Cortical Reorganization Is Associated with Surgical Decompression of Cervical Spondylotic Myelopathy.

Background: Cervical spondylotic myelopathy (CSM) results in sensorimotor limb deficits, bladder, and bowel dysfunction, but mechanisms underlying motor plasticity changes before and after surgery are unclear.

Methods: We studied 24 patients who underwent decompression surgery and 15 healthy controls. Patients with mixed upper and lower limb dysfunction (Group A) and only lower limb dysfunction (Group B) were then analysed separately.

Early clinical and radiographical results of keel-less and shallow keel cervical disc replacement.

Background: Cervical disc replacements has been shown to be as effective as fusions in the treatment of radiculopathy or myelopathy due to disc prolapse. Newer implants were designed to reduce the difficulty of end-plate preparation. Since 2010, the authors have started using Discocerv (Alphatec Spine, Carlsbad, USA) a keel-less implant and Activ-C (B.

Palliative surgery for cervical spine metastasis.

Introduction: The present study aimed to assess the immediate/early clinical outcomes and surgical results of 11 consecutive patients who underwent palliative cervical spine surgery for symptomatic spinal metastases.

Methods: This single-surgeon retrospective case series analysed 12 surgical procedures that were performed for symptomatic cervical spinal metastasis in 11 consecutive patients. All surgeries were carried out at Singapore General Hospital, Singapore, from 2007 to 2013.

A computed tomography morphometric study of occipital bone and C2 pedicle anatomy for occipital-cervical fusion.

Background: Occipital-cervical fusion (OCF) has been used to treat instability of the occipito-cervical junction and to provide biomechanical stability after decompressive surgery. The specific areas that require detailed morphologic knowledge to prevent technical failures are the thickness of the occipital bone and diameter of the C2 pedicle, as the occipital midline bone and the C2 pedicle have structurally the strongest bone to provide the biomechanical purchase for cranio-cervical instrumentation. The aim of this study was to perform a quantitative morphometric analysis using computed tomography (CT) to determine the variability of the occipital bone thickness and C2 pedicle thickness to optimize screw placement for OCF in a South East Asian population.

Surgical treatment of adult and pediatric C1/C2 subluxation with intraoperative computed tomography guidance.

Background: Surgical treatment of C1/C2 subluxation has evolved significantly over the past 2 decades, from the relatively simpler posterior wiring to more technically demanding instrumentations such as C1 lateral mass screws - C2 pedicle screws, C1/C2 transarticular screws, and occipital cervical fusion. Navigation with fluoroscopy is currently the standard of practice in most centers. However, fluoroscopy at this level carries several major drawbacks, such as blockage by the mandible and inability to produce axial images for assessment of the reduction of rotatory subluxation.

Surgery for atlanto-axial (C1-2) involvement or instability in nasopharyngeal carcinoma patients.

Nasopharyngeal cancer (NPC) is a common malignancy affecting Asian countries, especially the Chinese population. Treatment regimes and results have improved over the years with better overall survival outcome data. Radiotherapy with or without chemotherapy is successful in many patients.

A prospective study on the use of intraoperative computed tomography (iCT) for image-guided placement of thoracic pedicle screws.

Background: Placement of thoracic pedicle screws is a technically demanding procedure. The risk of thoracic pedicle breaches range from 6.5 to 41%.

Hypertensive primary intraventricular hemorrhage due to a phaeochromocytoma.

Primary intraventricular haemorrhage (IVH) is rare. We defined primary IVH as haemorrhage into the ventricles only as detected by computerized tomographic (CT) brain scan. This is in contrast with other intracerebral haemorrhages (e.

Results of surgical treatment for cerebral metastases.

Cerebral metastases are commonly encountered, with an incidence ranging from 20 to 30% of cancer cases. Medical and radiation therapy confer median survival ranging from 3 to 6 months only. A retrospective review of patients undergoing surgery with radiotherapy from January 1997 to January 2000 involved 26 patients (13 males, 13 females), with a mean age of 53.