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Nicholas Theodore, Paul M. Arnold and Ankit I. Mehta

Manipulation Arm (PUMA) in 1978, the robot was sophisticated enough to be introduced to medicine. The first working definition of the word “robot” was published, fittingly, by the Robotics Institute of America in 1980: “. . . a reprogrammable, multifunctional manipulator designed to move materials, parts, tools, or specialized devices through various programmed motions for the performance of a variety of tasks.” 6 In 1988, the six-degrees-of-freedom flexible arm PUMA 560 was used to guide a needle under CT guidance into the brain. 4 With the introduction of robotic arms

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Eduardo Martinez-del-Campo, Leonardo Rangel-Castilla, Hector Soriano-Baron and Nicholas Theodore

MR imaging . Clin Radiol 52 : 299 – 300 , 1997 17 Rentfrow B , Vaidya R , Elia C , Sethi A : Lead toxicity and management of gunshot wounds in the lumbar spine . Eur Spine J 22 : 2353 – 2357 , 2013 18 Romanick PC , Smith TK , Kopaniky DR , Oldfield D : Infection about the spine associated with low-velocity-missile injury to the abdomen . J Bone Joint Surg Am 67 : 1195 – 1201 , 1985 19 Shellock FG : Biomedical implants and devices: assessment of magnetic field interactions with a 3.0-Tesla MR system . J Magn Reson

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Eric M. Horn, Nicholas Theodore, Neil R. Crawford, Nicholas C. Bambakidis and Volker K. H. Sonntag

S urgery of the cervicothoracic junction presents a biomechanical challenge due to the transition between the mobile cervical and immobile thoracic vertebrae. Another complicating feature of this transition is the disparate anatomy between the cervical and thoracic posterior elements. The differences in anatomy are the substrate for the different styles of internal fixation devices utilized for stabilization and/or fusion. In the subaxial cervical spine, the most common type of posterior fixation is the use of lateral mass screws coupled with top

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

M inimally invasive surgery has become a major goal across surgical subspecialties. Issues such as cost containment, wound aesthetics, and decreased pain have all served to fuel the development of these techniques. Advances in endoscopic imaging devices have played an important role in this development. In spinal surgery, endoscopic techniques are now used to treat a variety of pathologies. 2 , 4 , 7 , 8 , 12–19 , 22 In particular, thoracoscopic surgical techniques are being used to perform sympathectomies, discectomies, and vertebrectomies; to correct

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Eric M. Horn, Nicholas Theodore, Iman Feiz-Erfan, Gregory P. Lekovic, Curtis A. Dickman and Volker K. H. Sonntag

patients, and only four fibrous unions were demonstrated during a mean follow-up period of 6.7 months. Fusion status could not be analyzed in the other 12 patients because of death (eight cases) or absence of available follow-up radiographs (four cases). Although we did not have access to the radiographs in these latter cases, x-ray films were reviewed by the treating clinician and a note was made of the stability status before removing the halo device. TABLE 2 Summary of complications in 22 elderly patients treated with halo fixation Complication

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Eric M. Horn, Jonathan S. Hott, Randall W. Porter, Nicholas Theodore, Stephen M. Papadopoulos and Volker K. H. Sonntag

screw placement has been the preferred method of atlantoaxial fixation since it was first reported by Magerl and Seeman in 1987. 20 The clinical outcomes achieved using this technique solely for atlantoaxial instability have been reported in several large series, 1 , 4 , 11 , 15 and the fusion rates have varied from 82.6 to 100%. This range compares favorably with posterior wiring techniques alone when the patient is maintained in a halo fixation device until fusion occurs. 2 Because the vast majority of patients treated with transarticular screw fixation only need

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Eric M. Horn, Nicholas Theodore, Rachid Assina, Robert F. Spetzler, Volker K. H. Sonntag and Mark C. Preul

of 4 m/second velocity with a 3-mm-diameter probe to a 1-mm depth to produce a complete SCI. 4 Immediately after impaction, the spinal subarachnoid space was accessed via a 22-gauge catheter inserted at the lumbrosacral junction in animals undergoing CSF drainage. Control animals did not undergo needle insertion. After impaction, a laser Doppler tissue perfusion probe (LDF100C, Biopac) was centered over the site of impaction and the perfusion value was recorded. The generic value scale of BPU (0–1000) is used by the device software to determine the blood

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Eric M. Horn, Phillip M. Reyes, Seungwon Baek, Mehmet Senoglu, Nicholas Theodore, Volker K. H. Sonntag and Neil R. Crawford

– 441 , 2001 16 Panjabi MM : Biomechanical evaluation of spinal fixation devices: I. A conceptual framework . Spine 13 : 1129 – 1134 , 1988 17 Panjabi MM : The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis . J Spinal Disord 5 : 390 – 396 , 1992 18 Roy-Camille R , Saillant G , Laville C , Benazet JP : Treatment of lower cervical spinal injuries–C3 to C7 . Spine 17 : S442 – S446 , 1992 19 Takayasu M , Hara M , Yamauchi K , Yoshida M , Yoshida J : Transarticular screw fixation in

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Leonardo B. C. Brasiliense, Nicholas Theodore, Bruno C. R. Lazaro, Zafar A. Sayed, Fatih Ersay Deniz, Volker K. H. Sonntag and Neil R. Crawford

, Dolinskas C , : Placement of pedicle screws in the thoracic spine. Part II: An anatomical and radiographic assessment . J Bone Joint Surg Am 77 : 1200 – 1206 , 1995 26 van Laar W , Meester RJ , Smit TH , van Royen BJ : A biomechanical analysis of the self-retaining pedicle hook device in posterior spinal fixation . Eur Spine J 16 : 1209 – 1214 , 2007 27 Weinstein JN , Rydevik BL , Rauschning W : Anatomic and technical considerations of pedicle screw fixation . Clin Orthop Relat Res 284 : 34 – 46 , 1992 28 White KK , Oka R

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Laura A. Snyder, Harry Shufflebarger, Michael F. O'Brien, Harjot Thind, Nicholas Theodore and Udaya K. Kakarla

internal fixation device that bridges the gap at the fracture site and maintains stability in all movements (flexion, extension, lateral bending, and axial rotation). Direct repair also allows for fracture repair without substantially altering the biomechanics of the intact spine. There are several methods to accomplish direct pars repair: Buck's technique, Scott's technique, modified Scott's technique, and the screw-rod-hook technique. 2 , 4 , 8 However, data on the usage and outcomes of these different surgical techniques are limited, especially in the adolescent