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Shinya Okuda, Takenori Oda, Ryoji Yamasaki, Takamitsu Haku, Takafumi Maeno and Motoki Iwasaki

neurological deficits, instrumentation failure, adjacent-segment degeneration (ASD), and fusion failure. Adjacent-segment degeneration was defined as a condition in which additional surgery was required to treat neurological deterioration caused by the adjacent segment. Complications that were not specific for spine surgery or did not affect recovery (for example, urinary tract infection and anemia) were excluded. Radiological Assessment Plain radiographs were obtained in all patients at 1, 6, 12, 18, and 24 months after surgery, and annually thereafter. Slip and disc

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Soo Eon Lee, Tae-Ahn Jahng and Hyun-Jib Kim

disease (ASD) were evaluated at each follow-up evaluation on plain radiographs or lumbar spinal CT. 4 Clinical Evaluation Clinical outcomes were assessed with the visual analog scale (VAS) for back and leg pain, the Korean version of the Oswestry Disability Index (ODI), and analgesics medication preoperatively, 3 months postoperatively, 12 months postoperatively, 24 months postoperatively, and at last follow-up. 10 Statistical Evaluation Statistical analysis was conducted using SPSS (version 17.0, SPSS Inc.). Significance was defined as p < 0.05. Results

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Aaron J. Clark, Roxanna M. Garcia, Malla K. Keefe, Tyler R. Koski, Michael K. Rosner, Justin S. Smith, Joseph S. Cheng, Christopher I. Shaffrey, Paul C. McCormick and Christopher P. Ames

maintaining a solid contemporary neurosurgical knowledge base in the practice of modern spinal surgery. Adult spinal deformity (ASD) is now recognized as a significant cause of pain and disability. Deformity in the sagittal plane, 17 spinopelvic alignment, 15 understanding of appropriate deformity-specific work-up, including hip joint evaluation, comprehensive knowledge of normal lumbar anatomy and lordosis, and indications for pelvic fixation must be included in the spinal surgeon's knowledge base. 10 , 13 Failure to do so can result in treatment failure and poor

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Lissa C. Baird, Catherine A. Mazzola, Kurtis I. Auguste, Paul Klimo Jr. and Ann Marie Flannery

No clear advantage of 1 valve over another. Randomized controlled trial. 344 pts w/ time to shunt failure as end point. Khan et al., 2010 Role of ASD. Class II No overdrainage in ASD group, 2 pts w/ overdrainage in non-antisiphon group; higher occlusion & infection in ASD group. 40 pts randomly assigned to shunt w/ ASD or differential valve. Prospective, randomized comparative trial. Small study w/ short follow-up (<6 mos). No end point variables reached statistical significance. Jain et al., 2000 Prospective data from 50

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Terje Sæhle, Dan Farahmand, Per Kristian Eide, Magnus Tisell and Carsten Wikkelsö

(32.4%) 0.62 weight in kg (mean ± SD) 76.8 ± 11.0 78.7 ± 18.9 1.00 height in cm (mean ± SD) 171.2 ± 10.1 172.9 ± 12.0 0.73 BMI in kg/m 2 (mean ± SD) 26.2 ± 3.3 26.1 ± 4.1 0.96 ASD  yes 24 (70.6%) 22 (64.7%)  no 10 (29.4%) 12 (35.3%) 0.80 anticoagulant medication  yes 7 (20.6%) 19 (55.9%)  no 27 (79.4%) 15 (44.1%) 0.006 * BMI = body mass index. The diagnosis of iNPH was based on clinical symptoms and radiological signs (Evans index > 0.3) of ventriculomegaly, a normal

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Lisheng Kan, Jian Kang, Rui Gao, Xiongsheng Chen and Lianshun Jia

A nterior cervical decompression and fusion, commonly including anterior cervical discectomy and fusion (ACDF) and anterior cervical corpectomy and fusion (ACCF), has proven to be effective in the treatment of cervical spondylosis. 23 However, many authors have reported that the increased biomechanical stress on the motion segment adjacent to the fused segment after fusion may accelerate the incidence of degenerative pathology at these adjacent levels, that is, so-called adjacent-segment degeneration (ASD). 13 , 14 Therefore, cervical disc arthroplasty

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Ralph J. Mobbs, Monish Maharaj and Prashanth J. Rao

.6  range 1–19 intraop blood loss in ml  mean 102  range 80–700 total operation time in mins  mean 97  range 40–195 * Values are the number of patients (%) unless noted otherwise. F ig . 3. Surgical indications for which ALIF was performed. ASD = adjacent-segment disease; R = radiculopathy. Radiological Outcomes The rate of solid arthrodesis was dependent on the specific level operated on and the number of surgically treated levels per patient. In total, surgery was performed at 142 levels in 110 patients. The

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Michael Y. Wang, Ram Vasudevan and Stefan A. Mindea

A djacent -segment disease (ASD) is common following lumbar spinal fusion. While some authors have theorized that this is the result of increased biomechanical forces on the neighboring motion segments, it is also clear that the unique biological and environmental factors for a patient who has already required a previous lumbar fusion predisposes that individual to additional degeneration at other levels of the spinal column. The patient developing ASD may present with axial pain due to spondylosis and/or lower extremity symptoms due to stenosis or nerve

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Justin S. Smith, Ellen Shaffrey, Eric Klineberg, Christopher I. Shaffrey, Virginie Lafage, Frank J. Schwab, Themistocles Protopsaltis, Justin K. Scheer, Gregory M. Mundis Jr., Kai-Ming G. Fu, Munish C. Gupta, Richard Hostin, Vedat Deviren, Khaled Kebaish, Robert Hart, Douglas C. Burton, Breton Line, Shay Bess, Christopher P. Ames and The International Spine Study Group

S ubstantial improvements in surgical techniques, instrumentation, perioperative management, and reduction of risk related to comorbid conditions have broadened the indications for correction of adult spinal deformity (ASD) and have enabled correction of increasingly more complex deformities. Although data thus far seem to indicate that selected adults with spinal deformity do have significant potential for improvement with surgical treatment, overall complication rates remain high and represent areas for continued improvement 7 , 8 , 32 , 39–43 Despite

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Mayur Jayarao, Kristin Sohl and Tomoko Tanaka

I n 1891, Hans Chiari documented 3 cases of congenital defects of the rhombencephalon, classified as types I, II, and III. 5 A Chiari I malformation, or Chiari malformation Type I (CM-I), is the mildest form and is associated with ectopia of the cerebellar tonsils through the foramen magnum, which can occur to various degrees. Diagnosis of CM-I is currently best made on cranial midsagittal MRI studies, with cerebellar tonsil herniation of at least 3 mm suggesting the condition. 2 Autism spectrum disorder (ASD) is a neurodevelopmental condition