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Thomas T. Lee, Gustavo J. Alameda, Erika B. Gromelski and Barth A. Green

ultrasonography have made possible the identification of patients whose myelopathy may have been previously attributed to posttraumatic intramedullary cysts or to posttraumatic myelomalacia. 5, 7, 16, 17, 25 Patients with large confluent cysts are classified under the syndrome of PPCM or posttraumatic syringomyelia, and those without demonstrable large cysts but with evidence of microcysts, myelomalacia, and spinal cord tethering are grouped under the syndrome of PPMM. Spinal cord tethering and cyst formation are frequently observed together. The traditional treatment of

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Blair Calancie, William Harris, James G. Broton, Natalia Alexeeva and Barth A. Green

displaced fracture; six patients), arteriovenous fistula (two patients), tethered cord (diastomatomyelia or posttraumatic; two patients), cervical spine tumor (chordoma or metastatic disease; two patients), and posttraumatic cervical syringomyelia (one patient). The anesthetic protocol of N2O, narcotic medication (fentanyl or sufenta) and propofol (constant infusion) was used successfully in every case, although in one case equipment failure necessitated a revision in drug delivery. There were no instances of patient recall and no adverse reactions that could be

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Thomas T. Lee, Jose M. Arias, Heather L. Andrus, Robert M. Quencer, Steven F. Falcone and Barth A. Green

degeneration or gliosis. 7, 10 Magnetic resonance (MR) imaging and intraoperative ultrasonography have made possible, with a good degree of reliability, the identification of those patients whose myelopathy could be attributed to posttraumatic intramedullary cysts or to posttraumatic myelomalacia. 9 Patients with large, confluent cysts are classified under the syndrome of progressive posttraumatic cystic myelopathy (PPCM) or posttraumatic syringomyelia. Patients without demonstrable large cysts, but with evidence of microcysts, myelomalacia, and cord tethering, are grouped

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Postoperative fibrosis after surgical treatment of the porcine spinal cord: a comparison of dural substitutes

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

Iftikharul Haq, Yenisel Cruz-Almeida, Edir B. Siqueira, Michael Norenberg, Barth A. Green and Allan D. Levi

T he use of a dural substitute to repair defects within the spinal dura mater or to enlarge the spinal dural sac is not an infrequent requirement in neurosurgery. Some of the more common spinal conditions include Chiari malformations, tethered cord, syringomyelia, and malignant intradural tumors. A postoperative inflammatory reaction followed by fibrosis involving the arachnoid membrane may lead to various complications. When dense adhesions between the spinal cord and the overlying dura mater occur, arachnoiditis, tethering, and neurological deterioration may

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Joshua D. Burks, Katie L. Gant, James D. Guest, Aria G. Jamshidi, Efrem M. Cox, Kim D. Anderson, W. Dalton Dietrich, Mary Bartlett Bunge, Barth A. Green, Aisha Khan, Damien D. Pearse, Efrat Saraf-Lavi and Allan D. Levi

in 2 cm 3 was approved. 2) Exclusion: persons unable to safely undergo an MRI. 3) Exclusion: persons with penetrating injury of the spinal cord or complete transection of the cord, as identified on MRI. 4) Exclusion: persons with severe, uncorrected postinjury spinal deformity and/or a spinal cord inadequately decompressed. 5) Exclusion: persons with a cavity structure that would preclude successful transplantation, as identified on MRI, which may include septations or irregularities in tissue structure. 6) Exclusion: persons with syringomyelia, defined as those