Review
Oncology
Joel Z. Passer, Christopher Alvarez-Breckenridge, Laurence Rhines, Franco DeMonte, Claudio Tatsui, Shaan M. Raza
Summary: The management of chordoma along the cranial-spinal axis is challenging due to the aggressive nature of the tumor, anatomic constraints, and limited response to radiation and chemotherapy. Treatment typically involves surgical resection, with postoperative radiation increasingly becoming a treatment option. Modern surgical techniques have improved outcomes, with multidisciplinary teams playing a crucial role in the management of this complex disease.
CURRENT TREATMENT OPTIONS IN ONCOLOGY
(2021)
Article
Clinical Neurology
Daniel G. Tobert, Sean P. Kelly, Grace X. Xiong, Yen -Lin Chen, Shannon M. MacDonald, Michiel E. Bongers, Santiago A. Lozano -Calderon, Erik T. Newman, Kevin A. Raskin, Joseph H. Schwab
Summary: This study aimed to report the mid-term results of primary spinal chordoma treated with en bloc resection and proton-based RT with a minimum of 5 years of follow-up. The study found that the addition of C70 RT to surgical excision conferred a benefit to overall survival and local recurrence.
Review
Pharmacology & Pharmacy
Margot Martinez Moreno, Elaina Wang, Christian Schroeder, Patricia Sullivan, Ziya Gokaslan
Summary: Despite advancements in radiation and surgical treatment, chordomas remain resistant to chemotherapy and local recurrence is common. Targeted chemotherapeutic agents for postoperative adjuvant treatment are needed to address these challenges.
EXPERT OPINION ON THERAPEUTIC TARGETS
(2023)
Review
Medicine, General & Internal
Sean M. Barber, Saeed S. Sadrameli, Jonathan J. Lee, Jared S. Fridley, Bin S. Teh, Adetokunbo A. Oyelese, Albert E. Telfeian, Ziya L. Gokaslan
Summary: Chordoma is a malignant and challenging low-grade notochordal tumor, with extent of surgical resection and adequacy of surgical margins being crucial prognostic factors. Ongoing research focuses on potential molecular therapy targets for improved outcomes.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Clinical Neurology
Peter Obid, Tamas Fekete, Philipp Drees, Daniel Haschtmann, Frank Kleinstueck, Markus Loibl, Dezsoe Jeszenszky
Summary: Chordomas are rare tumors with high local recurrence rate but low metastasis. This study analyzed the outcomes of revision surgery for cervical spine chordomas, with a 72.6% five-year overall survival rate and a common long-term complication of pharyngeal wall dehiscence. Thorough preoperative planning and adjuvant radiotherapy were found to improve surgical outcomes.
EUROPEAN SPINE JOURNAL
(2021)
Article
Clinical Neurology
Yixuan Zhai, Jiwei Bai, Mingxuan Li, Shuai Wang, Chuzhong Li, Xinting Wei, Yazhuo Zhang
Summary: The study aimed to establish and validate a prognostic nomogram for predicting progression-free survival (PFS) in chordoma patients. By analyzing the expression levels of biomarkers, the researchers confirmed clinical factors and biomarkers associated with PFS.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Nikita Zaborovskii, Adam Schlauch, Dmitrii Ptashnikov, Dmitrii Mikaylov, Sergei Masevnin, Oleg Smekalenkov, John Shapton, Dimitriy Kondrashov
Summary: This study investigates risk factors for instrumentation failure requiring revision surgery in patients with spinal tumors. The study finds that pelvic fixation, invasiveness of the surgery, and survival greater than 5 years are independent risk factors for hardware failure.
Article
Gastroenterology & Hepatology
Zhi-Peng Liu, Wei-Yue Chen, Yan-Qi Zhang, Yan Jiang, Jie Bai, Yu Pan, Shi-Yun Zhong, Yun-Ping Zhong, Zhi-Yu Chen, Hai-Su Dai
Summary: This study evaluated the impact of postoperative morbidity on tumor recurrence and mortality in patients with HCCA following curative resection. The results showed that postoperative morbidity is associated with decreased overall survival and recurrence-free survival, especially in cases of major morbidity.
WORLD JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Oncology
Walter Banfield, Myrsini Ioakeim-Ioannidou, Saveli Goldberg, Soha Ahmed, Joseph H. Schwab, Gregory M. Cote, Edwin Choy, John H. Shin, Francis J. Hornicek, Norbert J. Liebsch, Yen -Lin E. Chen, Shannon M. MacDonald, Thomas F. DeLaney
Summary: This study retrospectively reviewed the outcomes of high-dose proton-based definitive radiotherapy for newly diagnosed, unresected spinal and sacral chordomas. The results showed that high-dose definitive radiotherapy is an effective treatment option for medically inoperable or otherwise unresected mobile spine or sacrococcygeal chordomas.
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Oncology
Joshua M. Kolz, Elizabeth P. Wellings, Matthew T. Houdek, Michelle J. Clarke, Michael J. Yaszemski, Peter S. Rose
Summary: The study reviewed the outcomes of surgical treatment for primary mobile spine chordomas over a 25-year period, showing that en bloc resection with negative margins was associated with improved local recurrence-free survival. Complications were common, but en bloc resection appeared to offer better oncologic outcomes for these rare malignant tumors.
JOURNAL OF SURGICAL ONCOLOGY
(2021)
Article
Clinical Neurology
Abdul Karim Ghaith, Oluwaseun O. Akinduro, Carlos Perez-Vega, Antonio Bon Nieves, Kingsley Abode-Iyamah, Naresh Patel, Maziyar Kalani, Michelle J. Clarke, Peter Rose, Mohamad Bydon
Summary: This study aimed to predict long-term tumor progression in spinal chordomas using machine learning algorithms and immunohistochemical markers like EMA.
JOURNAL OF NEUROSURGERY-SPINE
(2023)
Article
Orthopedics
Pedro Berjano, Alice Baroncini, Riccardo Cecchinato, Francesco Langella, Stefano Boriani
Summary: This article presents a case of chordoma in L3 treated with an oncologically appropriate en-bloc resection using an open posterior approach combined with a mini-retroperitoneal approach. The results demonstrate that minimally invasive anterior surgery can be combined with open posterior access for the treatment of primary malignant tumors in the lumbar spine, highlighting the importance of extensive training in oncologic and minimally invasive surgery for the surgical team.
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
(2023)
Article
Surgery
Yukinori Kurokawa, Yuichiro Doki, Junki Mizusawa, Takaki Yoshikawa, Takanobu Yamada, Yutaka Kimura, Shuji Takiguchi, Yasunori Nishida, Norimasa Fukushima, Haruhiko Cho, Masahide Kaji, Motohiro Hirao, Mitsuru Sasako, Masanori Terashima
Summary: This study aims to compare the efficacy and safety of bursectomy and omentectomy alone in gastric cancer surgery. The results showed that bursectomy did not improve the overall survival rate of patients with gastric cancer, and it also increased the risk of intra-abdominal infection.
BRITISH JOURNAL OF SURGERY
(2022)
Article
Multidisciplinary Sciences
Derui Yan, Qi Zhao, Zixuan Du, Huijun Li, Ruirui Geng, Wei Yang, Xinyan Zhang, Jianping Cao, Nengjun Yi, Juying Zhou, Zaixiang Tang
Summary: This study aimed to develop an immune-related radiosensitivity gene signature to predict the survival of lower-grade gliomas (LGGs) patients who received radiotherapy. Patients were classified into a radiosensitive (RS) group and a radioresistant (RR) group based on this gene signature, and the RS group showed a higher overall survival rate. The gene signature was specific to radiotherapy and could serve as an independent prognostic indicator. By incorporating this gene signature and other clinical factors, the nomogram model performed well in predicting the survival of LGGs patients after radiotherapy.
SCIENTIFIC REPORTS
(2022)
Article
Clinical Neurology
Zach Pennington, Erick M. Westbroek, Sheng-fu Larry Lo, Daniel M. Sciubba
Summary: The study proposed a surgical approach algorithm for cervicothoracic spine tumors, classifying approaches based on staging and trajectory. The findings suggest that a combination of tumor histology and regional anatomy can help determine which patients may benefit from extended anterior surgical access.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Rafael De la Garza Ramos, Jong Hyun Choi, Ishan Naidu, Joshua A. Benton, Murray Echt, Vijay Yanamadala, Peter G. Passias, John H. Shin, David J. Altschul, C. Rory Goodwin, Daniel M. Sciubba, Reza Yassari
Summary: This retrospective cohort study aimed to investigate the impact of race on complications following spinal tumor surgery. The results showed that Black patients who underwent metastatic spinal tumor surgery were at a significantly higher risk of minor complications compared to non-Hispanic Whites. However, there was no significant difference in major complications between the two racial groups.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Bryn Hilton, Emma L. Gardner, Zhilin Jiang, Lindsay Tetreault, Jamie R. F. Wilson, Carl Moritz Zipser, K. Daniel Riew, James D. Guest, James S. Harrop, Michael G. Fehlings, Ricardo Rodrigues-Pinto, Vafa Rahimi-Movaghar, Bizhan Aarabi, Paul A. Koljonen, Mark R. N. Kotter, Benjamin M. Davies, Brian K. Kwon
Summary: This article discusses the importance of establishing diagnostic criteria for Degenerative Cervical Myelopathy (DCM), including factors that need to be considered and challenges that need to be overcome. Presently, there is no single set of diagnostic criteria for DCM, making it difficult for clinicians to make a diagnosis. Prompt diagnosis of DCM is crucial for early surgical intervention.
GLOBAL SPINE JOURNAL
(2022)
Article
Clinical Neurology
Aladine A. Elsamadicy, Andrew B. Koo, Benjamin C. Reeves, Zach Pennington, Margot Sarkozy, Andrew Hersh, John Havlik, Josiah J. Z. Sherman, C. Rory Goodwin, Luis Kolb, Maxwell Laurans, Sheng-Fu Larry Lo, John H. Shin, Daniel M. Sciubba
Summary: This study investigated the impact of frailty using the Hospital Frailty Risk Score (HFRS) on patients undergoing surgery for primary tumors of the spinal cord and meninges. The results showed that frail patients were older, experienced more postoperative complications, had longer length of stay, higher rates of non-routine discharge, and increased hospital costs. Frailty was found to be an independent predictor of extended length of stay and non-routine discharge.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Dimitri Tkatschenko, Sonja Hansen, Julia Koch, Christopher Ames, Michael G. Fehlings, Sigurd Berven, Lali Sekhon, Christopher Shaffrey, Justin S. Smith, Robert Hart, Han Jo Kim, Jeffrey Wang, Yoon Ha, Kenny Kwan, Yong Hai, Marcelo Valacco, Asdrubal Falavigna, Nestor Taboada, Alfredo Guiroy, Juan Emmerich, Bernhard Meyer, Frank Kandziora, Claudius Thome, Markus Loibl, Wilco Peul, Alessandro Gasbarrini, Ibrahim Obeid, Martin Gehrchen, Andrej Trampuz, Peter Vajkoczy, Julia Onken
Summary: This study provides an international overview of the heterogeneity of surgical site infection prevention strategies in spine surgery. The results demonstrate a significant variation in pre-, peri-, and postoperative measures to prevent surgical site infection. There is a need for developing universal guidelines and testing areas of controversy in prospective clinical trials.
GLOBAL SPINE JOURNAL
(2023)
Article
Oncology
Alexander C. Disch, Stefano Boriani, Aron Lazary, Laurence D. Rhines, Alessandro Luzzati, Ziya L. Gokaslan, Charles G. Fisher, Michael G. Fehlings, Michelle J. Clarke, Dean Chou, Nicole M. Germscheid, Klaus-Dieter Schaser, Jeremy J. Reynolds
Summary: Compared to secondary lesions, primary spinal tumors are rare. The effect of different resection strategies on local recurrence and survival in patients with benign primary spinal tumors under the age of 25 was studied. The results showed no correlation between the grade of aggressiveness in resection and local recurrence rates in this younger patient cohort. The most common tumors in young patients were osteoblastomas, osteoid osteomas, and aneurysmal bone cysts.
Article
Oncology
Alexander C. Disch, Stefano Boriani, Alessandro Luzzati, Laurence D. Rhines, Charles G. Fisher, Aron Lazary, Ziya L. Gokaslan, Dean Chou, Michelle J. Clarke, Michael G. Fehlings, Klaus-Dieter Schaser, Nicole M. Germscheid, Jeremy J. Reynolds
Summary: Extradural primary malignant spinal tumors in young patients are rare. This study reports the clinical outcomes of young patients who underwent surgery for these tumors. The results show that surgery, combined with adjuvant therapy, can achieve better overall survival and low local recurrence rates.
Article
Clinical Neurology
Raymond Wong, Nader Hejrati, Michael G. G. Fehlings
Summary: This article discusses several key challenges that clinical investigators evaluating novel therapeutic strategies to treat traumatic spinal cord injury (SCI) may face, and proposes potential solutions, including patient recruitment, patient follow-up, heterogeneity of patients, complex pathophysiology of SCI, capturing treatment effects, high costs, implementation of guidelines, demographic shifts, and navigating regulatory bodies.
EXPERT REVIEW OF NEUROTHERAPEUTICS
(2023)
Article
Clinical Neurology
Edwin Owolo, Zoey Petitt, Dana Rowe, Emily Luo, Brandon Bishop, Emily Poehlein, Cynthia L. Green, Chad Cook, Melissa Erickson, C. Rory Goodwin
Summary: This study reveals disparities in telemedicine utilization among the surgical spine patient population. Surgeons can use this information to guide interventions aimed at reducing existing disparities and collaborate with specific patient populations to find solutions.
Review
Cell & Tissue Engineering
Katarzyna Pieczonka, Michael G. Fehlings
Summary: Spinal cord injury (SCI) has a significant impact on quality of life and finances. Neural stem/progenitor cell (NSPC) transplantation shows promise for spinal cord regeneration, but the integration of transplanted cells remains a challenge. This review proposes various techniques, including molecular cues and alternative methods, to guide the integration of grafted cells towards specific circuits. Future research in these areas may improve outcomes for SCI patients.
STEM CELLS TRANSLATIONAL MEDICINE
(2023)
Article
Cell Biology
Katarzyna Pieczonka, Mohamad Khazaei, Michael G. G. Fehlings
Summary: In this study, the expression of Olig2 transcription factor was induced in tripotent neural progenitor cells (NPCs), leading to a significantly higher proportion of differentiated oligodendrocytes compared to NPCs. The induction of Olig2 was also associated with the upregulation of genes involved in oligodendrocyte development and function, and the downregulation of genes involved in other cell lineages. GO and GSEA analyses further confirmed the oligodendrocyte specification of the induced NPCs.
Article
Cell & Tissue Engineering
Katarzyna Pieczonka, Hiroaki Nakashima, Narihito Nagoshi, Kazuya Yokota, James Hong, Anna Badner, Jonathon C. T. Chio, Shinsuke Shibata, Mohamad Khazaei, Michael G. Fehlings
Summary: Traumatic spinal cord injury (SCI) causes the loss of neurons and glial cells. Current interventions for SCI lack regenerative solutions. Neural stem/progenitor cell (NPC) transplantation is a promising strategy for regeneration but inconsistent differentiation hinders functional recovery. This study generated oligodendrogenically biased NPCs (oNPCs) from human induced pluripotent stem cells (hiPSCs) and demonstrated their effectiveness in a rodent model of cervical SCI, showing enhanced tissue preservation, remyelination, and functional recovery without adverse effects. These findings highlight the therapeutic potential of oNPCs in cervical SCI and call for further investigation to optimize this approach.
STEM CELLS TRANSLATIONAL MEDICINE
(2023)
Article
Orthopedics
Nisaharan Srikandarajah, Mohammed Ali Alvi, Michael G. Fehlings
Summary: Traumatic spinal cord injury (SCI) is a serious disorder that leads to neurological impairment and disability, affecting the quality of life for patients. The pathophysiology involves primary and secondary phases, causing neurological damage. Current clinical management focuses on early decompressive surgery, optimizing arterial pressure, steroid therapy, and rehabilitation. Emerging therapies aim to repair the spinal cord through cell-based, gene, pharmacological, and neuromodulation approaches. Addressing both primary and secondary phases of SCI can enhance outcomes for patients.
JOURNAL OF ORTHOPAEDICS
(2023)
Review
Clinical Neurology
Ayesha Quddusi, Karlo M. M. Pedro, Mohammed Ali Alvi, Nader Hejrati, Michael G. G. Fehlings
Summary: Acute traumatic spinal cord injury (tSCI) is a severe event with global impact on morbidity and mortality. Early surgical intervention within 24 hours has been shown to improve prognosis and functional outcomes. This review explores the evidence, nuances, and challenges associated with timing of surgery, as well as the barriers to early surgical care for tSCI.
ACTA NEUROCHIRURGICA
(2023)
Review
Clinical Neurology
Nader Hejrati, Karlo Pedro, Mohammed Ali Alvi, Ayesha Quddusi, Michael G. Fehlings
Summary: Degenerative cervical myelopathy (DCM) includes age-related and genetically associated pathologies affecting the cervical spine. The RECODE-DCM consensus group has identified ten priority areas for translational research to improve the management and treatment of DCM. This article summarizes recent advancements in the field, including a refined definition, understanding of pathophysiology, assessment and diagnosis methods, treatment modalities, and genetic research opportunities.
ACTA NEUROCHIRURGICA
(2023)
Article
Public, Environmental & Occupational Health
Roger Wong, Margaret Anne Lovier
Summary: Older adults and people of colour are more vulnerable to COVID-19, and despite higher adherence to mitigation behaviours, minority older adults still have elevated odds of COVID-19. Research is needed to explore potential mechanisms for this disparity.
EPIDEMIOLOGY AND INFECTION
(2023)