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Rolf Gruber, Peter Jenny and Bruno Herzog

O bstruction of the ventricular catheter with fibrin, neuroglia, or plexus tissue is still the most frequent complication of cerebrospinal fluid (CSF) shunts in pediatric hydrocephalus 4, 8, 11, 12 The failure of customarily used shunt systems to inhibit chronic CSF overdrainage when the patient is mobilized is, in our experience, the major cause of this complication. 6 We believed that the patient's well-being might improve and the complication rate might be diminished by safeguarding the shunt system with a suction-inhibiting anti-siphon device (ASD

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Chao-Hung Kuo, Wen-Cheng Huang, Jau-Ching Wu, Tsung-Hsi Tu, Li-Yu Fay, Ching-Lan Wu and Henrich Cheng

-grade spondylolisthesis. 3 , 11–13 However, few reports have addressed the true incidence of adjacent-segment degeneration (ASD) after these spinal surgeries. The pathological process observed at the spinal disc adjacent to the level that was treated with arthrodesis is regarded as ASD. Owing to advances in image technology, asymptomatic ASD can be identified by abnormal findings on radiological examinations; these findings include disc degeneration, segmental instability, or spinal stenosis and are termed “radiological ASD.” These radiological ASDs can be completely free of symptoms

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Justin K. Scheer, Justin S. Smith, Frank Schwab, Virginie Lafage, Christopher I. Shaffrey, Shay Bess, Alan H. Daniels, Robert A. Hart, Themistocles S. Protopsaltis, Gregory M. Mundis Jr., Daniel M. Sciubba, Tamir Ailon, Douglas C. Burton, Eric Klineberg, Christopher P. Ames and The International Spine Study Group

T he surgical management of adult spinal deformity (ASD) can provide significant improvements in pain, disability, and health-related quality of life (HRQOL). 6 , 7 , 28 , 34 , 36–38 , 40–45 However, these procedures are technically demanding and are associated with a high complication rate. The patient population suitable for these complicated surgeries continues to increase, including patients of advanced age. 2 , 16 , 17 , 27 The reported complication rates in the literature are varied and range from 14% to 71%. 11 , 13 , 39 , 47 , 48 It has been

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Justin K. Scheer, Taemin Oh, Justin S. Smith, Christopher I. Shaffrey, Alan H. Daniels, Daniel M. Sciubba, D. Kojo Hamilton, Themistocles S. Protopsaltis, Peter G. Passias, Robert A. Hart, Douglas C. Burton, Shay Bess, Renaud Lafage, Virginie Lafage, Frank Schwab, Eric O. Klineberg, Christopher P. Ames and the International Spine Study Group

A dult spinal deformity (ASD) surgery remains technically challenging and is associated with high rates of complications, one of which is pseudarthrosis. 8–11 , 22 , 27 The rates of pseudarthrosis in ASD have ranged from 0% to 35%, 5 , 8–10 with one comprehensive review citing pseudarthrosis as the most frequent long-term complication of those studied, reporting a rate of 7.6%. 27 Patients who develop pseudarthrosis are at risk for instrumentation failure and may require revision surgery. Risk factors for pseudarthrosis have been studied and include

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Michael Y. Wang

Adult spinal deformities (ASD) pose a challenge for the spinal surgeon. Because the spine is often rigid, mobilization of the segments is critical for effective correction, particularly in the sagittal plane. While minimally invasive surgery (MIS) has many favorable attributes that would be of great benefit for the ASD population, improvements in lordosis and sagittal balance have remained problematic using MIS approaches, including MIS lateral methods. This video illustrates one method for achieving improvement of coronal and sagittal correction without the extensive exposure and soft tissue envelope disruption needed in open surgery, particularly for less severe deformities. By using multi-level TLIFs through a mini-open surgery, curves of less than 60° can be managed with minimal blood loss and within a reasonable surgical timeframe. While feasibility will have to be proven with larger series and improved surgical methods, this technique holds promise as a means of reducing the significant morbidity associated with surgery in the ASD population.

The video can be found here: http://youtu.be/I0rkDSAVas0.

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Malgosia A. Kokoszka, Patricia E. McGoldrick, Maite La Vega-Talbott, Hillary Raynes, Christina A. Palmese, Steven M. Wolf, Cynthia L. Harden and Saadi Ghatan

notes, pathology findings, and neurology and neurosurgery follow-up notes. Patients with the following diagnoses: autism; Asperger syndrome; Rett syndrome with autistic features; and pervasive developmental disorder, not otherwise specified (PDD-NOS) were included, regardless of etiology. These patients are collectively referred to throughout this report as those with autism spectrum disorder (ASD), based on recent changes in the Diagnostic and Statistical Manual, 5th Edition (DSM-5) guidelines for autism diagnosis. 1 , 2 Study Participants Fifty

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Alex P. Michael, Matthew W. Weber, Kristin R. Delfino and Venkatanarayanan Ganapathy

A djacent -segment disease (ASD) is a well-recognized long-term consequence of lumbar interbody fusion. 8 , 12 , 15 , 16 , 22 , 25 , 27 , 30 The literature has shown that minimally invasive lumbar fusion techniques result in similar clinical outcomes as open approaches and offer the advantages of a smaller incision, less soft-tissue trauma, and quicker return to normal activities. 31 Compared to other minimally invasive options, the axial lumbar interbody fusion (AxiaLIF) system (TranS1 Inc.) has the added benefit of avoiding the critical anterior neurovascular

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Michael L. Levy, Karen M. Levy, Dayna Hoff, Arun Paul Amar, Min S. Park, Jordan M. Conklin, Lissa Baird and Michael L. J. Apuzzo

A utism spectrum disorders are characterized by social symptoms that may include a lack of interaction with other persons, avoidance of eye contact, delayed ability in understanding the thoughts or emotions of others, and problems with emotional control. Persons with autism usually have difficulty with communication and may exhibit repetitive behaviors. In addition, mental retardation and seizures are sometimes noted in persons with ASD. 19 An estimated 5–38% of children with autism also have epilepsy. 15 The same brain dysfunction associated with autism

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Takashi Kaito, Noboru Hosono, Yoshihiro Mukai, Takahiro Makino, Takeshi Fuji and Kazuo Yonenobu

. Possibly as a result of altered biomechanics at the adjacent mobile segments, ASD, a serious complication of PLIF, can occur. The actual cause of ASD, however, remains unknown. Some authors have attributed ASD to the altered biomechanical property due to immobilization of the fusion segment, 4 , 19 , 20 , 23 whereas others have argued that ASD is nothing more than a common aging process rather than a consequence of spinal fusion. 10 , 13 , 17 , 18 , 26 , 34 Several risk factors for the development of ASD have been proposed to date, such as the number of segments

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Joyce Koueik, Mark R. Kraemer, David Hsu, Elias Rizk, Ryan Zea, Clayton Haldeman and Bermans J. Iskandar

therapies for chronic headaches. 44 Surgical interventions include valve change, addition of antisiphon devices (ASDs), 19 and cranial vault expansion. 24 , 36 Recent evidence indicates that chronic shunt overdrainage is a significant, if not leading, cause of repetitive proximal shunt obstruction. 23 Based on these observations, we aimed to raise a shunt’s resistance to flow by adding ASDs. Early in the series, this was done primarily in patients who had suffered more than the average number of shunt malfunctions. With perceived success over time, we expanded our