Athrodesis of the lateral atlanto-axial joint for the relief of neck pain and cervicogenic headache.

Background: Osteoarthrosis of the lateral atlanto-axial joint (LAAJ) may be a cause of upper neck pain and headache. Intra-articular injection of steroids may provide only short-lasting relief. For intractable pain, arthrodesis of the joint might be considered.

Simultaneous cochlear implantation during resection of a cerebellopontine angle meningioma: case report.

Cerebellopontine angle (CPA) meningiomas commonly involve the internal auditory canal (IAC). We report a case of a 68-year-old lady with idiopathic profound bilateral deafness with a meningioma which was discovered on workup for cochlear implantation. We performed simultaneous excision of her CPA and IAC meningioma with insertion of a cochlear implant (CI).

Identifying factors influencing mortality in patients aged over 65 following an acute type II odontoid process fracture. A retrospective cohort study.

Objective: Compare short-term mortality rates following operative and nonoperative management of geriatric patients following an acute type II odontoid process fracture.

Methods: One hundred forty-one patients with a type II odontoid fracture were identified from a single centre between 2002 and 2018. Patient demographics, details of injury and management, plus mortality data were collected.

Simultaneous cochlear implantation and removal of acoustic neuroma: implications for hearing.

Objective: To present our data evaluating the feasibility of simultaneous cochlear implantation with resection of acoustic neuroma.

Methods: This paper describes a case series of eight adult patients with a radiologically suspected acoustic neuroma, treated at a tertiary referral centre in Newcastle, Australia, between 2012 and 2015. Patients underwent cochlear implantation concurrently with removal of an acoustic neuroma.

Outcomes for Vertebrectomy for Malignancy and Correlation to the Spine Instability Neoplastic Score (SINS): a 10-Year Single-Center Perspective.

Objective: The clinical prognostic value of the Spinal Instability Neoplastic Score (SINS), in the context of vertebrectomy for neoplasia, has not yet been established. This retrospective study of 134 patients aims to evaluate the efficacy of the SINS to predict outcomes and survival after vertebrectomy for malignancy.

Methods: The patients were classified into 2 groups: indeterminate stability (SINS 7-12) and unstable (SINS 13-18).

Vertebrectomy in metastatic spinal tumours: A 10 year, single-centre review of outcomes and survival.

Metastatic disease to the vertebral column can cause spinal instability, neurological deterioration and pain. The present study was designed to provide insight into the cohort undergoing vertebrectomy for metastatic disease to the spinal column, assessing the associated morbidity, functional outcomes and survival. A retrospective review of 141 consecutive vertebrectomies for metastatic disease was undertaken.

Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project.

Introduction And Purpose: Little information exists on surgical characteristics, complications and outcomes with corrective surgery for rigid cervical kyphosis (CK). To collate the experience of international experts, the CSRS-Europe initiated an international multi-centre retrospective study.

Methods: Included were patients at all ages with rigid CK.

A Prospective, Randomized, Multicenter Study Comparing Silicated Calcium Phosphate versus BMP-2 Synthetic Bone Graft in Posterolateral Instrumented Lumbar Fusion for Degenerative Spinal Disorders.

Study Design: A prospective, Phase IV, multicenter, randomized study.

Objective: The aim of this study was to compare vertebral fusion success rates following posterolateral fusion [(PLF)/posterolateral intertransverse fusion (PITF)] surgery. The surgical procedure combined posterior lumbar interbody fusion (PLIF) and PLF with internal fixation over one or two levels using silicated calcium phosphate (SiCaP) or bone morphogenetic protein (BMP)-2 as graft material in patients with a degenerative disorder of the lumbar spine.

Infant with recurrent ventriculoperitoneal shunt migration to right scrotum.

Migration of the distal catheter of a ventriculoperitoneal shunt to the scrotum is a documented but rare event. We present a case in which a 13 month old infant with hydrocephalus had recurrent migration of the peritoneal catheter to the right scrotum associated with a developing hydrocele. The patient underwent two revision operations and the distal catheter was ultimately shortened.

Cervical spine immobilization following blunt trauma: a systematic review of recent literature and proposed treatment algorithm.

Background: Management of the cervical spine following blunt trauma is commonplace. In 2013, the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) published practice guidelines drawn from evidence dating to 2011. Since then, further publications have emerged that are reviewed, and a simple management algorithm produced to assist practitioners in Australian trauma centres.

Successful surgical treatment of intractable spontaneous intracranial hypotension due to a calcified thoracic disc prolapse.

We present a patient with spontaneous intracranial hypotension due to a calcified thoracic disc prolapse. Although most cases of spontaneous intracranial hypotension resolve with conservative measures, a few reported patients require surgical intervention. We discuss an uncommon presentation of spontaneous intracranial hypotension, requiring surgical repair of a thoracic dural defect to achieve symptom resolution.

Long-term follow-up of minimal-access and open posterior lumbar interbody fusion for spondylolisthesis.

Background: Although posterior lumbar interbody fusion (PLIF) is regarded as an effective treatment for spondylolisthesis, few studies have reported comprehensive, long-term outcome data, and none has investigated the incidence of deterioration of outcomes.

Objective: To determine and compare the success rates and long-term stability of outcomes of open PLIF and minimal-access PLIF in the treatment of radicular pain and back pain in patients with spondylolisthesis.

Methods: Forty-three patients were followed for a minimum of 3 years.

Seatbelt: a double-edged sword.

Intra-abdominal vascular injury due to blunt trauma is unusual in children. Due to its rarity, detailed reports dealing with its management are scarce in paediatric literature. Diagnosis of these injuries is challenging, and a high degree of awareness is necessary for rapid identification and treatment of these injuries.

Serial spread of benign metastasizing leiomyoma to the thoracic spine.

Benign metastasizing leiomyoma (BML) is a rare condition due to a histologically benign smooth muscle tumour originating from a uterine leiomyoma. It rarely affects the spine to cause spinal cord compression. Here we report a patient with serial metastases to the thoracic spine causing neurological compromise.

The efficacy of transforaminal injection of steroids for the treatment of lumbar radicular pain.

Background: Transforaminal injection of steroids is used to treat lumbar radicular pain. Not known is whether the route of injection or the agent injected is significant.

Study Design: A prospective, randomized study compared the outcomes of transforaminal injection of steroid and local anesthetic, local anesthetic alone, or normal saline, and intramuscular injection of steroid or normal saline.

Minimal access versus open posterior lumbar interbody fusion in the treatment of spondylolisthesis.

Objective: To compare the safety and effectiveness of minimal access posterior lumbar interbody fusion (MAPLIF) with open posterior lumbar interbody fusion (OPLIF) in patients with spondylolisthesis and radicular pain.

Methods: A prospective study was performed of 47 patients with radicular pain resulting from lumbar spondylolisthesis with a slip of less than 50% who underwent either MAPLIF (n = 23) or OPLIF (n = 24). At 12 months after treatment, clinical outcomes were measured using the Short-Form Health Survey 36 and the visual analog score for both leg pain and back pain, and the degree of reduction of spondylolisthesis, restoration of disc height, and presence of fusion were assessed.

Dynamic plates in anterior cervical fusion surgery: graft settling and cervical alignment.

Study Design: Retrospective cohort.

Objective: To evaluate the effect of graft subsidence associated with the use of dynamic cervical plates on cervical alignment and clinical outcome of patients undergoing anterior cervical decompression and fusion.

Summary And Background Data: Dynamic cervical plates allow graft loading which may enhance fusion.

Recovery of ankle dorsiflexion weakness following lumbar decompressive surgery.

This retrospective study evaluated the recovery of ankle dorsiflexion (ADF) weakness following decompressive surgery in order to identify factors indicative of a better outcome. Fifty-six consecutive patients with ADF weakness secondary to nerve root compression underwent lumbar decompressive surgery. The demographic features, duration and severity of preoperative ADF weakness, associated radicular pain, as well as the radiological and intraoperative findings were recorded.

Clinical and functional outcomes of anterior cervical discectomy without fusion.

Anterior cervical discectomy without fusion is an effective treatment for myeloradiculopathy arising from a medial disc prolapse. However, the long-term clinical results are not well known. Between 2000 and 2006, 38 patients with persistent radiculopathy and medial disc prolapse or myelopathy due to acute disc prolapse underwent subtotal anterior cervical discectomy without fusion.

Transient global brainstem dysfunction after microvascular decompression of the trigeminal nerve.

Microvascular decompression of the trigeminal nerve root entry zone has become a standard treatment for trigeminal neuralgia. It has been widely reported with a low morbidity. This case report details an unusual and previously unreported complication of this procedure.

Anterior correction of cervical kyphotic deformity: effects on myelopathy, neck pain, and sagittal alignment.

Object: Cervical myelopathy may develop as a result of spinal cord compression with or without deformity. The effect of persistent kyphotic deformity on the ability of the cervical cord to recover following decompressive surgery is not known.

Methods: Between 1997 and 2000, a total of 28 patients with progressive myelopathy and kyphotic deformity underwent anterior decompression, deformity correction (0-4 degrees of lordosis), and fusion with anterior plating.

Surgical management of ruptured aneurysms in the eighth and ninth decades.

Background: The surgical management of elderly patients with aneurysmal subarachnoid haemorrhage (SAH) is controversial. The present study was performed to more clearly define issues facing elderly SAH patients undergoing surgical repair of their aneurysms.

Method: Between 1990 and 2000, 100 patients, aged 70 years or older, were managed consecutively with aneurysmal surgical repair at Verona City Hospital.

Temporary arterial occlusion in the repair of ruptured intracranial aneurysms: an analysis of risk factors for stroke.

Object: This study was performed to further elucidate technical and patient-specific risk factors for perioperative stroke in patients undergoing temporary arterial occlusion during the surgical repair of their aneurysms.

Methods: One hundred twelve consecutive patients in whom temporary arterial occlusion was performed during surgical repair of an aneurysm were retrospectively analyzed. Confounding factors (inadvertent permanent vessel occlusion and retraction injury) were identified in six cases (5%) and these were excluded from further analysis.

Bypass to the intracranial internal carotid artery.

Extracranial to intracranial internal carotid artery bypass surgery with vein is well described for a number of diverse conditions. They provide high blood flow with good initial patency. However, long term patencies for specific graft types remains unknown.

The neuro-cardio-endocrine response to acute subarachnoid haemorrhage.

Objective: Whereas cardiac hormones increase after subarachnoid haemorrhage (SAH), and may contribute to sodium wastage and hyponatraemia, there is controversy concerning the relative roles of atrial natriuretic peptide (ANP) vs. brain natriuretic peptide (BNP) and the factors initiating their secretion. Noting previous work linking stress hormone responses with cardiac injury after SAH, we have studied responses in stress hormones, markers of cardiac injury and the temporal changes in ANP and BNP and related them to changes in sodium status post ictus and during recovery from acute SAH.