pTLIF allows for safe and efficient minimally invasive treatment of single and multilevel degenerative lumbar instability with good clinical results. Further prospective studies investigating long-term functional results are required to assess the definitive merits of percutaneous instrumentation of the lumbar spine.

This review paper gives an overview and summarizes the different methods of cranioplasty for reconstruction of the bony skull. There are various origins of cranial defects including trauma, tumours, congenital deformities or postoperative defects due to the surgical procedure itself. The overall goal of skull reconstruction is, on the one hand, appropriate closure, and on the other hand, the perfect cosmetic result. The cranioplasty should be safe, fast and easy to handle. Cost-effectiveness of the procedure represents a further important point. To solve these complex and multimodal problems, different techniques and also various materials for the reconstruction are available. This report details the usual procedures for skull reconstruction, as well as the advantages and limitations of the different materials and operative strategies.

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These tumors harbor diagnostic and therapeutic pitfalls. In general, the tumors are surgically more challenging, and clinically significant bleeding as well as local tumor recurrence is more common than in intradural hemangioblastomas, mostly because of the frequency of incorrect initial radiographic diagnosis. We suggest that because of the surgical consequences, hemangioblastoma should always be considered to be an important radiological differential diagnosis for nerve sheath tumors. Angiography can bring clarification to ambiguous cases.

We conclude that minimally invasive percutaneous fixation is a feasible and effective technique to achieve immediate pain release, avoid long-term immobilization and overcome the disadvantages of a dorsoventral procedure. However, surgical complications and possible follow-up procedures supplement the patients' risks of adverse reactions of the disease.

Study design Analysis of the Nationwide Inpatient Sample (NIS) from 1998 to 2008.Objective To analyze the most recent available and nationally representative data for risk factors contributing to in-hospital mortality after primary lumbar spine fusion. Summary of background data The total number of lumbar spine fusion surgeries has increased dramatically over the past decades. While the field of spine fusion surgery remains highly dynamic with changes in perioperative care constantly affecting patient care, recent data affecting rates and risk for perioperative mortality remain very limited. Methods We obtained the NIS from the Hospital cost and utilization project. The impact of patient and health care system related demographics, including various comorbidities as well as postoperative complications on the outcome of in-hospital mortality after spine fusion were studied. Furthermore, we analyzed the timing of in-hospital mortality.Results An estimated total of 1,288,496 primary posterior lumbar spine fusion procedures were performed in the US between 1998 and 2008. The average mortality rate for lumbar spine fusion surgery was 0.2 %. Independent risk factors for in-hospital mortality included advanced age, male gender, large hospital size, and emergency admission. Comorbidities associated with the highest in-hospital mortality after lumbar spine fusion surgery were coagulopathy, metastatic cancer, congestive heart failure and renal disease. Most lethal complications were cerebrovascular events, sepsis and pulmonary embolism. Furthermore, we demonstrated that the timing of death occurred relatively early in the in-hospital period with over half of fatalities occurring by postoperative day 9. Conclusion This study provides nationally representative information on risk factors for and timing of perioperative mortality after primary lumbar spine fusion surgery. These data can be used to assess risk for this event and to develop targeted intervention to decrease such risk.

Neuraxial anesthesia is associated with decreased odds for major complications and resource utilization after joint arthroplasty for all patient groups, irrespective of age and comorbidity burden.