Background: High-grade glioma (HGG), formerly known as Glioblastoma multiforme, can be complicated by hematomas, either at the initial presentation or after surgical removal. Rarely, postoperative bleeding can occur extra-axially, resulting in subdural hematomas (SDH) that might require surgical evacuation. Of note, little is known about the cellular composition of those hematomas. Observations: We present the case of a patient operated on for HGG who developed postoperative recurrent SDH that required multiple surgical evacuations. Histopathological analyses of the membranes comprising the SDH revealed the presence of HGG tumoral cells. Conclusions: Based on our observation, hematomas associated with HGG, either extra or intra-axial, should be suspected of being a sign of tumoral recurrence or spread and histopathological analyses might be considered as they could lead to further adaptation of the patient’s treatment.

Background/Objectives: Degenerative cervical myelopathy (DCM) is the leading cause of non-traumatic spinal cord dysfunction in adults. Both anterior and posterior surgical approaches are widely used for its treatment, yet their comparative impact on clinical outcomes and complication profiles remains clinically relevant. This study aimed to describe early and one-year postoperative outcomes between anterior and posterior surgical strategies in a consecutive single-center cohort. Methods: We conducted a retrospective single-center study of 102 consecutive adult patients surgically treated for DCM between 2013 and 2024, with complete datasets and a minimum one-year follow-up. Surgical approaches were classified as anterior, posterior, or combined. Clinical outcomes were assessed using the modified Japanese Orthopaedic Association scale (mJOA), Neck Disability Index (NDI), and Numeric Rating Scale for arm pain (NRS-arm) preoperatively, at 4–6 weeks and at one year. Complications were systematically recorded and stratified by approach. Nonparametric tests were used for all comparisons (significance threshold p < 0.05). Results: Anterior procedures were performed in 82 patients (80.4%), posterior in 18 (17.6%), and combined in 2 (2.0%). No significant between-group differences were observed in neurological, functional, or pain outcomes at either time point (ΔmJOA p = 0.268; ΔNDI p = 0.632; ΔNRS p = 0.562 at one year). Complications occurred in 13 patients (12.7%), with approach-specific profiles: anterior surgery was associated with hematoma, dysphagia, and dysphonia, posterior surgery with CSF leak, wound infection, and kyphosis. No C5 palsy was recorded. Conclusions: Both anterior and posterior surgical approaches were followed by neurological and functional improvement at one year. Given the descriptive nature of the study and the baseline differences between groups, these findings should not be read as a formal comparison of effectiveness, but they reinforce the importance of individualized, pathology-driven surgical planning in DCM.

Purpose: Percutaneous endoscopic spine surgery and tubular minimally invasive surgery (MIS) each offer distinct advantages but also important limitations. We describe a proof-of-concept study of a hybrid technique—tubular endoscopic spine surgery (TESS)—combining a tubular retractor with a 30° endoscope and continuous irrigation, aiming to integrate the advantages of both approaches. Methods: TESS was first evaluated in a cadaveric L4–L5 model and subsequently applied in a single clinical case of L4–L5 lumbar stenosis with right L5 radiculopathy. The technique uses a standard tubular retractor to establish a single paramedian muscle-splitting corridor. A 30° endoscope is introduced through the tube with continuous irrigation, while standard microsurgical instruments are used through the working channel. Results: The tubular retractor provided a stable, reproducible single-incision transmuscular corridor to the interlaminar space. The addition of the endoscope with irrigation ensured a consistently clear operative field, while maintaining the ergonomics and simplicity of a single working channel. Instrument handling and exchange were straightforward, and no specific technical difficulties were encountered. In the clinical case, adequate decompression was achieved with complete symptom resolution at 6 and 12 months. Conclusion: TESS is a feasible hybrid technique that combines the familiar ergonomics of tubular MIS surgery with the dynamic visualization of endoscopic systems using irrigation. Further studies are needed to evaluate its clinical value before widespread clinical adoption.

Background/Objectives: Surgical planning in degenerative cervical myelopathy (DCM) considers the type of pathology, the number of levels involved, and cervical alignment and stability, but how the pathological entity, the operated level, and the procedure performed relate to one another remains unclear. This study described their distribution and associations in a consecutive surgical cohort. Methods: A total of 154 consecutive adults operated for DCM at a single center between 2013 and 2024 were studied retrospectively. Six non-mutually-exclusive pathological entities, five procedure types and every operated level (C2-C3 to T1-T2) were recorded, with combined procedures counted once. Associations were tested with Fisher–Freeman–Halton exact tests, with sensitivity analyses using a single dominant entity per patient and patient-level clustering, and a comparison of patients treated by ACDF alone versus any alternative strategy. Results: Procedure selection was related to the pathological entity (p < 0.001): isolated disc herniation was treated almost exclusively with ACDF (93.2%), whereas spondylolisthesis was the most heterogeneous, managed with posterior decompression and fixation (33.3%), ACCF (23.3%) or ACDF (23.3%); this persisted in the dominant-entity analysis (p = 0.002). The 46 patients (29.9%) not treated by ACDF alone were older, had more operated levels, worse baseline mJOA and more often circumferential compression (all p ≤ 0.005), whereas sagittal profile and cord and canal morphometry did not differ. Neither entities nor procedures were associated with the operated level across C3-C7 (p = 0.84 and p = 0.93); a nominally significant all-level result (p = 0.008) arose only from the sparsely operated terminal levels. Conclusions: Procedure selection in DCM was driven mainly by the underlying pathological entity, disease extent and compression geometry, rather than by the operated level or cervical alignment. No outcome data were analyzed, so these descriptive, hypothesis-generating findings require confirmation in larger multicenter cohorts with adequate representation of the terminal levels.