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Spinal cord infarction (SCI) is a catastrophic neurologic deficit following spine surgery. Because of the opposite management regimens used for SCI and acute epidural hematoma, accurate diagnosis of SCI is of great importance to maximally reserve neurologic functions and improve outcomes. A 21-year-old man developed acute paralysis and sensory deficits of the bilateral lower limbs shortly after undergoing two-stage combined posterior and anterior multilevel en bloc corpectomy. An emergency second-look surgery revealed wide-spectrum blackness of the thecal sac with no signs of an epidural hematoma. The patient underwent anticoagulation therapy, ventilation support, microcirculation perfusion, and fluid optimization. He regained an ambulatory status without other severe complications. Upon discharge, his muscle strength had returned to grade 4 and his Eastern Cooperative Oncology Group performance score had decreased to 0. At the final 48-month follow-up, the implants were in good position without local recurrence, and the patient was able to lead an independent life and work in his full capacity. An epidural hematoma did not appear to be the cause of SCI after spinal tumor surgery in this case; however, SCI was a possible reason for the acute paralysis. Anticoagulation treatment with adjuvant therapies may be an effective option in managing SCI.

Background The spinal chondrosarcoma has high risk of recurrence if the initial surgery is not performed in an en bloc fashion. It remains technically demanding to surgically manage the refractory recurrent spinal chondrosarcoma (RRSC). This study is to assess the clinical features and investigate the prognostic factors for patients with RRSCs. Methods forty-nine patients with RRSCs underwent salvage surgeries in our institution, and the clinical characteristics were collected and recorded by two independent reviewers. Univariate and multivariate analyses were performed to investigate the independent prognostic factors of recurrence-free survival (RFS) and overall survival (OS) for patients with RRSCs. Results During the mean follow-up of 31.7 ± 21.04 months (Range 9–93), the 3-year RFS and OS rate was 24.5% and 34.5%, respectively. According to the Cox proportional hazards regression model, wide excision with tumor-free margin (>4 mm) was associated with both better RFS and OS for patients with RRSCs. Meanwhile, the number of recurrences ≤2 was beneficial to RFS, while high pathological grade was correlated with worse OS. Conclusions Wide excision with tumor-free margin (>4 mm) is recommendable if appropriate in the salvage surgery for patients with RRSCs. Patients with number of recurrences ≤ 2 and lower pathological grade may have better RFS and OS, respectively.

Scalable video coding is a promising technique to enable flexible video transmission for heterogeneous terminals and varying channel throughput. However, it is challenging to perform in-network adaptation in conventional networks because the network nodes are uncontrollable and transparent for media streaming applications. Software-defined networking (SDN) is an attractive network technology that supports the applications to collaborate with network nodes to achieve intelligent and dynamic service provisioning. Against this changing network landscape, we redesign the scalable multimedia multicast streaming by exploiting the complete network knowledge of the SDN controller to enable intelligent scalable video transmission. The proposed scalable multimedia multicast streaming framework is capable of in-network identifying, processing, and manipulating the media streams. In order to achieve the in-network adaptation, we apply equivalent bandwidth theory to estimate the affordable video layers that a link may accommodate, and apply finite-state machine to implement adaptive enhancement layer switching for multicast paths. In contrast to IP multicast, the proposed method is a controllable multicast scheme, which provides admission control in a multicast context, in-network adaptation, and supporting heterogeneous devices having different display capability. We further implement a prototype for illustrating the success of the proposed solution. The experimental results are also presented to show the effectiveness of the proposed equivalent bandwidth based adaptive enhancement layer switching algorithm.