Background and Importance: Developmental craniovertebral junction (CVJ) anomalies are often comprised of irreducible atlantoaxial dislocation (AAD) and basilar invagination (BI) associated with the fusion of the C1 arch. BI is described as a congenital upward displacement of mostly the odontoid process into the foramen magnum, which AAD can accompany. The DCER (Distraction, Compression, Extension, and Reduction) consists of decompression of craniocervical junction, BI reduction followed by occipitocervical fusion in anatomic lordotic curvature –performing extension and compression. This technique has recently been applied in patients with BI and AAD, demonstrating satisfactory results. Case Presentation: Herein, we report two cases of BI with AAD who underwent surgery with the DCER technique for the first time in our center. Conclusion: BI has been managed with combined approach (anterior odontoid resection followed by posterior craniocervical fusion). Since last decade, single posterior approaches has been utilized to reduce and stabilize BI and AAD. DCER approach is the most recent and successful procedure.

Background and Importance: Plasmacytoma is more likely to involve the spine with up to 50%, most commonly in the thoracic spine. Case Presentation: This study examined a patient with solitary plasmacytoma with neck pain and abnormal C1-C2 range of motion, which happened to have an osteolytic C2 lesion on CT scanning. The patient underwent a fluoroscopically guided anterior percutaneous C2 vertebroplasty without posterior fusion, leading to management of pain, maintenance of normal motions, and restoration of cervical alignment. Conclusion: This case represents fluoroscopically guided anterior percutaneous C2 vertebroplasty as an effective treatment for C2 osteolytic lesions with an abnormal range of motion, which can be considered in selected cases as an alternative approach for demanding open surgical approaches to this challenging region.

Background: Cerebrospinal fluid (CSF) contains pro-growth factors that can affect proliferation, migration and differentiation of Mesenchymal Stem Cells (MSCs). Objective: This study aimed to isolate MSC like cells from CSF of patients with meningioma and psudotumorcerebri (PTC) and identify differentially expressed proteins in these cells. Methods: Five patients with newly diagnosed intracranial meningioma and five patients with PTC were recruited in this comparative proteomics study. MSCs were isolated from CSF and validated by mesenchyml and non-mesenchyml fluorochrome antibodies, and flow cytometer analysis. Two- Dimensional Gel Electrophoresis (2-DE) coupled with Mass Spectrometry (MS) was performed to identify differentially expressed proteins. Results: Microscopic views of the isolated cells as well as flow cytometer analysis were found to be compatible with MSC-like cells. Eight distinct protein spots were differentially and reproducibly expressed among the stained gels of two studied groups. The identified proteins were Phosphoglycerate Mutase 1 (PGAM1), LIM and SH3 domain protein (LASP1), peroxiredoxin-6 (PRDX-6), type I cytoskeletal 9 (KRT9), Superoxide Dismutase (SOD), endoplasmin, Stathmin 1 (STMN1), and glutathione S-transferase (GST). Conclusion: This study provides new insights into the plausible role of CSF derived MSCs in cancer progression, and reveals a promising therapeutic opportunity for targeting of MSC proteins in patients with meningioma.