Imaging-based algorithmic approach to gallbladder wall thickening

Gallbladder(GB) wall thickening is a frequent finding caused by a spectrum of conditions. It is observed in many extracholecystic as well as intrinsic GB conditions. GB wall thickening can either be diffuse or focal. Diffuse wall thickening is a secondary occurrence in both extrinsic and intrinsic pathologies of GB, whereas, focal wall thickening is mostly associated with intrinsic GB pathologies. In the absence of specific clinical features, accurate etiological diagnosis can be challenging. The survival rate in GB carcinoma(GBC) can be improved if it is diagnosed at an early stage, especially when the tumor is confined to the wall. The pattern of wall thickening in GBC is often confused with benign diseases, especially chronic cholecystitis, xanthogranulomatous cholecystitis, and adenomyomatosis. Early recognition and differentiation of these conditions can improve the prognosis. In this minireview, the authors describe the patterns of abnormalities on various imaging modalities(conventional as well as advanced) for the diagnosis of GB wall thickening. This paper also illustrates an algorithmic approach for the etiological diagnosis of GB wall thickening and suggests a formatted reporting for GB wall abnormalities.     

Minimally invasive lateral approach to the thoracolumbar junction for corpectomy

Diseases that affect the thoracolumbar junction present a unique challenge to the spine surgeon. Various techniques have been described to treat this clinical entity from the anterior, lateral, or posterior direction. These can be associated with significant morbidity due to extensive tissue dissection, blood loss, and postoperative pain leading to a lengthy recovery. The use of a tubular retractor allows the surgeon to minimize tissue dissection and potentially reduce approach-related morbidity while obviating the need for an approach surgeon for exposure. The surgical technique of a minimally invasive lateral approach to the thoracolumbar junction for corpectomy is described in detail and two illustrative patients are presented.     

Pivoting to Telehealth: the HSS Experience,Value Gained,and Lessons Learned

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