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Frank S. Bishop, Andrew T. Dailey and Meic H. Schmidt

C harcot disease of the spine, also known as spinal neuropathic or neurogenic arthropathy, is a destructive degenerative process involving the vertebral bodies and surrounding discs. This condition results from repetitive microtrauma in patients who have decreased joint protective mechanisms from loss of deep pain and proprioceptive sensation, typically because of spinal cord injury or sensory neuropathies. The patient typically presents with back pain and progressive spinal instability and deformity. We report a unique case of massive Charcot spinal disease

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Karthik Madhavan, Lee Onn Chieng, Lynn McGrath, Christoph P. Hofstetter and Michael Y. Wang

G iven the rapid aging of our population, degenerative scoliosis is a substantial burden for our society. 23 Several factors lead to progression of adult deformity, including osteoporosis, asymmetrical degeneration of the disc, previous spine surgeries, and trauma. 3 Coronal deformity is defined as greater than 10° of curve seen in the lumbosacral and thoracolumbar spine. It is better tolerated than sagittal deformity by patients because it requires less expenditure of energy. 3 On the other hand, coronal deformity is well known to cause significant

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Jotham C. Manwaring, Devon Truong, Armen R. Deukmedjian, Carolyn M. Carey, Bruce B. Storrs, Luis F. Rodriguez, Lisa Tetreault and Gerald F. Tuite

S evere cranial deformity can occur after shunt placement in newborns with extreme hydrocephalus. Deformity frequently develops due to CSF overdrainage. This problem can be lessened with the use of programmable shunts, high-pressure valves, or flow-control devices, with or without the use of a cranial orthotic helmet and vigilant repositioning. 1 However, despite these efforts, hydrocephalic newborns with macrocephaly who undergo CSF shunting, and who have a high proportion of intracranial CSF compared with brain parenchyma, are still at risk for marked

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Patrick C. Hsieh, Tyler R. Koski, Daniel M. Sciubba, Dave J. Moller, Brian A. O'shaughnessy, Khan W. Li, Ziya L. Gokaslan, Stephen L. Ondra, Richard G. Fessler, and John C. Liu

. As spine surgeons become more experienced with the techniques and technology associated with MIS, the indications for MIS continue to expand. 12 Interestingly, the benefit of decreasing approach-related morbidity might be far greater for more complex surgeries in spinal trauma, spinal deformity, and spinal oncology. In this report, we discuss the techniques in, and the rationale for, using MIS in these complex spinal disorders and provide illustrative cases for each. Spinal Trauma More than 150,000 Americans annually suffer from traumatic injuries to the

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Justin S. Smith, Christopher I. Shaffrey, Virginie Lafage, Benjamin Blondel, Frank Schwab, Richard Hostin, Robert Hart, Brian O'Shaughnessy, Shay Bess, Serena S. Hu, Vedat Deviren, Christopher P. Ames and International Spine Study Group

-related quality of life measures. 8 , 31 Although most improvement in sagittal alignment after spinal deformity surgery occurs within the instrumented and fused spinal segments, there is increasing appreciation of the changes in spinopelvic alignment that occur outside the fused spinal segments. These alignment changes have been termed “reciprocal changes” and have been reported for the thoracic and lumbar regions, as well as the pelvis. Klineberg et al. 15 recently reported that a thoracic osteotomy with limited fusion for correction of kyphosis results in a spontaneous

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Matthew L. Mundwiler, Khawar Siddique, Jeffrey M. Dym, Brian Perri, J. Patrick Johnson and Michael H. Weisman

then explore the diseased spine's susceptibility to noninflammatory lesions such as microfractures and deformity. We also describe other sequelae of AS, such as early osteoporosis and CES. Both the medical and surgical approaches to treatment are summarized. There is a special focus on osteotomy techniques. By the conclusion of the article, the clinician should have a better understanding of the diagnostic and treatment possibilities in AS spinal disease. Diagnosis of Inflammatory Back Pain and AS Because AS can markedly respond to the newer biological agents

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Adelola Adeloye

O ne of the anatomical abnormalities described in cases of Arnold-Chiari malformation is a beaking deformity of the tectal plate. Cleland referred to it in 1883, 4 but Chiari concentrated on various hindbrain defects, and failed to mention it in his detailed description of the different types of the malformation that now bears his name. 2, 3 In recent years, this curious tectal defect has been mentioned by others, the most notable being Peach, 11, 12 who reported its occurrence in 75% of cases of Arnold-Chiari malformation. This paper describes some of

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Tatsuya Yasuda, Tomohiko Hasegawa, Yu Yamato, Daisuke Togawa, Sho Kobayashi, Go Yoshida, Tomohiro Banno, Hideyuki Arima, Shin Oe and Yukihiro Matsuyama

R ecent studies have shown that sagittal spinopelvic alignment, including pelvic position, plays a critical role in the health-related quality of life of patients with adult spinal deformity (ASD). 4 , 7 , 12 , 13 Therefore, the goal of corrective surgery for ASD is to achieve and maintain optimal spinopelvic alignment. Lumbar lordosis (LL) is one of the important parameters for optimal sagittal alignment. The achievement of adequate LL is necessary for good results in corrective surgeries in spinal fusion. Additionally, LL is one of the main parameters that

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Ashwin Viswanathan, Katherine Relyea, William E. Whitehead, Daniel J. Curry, Thomas G. Luerssen and Andrew Jea

I n the surgical correction of spinal deformities, the addition of internal fixation serves the dual function of improving solid arthrodesis by rigid immobilization of the instrumented segments and correcting preexisting deformities by facilitated application of the corrective forces. Since the introduction of spinal PSs by Boucher 4 in the late 1950s and the Harrington instrument 13 in the early 1960s, spinal internal PS fixation has gained widespread use and popularity in the correction of spinal deformities. 3 , 19 , 29 , 30 The noted advantages of

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Sunil Manjila, Harvey Chim, Sylvia Eisele, Shakeel A. Chowdhry, Arun K. Gosain and Alan R. Cohen

T he cloverleaf skull, or Kleeblattschädel, is a rare skull deformity resulting from premature fusion of multiple cranial sutures and characterized by a trilobar skull with bossing of the forehead, temporal bulging, and a flat posterior skull. 20 , 24 , 40 Inconsistent patterns of suture fusion have been reported, with the coronal and lambdoid sutures most often involved. 1 The condition is further characterized by cosmetic facial deformity and micromyelia and can be further complicated by increased intracranial pressure, hydrocephalus, hindbrain