Notes

Calm Infiltrative Non-mass-like Mind Parenchymal Wounds on MRI: Distinguishing Lymphomatosis Cerebri looking at the Mimics.
The Cohen κ value for intraobserver agreement was also substantial, with 0.68 (95% CI = 0.45-0.92). The interobserver agreement analysis for the subtypes of this classification was overall substantial, with 0.60 (95% CI = 0.37-0.83) in the first reading and 0.61 (95% CI = 0.41-0.81) in the second reading. The overall intraobserver agreement for subtypes of the classification was also substantial, with 0.63 (95% CI = 0.34-0.93).

The new classification developed by Pola et al showed substantial interobserver and intraobserver agreements. More studies are required to validate the usefulness of this classification especially in clinical practice.
The new classification developed by Pola et al showed substantial interobserver and intraobserver agreements. More studies are required to validate the usefulness of this classification especially in clinical practice.
Retrospective cohort study.

The goal of this study was to determine how smoking status influences patient-reported outcome measurements (PROMs) in patients undergoing lumbar decompression surgery.

Patients undergoing lumbar decompression between 1 to 3 levels at a single-center, academic hospital were retrospectively identified. Patients <18 years old, and those undergoing surgery for infection, trauma, tumor, or revision, with less than 12 months of follow-up were excluded. Patients were divided into 3 groups (1) never smokers (NSs); (2) current smokers (CSs); and (3) former smokers (FSs). PROMs analyzed included the Physical Component Score and Mental Component Score of the Short Form-12 Health Survey, the Oswestry Disability Index, and Visual Analogue Scale Back and Leg pain scores. One-way ANOVA was used to compare preoperative and postoperative scores between smoking groups, and multiple linear regression analysis was performed to determine whether smoking status predicted change in each outcome score, controlling for factors such as age, sex, body mass index, and other clinical variables. A
value <.05 was considered to be significant.

A total of 195 patients were included in the final cohort, with 121 (62.1%) patients in the NS group, 22 (11.3%) in the CS group, and 52 (26.6%) in the FS group. There were no significant differences between groups at baseline or postoperatively. Smoking status was also not a significant predictor of change in any outcome scores over time on multivariate analysis.

These results suggest that smoking status does not significantly affect short-term complications or outcomes in patients undergoing lumbar decompression surgery.
These results suggest that smoking status does not significantly affect short-term complications or outcomes in patients undergoing lumbar decompression surgery.
Biomechanical study.

Failure of pedicle screws is a major problem in spinal surgery not only postoperatively, but also intraoperatively. The aim of this study was to evaluate whether cement augmentation may restore mounting of initially loosened pedicle screws.

A total of 14 osteoporotic or osteopenic human cadaveric vertebral bodies (L2)-according to quantitative computed tomography (QCT)-were instrumented on both sides by conventional pedicle screws and cement augmented on 1 side. In vitro fatigue loading (cranial-caudal sinusoidal, 0.5 Hz) with increasing peak force (100 N + 0.1 N/cycles) was applied until a screw head displacement of 5.4 mm (∼20°) was reached. After loosening, the nonaugmented screw was rescue augmented, and fatigue testing was repeated.

The fatigue load reached 207.3 N for the nonaugmented screws and was significantly (
= .009) exceeded because of initial cement augmentation (300.6 N). E64d cost The rescue augmentation after screw loosening showed a fatigue load of 370.1 N which was significantly higher (
< .001) compared with the nonaugmented screws. The impact of bone density on fatigue strength decreased from the nonaugmented to the augmented to the rescue-augmented screws and shows the greatest effect of cement augmentation on fatigue strength at low bone density.

Rescue augmentation leads to similar or higher fatigue strengths compared with those of the initially augmented screws. Therefore, the cement augmentation of initially loosened pedicle screws is a promising option to restore adequate screw stability.
Rescue augmentation leads to similar or higher fatigue strengths compared with those of the initially augmented screws. Therefore, the cement augmentation of initially loosened pedicle screws is a promising option to restore adequate screw stability.
Retrospective observational study.

To study the neurological recovery in patients with progressive neurological deficit undergoing delayed decompression and fixation in tuberculosis of spine.

Retrospective analysis of 50 cases with thoracolumbar tuberculosis of spine, undergoing posterior decompression and instrumentation was done. Parameters like time interval between appearance of neurological deficit to decompression surgery, maximal spinal cord compression, neurology on admission, presence of drug resistance, and number of vertebrae involved were evaluated. The subjects were divided into 2 groups depending on neurological improvement measured with LEMS (Lower Extremity Motor Score) at the end of 1-year follow-up.

The mean LEMS score on admission was 27.72 (SD 12.88), which improved to 40.80 (SD 10.46) at the end of 1 year (
< .001). A total of 26 (52%) subjects were categorized into "Satisfactory" outcome (LEMS >10) group and remaining 24 subjects formed the "nonsatisfactory" outcome grouptoperative neurological outcome.
Descriptive study.

Assessing the applicability of blended learning to specific domains of spine surgery.

After the needs assessment, a blended pediatric spine deformity course program was designed. A total of 33 participants, including orthopedic and neurosurgeons, registered for the course and all of them completed an online entrance quiz. Thus, they were eligible to have online part of course, which included the theoretical part of the course and also a discussion forum where the discussions about the topics facilitated by faculty. Thirteen of 33 subjects participated second part of the blended pediatric spine deformity course. This face-to-face (F2F) part consisted of case discussions for each topic and discussions facilitated by faculty members. The same quiz was also taken before and after the F2F part. All quiz results were compared statistically.

There were 11 lectures within the online part and 6 case discussions in the F2F part. The quiz scores were improved significantly by having a complete blended pediatric deformity course (
< .
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