Pigmented villonodular synovitis (PVNS) is a proliferative disease of the synovial membranes. Large joints are most commonly affected, while PVNS rarely affects the spine. We present a 70-year-old female patient with PVNS in the cervical spine who experienced both radiculopathy and myelopathy. An osteolytic lesion was observed over the sixth and seventh intervertebral foramina on the right cervical vertebrae on the radiological examination, and surgery was performed to remove the tumor and stabilize the cervical spine. Partial tumor resection was performed to preserve the right seventh cervical root. She was pathologically diagnosed with PVNS. After surgery, the patient's symptoms improved, and no recurrence was observed at outpatient follow-up 1 year later. In consideration of the recurrence rate, complete resection of the tumor is considered the standard treatment, but additional research is needed because there is no standard for adjuvant treatment in cases of incomplete resection or for methods to reduce the recurrence rate.

The reliability of the thoracolumbar injury classification and severity (TLICS) score is well established; however, its reliability among young neurosurgeons in particular has not been investigated. This study was designed to identify intra-and inter-observer differences between the TLICS system and the McAfee classification among young neurosurgeons, with the goal of facilitating communication between physicians and treatment decision-making for patients with thoracolumbar injuries. Methods: Six young neurosurgeons reviewed thoracolumbar spinal fracture patients between January 2016 and October 2020 and analyzed thoracolumbar fractures according to the 2 classification systems. The intra-and inter-observer reliability of the TLICS and the McAfee scale was assessed with the Cohen and Fleiss kappa tests. Results:The intra-observer kappa value for the TLICS exhibited excellent reliability (κ = 0.85) compared to the McAfee classification (κ = 0.79). The inter-observer kappa values for each category of the TLICS were 0.69 (morphology), 0.93 (neurologic status), 0.74 (posterior ligamentous complex), and 0.72 (total score). The kappa value of the McAfee classification was lower (κ = 0.52). Conclusion: The TLICS system showed higher reliability than the McAfee classification. The TLICS score showed more consistent results for thoracolumbar spinal fractures and may thus serve as a guideline for young neurosurgeons in treating patients with thoracolumbar fractures.