World Neurosurg
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To determine if there is a difference in reoperation rates for symptomatic nonunions in atlantoaxial (C1-C2) fusions with or without bone morphogenetic protein (BMP) using data from a national spine registry and to analyze the different types of bone grafts used in the non-BMP group. ⋯ Using one of the largest retrospective studies on C1-C2 fusions with and without BMP, we found no difference in reoperation rates for symptomatic nonunions. For the non-BMP group, we found that lamina (+/- allograft) or allograft alone may also be just as effective as iliac crest graft (+/- allograft) in having no reoperations for symptomatic nonunions.
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The implications of diagnosis and treatment of central or axial atlantoaxial dislocation (CAAD) as a cause of symptoms of cervical myelopathy are evaluated. ⋯ Identification and treatment of CAAD can have a significant management impact on patients where the cause of spastic quadriparesis is otherwise undiagnosed.
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Patients with a ventriculoperitoneal shunt for hydrocephalus often undergo multiple follow-up computed tomography (CT) scans of the head, increasing the risk for long-term effects of ionizing radiation. The purpose of our study was to evaluate the necessity as a routine diagnostic procedure and cost analysis of routine postoperative CT scan of the head after ventriculoperitoneal shunt surgery. ⋯ Routine postoperative head CT scans after fentriculoperitoneal shunting are not necessary in all cases. The reduction of exposure to ionization radiation and the beneficial economic factor are main advantages.
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We assessed the efficacy of "only fixation" as treatment for cervical radiculopathy. ⋯ Instability of the spinal segment is the nodal point of pathogenesis and the primary cause of symptoms related to degenerative spondylotic radiculopathy. The treatment is spinal stabilization. No direct bone or soft tissue decompression is necessary.