Biomechanical comparison of four C1 to C2 rigid fixative techniques: anterior transarticular, posterior transarticular, C1 to C2 pedicle, and C1 to C2 intralaminar screws.

Objective: We performed a biomechanical comparison of several C1 to C2 fixation techniques including crossed laminar (intralaminar) screw fixation, anterior C1 to C2 transarticular screw fixation, C1 to 2 pedicle screw fixation, and posterior C1 to C2 transarticular screw fixation.

Methods: Eight cadaveric cervical spines were tested intact and after dens fracture. Four different C1 to C2 screw fixation techniques were tested.

The tethered cord syndrome in adults with spina bifida occulta.

The management of adult-onset tethered cord syndrome (TCA) remains controversial, although the necessity of early surgery in children with TCS is well established. In this paper, we review the major publications that discuss the congenital tethered spinal cord (spina bifida occulta) presenting in adulthood. Data concerning acquired tethered cord from prior myelomeningocele repair were excluded.

Correlation between auditory function and internal auditory canal pressure in patients with vestibular schwannomas.

Object: Hearing loss is the most common presenting symptom in patients who harbor a vestibular schwannoma (VS). Although mechanical injury to the cochlear nerve and vascular compromise of the auditory apparatus have been proposed, the exact mechanism of this hearing loss remains unclear. To test whether pressure on the cochlear nerve from tumor growth in the internal auditory canal (IAC) is responsible for this clinical finding, the authors prospectively evaluated intracanalicular pressure (ICaP) in patients with VS and correlated this with preoperative brainstem response.