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querying the Cochrane Collaboration, Educus journal search, PubMed, and Google Scholar databases using the following phrases: “spine injury return to play,” “cervical spine injury athletes,” and “return to play thoracolumbar.” Additionally relevant references from these articles were reviewed. Results: All recommendations represent level III evidence. Absolute contraindications for return to play include atlantoaxial fusions, occipitalcervical fusions, atlantodental interval >3mm adult (> 4mm child),acute herniated discs, discs with pain and neurologic deficits

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Mohamad Bydon, Joseph A. Lin, Rafael de la Garza-Ramos, Daniel M. Sciubba, Jean Paul Wolinsky, Timothy F. Witham, Ziya L. Gokaslan and Ali Bydon

also report the results of a meta-analysis of case reports and case series involving CSCs, which we conducted in order to compare outcomes in patients with atlantoaxial versus subaxial cysts and in patients treated with and without spinal fusions. Methods Current Series We performed a retrospective electronic medical record review of cases of surgically treated symptomatic cervical spine and cervicothoracic junction (C-1 to T-1) synovial cysts either proven by pathology or (when not excised) identified intraoperatively at our institution from 1991 to 2013

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Michelle J. Clarke, Patricia L. Zadnik, Mari L. Groves, Daniel M. Sciubba, Timothy F. Witham, Ali Bydon, Ziya L. Gokaslan and Jean-Paul Wolinsky

, Gokaslan ZL : Management of atlantoaxial metastases with posterior occipitocervical stabilization . J Neurosurg 98 : 2 Suppl 165 – 170 , 2003 11 Fujita T , Kawahara N , Matsumoto T , Tomita K : Chordoma in the cervical spine managed with en bloc excision . Spine (Phila Pa 1976) 24 : 1848 – 1851 , 1999 12 George B , Archilli M , Cornelius JF : Bone tumors at the cranio-cervical junction. Surgical management and results from a series of 41 cases . Acta Neurochir (Wien) 148 : 741 – 749 , 2006 13 Hsieh PC , Galia GL , Sciubba

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Benjamin D. Elder, Wataru Ishida, C. Rory Goodwin, Ali Bydon, Ziya L. Gokaslan, Daniel M. Sciubba, Jean-Paul Wolinsky and Timothy F. Witham

Spine J 17 : 600 – 609 , 2008 43 Mahajan A : Normal tissue complications from low-dose proton therapy . Health Phys 103 : 586 – 589 , 2012 44 Matsumoto M , Watanabe K , Tsuji T , Ishii K , Nakamura M , Chiba K , : Late instrumentation failure after total en bloc spondylectomy . J Neurosurg Spine 15 : 320 – 327 , 2011 45 Menezes AH , Ahmed R : Primary atlantoaxial bone tumors in children: management strategies and long-term follow-up . J Neurosurg Pediatr 13 : 260 – 272 , 2014 46 Metcalfe S , Gbejuade H , Patel

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orthosis, 2 with a Minerva brace, and 1 with a halo. Two patients required cervical surgery; an occipital cervical fusion for a type 2 odontoid fracture and one atlantoaxial fusion for atlantoaxial instability was performed. At the follow up appointments, none of the patients were found to have delayed instability based on clinical examination, upright x-rays or flexion-extension x-rays. Conclusion: All isolated OCF are likely stable injuries. Our data suggests all isolated OCF may be treated conservatively with any type of cervical orthosis and minimal follow up