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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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Takuma Nomiya, Kenji Nemoto, Toshihiro Kumabe, Yoshihiro Takai and Shogo Yamada

M alignant gliomas and astrocytomas account for approximately 50% of primary CNS tumors in adults: glioblastomas multiforme account for approximately 30%, AAs for approximately 10%, and low-grade astrocytomas for approximately 10%. It has been reported that the median survival period of patients with AA is 10 to 40 months (~ 20–30 months on average). 6 , 16 , 20 , 22 It has been reported as well that the major prognostic factors for patients with AA are age, KPS status, and extent of surgery. In some studies investigators have also shown that the

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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

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Gabriel Zada, Walavan Sivakumar, Dawn Fishback, Peter A. Singer and Martin H. Weiss

-term normalization of GH levels can be achieved via multimodal surgical, medical, and radiosurgical therapy. After successful resection of a GH-secreting adenoma, patients may experience rapid improvement in cardiovascular, respiratory, and endocrinological function. 9 , 16 , 18 , 19 Furthermore, immediate improvement in soft-tissue edema has been reported to occur in 97% of patients and is often accompanied by a notable diuresis of third-space fluid. 14 , 21 The brisk diuresis encountered during the first few days following transsphenoidal surgery in patients with acromegaly

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Michael H. Brisman, Chandranath Sen and Peter Catalano

P atients with head and neck cancers that involve the carotid artery at the skull base have a poor prognosis, and morbidity and mortality rates are usually related to local tumor growth and recurrence. 1, 5, 9 There have been reports advocating that some of these tumors be resected while preserving the carotid artery. 4, 14 Also, some authors have argued for tumor resection with a policy of strict preservation of the carotid artery. 3 With advances in skull base surgery and carotid artery revascularization several surgeons have suggested that these tumors

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Mazda K. Turel, Sumit Thakar and Vedantam Rajshekhar

A discrepancy between surgeon-assessed and patient-perceived outcomes of vestibular schwannoma (VS) surgery has been reported. 16 , 19 , 22 Hence, there is a need for greater emphasis on quality of life (QOL) outcomes (which are patient reported) following surgery for VS. Most of the QOL studies in patients undergoing surgery for VS are retrospective and include patients with small tumors. 1–7 , 14 , 18 , 21 , 23 , 27 , 28 , 31 Few studies have reported QOL following surgery for large VS, but even those have mostly been retrospective in nature. 22 , 25

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Kazunori Hayashi, Louis Boissière, Fernando Guevara-Villazón, Daniel Larrieu, Susana Núñez-Pereira, Anouar Bourghli, Olivier Gille, Jean-Marc Vital, Ferran Pellisé, Francisco Javier Sánchez Pérez-Grueso, Frank Kleinstück, Emre Acaroğlu, Ahmet Alanay and Ibrahim Obeid

important factor in patient-centered measures of healthcare for evaluating surgical success. Achieving adequate satisfaction is often regarded as one of the goals of ASD management. (Throughout this article, “satisfaction” refers to patient satisfaction with the results of management.) However, there is a lack of discussion on the specific demographic, radiographic, and health status factors associated with satisfaction. Spine surgeons should avoid targeting only the postoperative radiographic spinal alignment without considering the goal of the surgery. Furthermore, the

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Fredrik Strömqvist, Björn Strömqvist, Bo Jönsson, Paul Gerdhem and Magnus K. Karlsson

L umbar disc herniation (LDH) has been thoroughly evaluated in adults, in respect to epidemiology, 28 natural history, 60 and surgical outcome. 42 , 49 , 61 Due to the low incidence of LDH in children, few studies have evaluated pediatric cases. Most young patients with LDH are treated nonoperatively, and in Sweden, LDH surgery is only performed at a rate of approximately 20 per 100,000 individuals per year ( www.4s.nu ). Furthermore, only 3% of all LDH surgery is done in individuals below the age of 20 years, and in only 0.5% in those younger than 16

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Aladine A. Elsamadicy, Owoicho Adogwa, Emily Lydon, Amanda Sergesketter, Rayan Kaakati, Ankit I. Mehta, Raul A. Vasquez, Joseph Cheng, Carlos A. Bagley and Isaac O. Karikari

significant risk factor for poor surgical outcomes after spine surgery, such as increased pain and postoperative disability. 15 , 17 In particular, postoperative delirium has also been associated with increases in complication rates, hospital length of stay, in-hospital mortality, and overall health care costs. 3 , 14 Due to the quality of care and economic implications of postoperative delirium, previous studies have attempted to determine independent associations and risk factors for postoperative delirium. In a retrospective study of 549 patients who underwent spinal

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Darryl Lau, Matthew R. Leach, Frank La Marca and Paul Park

pain; 35 , 38 myelopathy; 11 and in many cases, loss of ambulation. 2 , 32 Surgical management of spinal metastasis is widely considered a palliative intervention, and prognosis remains poor, with survival times commonly less than a year after surgery. 13 , 27 , 40 In the current literature there are very few large studies that directly examined risk factors and predictors of survival in patients who underwent surgery for spinal metastasis using multivariate analysis, and it remains elusive as to which methods are truly reliable. 3 , 13 , 28 , 41 , 42 There are