Microscope-assisted anterior cervical discectomy and fusion combined with posterior minimally invasive surgery through tubular retractors for multisegmental cervical spondylotic myelopathy: A retrospective study.

This study aimed to investigate the clinical efficacy and outcome of combined microscope-assisted anterior cervical discectomy and fusion (ACDF) with posterior minimally invasive surgery through tubular retractors for patients with multisegmental cervical spondylotic myelopathy (MCSM).This retrospective study included 28 patients (19 males and 9 females) with multisegmental cervical spondylotic myelopathy, who underwent combined microscope-assisted ACDF with posterior minimally invasive surgery through tubular retractors in our single center between January 2012 and December 2016. The evaluated postoperative clinical outcomes were operation time, length of hospitalization, blood loss, levels of creatine phosphokinase isoenzyme MM (CPK-MM), Japanese Orthopedic Association (JOA) scores, visual analogue scale (VAS) scores, Cobb angle of C2-C7, and radiological assessments (included X-rays, computed tomography scans, and magnetic resonanceimaging images).The mean surgery time was 198.42 ±â€Š17.53 minutes, the average hospitalization length of hospital was 7.59 ±â€Š1.38 days, and the mean follow-up time was 13 ±â€Š2.45 months. On average, about 36.42 ±â€Š10.15 mL of blood was lost and CPK-MM increased to 331.75 ±â€Š23.15 IU/mL postoperatively (P < .001). The mean modified JOA scores increased from 8.21 ±â€Š0.69 preoperatively to 13.96 ±â€Š1.57 postoperatively (P < .001), whereas the mean VAS scores decreased from 6.64 ±â€Š1.28 preoperatively to 0.39 ±â€Š0.50 postoperatively (P < .001). Cobb angle of C2-C7 increased from 13.86°â€Š±â€Š5.69° preoperatively to 14.10°â€Š±â€Š5.56° postoperatively (P = .16).In conclusion, combined microscope-assisted ACDF with posterior minimally invasive surgery through tubular retractors appears to be a safe and effective treatment for patients with MCSM.

Primary spinal glioblastoma multiforme: A case report and review of the literature.

RATIONALE: Primary spinal glioblastoma multiforme (GBM) is a rare clinical entity with an aggressive course and an invariably dismal prognosis. Its clinical characteristics, radiologic and pathologic findings, and treatment protocols have been discussed in a few cases. PATIENT CONCERNS: A 15-year-old female was admitted to the neurology department with a chief complaint of progressive numbness and weakness in her left upper extremity for 3 months and neck pain for 1 month. DIAGNOSES: Spinal magnetic resonance imaging showed an intramedullary expansile mass localized between C4 and C7. The diagnosis of GBM was determined on the basis of the histopathological findings after operation. INTERVENTIONS: Laminotomy and laminoplasty between C4 and C7 were performed, and the tumor was partially resected. The patient was administered focal adjuvant radiotherapy concomitantly with oral chemotherapy following the surgery. OUTCOMES: With severe neurologic deficits at 13 months after the diagnosis, the patient expired. LESSONS: Although therapeutic options have been improving, the prognosis of the primary spinal GBM remains poor. The treatment of primary spinal GBM entered into a central registry and multiple-center cooperation is important in establishing future therapeutic strategies.