A 17-year-old female presented with a 2-year history of progressive headaches and gait imbalance. Cranial CT revealed a cerebellar expanding mass and hydrocephalus. The patient underwent shunt insertion and was referred to our department for treatment. MRI demonstrated a non-enhancing left hemisphere cerebellar tumor (Figure 1) which was subtotally resected during surgical procedure. Figure 2 shows the histological findings. Postoperative course was uneventful.

Aim: This radiological morphometric study aimed to investigate the morphometry of the pedicles of subaxial cervical vertebrae (C3–C7) and emphasize the importance of preoperative planning to prevent complications during spinal surgery. Materials and Methods: Computed tomography scans of the subaxial cervical vertebrae of 40 patients without cervical pathology were morphometrically evaluated. Key parameters such as pedicle height, pedicle width, pedicle length, pedicle axial angle, pedicle sagittal angle, and vertebral foramen diameter were measured at each vertebral level (C3–C7). Statistical analysis was performed to identify morphometric differences based on individual vertebral levels and patient demographics, particularly between male and female populations. Results: The study revealed significant variations in the pedicle morphometry between different cervical vertebral levels and between sexes. Notably, the C3 vertebrae exhibited the narrowest pedicles, and female patients had consistently smaller pedicle dimensions than male patients. The pedicle axial and sagittal angles also demonstrated substantial variability, with a decreasing trend from C4 to C7. These variations suggest a high degree of anatomical heterogeneity in the subaxial cervical spine. Discussion: The morphometric differences in subaxial cervical vertebrae, particularly between sexes and individual and vertebral levels, highlight the significance of individualized preoperative planning. Thorough radiological assessment of pedicle anatomy is essential for tailoring surgical approaches and reducing the risk of complications such as neurovascular injury due to pedicle screw misplacement. Conclusion: Our findings underscore the critical need for patient-specific preoperative planning to enhance the accuracy of pedicle screw placement and minimize surgical risks in the subaxial cervical spine.

Background/Objectives: There is no consensus on whether it is possible to preserve implant retention during deep surgical site infections (SSIs), and there is no widely accepted treatment protocol to date for these patients. The aim of this study is to evaluate the efficacy of the debridement, antibiotics, and implant retention (DAIR) protocol in patients who were treated for degenerative thoracolumbar spinal disorder using spinal instrumentation. Methods: This retrospective study describes the 24-month outcomes of deep SSI that developed in 25 of 720 patients (3.5%) who underwent surgery for thoracolumbar degenerative spinal disorders (disc disease, spinal stenosis, and scoliosis) and were treated according to the DAIR protocol. Results: Of these 25 patients, 18 developed early infection (3 months). Staphylococcus aureus was isolated in 56% of the patients. The DAIR protocol was successful in 22 (88%) of the patients, while it failed in 3 (12%). Surgical implants were removed in 25% of patients with late-onset SSI, and only 11.1% with early onset and 0% with delayed SSI. All patients who failed DAIR were smokers. A significant association was found between the Charlson Comorbidity Index and the number of surgical interventions (p = 0.022). Conclusions: In this small retrospective cohort, the DAIR protocol appeared to be a feasible treatment option for deep SSI, particularly in early infections. Implant removal may be considered when infection persists after repeat DAIR or when implant loosening is observed.

Cholesterol granuloma (CG) is a benign expansile lesion caused by the breakdown of blood products and subsequent granulomatous reaction, most often found in pneumatized bones. Frontal sinus involvement is exceedingly rare, especially in children, and may mimic mucoceles, abscesses, or fungal disease on imaging. We present a 16-year-old male with a painful, progressively enlarging frontal swelling and headache. MRI revealed a lobulated lesion hyperintense on both T1- and T2-weighted sequences with peripheral enhancement, initially suggesting an abscess-like process. CT showed an expansile lytic lesion with erosion of the frontal sinus tables. Due to significant bony destruction, a bicoronal open approach was performed, achieving complete excision and cranioplasty. Histopathology confirmed CG, demonstrating cholesterol clefts, hemosiderin-laden macrophages, and multinucleated giant cells. The postoperative course was uneventful, and no recurrence was observed. This case highlights the diagnostic challenge of frontal sinus CG, particularly in younger patients, and emphasizes the importance of recognizing its radiologic characteristics to avoid misdiagnosis. Early identification and surgical excision are essential to prevent orbital or intracranial complications and achieve favorable clinical outcomes.