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Objective Vertebral hemangiomas are benign but highly vascular lesions and are one of the most common lesions of the vertebral column. Anterior soft-tissue compression of spinal cord due to vertebral body hemangioma is challenging to manage. Our objective was to assess long-term clinical and radiologic effects of direct transpedicular absolute alcohol embolization, laminectomy, and short-segment instrumented fusion on resolution of extraosseous epidural soft tissue and improvement in myelopathy in cases of vertebral hemangioma causing anterior soft-tissue compression. Materials and Methods This was a retrospective analysis that included patients with single-level vertebral hemangioma with anterior intraspinal soft-tissue growth causing spinal cord compression and clinical features of myelopathy between June 2007 and June 2019 at authors' institute. Transpedicular vertebral body injection of absolute alcohol, laminectomy, and pedicle screw rod instrumentation was performed in all patients. Clinicoradiologic outcomes of surgery were noted. We proposed a grading system for the extent of anterior extraosseous epidural soft-tissue compression. Results In total, 14 patients were included in study. Their mean age was 28.4 ± 14.4 years. Mean follow-up duration was 67.5 ± 36.2 months. All patients had preoperative radiologic grade 4 compression. Postoperative radiologic grading improved to grade 1 in 4 (28.6%), grade 2 in 8 (57.1%), and grade 3 in 2 (14.3%). All the patients improved neurologically after surgery. Eleven patients improved to American Spinal Injury Association (ASIA) grade E, 2 improved to ASIA D, and 1 improved to ASIA C at the last follow-up visit. Conclusions Vertebral hemangiomas with anterior extraosseous epidural extension causing spinal canal compromise and myelopathy can be managed with direct transpedicular ethanol embolization, laminectomy, and short-segment instrumented fusion with resolution of the extraosseous soft tissue and improvement in myelopathy. The procedure is relatively simple, cost effective, and has a good outcome.

Craniovertebral junction anomalies are known to be associated with many bony, soft tissue, and vascular anomalies. We encountered a case of Chiari malformation type 1 with C2-D2 syrinx, in which computed tomography angiography showed an aberrant vessel (probably vein) coursing through the soft tissue along the posterior aspect of C1-C7 vertebral bodies along the right-sided joints, superiorly coursing posterior to C1-C2 joint and curving anteriorly over C1 to enter into the foramen magnum. Had this abnormality not been detected, catastrophic vascular consequences could have occurred.

Background Locally aggressive vertebral body tumors of the axis must be treated with wide local excision for best outcome. Reconstruction of the load-bearing vertebra needs to be done after tumor resection in such a manner so as to give stable, long-term fusion in this young population. Methods We describe the management strategy of a 25-year-old acutely quadriplegic patient, with respiratory distress, with a C2 giant cell tumor. The use of a novel iliac crest graft modification used for C2 reconstruction along with a modified mesh cage used as an anterior plate has been reported. Results The patient had a good outcome at 18 months' follow-up, with neurologic improvement and a solid fusion. Conclusions Iliac crest autograft is inexpensive and easy to harvest and can be considered as a C2 prosthesis, especially in a resource-constrained setting. Modified iliac crest graft can be used for load transmission from C1 lateral mass to C3 body, and the mesh cage can be modified according to need as a plate with good results in an emergency.

Jute fibre finds application as filler in many polymer matrices. Polypropylene(PP) is a polyolefin which has found to be used extensively in applications where low density and optimum strength is require because of it optimum melting point and ease of processability. Jute has been used as filler in PP. However due to problem in interface adhesion of PP and jute, surface treatment and coupling agent have been used to improve interfacial adhesion. But in all these methods chemicals are used to improve the interfacial adhesion which affect environment and also the people working with it. Here we have used a eco-friendly method to modify the surface of jute. The method involves the treatment of fibre using enzyme. Jute fibre was treated using various concentration of the enzymes and optimum enzyme content was chosen. Modified Jute fibre was used in different concentrations in PP and mechanical properties and thermal properties of the composites were studied.

Background Screw diameters currently available are based on the literature available. No data are available for the safety margin available for C2 pedicle screw placement. The objective of this study was to define the average pedicle size available for placing C2 pedicle screws and to quantify the safety margin available in case of lateral breach of screw. Methods Computed tomography angiograms of 259 patients (161 men, 98 women) were analyzed to calculate the C2 pedicle width, the area of the transverse foramen (TF) and the vertebral artery (VA), and the occupation ratio (OR) of the VA within the TF. The VA was classified into groups based on its lie within the TF (anteromedial, anterolateral, posteromedial, posterolateral, central, ectatic). The distance which the pedicle screw can breach without encountering the VA was calculated (lateral pedicle to vertebral artery distance [LPVA]). The diameters of the VA and the TF were estimated, and their difference gives the safety margin in case of breach of the lateral cortex of the C2 pedicle. Results The mean mediolateral diameter of the pedicle isthmus, perpendicular to the pedicle axis, in women was 5.3 mm and in men it was 5.8 mm. This difference was statistically significant. In 53.9% (122/226) of patients, the VA was dominant on the left side. The overall mean OR at the C2 vertebral level was found to be 37.3%. The mean LPVA was 0.9 mm, and the average overall safety margin available was 2.5 mm (range, 0.4–5.3 mm). Conclusions This study describes the relationship of the VA in the C2 TF and the relative risk during pedicle screw fixation.

Background Gangliogliomas (GGs) are rare intra-axial tumors. Cerebellar seizures caused by GGs have been described only rarely. Pigmented neural cell tumors are well described in the literature but are infrequent, especially when presenting as primary neuroepithelial tumors. Only 5 cases of pigmented GG have been reported previously, including 4 in the pediatric population. Case Description A 17-year-old female presented to us with cerebellar seizures, which resolved after tumor excision. Histopathological examination revealed a pigmented GG. Conclusions We present the sixth documented case of a pigmented ganglioglioma, the first such case reported in cerebellar location, associated with a rare presentation of cerebellar seizures.

Background Calcified intraspinal epidermoids are a rare entity. We discuss the various pathogenesis and the clinical implication of such a finding during surgery. Case Description A 32-year-old female presented with progressive spastic paraparesis with incontinence. Imaging showed an unusual intralesional calcification, which was removed. Postoperatively she had no fresh deficits. Conclusions To our knowledge this is the first reported case of spinal intramedullary epidermoid with intralesional calcification.

Epidermoid cysts in the lateral temporal lobe presenting with seizures are rare accounting for5% of all intracranial epidermoid cysts. Preoperative diagnosis can be further confounded by unusual imaging as presented in this case, thus leading to the wrong preoperative diagnosis of the case as a neoplastic pathology.