Surgical cordotomy helps psychosocial suffering.

A young woman was admitted to our palliative care unit with severe pain to her right hip and leg. Her pain was uncontrolled despite aggressive use of opioids, adjuvant pain medications and spinal analgesia. She experienced significant psychological and social distress, but engaging in therapies with our multidisciplinary team proved difficult.

Heterotopic ossification and radiographic adjacent-segment disease after cervical disc arthroplasty.

Objective: Cervical disc arthroplasty (CDA) is an accepted motion-sparing technique associated with favorable patient outcomes. However, heterotopic ossification (HO) and adjacent-segment degeneration are poorly understood adverse events that can be observed after CDA. The purpose of this study was to retrospectively examine 1) the effect of the residual exposed endplate (REE) on HO, and 2) identify risk factors predicting radiographic adjacent-segment disease (rASD) in a consecutive cohort of CDA patients.

Intrathecal Saline Infusion as an Effective Temporizing Measure in the Management of Spontaneous Intracranial Hypotension.

Background: Spontaneous intracranial hypotension (SIH) is a rare condition for which no optimal treatment guidelines have been determined. The most common presentation is orthostatic headaches, but patients can present with a variety of symptoms.

Case Description: We present a case of a 34-year-old man who developed progressive orthostatic headaches and bilateral subdural collections.

Patient Predictors of Surgical Candidacy in Elective Spine Disorders.

Background: The expansion of age-related degenerative spine pathologies has led to increased referrals to spine surgeons. However, the majority of patients referred for surgical consultation do not need surgery, leading to inefficient use of healthcare resources. This study aims to elucidate preoperative patient variables that are predictive of patients being offered spine surgery.

Thoracic epidural blood patch for spontaneous intracranial hypotension: case report and review of the literature.

Spontaneous intracranial hypotension (SIH) is caused by spinal leakage of cerebrospinal fluid (CSF). Treatment is directed at sealing the site of leak, which is often difficult to localize. We present a case of near fatal SIH that was treated with thoracic epidural blood patching.

Design limitations of Bryan disc arthroplasty.

Background Context: Disc arthroplasty is gaining momentum as a surgical procedure in the treatment of spinal degenerative disease. Results must be carefully scrutinized to recognize benefits as well as limitations.

Purpose: The aim of this study was to investigate factors associated with segmental kyphosis after Bryan disc replacement.

Minimally invasive anterior approach to upper cervical spine: surgical technique.

Objective: The transoral approach of Spetzler is the classic anterior access to the upper cervical spine that provides direct exposure for anterior decompression of the spinal cord. The risks of infection, the limits in extension, and the postoperative recovery difficulties of transmucosal access suggest the use of an alternative anterior extraoral approach in upper cervical surgery. However, this approach results in complications from nerve palsy because of excessive retraction of the hypoglossal and the superior laryngeal nerves.

Posterolateral dislocation of the C1-C2 articulation associated with fracture of the anterior arch of C1: a case report.

Study Design: Case report.

Objective: To report a rare traumatic C1-C2 dislocation associated with fracture of the anterior arch of the atlas in a neurologically intact patient.

Summary Of Background Data: Isolated fractures of the anterior arch of C1 are very rare.

Suspended laminoplasty for wide posterior cervical decompression and intradural access: results, advantages, and complications.

Object: Cervical laminoplasty is a recognized technique commonly used for multilevel posterior cervical decompression, and it is favored over laminectomy for maintaining spinal stability. Traditional hinge techniques, however, limit lateral exposure on one side and can limit dural exposure. The authors present their experience with a modified laminoplasty technique incorporating complete laminectomy and placement of titanium miniplate instrumentation.