Peek cage-assisted anterior cervical discectomy and fusion at four levels: clinical and radiographic results.

AIM: The aim of this retrospective clinical and radiographic study was to provide follow-up data on the surgical success and patient outcome of polyetheretherketone (PEEK) cage-assisted anterior cervical discectomy and fusion (ACDF) at four levels. The literature on four-level ACDF is scanty, and the reported series are not enterely comparable because of differences in patient characteristics, types of spinal arthrodesis, and methods for quantitating outcome. METHODS: During the period between January 2003 and January 2005 10 patients (3 males and 7 females, with a mean age of 54.9 years) suffering from cervical myeloradiculopathy due to compressive spondylosys from C3-C4 to C6-C7 underwent PEEK cage-assisted ACDF at four levels. RESULTS: No intra- or postoperative complications were noted. The follow-up period ranged from 12 to 24 months (mean 15.8 months). The NCSS score was 9.2+/-1.48 preoperatively and 12.7+/-0.67 at follow-up examination (P<0.05). Preoperatively, the curvature, range of motion (ROM), and height of the foramina of the cervical spine were 16.9+/-5.84 degrees , 27.6+/-3.5 degrees , and 8.1+/-2.33 mm respectively, whereas at follow-up evaluation they were 19.5+/-7.03 degrees (P>0.05), 22.2+/-3.43 degrees (P<0.05), and 10.6+/-1.71 mm (P<0.05) respectively. None of the patients showed pre- or postoperative cervical instability. The fusion rate was 97.5%. CONCLUSION: PEEK cage-assisted ACDF at four levels is an effective procedure for the treatment of patients with spondylotic compression of the spinal cord and/or nerve roots from C3-C4 to C6-C7.

Lymphoplasmacyte rich meningioma. A case report and review of the literature.

A peculiar type of meningioma with conspicious plasma-cell components is described. In accordance with the World Health Organization's Histological Typing of Tumours of the Central Nervous System, this rare clinical entity is recently designed as lymphoplasmacyte rich (LPR) meningioma. This type of meningioma is usually accompanied by prominent peripheral blood abnormalities, anemia and/or policlonal gammophaty, that disappear after surgical removal of the tumor. Actually, the origin (neoplastic or inflammatory) of this tumor is unclear; its biological behavior and clinical course are anomalous so it is considered closer to intracranial inflammatory masses rather than typical meningioma. In this paper, a new case of intracranial LPR meningioma occurring in a woman, is reported and a review the literature is made.

Bilateral chronic subdural hematoma associated with meningioma. Case report and review of the literature.

Gross intracranial hemorrhage associated with brain tumor has been reported to range from 3.6-10%. Brain metastases and malignant glioma are the most frequent underlying pathologies. Intracranial hemorrhage related to meningioma is a rare condition. Subarachnoid hemorrhage, acute subdural hematoma, intratumoral and intraparenchymal hematomas are the most common forms of bleeding associated with meningioma. By contrast, chronic subdural hematoma (cSDH) and intraventricular hemorrhage are seen less frequently. The authors report a very rare case of left fronto-parietal convexity meningioma associated with bilateral cSDH in a patient with history of recent minor head trauma and review the literature on hemorrhage associated with meningiomas.