Cervical sagittal balance parameters after single-level anterior cervical discectomy and fusion: Correlations with clinical and functional outcomes.

Background: Normal sagittal cervical alignment has been associated with improved outcome after anterior cervical discectomy and fusion (ACDF).

Objective: The aim of this study is to identify alterations of cervical sagittal balance parameters after single-level ACDF and assess correlations with postoperative functionality.

Methods: A retrospective chart review was performed between January 2010 and January 2014 to identify adult patients with no previous cervical spine surgery who underwent ACDF at any one level between C2 and C7 for the single-level degenerative disease.

Correlation of Clinical and Radiological Outcome After Anterior Cervical Discectomy and Fusion With a Polyetheretherketone Cage.

Background: Anterior cervical discectomy and fusion (ACDF) with a polyetheretherketone (PEEK) cage is considered as the gold standard for patients with cervical disc disease. However, there are limited data on the impact of ACDF on the cervical kinematics and its association with patient-reported clinical outcomes. The purpose of this study was to investigate the impact of altered cervical sagittal alignment (cervical lordosis) and sagittal range of motion (ROM) on patients' self-reported pain and functional disability, after ACDF with a PEEK cage.

Percutaneous screw placement in the lumbar spine with a modified guidance technique based on 3D CT navigation system.

Several guidance techniques have been employed to increase accuracy and reduce surgical time during percutaneous placement of pedicle screws (PS). The purpose of our study was to present a modified technique for percutaneous placement of lumbar PS that reduces surgical time. We reviewed 23 cases of percutaneous PS placement using our technique for minimally invasive lumbar surgeries and 24 control cases where lumbar PS placement was done via common technique using Jamshidi needles (Becton, Dickinson and Company, Franklin Lakes, NJ, USA).

Steinmann Pins for C1 Lateral Mass Screw Placement During Atlantoaxial Stabilization.

Objective: The authors describe a modified technique for placement of the C1 lateral mass screw using a Steinmann pin as a guide. This technique minimizes dissection and provides atlantoaxial stabilization during arthrodesis.

Methods: In our technique, a nonthreaded 1.

The Role of Gait Analysis in the Evaluation of Patients with Cervical Myelopathy: A Literature Review Study.

Background: Gait analysis represents one of the newest methodologies used in the clinical evaluation of patients with cervical myelopathy (CM).

Objective: To describe the role of gait analysis in the clinical evaluation of patients with CM, as well as its potential role in the evaluation of the functional outcome of any surgical intervention.

Methods: A literature review was performed in the PubMed, OVID, and Google Scholar medical databases, from January 1995 to August 2016, using the terms "analysis," "anterior," "cervical myelopathy," "gait," "posterior," and "surgery.

Large, spontaneous spinal subdural-epidural hematoma after epidural anesthesia for caesarean section: Conservative management with excellent outcome.

Background: Iatrogenic or spontaneous spinal hematomas are rarely seen and present with multiple symptoms that can be difficult to localize. Most spontaneous spinal hematomas are multifactorial, and the pathophysiology is varied. Here, we present a case of a scattered, multicomponent, combined subdural and epidural spinal hematoma that was managed conservatively.

Hemoptysis as the Presenting Clinical Sign of a T8-T9 Spine Fracture with Diffuse Idiopathic Skeletal Hyperostosis Changes.

Diffuse idiopathic skeletal hyperostosis (DISH) is a noninflammatory degenerative disease that affects multiple spine levels and, in combination with osteoporosis, makes vertebrae more prone to fractures, especially in elderly people. We describe a rare case of thoracic fracture in an ankylosed spine in which hemoptysis was the only clinical sign. The patient (age in the early 80s) presented with chest pain and a cough associated with hemoptysis.

Anterior Cervical Discectomy and Fusion: Practice Patterns Among Greek Spinal Surgeons.

Background: A web-based survey was conducted among Greek spinal surgeons to outline the current practice trends in regard to the surgical management of patients undergoing anterior cervical discectomy and fusion (ACDF) for degenerative cervical spine pathology. Various practice patterns exist in the surgical management of patients undergoing anterior cervical discectomy for degenerative pathology. No consensus exists regarding the type of the employed graft, the necessity of implanting a plate, the prescription of an external orthotic device, and the length of the leave of absence in these patients.

Posterior Reversible Encephalopathy Syndrome Resolving Within 48 Hours in a Normotensive Patient Who Underwent Thoracic Spine Surgery.

Posterior reversible encephalopathy syndrome (PRES) usually manifests with severe headaches, seizures, and visual disturbances due to uncontrollable hypertension. A patient (age in the early 60s) with a history of renal cell cancer presented with lower-extremity weakness and paresthesias. Magnetic resonance imaging (MRI) of the thoracic spine revealed a T8 vertebral body metastatic lesion with cord compression at that level.

Patient variables and referral paradigms associated with osteoporosis screening and treatment in neurosurgical patients undergoing kyphoplasty.

OBJECT Vertebral fractures are the most common osteoporotic fracture. Bone density testing and medical treatment with bisphosphonates or parathormone are recommended for all patients with an osteoporotic fracture diagnosis. Inadequate testing and treatment of patients presenting with low-impact fractures have been reported in various specialties.

Assessment of Nogo-66 receptor 1 function in vivo after spinal cord injury.

Background: Neuronal Nogo-66 receptor 1 (NgR1) has attracted attention as a converging point for mediating the effects of myelin-associate inhibitory ligands in the central nervous system, establishing the growth-restrictive environment, and limiting axon regeneration after traumatic injury.

Objective: To investigate the factors that may be contributing to the discrepancy in the importance of NgR1, which has been undermined by several studies that have shown the lack of substantial axon regeneration after spinal cord injury (SCI) in NgR1-knockout or -knockdown animal models.

Methods: We used mice carrying either a homozygous or heterozygous null mutation in the NgR1 gene and subjected them to either a moderate or severe SCI.

Ventriculosubgaleal shunting--a strategy to reduce the incidence of shunt revisions and slit ventricles: an institutional experience and review of the literature.

Background/aims: Slit ventricles and multiple episodes of shunt failure are problematic in many infants and preterm neonates shunted for hydrocephalus. We utilized ventriculosubgaleal (VSG) shunting as the initial neurosurgical intervention in neonates with hydrocephalus associated with intraventricular hemorrhage and infants with myelomeningocele.

Methods: We conducted a chart review of 21 children initially treated with a VSG shunt between November 2002 and July 2009.

The pearls and pitfalls of skull trephination as described in the Hippocratic treatise "On Head Wounds".

The purpose of our current study is to describe the guidelines regarding trephination as suggested in the Hippocratic writer's book, "Peri ton en cephali traumaton" ("On Head Wounds"). The ancient Greek text was reviewed as well as two English translations. The Hippocratic author described the indications, timing, and techniques of trephination for patients with head injury.

Skull morphology and its neurosurgical implications in the Hippocratic era.

Differences in skull morphological characteristics among various human populations were first described by Herodotus of Halicarnassus. The Hippocratic treatise On Head Wounds provided the first detailed description of human skull anatomy. The Hippocratic author presented the first systematic attempt to create a classification system of skull and cranial suture morphology.

Spontaneous posterior fossa hemorrhage associated with low-molecular weight heparin in an adolescent recently diagnosed with posterior reversible encephalopathy syndrome: case report and review of the literature.

Background: Posterior reversible encephalopathy syndrome (PRES) constitutes a well-described clinical entity, classically entailing characteristic edematous lesions on imaging studies in a patient with altered mental status, visual disturbances, headache, and seizures. PRES is reversible in the vast majority of cases, although progression to ischemia and hemorrhage has been documented.

Methods: We report a case of a 16-year-old male with chronic renal failure who developed PRES during a hypertensive crisis.

Familial intracranial ependymomas. Report of three cases in a family and review of the literature.

Familial cases of intracranial ependymomas have been well documented in the literature. The authors present two cases from a family in which three members harbored intracranial ependymomas. A 54-year-old man with fourth ventricular ependymoma underwent resection of the tumor followed by radiation therapy.

Head injury management algorithm as described in Hippocrates' "peri ton en cephali traumaton".

HIPPOCRATIC WORKS LEND themselves still today to the modern physician for further analysis of his approach to the diagnosis and treatment of various pathological conditions. We present an attempt to systematize his methodology regarding the management of head trauma and present it in the format of a modern-era algorithm.

Surgical treatment of acute type II and rostral type III odontoid fractures managed by anterior screw fixation.

Objectives: In the present study, the authors comment on their experience with anterior odontoid screw fixation in the management of odontoid fractures, in an attempt to further assess the safety and the efficacy of this procedure.

Materials And Methods: A retrospective analysis of 50 consecutive patients with reducible type II or rostral type III odontoid fractures, operated at our hospital with anterior odontoid screw fixation. Radiographic bony fusion, complications, and clinical outcome were evaluated.

Literature review regarding the methodology of assessing third nerve paresis associated with non-ruptured posterior communicating artery aneurysms.

The association of third cranial nerve palsy subsequent to an enlarging posterior communicating artery (P-Com A) aneurysm has been well described. In our current communication, we review the relevant literature and propose a classification system for the severity of the third cranial nerve palsy, correlating it to the postoperative recovery. Our four grade scale (I-IV) included the degree of the levator palpebrae muscle paresis, the presence of pupillary reaction and the impairment of the third nerve mediated extraocular muscle movement.

Results of long-term follow-up in patients undergoing anterior screw fixation for type II and rostral type III odontoid fractures.

Study Design: Retrospective analysis of the fusion rate of a group of 38 patients having undergone anterior screw fixation for type II and "shallow" type III odontoid fractures. OBJECTIVE.: To determine primarily the long-term fusion rate after anterior screw fixation and to study the clinical characteristics of patients that have a statistically significant or nonsignificant influence on successful outcome.

Is non-invasive monitoring of intracranial pressure waveform analysis possible? Preliminary results of a comparative study of non-invasive vs. invasive intracranial slow-wave waveform analysis monitoring in patients with traumatic brain injury.

Background: An increasing body of evidence supports the concept that intracranial pressure (ICP) slow B waves represent the auto-regulatory response of spontaneous fluctuations of cerebral perfusion pressure. A relationship between cerebral auto-regulation and clinical outcome in patients with traumatic brain injury has also been established. The objective of our prospective clinical study was to compare the B slow ICP waves obtained invasively by standard ICP monitoring to those obtained noninvasively using a new ultrasound technology.