• Cervical meningioma
• Minimally invasive surgery
• Neuronavigation
• Virtual reality

• Complications
• Dural attachment
• Outcomes
• Posterior approach
• Recurrence
• Spinal meningioma

• Anterior approach
• Delayed presentation
• Lower cervical facet dislocations
• Neglected
• Posterior approach

• central nervous system
• gross total resection (GTR)
• meningiomas
• microsurgery (MS)
• minimally invasive (MIS)
• spinal meningiomas
• stereotactic body radiation therapy (SBRT)
• ultrasonic dissection

• cervical spine
• clear cell meningioma
• genetics
• meningioma
• spinal tumors

• complications
• dural attachment
• oncology
• posterior approach
• recurrence
• spinal meningioma

• Humans
• Female
• Middle Aged
• Meningioma/surgery
• Meningioma/pathology
• Meningeal Neoplasms/surgery
• Meningeal Neoplasms/pathology
• Follow-Up Studies
• Neurosurgical Procedures
• Spinal Neoplasms/surgery
• Retrospective Studies
• Treatment Outcome
• Neoplasm Recurrence, Local/epidemiology
• Neoplasm Recurrence, Local/surgery
• Neoplasm Recurrence, Local/pathology

Intradural spinal tumors are uncommon and while associations between clinical characteristics and surgical outcomes have been explored, there remains a paucity of literature unifying diverse predictors into an integrated risk model. To predict postresection outcomes for patients with spinal tumors.

IBM MarketScan Claims Database was queried for adult patients receiving surgery for intradural tumors between 2007 and 2016. Primary outcomes-of-interest were nonhome discharge and 90-day postdischarge readmissions. Secondary outcomes included hospitalization duration and postoperative complications. Risk modeling was developed using a regularized logistic regression framework (LASSO, least absolute shrinkage and selection operator) and validated in a withheld subset.

A total of 5,060 adult patients were included. Most surgeries utilized a posterior approach (n=5,023, 99.3%) and tumors were most commonly found in the thoracic region (n=1,941, 38.4%), followed by the lumbar (n=1,781, 35.2%) and cervical (n=1,294, 25.6%) regions. Compared to models using only tumor-specific or patient-specific features, our integrated models demonstrated better discrimination (area under the curve [AUC] [nonhome discharge] = 0.786; AUC [90-day readmissions] = 0.693) and accuracy (Brier score [nonhome discharge] = 0.155; Brier score [90-day readmissions] = 0.093). Compared to those predicted to be lowest risk, patients predicted to be highest-risk for nonhome discharge required continued care 16.3 times more frequently (64.5% vs. 3.9%). Similarly, patients predicted to be at highest risk for postdischarge readmissions were readmitted 7.3 times as often as those predicted to be at lowest risk (32.6% vs. 4.4%).

Using a diverse set of clinical characteristics spanning tumor-, patient-, and hospitalization-derived data, we developed and validated risk models integrating diverse clinical data for predicting nonhome discharge and postdischarge readmissions.

• Anterior approach
• Cervical corpectomy and fusion
• Cervical tumor
• Meningioma
• Spinal cord

• dural resection
• duraplasty
• meningioma
• oncology
• recurrence
• spine tumor

• Anterior
• Cervical
• Meningioma
• Outcomes
• Spine
• Surgical technique
• Ventral

• Anterior cervical approach
• Distraction-flexion
• Immediate reduction
• Lower cervical spine
• Posterior cervical approach
• Spinal cord injury

Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability. Therefore, a consistent and evidence-based treatment plan is imperative.

The literature regarding the management of traumatic unilateral locked cervical facet dislocations was reviewed. Two patient cases (a 30-year-old Asian man and a 25-year-old Asian woman) who suffered irreducible cervical facet dislocations were presented. These two patients received surgical treatments including posterior reduction by poking facet joints, adjacent spinous process fixation by wire rope banding, anterior plate fixation, and intervertebral fusion after the failure of skull traction and closed reduction. At the postoperative 24-month follow-up, intervertebral fusion was achieved and our patients’ neurological status improved based on the American Spinal Injury Association scale, compared with their preoperative status.

Unilateral facet joint dislocations of subaxial cervical spine are difficult to reduce when complicated with posterior facet fractures or ligamentous injury. Magnetic resonance imaging can be beneficial for identifying ventral and dorsal compressive lesions, as well as ligamentous or capsule rupture. The combination of posterior reduction and anterior fixation with fusion has advantages in terms of clinical safety, ease of operation, and less iatrogenic damage.

• Cervical spine
• Facet dislocation
• Radiography
• Surgery
• Trauma

• Spinal cord injuries
• Subaxial cervical spine injury
• cervical vertebrae
• decision making
• emergency management
• emergency treatment
• neurological aspects
• surgical management

• Anterolateral approach
• Cervical spine meningioma
• Oblique corpectomy
• Spinal canal meningioma

• Intradural lesions
• Meningioma
• Spinal tumors

• Antero-posterior
• Cervical spine
• Dislocation
• Fixation
• Stabilization

The authors report a rare case of complete C2–C3 dislocation with unexpectedly mild neurological symptoms in a 57 year old man involved in a motor vehicle accident, who had previously undergone posterior laminectomy from C3 through C7. A retrospective chart analysis and a thorough radiographic review were performed. X-rays and CT of the cervical spine demonstrated a complete dislocation at the C2–C3 level. Computed tomographic angiography revealed disruption of both vertebral arteries; however, blood flow was evident in the basilar artery. After radiologically guided placement in cervical traction with tongs that reduced the subluxation by approximately 50% the patient had spontaneous eye opening and was able to follow commands. A two-stage 360^o stabilization and fusion was performed and the patient was finally discharged 24 days after admission with his neurological status essentially unchanged. In conclusion, our patient presented with surprisingly mild neurological symptoms. The previously performed laminectomy could have both predisposed to injury as well as protected his spinal cord from potentially fatal trauma.

• Angiography
• Basilar Artery/physiopathology
• Cervical Vertebrae/diagnostic imaging
• Cervical Vertebrae/injuries
• Cervical Vertebrae/surgery
• Humans
• Joint Dislocations/complications
• Joint Dislocations/diagnostic imaging
• Joint Dislocations/therapy
• Laminectomy
• Male
• Medical Records
• Middle Aged
• Nervous System Diseases/etiology
• Nervous System Diseases/physiopathology
• Regional Blood Flow
• Severity of Illness Index
• Spinal Fusion
• Tomography, X-Ray Computed
• Traction
• Vertebral Artery/diagnostic imaging