Retropharyngeal/anterolateral approach for C2 corpectomy.

Instability of the high cervical spine, particularly C1 and C2, is commonly treated via a posterior approach. Access to this region via transoral approaches is often avoided due to the high risk of wound contamination, limited exposure, and lack of experience on the part of the surgeon. We present a 48-year-old man exhibiting complete C2 vertebral body involvement by multiple myeloma with a pathologic fracture, which we treated via the anterolateral/retropharyngeal approach to the high cervical spine.

Odontoid screw placement using Isocentric 3-dimensional C-arm fluoroscopy.

Study Design: We describe the use of isocentric 3-dimensional fluoroscopy to place odontoid screws in 9 patients.

Objective: We wanted to show the benefits of using isocentric 3-dimensional fluroscopy in odontoid screw placement.

Summary Of Background Data: Odontoid screw fixation for treatment of type II odontoid fractures has gained popularity since its introduction in the early 1980s.

Postoperative cranial fasciitis. Report of two cases and review of the literature.

The authors report two cases of cranial fasciitis occurring at prior craniotomy sites. They review the presentation and pathological features associated with cranial fasciitis and describe two unusual cases and their treatment. The first case is that of a 16-year-old girl who underwent suboccipital craniectomy for resection of medulloblastoma and 14 months later was found to have a 4-cm nontender mass at the incision site, with evidence of skull erosion on neuroimaging.

Image fusion of fluid-attenuated inversion recovery magnetic resonance imaging sequences for surgical image guidance.

Background: Nonenhancing brain lesions can be relatively poorly defined on volumetric data sets routinely used for surgical guidance. Fluid-attenuated inversion recovery MRI sequences can provide better margin visualization of nonenhancing or poorly enhancing lesions.

Methods: Using image fusion programs, we combined data sets of SPGR imaging pulse sequence or volumetric CT with volumetrically acquired FLAIR sequences and subsequently used the fused data set for image-guided surgery.

Zenker diverticulum: a rare complication after anterior cervical fusion.

Esophageal injury is a rare but serious complication occurring after anterior cervical spine surgery. Pharyngoesophageal, or Zenker, diverticulum is an acquired outpouching of the pharyngeal musculature just proximal to a functional esophageal stricture, clinically manifesting as dysphagia, aspiration, and weight loss. We report a case in which a patient developed a pharyngoesophageal diverticulum, accompanied by retropharyngeal abscess, first identified 2 years after a 3-level anterior cervical fusion with allograft and anterior plating.

Tuberculosis infection presenting as brain abscess in an immunocompromised host.

Despite advances in modern treatment, tuberculosis remains an ever-present problem. With the HIV epidemic, the prevalence of tuberculosis has risen. Contributing to this trend has been the development of multi-resistant tuberculosis strains, as well as rising immigration from nations where tuberculosis is endemic.

Hydrocephalus.

In treating patients with hydrocephalus, cerebral ventricular shunts and their complications are often encountered by the primary care provider. Caring for these patients can provoke anxiety and doubt in those who have had little exposure in dealing with shunts. Becoming familiar with the clinical findings, etiology, and treatment of hydrocephalus, as well as the signs and symptoms of cerebral ventricular shunt complications, will aid the primary care physician in the management, treatment, referral, and continuing care of these patients.