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Saumitra K. Thakur, Benjamin A. Rubin and David H. Harter

complications. 3 Our group described a novel technique for paraspinal subfascial catheter placement. Of the 20 patients who underwent the procedure, none had hardware complications or CSF leakage that required replacement or revision over an average follow-up period of 5 months. 5 This study expands on the original work by our group by following 43 patients who underwent paraspinal subfascial ITB placement with a median follow-up of 3.0 years. Methods Study Review Using an institutional review board (IRB)-approved protocol, the electronic medical records were

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Hannah E. Gilder, Ross C. Puffer, Mohamad Bydon and Robert J. Spinner

specifically, spinal tumors have been theorized to have a greater potential for brain metastases. Nonetheless, no published literature to date has shown a potential mechanism for these hypotheses, although CSF is the hypothesized route for malignant dissemination. 9 In this study, we sought to compare tumors with intradural extension to those remaining in the epidural or paraspinal space with the hypothesis that intradural extension may be a mechanism for seeding of the CSF with malignant cells, thereby resulting in higher rates of CNS metastases and shorter overall

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Patrick Paullus, Taylor A. Wilson, Paul Lee, Arunprasad Gunasekaran and Noojan Kazemi

In this video, the authors demonstrate a minimally invasive approach and resection of a paraspinal schwannoma. Using an expandable retractor, the authors were able to identify important adjacent bony landmarks and hence visualize and remove this peripheral nerve sheath tumor. While a tubular retractor is commonly used for interbody fusion procedures, the location of the tumor allowed this minimally invasive approach resulting in excellent access, minimal soft-tissue injury, and a short hospital stay. The authors present this approach as a less invasive and yet effective technique for resection of otherwise difficult-to-access nerve lesions.

The video can be found here:

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Ryan S. Kitagawa, Michel E. Mawad, William E. Whitehead, Daniel J. Curry, Thomas G. Luersen and Andrew Jea

A lthough both spinal and paraspinal AVMs are uncommon, spinal AVMs have been well documented and classified according to anatomical and pathophysiological features with implications for prognosis and treatment. 10 , 12 , 16 Paraspinal AVMs are much less common 3 and present unique challenges in diagnosis and management; their significance lies in their potential to cause spinal cord dysfunction manifesting as spinal venous congestion 8 or spinal epidural hematoma as well as congestive heart failure. We review 16 previously published pediatric cases of

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Ali Tahmouresie, Peter M. Farmer and Norman Stokes

M yxomas originating from the skeletal muscles have been reported only rarely. 8, 9 We are presenting a case of myxoma of the thoracolumbar paraspinal muscle, with erosion of the T11–12 spinous processes and laminae, epidural mass effect, and spinal cord compression. Case Report This 50-year-old man entered Kings County Hospital in March, 1977, with the chief complaints of severe back pain and progressive gait disturbance. His history began 30 years before with the development of sudden midback pain when he bent to pick up an object. He was treated

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Marc S. Arginteanu and Noel I. Perin

, knees, and elbows. 9, 11 Rarely, calcinosis is manifested as a large tumoral mass that may cause symptoms by impinging on contiguous structures. 4 Paraspinal calcinosis has been the subject of a few case reports; 5, 6, 9, 11 however, its occurrence in the cervical spine with attendant canal compromise and spinal instability has not been discussed. We report a case of symptomatic cervical paraspinal calcinosis in a patient with progressive systemic sclerosis and discuss the cause and treatment of this disorder. Case Report This 65-year-old woman was diagnosed

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Joseph S. Domino, Shane Weindel and Sarah Woodrow

I ntramuscular myxomas (IMMs) are rare tumors of mesenchymal origin that are most often located in large skeletal muscles, particularly of the thigh. 3 , 14 , 24 Although benign and slow growing, these tumors can become symptomatic due to local mass effect. IMMs have been reported in the paraspinal musculature of the cervical, thoracic, and lumbosacral regions. 2 , 5 , 13 , 19 , 21 , 27 When located in the paraspinal musculature, neurological symptoms such as radiculopathy and myelopathy from spinal cord compression have been reported. 6 , 26 Growth patterns

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Katharine D. Harper, Dayna Phillips, Joseph M. Lopez and Zeeshan Sardar

the paraspinal musculature and therefore is not well studied in this setting. In our review of the literature, we found that 17 patients have been previously identified as having an acute paraspinal compartment syndrome; however, none of the reports addressed the details of surgical management with a technical description. 1 , 4 , 5 , 10 , 11 We describe a case of acute, traumatic paraspinal compartment syndrome and the path leading to its diagnosis and treatment. Surgical fasciotomy led to a positive response without significant neurological deficits

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Fumio Shima, Keiichi Mihara and Shoji Hachisuga

A ngiomas limited to the paraspinal and epidural tissues are rare. 11 Epidural hematomas appear to be an unusual complication of angiomas lying in the epidural tissue 4, 11 or vertebrae. 8 The case reported in this paper is quite a rare instance of angioma situated mainly in the paraspinal muscles and extending partly into the epidural tissue, where a hematoma developed. Emphasis is placed on the diagnostic and therapeutic value of a detectable spinal bruit. Percutaneous embolization reduced bleeding and facilitated surgical excision of the angioma and

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Mark E. Oppenlander, M. Yashar S. Kalani and Curtis A. Dickman

paraspinal space and the vertebral bodies anteriorly. Computed tomography angiography of the neck revealed extensive bony erosion and circumferential encasement of the paraspinal C5–7 nerves and the right vertebral artery. F ig . 1. Sagittal (A) , parasagittal (B) , and axial (C) T2-weighted MR images showing an extensive intradural/extramedullary, epidural, and intraosseous lesion. The patient was admitted to our neurosurgical service. The initial differential diagnosis was an atypical nerve sheath tumor, metastatic malignancy, or sarcoma. Stereotactic