Patients suffering from schwannomatosis tend to be younger than those presenting with solitary schwannomas. Therefore, individuals presenting at a young age with multiple schwannomas but not meeting the criteria for NF2 should prompt the physician to suspect schwannomatosis. Patients with schwannomatosis who report pain should be exhaustively examined. The spine is affected in the majority of patients, and MR imaging of the spine should be part of the routine evaluation. Rapid enlargement of schwannomas in the context of FS should raise suspicion of malignant transformation.

The findings demonstrate a learning curve for PS placement. In this series, the asymptote for this technique for an inexperienced SSF, started after about 80 screws (approximately 25 cases).

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There are three phases in prophylaxis of surgical site infections (SSI): preoperative, intraoperative and postoperative. There is lack of consensus and paucity of evidence with SSI prophylaxis in the postoperative period. The authors systematically evaluate the literature, and provide evidencebased recommendations on postoperative measures for SSI prophylaxis in spine surgery. Methods A systematic review conforming to PRIMSA guidelines was performed utilizing PubMed (MEDLINE), EMBASE, and the Cochrane Database from inception to January 2019. The GRADE approach was used for quality appraisal and formulation of recommendation. Six postoperative care domains with associated key questions were identified. Included studies were extracted into evidence tables, data synthesized quantitatively and qualitatively, and evidence appraised per GRADE approach. Results Forty-one studies (9 RCT, 32 cohort studies) were included. In the setting of standard-of-care preincisional antimicrobial prophylaxis (AMP) administration, the use of postoperative AMP for SSI reduction is not necessary in decompression-only or lumbar spine fusion surgery. Prolonged administration of AMP for more than 48h postoperatively does not seem to reduce rate of SSI in decompression-only or lumbar spine fusion surgery. Utilization of wound drainage systems in lumbosacral spine and adolescent idiopathic scoliosis corrective surgery does not seem to alter the overall rate of SSI in spine surgery. Concomitant administration of AMP in the presence of a wound drain does not seem to reduce the overall rate of SSI, deep SSI, or superficial SSI in thoracolumbar fusion performed for degenerative and deformity spine pathologies, and in adolescent idiopathic scoliosis corrective surgery. Enhanced-recovery after surgery (ERAS) clinical pathways and infectionspecific protocols does not seem to reduce rate of SSI in spine surgery. There is insufficient evidence to provide recommendations on all other types of spine surgeries with respect to their respective indications and postoperative SSI prophylactic measures. This also includes other non-AMP pharmacological measures, dressing type & duration, suture & staples management and postoperative nutrition for SSI prophylaxis in spine surgery. Conclusion Despite the postoperative period being key in SSI prophylaxis, the literature is sparse and without consensus on optimum postoperative care for SSI prevention in spine surgery. The current best