Diaphragm paralysis from cervical disc lesions.

An opera singer, who "made her living with her diaphragm", developed a post-traumatic unilateral radiculopathy due to cervical disc lesions, C3 to C6. During one year of severe neck and left arm pain she gradually lost the ability to sing difficult operatic passages which brought an end to her music career. Following a three level anterior cervical decompression and fusion, the neck and arm pain was immediately relieved.

Posterior lumbar interbody fusion updated.

Based on over 45 years' experience in the surgical treatment of lumbar disc disease, it is recommended that the following operations be eliminated: the simple discectomy, which may cure the sciatica but not the back pain; the "decompressive laminectomy," which leaves the patient with painful instability and nerve-root scarring; and chemonucleolysis, which does not provide permanent relief of either low-back or leg pain. The PLIF technique is the answer to treatment of diseases of the lumbar spine and may be the operation of the future.

Progressive idiopathic anterior dislocation of the upper cervical spine with severe myelopathy.

Three unusual and rare cases are reported with progressive anterior dislocation of the cervical spine of unknown etiology causing severe myelopathy. Spinal pathology was confined to a single level and at different locations in each case. Narrowing of the spinal canal resulted in three different neurological syndromes, each requiring a different operative approach: one anterior, one posterior, and one both.

Spondylolisthesis: treatment by laminectomy and posterior interbody fusion.

Spondylolisthesis is a hereditary anomaly of the spine, often associated with intractable pain in the back and lower extremities. The diagnosis is commonplace. Approximately 5% to 7% of the population in the United States has the anomaly.

Gas-sterilized cadaver bone grafts for spinal fusion operations. A simplified bone bank.

Cadaver bone for spinal fusion operations is as safe as autografts. The author's 35 years' experience using cadaver bone for interbody spinal fusion operations has led to the development of a simplified bone bank method. Unsterile bone removed from young, fresh cadavers is cut into appropriate sizes and shapes, washed clean, packaged and sterilized with ethylene oxide gas, then aerated and stored at room temperature.

Removal of giant clival chordoma by an anterior cervical approach.

Chordoma, a primary malignant neoplasm of the cerebro-spinal axis, is difficult to diagnose and impossible to cure. The only effective treatment is early radical surgical removal, regardless of its size or location. A giant, 65gm tumor arising from the clivus, C1 and C2 vertebrae was successfully removed with low morbidity.

Metastatic disc infection and osteomyelitis of the cervical spine. Surgical treatment.

Two cases of vertebral osteomyelitis and discitis in the cervical spine are presented, both having arisen from hematogenous spread to the spine. Bacteriologic diagnosis was established in 1 patient, but the infection had subsided in the other. Both patients were treated with anterior debridement and fusion, and a supplemental posterior wiring and fusion was performed in the second case to reduce kyphotic angulation.