Joint International SILACO, SICCMII, ISASS Symposium as a Model for a Collaborative Framework to Create Literature on Advances in Spine Surgery, Patient Care, and Policy.

International collaborations can be the key to overcoming innovation implementation hurdles. The authors report on a joint symposium between the International Society For The Advancement of Spine Surgery (ISASS) and La Sociedad Iberolatinoamerica de Columna (SILACO), and La Sociedad Interamericana de Cirurgia de columna de Minima invasión (SICCMII) aimed at improving joint surgeon education programs. The symposium highlighted that patient-related spine care issues are similar across geographical, cultural, and language barriers. The sustainability of such programs depends on funding and mutually respectful relationships orchestrated by multi-lingual leaders who will bridge gaps created by geographical, cultural, and language barriers to effectively develop clinical research content focused on advancing surgeon education and improving patient outcomes across the Americas.

Identifying Priorities, Targets, and Actions for the Long-term Social and Ecological Management of Invasive Non-Native Species.

Formulating effective management plans for addressing the impacts of invasive non-native species (INNS) requires the definition of clear priorities and tangible targets, and the recognition of the plurality of societal values assigned to these species. These tasks require a multi-disciplinary approach and the involvement of stakeholders. Here, we describe procedures to integrate multiple sources of information to formulate management priorities, targets, and high-level actions for the management of INNS. We follow five good-practice criteria: justified, evidence-informed, actionable, quantifiable, and flexible. We used expert knowledge methods to compile 17 lists of ecological, social, and economic impacts of lodgepole pines (Pinus contorta) and American mink (Neovison vison) in Chile and Argentina, the privet (Ligustrum lucidum) in Argentina, the yellow-jacket wasp (Vespula germanica) in Chile, and grasses (Urochloa brizantha and Urochloa decumbens) in Brazil. INNS plants caused a greater number of impacts than INNS animals, although more socio-economic impacts were listed for INNS animals than for plants. These impacts were ranked according to their magnitude and level of confidence on the information used for the ranking to prioritise impacts and assign them one of four high-level actions-do nothing, monitor, research, and immediate active management. We showed that it is possible to formulate management priorities, targets, and high-level actions for a variety of INNS and with variable levels of available information. This is vital in a world where the problems caused by INNS continue to increase, and there is a parallel growth in the implementation of management plans to deal with them.

Invasive trees rely more on mycorrhizas, countering the ideal-weed hypothesis.

The ideal-weed hypothesis predicts that invasive plants should be less dependent on mutualisms. However, evidence in favor of or against this hypothesis comes mainly from observational studies. Here, we experimentally tested this hypothesis using a two-factor greenhouse experiment, comparing the seedling growth response of different Pinus species (varying in invasiveness) to ectomycorrhizal fungal inoculation. Most species showed no response until they were 6 mo old, at which point inoculation increased growth between 10 and 260% among the different species. This growth response was higher for species with lower seed mass, higher dispersal ability, higher Z score (a proxy for invasiveness) and higher number of naturalized regions, all of which correspond to higher invasiveness. Our results show that timing is a crucial factor when comparing mycorrhizal dependency of different species. Dependence on mutualistic microorganisms could be part of a strategy in which invasive species produce smaller seeds, in greater number, which can disperse further, but where seedlings are more reliant on mycorrhizas to improve access to water, nutrients, and protection from pathogens. Our results suggest that reliance on mutualisms may enhance, rather than limit, nonnative species in their ability to spread, establish, and colonize.

Cordomas cervicales. Reporte de casos / Cervical chordomas. Case report

Introducción La detección temprana del cordoma constituye un desafío médico dada su baja frecuencia, calculada entre 2-4% de todos los tumores primarios del hueso, requiriendo un alto índice de sospecha clínica. El diagnóstico tardío incrementa la morbimortalidad y compromete la sobrevida del paciente, por lo que el conocimiento actualizado sobre su etiopatogenia, clínica y tratamiento es de suma importancia para el cirujano espinal, quien forma parte esencial del grupo interdisciplinario terapéutico. Reporte de casos Reportamos dos casos de cordomas cervicales, localmente agresivos sin extensión sistémica, el primero de ellos ubicado en la columna cervical y el segundo en la unión craneocervical. Ambos con diferentes formas de presentación, síntomas, tiempo de evolución (5 años y 7 meses respectivamente), infiltración tumoral y abordaje quirúrgico, pero similar tratamiento oncológico. El objetivo del manuscrito es demostrar la variedad de presentación cervical de la entidad y las diferentes formas de abordarla. Se incluye una revisión actualizada de la literatura donde se evidencia la importancia de la inmunoterapia como nuevo horizonte terapéutico, y se reafirma la resección quirúrgica como base del mismo. Discusión Se presentan los resultados imagenológicos de descompresión medular, resección ósea y de partes blandas, los tipos de fijación espinal y la evolución clínica, sin recidiva local a los 2 años y a los 12 meses respectivamente en cada caso, luego del manejo quirúrgico y la radioterapia adyuvante.

Background Early detection of chordoma is a medical challenge given its low frequency, a high index of clinical suspicion is required for the diagnosis. The late diagnosis increases morbidity and mortality and compromises the survival of the patient. Knowledge about its etiology, clinical manifestations and treatment is of utmost importance for the spinal surgeon as well as for the therapeutic group. The aim of the report is to demonstrate the variety of cervical presentation of the entity and the different ways of approaching it. Case Report We report two cases of locally aggressive cervical chordomas without systemic extension, the first one located in the cervical spine and the second in the craniocervical junction. Both with different forms of presentation, symptoms, evolution time (5 years and 7 months respectively), tumor infiltration and surgical approach, but similar oncological treatment. Discussion The imaging results of medullar decompression, bone and soft tissue resection, types of spinal fixation and clinical evolution were presented. No local recurrence at 2 years and 12 months respectively after surgical management and adjuvant radiation therapy were found.

Highly invasive tree species are more dependent on mutualisms.

Why some species become invasive while others do not remains an elusive question. It has been proposed that invasive species should depend less on mutualisms, because their spread would then be less constrained by the availability of mutualistic partners. We tested this idea with the genus Pinus, whose degree of invasiveness is known at the species level (being highly and negatively correlated with seed size), and which forms obligate mutualistic associations with ectomycorrhizal fungi (EMF). Mycorrhizal dependence is defined as the degree to which a plant needs the mycorrhizal fungi to show the maximum growth. In this regard, we use plant growth response to mycorrhizal fungi as a proxy for mycorrhizal dependence. We assessed the responsiveness of Pinus species to EMF using 1,206 contrasts published on 34 species, and matched these data with data on Pinus species invasiveness. Surprisingly, we found that species that are more invasive depend more on mutualisms (EMF). Seedling growth of species with smaller seeds benefited more from mutualisms, indicating a higher dependence. A higher reliance on EMF could be part of a strategy in which small-seeded species produce more seeds that can disperse further, and these species are likely to establish only if facilitated by mycorrhizal fungi. On the contrary, big-seeded species showed a lower dependence on EMF, which may be explained by their tolerance to stressful conditions during establishment. However, the limited dispersal of larger seeds may limit the spread of these species. We present strong evidence against a venerable belief in ecology that species that rely more on mutualisms are less prone to invade, and suggest that in certain circumstances greater reliance on mutualists can increase spread capacity.

Seed predation does not explain pine invasion success.

Why some non-native plant species invade, and others fail remains an elusive question. Plant invasion success has been associated with specific species traits. Yet, we have limited knowledge of the mechanisms relating these traits to invasion potential. General patterns of biotic resistance by seed predation may provide a mechanism that helps separate invasive from non-invasive plants. Seed predation is an important barrier against plant establishment for many plant species. It may, therefore, create a selective filter against non-native plant establishment based on plant traits related to seed predation rate. In two cafeteria-style seed predation experiments in a steppe ecosystem in Patagonia (Argentina) we provided seeds of 16 non-native Pinaceae covering a 300-fold variation in seed mass, a 200-fold variation in seed volume and 75-fold variation in seed toughness. Seed removal decreased with seed mass and seed volume. Seed toughness was not a significant predictor while seed volume was the best predictor of predators' preference. However, for species of this family small seed size is the most important predictor of species invasiveness. Our results show that seed predation does not explain Pinaceae invasive success. In our system, species that have smaller seeds (i.e., more invasive) are preferentially consumed by seed predators. Seed mass was not the best predictor of granivory rates, despite being the seed trait on which most studies have been focused. Our ability to predict future invasion and understand invasion success could benefit from other studies that focus on the mechanisms behind invasive traits.

Errata: Análisis comparativo de pacientes con estenosis degenerativa lumbar pura (EDLP) y estenosis secundaria a espondilolistesis degenerativa lumbar (ELDL) tratados quirúrgicamente en el período de 2008 a 2011... / Errata de: Análise comparativa de pacientes com estenose degenerativa pura lombar (EDPL) e estenose secundária a espondilolistese lombar degenerativa lombar (ELDL) tratados cirurgicamente no período de 2008 a 2011 no Hospital Metropolitano de Quito, Equador / Erratum to: Comparative analysis in patients with pure degenerative lumbar stenosis (EDLP) and stenosis secundary to degenerative lumbar spondilolisthesis (ELDL) surgically treated between 2008-2011 at the Hospital Metropolitano, Quito, Ecuador

Solicitação de alteração da ordem dos autores do artigo "Análisis comparativo de pacientes con estenosis degenerativa lumbar pura (EDLP) y estenosis secundaria a espondilolistesis degenerativa lumbar (ELDL) tratados quirúrgicamente en el período de 2008 a 2011 en el Hospital Metropolitano de Quito-Ecuador"

Análisis comparativo de pacientes con estenosis degenerativa lumbar pura (EDLP) y estenosis secundaria a espondilolistesis degenerativa lumbar (ELDL) tratados quirúrgicamente en el período de 2008 a 2011... / Análise comparativa de pacientes com estenose degenerativa pura lombar (EDPL) e estenose secundária a espondilolistese lombar degenerativa lombar (ELDL) tratados cirurgicamente no período de 2008 a 2011 no Hospital Metropolitano de Quito, Equador / Comparative analysis in patients with pure degenerative lumbar stenosis (EDLP) and stenosis secundary to degenerative lumbar spondilolisthesis (ELDL) surgically treated between 2008-2011 at the Hospital Metropolitano, Quito, Ecuador

OBJETIVO: Establecer si existen diferencias demográficas, de tratamiento y en resultados entre los grupos de EDLP y ELDL. MÉTODOS: Estudio retrospectivo observacional de 76 pacientes con EDL tratados quirúrgicamente. Se analizan por separado los datos demográficos y la evolución del grupo 1 (EDLP, 53 pacientes) y del grupo 2 (ELDL, 23 pacientes). RESULTADOS: Grupo 1: 51% mujeres y 49% varones. Edad promedio 56,8 años. Evolución preoperatoria 34 meses; Grupo 2: 78% de mujeres y 22% de varones. Edad promedio 63,4 años. Evolución preoperatoria 10 meses. Los dos grupos fueron intervenidos con la misma técnica, por el mismo equipo quirúrgico. El porcentaje de satisfacción postoperatoria fue mejor para el grupo 1 cuando el tiempo de evolución preoperatoria fue menor a 18 meses. En el grupo 2 los hallazgos no fueron significativos. CONCLUSIÓN: La estenosis por ELDL tiene características de edad y sexo muy diferentes dela EDLP. La cirugía precoz presentó un mayor porcentaje de satisfacción.

OBJETIVO: Determinar se existem diferenças demográficas, de tratamento e nos resultados entre os grupos EDLP e ELDL. MÉTODOS: Estudo observacional retrospectivo de 76 pacientes com EDLP tratados cirurgicamente. Analisamos separadamente os dados demográficos e os resultados do grupo 1 (EDLP, 53 pacientes) e do grupo 2 (ELDL, 23 pacientes). RESULTADOS: Grupo 1: 51% mulheres e 49% homens; média de idade, 56,8 anos. Evolução pré-operatória, 34 meses. Grupo 2: 78% mulheres e 22% homens; média de idade, 63,4 anos. Evolução pré-operatória, 10 meses. Os dois grupos foram operados com a mesma técnica e pela mesma equipe cirúrgica. A porcentagem de satisfação pós-operatória foi maior no Grupo 1 quando a evolução pré-operatória foi inferior a 18 meses. No Grupo 2, os resultados não foram significativos. CONCLUSÃO: Na estenose secundária a ELDL, a idade e distribução por gênero foram muito diferentes do encontrado na EDLP. A cirurgia precoce gerou uma maior porcentagem de satisfação.

OBJECTIVE: Establish whether there are differences regarding demographics, treatment and outcomes between the groups EDLP and ELDL. METHODS: Retrospective observational study of 76 patients with EDLP surgically treated. Demographic data and outcomes of Group 1 (EDLP, 53 patients) and Group 2 (ELDL, 23 patients) were analyzed separately. RESULTS: Group 1: 51% female; 49% male. Mean age, 56.8 years. Pre-surgical development, 34 months. Group 2: 78% female; 22% male. Mean age, 63.4 years. Pre-surgical development, 10 months. Both groups were operated with the same technique and by the same surgical team. In Group 1, postoperative satisfaction was higher when the pre-surgical development was less than 18 months. In Group 2 there where no significant findings. CONCLUSION: In stenosis secondary to ELDL, age and gender distribution were very different from that found in EDLP. Early surgery led to a higher percentage of satisfaction.

Gangrena gaseosa y tromboflebitis Séptica

Gangrena gaseosa y tromboflevitis séptica o supurativa, son dos entidades clínico quirúrgicas diferentes, poco frecuentes en la práctica médica y con una alta incidencia en lo que a morbimortalidad se refiere. El presente caso es el de un paciente jóven, quien desarrolla estas dos patologías al mismo tiempo, con na etiopatogenia atípica a la referida en la literatura médica. Se demuestra la eficacia de la resonancia magnética nuclear, como un estudio complementario fundamental en el diagnóstico de procesos infecciosos ocultos de las extremidades. Se hace un resumen del tratamiento médico agresivo que debe ser institutido en estos casos poco comunes.