Summary of Key Points Pediatric spinal cord injury (SCI) is rare and requires a review of the principles of medical management. The goals of pediatric SCI management are to optimize neurological recovery, minimize medical complications, initiate early mobilization, and facilitate…
Summary of Key Points Although there is significant preclinical research supporting early surgery for traumatic spinal cord injury (tSCI), the timing of surgery remains a controversial topic among spine surgeons. The evidence supporting early surgery consists primarily of retrospective studies…
Summary of Key Points Avoiding hypotension after spinal cord injury (SCI) is a key pillar of modern SCI management. The concept of a complete SCI is outdated: no intervention (including surgery) should be delayed in the acute setting as a…
Summary of Key Points Radiosurgery is safe and effective, with durable symptomatic response and local control for even radioresistant histologies, regardless of prior fractionated radiotherapy. The ability to deliver cytotoxic doses to the tumor while sparing normal tissue offers a…
Summary of Key Points Percutaneous computed tomography–guided biopsy should be performed in patients when diagnosis may influence the decision to proceed with surgery or the extent of surgery. It is critical that wide negative margins are obtained in tumor resection.…
Summary of Key Points Primary spinal tumors in the thoracic and lumbar region are uncommon, but they represent tumors that may have the potential for a cure. Metastatic tumors in this region, however, represent an advanced stage of primary cancer.…
Summary of Key Points The cervicothoracic junction (CTJ) is subject to unique biomechanical stresses because it is the transitional zone between the cervical and thoracic spine, and lesions in this area can lead to progressive instability, resulting in kyphosis and…
Summary of Key Points A wide array of benign and malignant tumors can arise in the region of the foramen magnum and craniocervical junction. These can be intradural or extradural tumors. The most common symptoms of foramen magnum tumors are…
Summary of Key Points The NOMS framework consists of four considerations (neurological, oncological, mechanical, and systemic) and facilitates decision making for patients with metastatic spine tumors. Conventional external beam radiation provides local tumor control in patients with radiosensitive tumors, whereas…
Summary of Key Points Establishing histopathological diagnosis is critical to understanding the natural history, aggressiveness, and likelihood of the tumor to respond to chemotherapy, radiation, or other adjuvant treatments. Once accurate diagnosis is established, surgical planning requires knowledge of the…