World Neurosurg
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Congenital absence of C2 posterior arch may present with C2-C3 dislocation. Previously these cases were managed by fusing occiput-C1-C4 without including C2 in the construct. Such constructs are likely to immobilize the long segment of the cervical spine, and exclusion of C2 may not yield the best result. ⋯ Absence of the posterior arch of axis may be associated with adjacent C1-C2 along with C2-C3 dislocation, so both levels need to be addressed. The radiology should be critically evaluated for other structures developing from the C2 neural arch. It is important to include C2 to achieve a stable construct without compromising adjacent-level mobility.
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The authors present a case report of a patient with a giant thoracic calcified disc. The patient underwent a posterior thoracic laminectomy and fusion without resection of the disc. The calcified disc regressed in size and lost its calcified component postoperatively.
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The aim of this study was to describe the anatomic trajectory of the extracranial needle for percutaneous rhizotomy and correlate this with structures at risk during such a procedure. ⋯ To our knowledge, this is the first study to describe the detailed extracranial anatomic needle pathway using the Hartel approach. Such data might help surgeons better recognize potential complications from such procedures.
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The causes and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, cause, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. ⋯ Incidence, complications, concurrent injuries, and fusions have increased since 2005. Length of stay, SCIs, decompressions, and halo insertions have decreased. Indicated trends should guide future research in management guidelines.
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Case Reports
Nerve transfers in patients with Brown Sequard pattern of spinal cord injury: Report of 2 cases.
Use of distal nerve transfer for improving upper limb function has been well described for patients with tetraplegic spinal cord injury and brachial plexus injuries but has not previously been described for Brown-Séquard type spinal cord injury. We describe our experience with 2 cases of combined Brown-Séquard injury and unilateral brachial amyotrophy. ⋯ Our early experience of nerve transfer with 2 patients with combined Brown-Séquard cord injury and brachial amyotrophy indicated acceptable surgical safety and demonstrated encouraging results.