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M. Yashar S. Kalani, Nikolay L. Martirosyan, Andrew S. Little, Udaya K. Kakarla and Nicholas Theodore

a growing geriatric population, clinicians should be familiar with the presentation of and management options for these lesions. Case Report History and Examination This 13-year-old boy with a 2-year history of midthoracic back pain and rapidly progressing scoliosis was referred to our spine clinic for evaluation and correction of his spinal deformity. The patient's neurological evaluation revealed 5/5 strength in all muscle groups and no bowel or bladder symptoms. His reflexes were normal, and his sensation to light touch and his proprioception were

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Mark E. Oppenlander, Forrest D. Hsu, Patrick Bolton and Nicholas Theodore

( Fig. 2E and F ). Postoperative Course The patient remained quadriplegic and ventilator dependent. In accordance with family wishes, care was with-drawn and the patient died 5 days after the second operation. Discussion Patients with cervical instability, deformity, or critical spinal canal stenosis are identified by anesthesiologists, critical care physicians, and neurosurgeons as patients with difficult airways associated with the potential for spinal cord injury related to neck manipulation. 3 , 12 These 2 cases illustrate devastating neurological

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Udaya K. Kakarla, M. Yashar S. Kalani, Giriraj K. Sharma, Volker K. H. Sonntag and Nicholas Theodore

coccidioidal infection. Clinical and hospital records, neuroimaging studies, and operative and pathology reports were available for all cases. Follow-up clinical notes and imaging studies were available for 19 (73%) of the 27 patients. Results Clinical Findings All patients presented with localized or radiating pain. Several patients presented with a long-standing history of previously diagnosed coccidioidomycosis. Nine patients (33%) presented with myelopathic symptoms, 4 (15%) presented with fever, and 12 (44%) presented with progressive spinal deformity

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Francisco A. Ponce, Brendan D. Killory, Scott D. Wait, Nicholas Theodore and Curtis A. Dickman

deformities; to stabilize spinal fractures after trauma; and to biopsy and resect tumors. Thoracoscopy may be used in place of thoracotomy to resect certain intrathoracic neoplasms such as paraspinal neurogenic tumors. 9 Although these tumors are uncommon, they account for 75% of posterior mediastinal masses. 23 More than 95% of these tumors are benign. 11 , 20 Most tumors are discovered incidentally, but patients can become symptomatic with dyspnea, shortness of breath, pain, Horner syndrome, pneumonia, and hoarseness. We present our experience with the

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Samuel Kalb, Nikolay L. Martirosyan, Luis Perez-Orribo, M. Yashar S. Kalani and Nicholas Theodore

for a local or segmental type of OPLL that extends fewer than 3 vertebral levels below C-2 and above T-1 in a patient with no congenital stenosis. The ossified mass should be hill-shaped, the occupying ratio should be ≥ 60%, and local kyphosis of the spinal cord should be present. 13 , 27 , 29 In contrast, the posterior surgical approach, mainly laminoplasty, is widely used to treat high-risk patients older than 65 years with multilevel disease and a nonkyphotic deformity. 3 Even though the anterior approach for cervical OPLL is more technically demanding than a

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Sam Safavi-Abbasi, Timothy B. Mapstone, Jacob B. Archer, Christopher Wilson, Nicholas Theodore, Robert F. Spetzler and Mark C. Preul

anatomical abnormalities he termed spina bifida and sketched the entity ( Fig. 2 ). 43 In addition, he described 1 patient with a myelomeningocele whom he treated surgically by dissecting the myelomeningocele sac and ligating the pedicle. However, the patient died shortly after the procedure as a result of infection at the surgical site. Recognizing that surgical intervention for spinal deformity was associated with grave risks to patients, including further damage to spinal cord function, 16 Tulp cautioned others to “let the surgeons not unprudently open such a swelling

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Eduardo Martinez-del-Campo, Jay D. Turner, Leonardo Rangel-Castilla, Hector Soriano-Baron, Samuel Kalb and Nicholas Theodore

changes were noted in any case. Most patients included in this series presented with severe and sometimes devastating injuries to the OC junction and cervical spine requiring extensive instrumentation to correct basal deformities and to improve stability. The median number of instrumented levels was 5 (from occiput to C-4 in 17 [42.5%] cases), followed by 4 levels (from occiput to C-3 in 10 [25%] cases). There were 2 occiput–C2 (5%), 1 occiput–C5 (2.5%), and 1 occiput–C6 (2.5%) constructs. Among constructs extending to the thoracic spine, there were 6 (15%) at occiput

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Eduardo Martinez-del-Campo, Jay D. Turner, Hector Soriano-Baron, Anna G. U. S. Newcomb, Samuel Kalb and Nicholas Theodore

. Ongoing radiographic control can be achieved using the C-2 plumb line (C-2 SVA), CSA, posterior C2–7 angle (CSC), and C2–7 lordosis (Cobb) angle. 1–3 , 27 Our institution treats a considerable number of patients with complex spinal pathologies, and some patients included in this series presented preoperatively with severe cervical abnormalities from trauma and/or congenital deformities. Previous pediatric series have considered changes greater than 2 mm in lordotic alignment and more severe than −11° in curvature to be abnormal at final follow-up, 21 whereas others

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Evgenii Belykh, Kashif Malik, Isabelle Simoneau, Kaan Yagmurlu, Ting Lei, Daniel D. Cavalcanti, Vadim A. Byvaltsev, Nicholas Theodore and Mark C. Preul

extended far beyond science, playing an integral role in changing misguided perceptions shrouding patients with disfigurements, defects, deformities, and so-called monstrous births. In particular, Feil's 1919 medical school thesis on cervical abnormalities was a critical publication in defying long-held theory and opinion that human “monstrosities,” anomalies, developmental abnormalities, and altered congenital physicality were a consequence of sinful behavior or a reversion to a primitive state. In fact, his thesis on a spinal deformity centering on his patient, L

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Bruno C. R. Lazaro, Fatih Ersay Deniz, Leonardo B. C. Brasiliense, Phillip M. Reyes, Anna G. U. Sawa, Nicholas Theodore, Volker K. H. Sonntag and Neil R. Crawford

of the montage. An intact posterior column is not necessary to apply the hardware; compared with other methods of fixation, deformities are corrected more effectively. Finally, spinal canal encroachment does not occur, unlike with wires or hooks. 13 , 14 , 16 , 23 , 32 Nonetheless, placing pedicle screws in the thoracic spine can be challenging, given the great variability in pedicle size and orientation; the surrounding anatomy, especially neural and vascular structures, can be jeopardized. 21 , 28 When several pedicles are fixed in a long-segment construct