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Nestor G. Rodriguez-Martinez, Luis Perez-Orribo, Samuel Kalb, Phillip M. Reyes, Anna G. U. S. Newcomb, Jeremy Hughes, Nicholas Theodore and Neil R. Crawford

world's adult population (4.7 billion, United Nations) were obese, further detailing that at least 2.8 million adults die each year as a result of comorbid conditions related to being overweight or obese. In addition, 44% of the diabetes burden, 23% of the ischemic heart disease burden, and between 7% and 41% of certain cancer burdens are attributable to being overweight or obese. Increased BMI is a major risk factor for diseases such as musculoskeletal disorders, especially lumbar spine degenerative disc disease, which is the second highest cause of employment

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

radiculopathy requiring screw removal. Given that the patient with pseudarthrosis (2 pars defects) required revision surgery and 1 patient had 2 pars defects, of which only 1 was noted to heal on follow-up CT, bony healing was seen in 26 (89.6%) of 29 pars defects after the first surgery. Thus, 2 of 16 patients without bony healing were identified (12.5%) after the first surgery. No implant failures were encountered ( Table 3 ). F ig . 1. Preoperative axial and sagittal CT images of the lumbar spine (A) , intraoperative lateral radiographs of the lumbar spine (B

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

“magnetic resonance,” “lumbar,” “spine,” “gunshot,” “bullet,” and “metal.” Additional articles were located by cross-referencing articles encountered initially through PubMed searches. Inclusion criteria comprised articles (case reports, case series, literature reviews, and guidelines) published in the peer-reviewed literature; these articles described in vitro and in vivo studies, with tests addressing the radiological and physical interactions between magnetic fields and bullets or magnetic fragments. Thirty-eight articles were reviewed, and 25 were selected for

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Michael A. Mooney, Mark E. Oppenlander, U. Kumar Kakarla and Nicholas Theodore

T umoral calcinosis (TC) is a rare clinical syndrome caused by calcium deposition in periarticular soft tissue. Most commonly, TC affects the joints of the upper limbs and the hips; however, it is known to involve the articular surfaces of the cervical, thoracic, and lumbar spine. 10 In cases of spinal involvement, direct compression of neural elements and/or surrounding anatomical structures causes clinical symptoms that can be treated with direct surgical decompression. 1 , 3 , 4 , 8 , 15 , 16 , 20 , 23 , 25–28 , 30 , 32 , 33 Awareness of TC is essential for

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

diagnosis was 55 years, with females being diagnosed at a slightly earlier age (mean 53.3 years, range 12–71 years) than males, who have been diagnosed at a mean age of 56.05 years (range 17–90 years). Most lesions have involved the lumbar spine (46.3%), but lesions in the cervical (36.5%), thoracic (22%), and sacral segments (5%) have also been reported. The severity of presented neurological symptoms has varied between pain and severe neurological deficit. Rheumatoid arthritis, systemic sclerosis, and the Raynaud phenomenon are common comorbid conditions at the time of

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

O ssification of the posterior longitudinal ligament is a pathological ectopic ossification of this ligament that usually occurs in the cervical or thoracic spine and, less frequently, in the lumbar spine. 37 It has long been considered a disease of Asian origin, and more specifically of the Japanese population. Increasingly, however, this disorder is being recognized in European and North American populations. The prevalence of OPLL in Japanese and East Asian countries has ranged from 1.9% to 4.3%, 17 , 21 , 34 , 42 , 43 while in white populations it has

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

the only manifestation of disseminated diseases, suggesting that the disease may have a predilection for vertebral column. In our series, there was a clear male predisposition for the disease—almost 90%. African Americans are the most commonly affected ethnic group, comprising more than 50% of the cases. Every patient in our series presented with symptoms of localized or radiating pain. The thoracic spine was the region most frequently affected, although cases also involved the cervical and lumbar spine. Our experience shows that spinal surgery can serve as an

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Patrick P. Han, Nicholas Theodore, Randall W. Porter, Paul W. Detwiler, MichaeL T. Lawton and Robert F. Spetzler

spinal angiography, failed to demonstrate the source of the hemorrhage. The patient was treated conservatively and her symptoms resolved. Radiological Examination On admission to our institution, the patient underwent computerized tomography of the brain, MR angiography of the brain, neck, and upper thorax, MR imaging of the brain and lumbar spine, and two cerebral and selective spinal angiography sessions; all of these failed to demonstrate a pathological process. A T 2 -weighted MR image obtained in the thoracic spine, however, revealed a low-intensity signal

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Tsinsue Chen, Karam Moon, Daphne E. deMello, Iman Feiz-Erfan, Nicholas Theodore and Ratan D. Bhardwaj

of tonsillar descent, as well as an 11-mm contrast-enhancing intradural extramedullary cervical mass, expanding the levels of C-1 through C-3. The lesion was eccentric to the left, causing 40% effacement of the spinal canal and moderate cord compression ( Fig. 1A and B ). On the basis of the imaging characteristics, the lesion was suspected to be intradural and neoplastic in nature. MRI results of the thoracic and lumbar spine were both normal. He was neurologically intact with full strength on admission, with a primary complaint of headache and left-sided neck

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Ali A. Baaj, Juan S. Uribe, Tann A. Nichols, Nicholas Theodore, Neil R. Crawford, Volker K. H. Sonntag and Fernando L. Vale

Trauma 63 : 83 – 89 , 2007 10 Gray DT , Deyo RA , Kreuter W , Mirza SK , Heagerty PJ , Comstock BA , : Population-based trends in volumes and rates of ambulatory lumbar spine surgery . Spine 31 : 1957 – 1964 , 2006 11 Lad SP , Patil CG , Berta S , Santarelli JG , Ho C , Boakye M : National trends in spinal fusion for cervical spondylotic myelopathy . Surg Neurol 71 : 66 – 69 , 2009 12 Lad SP , Patil CG , Lad EM , Boakye M : Trends in pathological vertebral fractures in the United States: 1993 to 2004