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Edward A. Engle and F. Donald Cooney

was elected to perform a laminectomy as the initial approach. Anterior stabilization was attempted when the patient demonstrated neurological improvement, and after he had been treated with steroids for 3 weeks. We believed that steroid therapy was indicated in order to facilitate fusion of the sarcoid bone. Because roentgenograms of the pelvis showed possible pathological involvement of the iliac crests, the report of sarcoid lesions in the iliac plug used for fusion was not unexpected. This case demonstrates successful grafting of sarcoid bone with appropriate

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Frances K. Conley, Richard H. Britt, John W. Hanbery and Gerald D. Silverberg

spine instability often accompanies an injury that crushes a cervical vertebral body. Before choosing an anterior stabilization procedure for an injured cervical spine an attempt should be made to determine the extent of posterior instability. If significant injury has occurred to the posterior bone and/or ligaments, one must be prepared to provide rigid external immobilization by halo cast or to perform posterior cervical fusion in addition to the anterior procedure. Our limited experience with neoplastic disease of the cervical spine suggests that the same

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Narayan Sundaresan, Joseph H. Galicich and Joseph M. Lane

outcome. Proceedings of the American Society of Clinical Oncology , 1982 , p 6 (Abstract) Harper GR, Rodichok LD, Prevosti L, et al: Early diagnosis of spinal epidural metastases leads to improved treatment outcome. Proceedings of the American Society of Clinical Oncology , 1982, p 6 (Abstract) 10. Harrington KD : The use of methyl methacrylate for vertebral body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg (Am) 63 : 36

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Kevin D. Harrington

compromise (3 and 5 months, respectively, after laminectomy) associated with progressive kyphosis. Thus, of the 13 patients who had undergone previous decompressive laminectomy, one was improved and six deteriorated. Fig. 2. Case 45. Lateral roentgenograms of the thoracolumbar spine reproduced from Harrington 19 with permission of the Journal of Bone and Joint Surgery . Left: Film taken 36 months after laminectomy from T-11 to L-3, and 13 months after attempted anterior stabilization with iliac and rib grafts. The L-2 vertebral body is essentially absent, and

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Narayan Sundaresan, Joseph H. Galicich, Joseph M. Lane, Manjit S. Bains and Patricia McCormack

be obtained by comparing results in non-ambulatory patients; the 70% improvement is twice the rate generally reported for non-ambulatory patients who are treated by RT. 20, 37 The importance of providing immediate stability to the spine is a goal that has gained considerable emphasis over the past few years. Posterior stabilization with acrylic or by instrumentation (Harrington or Luque rods), and anterior stabilization with acrylic or bone grafts have been advocated for the treatment of pain and neurological deficits associated with structural changes in the

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Satoru Kadoya, Tsutomu Nakamura, Ryungchan Kwak and Genjiro Hirose

. We are presently studying the results of anterior stabilization of multiple interspaces, the subsequent changes in neurological symptoms, and the changes in the nonoperated vertebrae. The follow-up period in this series of patients with developmentally narrow cervical canals was 1 to 8 years, and so far only one case each of spondylolisthesis and soft disc herniation has occurred after postoperative improvement. Symptoms in both cases subsequently improved with surgery in the former case and with cervical traction therapy in the latter case. References

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Brian Shaw, Frederick L. Mansfield and Lawrence Borges

spine. J Neurosurg 61: 107–117, 1984 11. Harrington KD : The use of methylmethacrylate for vertebral-body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg (Am) 63 : 36 – 46 , 1981 Harrington KD: The use of methylmethacrylate for vertebral-body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg (Am) 63: 36–46, 1981 12. Hodgson

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Fred C. Williams, Joseph M. Zabramski, Robert F. Spetzler and Harold L. Rekate

–720, 1989 10. Harrington KD : The use of methylmethacrylate for vertebral-body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg (Am) 63 : 36 – 46 , 1981 Harrington KD: The use of methylmethacrylate for vertebral-body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg (Am) 63: 36–46, 1981 11. Heros RC , Debrun GM , Ojemann

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Ricardo Segal, Moufid Alsawaf, Ali Tabatabai, Reisuke Saito, Eduardo D. Segal and Robert McKinstry

reconstruction of major defects in the cranial vault. Surg Neurol 6 : 137 – 138 , 1976 Habal MB, Leake DL, Maniscalco JE: A new method for reconstruction of major defects in the cranial vault. Surg Neurol 6: 137–138, 1976 8. Harrington KD : The use of methyl methacrylate for vertebral-body replacement and anterior stabilization of pathological fracture-dislocations of the spine due to metastatic malignant disease. J Bone Joint Surg (Am) 63 : 36 – 46 , 1981 Harrington KD: The use of methyl methacrylate for vertebral

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Aizik Wolf, Lion Levi, Stuart Mirvis, John Ragheb, Stephen Huhn, Daniele Rigamonti and Walker L. Robinson

computerized tomography (CT)-myelography studies, only one had signs of a herniated disc fragment. This was the only case in which contrast-enhanced CT studies and/or magnetic resonance (MR) imaging influenced the management decision. Four patients with anterior compression due to bone pathology underwent anterior stabilization: two as an initial procedure and two subsequent to posterior fusion. After surgery, Yale braces were used for 41 patients and halo vests for eight. Morbidity and Mortality Rates Four (30.7%) of the 13 patients with incomplete myelopathy had