziya L. Gokaslan, Timothy F. Witham, Ali Bydon, Jean-Paul Wolinsky and Daniel M. Sciubba

tumor was excised and harvested from the female athymic carrier rats for intravertebral tumor implantation. Harvested solid tumor was maintained in sterile saline solution before its implantation, and the tissue was cut into approximately 0.1-cm 3 fragments, a volume smaller than that of the 1-mm drilled cavity, to leave sufficient room for additional placement of an absorbable bovine collagen sponge, which served as the drug delivery vehicle. Specifically, animals in the experimental cohort received sponges impregnated with 15 μg of rhBMP-2 (10 μl of 1.5-mg