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Andrei F. Joaquim, Wellington K. Hsu and Alpesh A. Patel

P roper treatment of spine injuries in high-level athletes is of paramount importance to ensure player safety as well as avoid problems with medicolegal issues. 8 , 9 High-level athletes involved in collision sports, such as rugby, football, and wrestling, are at a higher risk of spinal cord injuries than athletes involved in other sports. 2 , 3 , 6 There may be a substantial additional increase in risk for athletes with a spinal condition such as cervical spondylosis or congenital cervical stenosis. The nuances involved in the management of athletes

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Jun Jiang, Zezhang Zhu, Bangping Qian, Zhen Liu and Yong Qiu

C ervical myelomeningocele is a rare congenital lesion, accounting for only 1%–5% of all neural tube anomalies. 8 , 12 This lesion mostly occurs in the dorsal part of the body and is typically characterized by a skin-covered mass in the posterior midline. In our review of the literature, we found only one reported case of an anterior cervical MMC. 3 Here, we report a second case, which was diagnosed when the patient began to experience symptoms in adulthood. Case Report History and Presentation This 23-year-old woman presented to our

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Michelle J. Clarke, Patricia L. Zadnik, Mari L. Groves, Daniel M. Sciubba, Timothy F. Witham, Ali Bydon, Ziya L. Gokaslan and Jean-Paul Wolinsky

expanded for other indications. Perioperative complications and outcomes of this challenging technique are also discussed. Methods A retrospective review was performed of the medical records of all 7 patients who underwent lateral mass cage placement or fibular strut grafting from 2007 to 2009 at 2 academic institutions. These procedures were used as a component of cervical spine reconstruction following iatrogenic destabilization. Review of medical records was conducted in accordance with the institutional review board rules and regulations at both institutions

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Sarah T. Garber and Douglas L. Brockmeyer

S ubaxial (C3–7) cervical instability in children may be caused by a variety of conditions, including trauma, neoplasms, skeletal dysplasia, and congenital vertebral anomalies. Despite these varying etiologies, the underlying principles governing management of subaxial instability are the same: to provide structural support and stability to the vertebral column and spinal cord; to preserve cervical motion; and to ensure future spine growth. Applying those principles to the management of pediatric subaxial instability is particularly challenging in very

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Lauren Harris, Edward Dyson, Matthew Elliot, David Peterson, Christian Ulbricht and Adrian Casey

A rthroplasty and anterior cervical discectomy and fusion are successful means of relieving cervical radiculopathy and arresting the progression of cervical myelopathy. 22 Cervical disc arthroplasty emerged in the 1960s as an alternative treatment option to fusion. 22 Meta-analyses have consistently shown modern arthroplasty devices to be comparable or superior to fusion overall, with improved neurological outcome, patient satisfaction, dysphagia, range of movement, and reoperation rates (6% in arthroplasty vs 12% in discectomy and fusion). 21 , 39 , 41–45 The

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Peter G. Passias, Bassel G. Diebo, Bryan J. Marascalchi, Cyrus M. Jalai, Samantha R. Horn, Peter L. Zhou, Karen Paltoo, Olivia J. Bono, Nancy Worley, Gregory W. Poorman, Vincent Challier, Anant Dixit, Carl Paulino and Virginie Lafage

D egenerative changes in the cervical spine are a near-universal feature of aging 9 , 18 and are at the root of a wide spectrum of clinical presentations and sequelae. Cervical spine pathologies might include cervical radiculopathy and/or cervical myelopathy and can manifest variably, with common symptoms including neck and/or arm pain. The incidence of cervical spine pathologies has varied, depending on the specific diagnosis; cervical radiculopathy has been estimated annually at an incidence rate of 83 per 100,000 persons and cervical myelopathy rates are

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Syed F. Abbas, Morgan P. Spurgas, Benjamin S. Szewczyk, Benjamin Yim, Ashar Ata and John W. German

D egenerative cervical myelopathy (DCM) is a recently introduced term that encompasses degenerative etiologies of cervical myelopathy including spondylosis, ossification of the posterior longitudinal ligament, and ossification of the ligamentum flavum. 22 , 26 Patients with progressive myelopathy are often offered surgical treatment to help stabilize or improve their neurological symptoms and function. 8 To date, the specific choice of surgical treatment of such patients remains unclear and specific guidelines regarding the choice of surgical technique

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Shaun D. Rodgers and David H. Harter

Intradural intramedullary cervical spinal cord tumors pose a significant challenge for the neurosurgeon to resect with minimal morbidity. We present the case of a 12-year-old male with a cervical ependymoma and demonstrate our resection technique.

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Andrei F. Joaquim and K. Daniel Riew

P osterior cervical approaches for the treatment of intradural spinal lesions, such as intramedullary or extramedullary tumors, require posterior decompressive techniques. Cervical spine deformity secondary to sagittal and/or coronal imbalance after a laminectomy may result in important cervical pain and functional deterioration, along with neurological deficits in the most severe cases. 2 , 10 , 21 In general, the majority of deformities secondary to cervical laminectomy occur in the sagittal plane, resulting in cervical kyphosis. 9 , 14 Many risk

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Rudolph J. Schrot, Jesna S. Mathew, Yueju Li, Laurel Beckett, Hyun W. Bae and Kee D. Kim

H eadache is commonly associated with lower cervical spondylosis. Anterior neck surgery is associated with a significant reduction in headache. 10 14 19 20 22 25 Cervicogenic headache (International Headache Society [IHS] diagnosis 11.2.1) is defined according to strict criteria by the IHS and is thought to be referred from structures in the neck. 5 The putative mechanism for cervicogenic headache involves afferent sensory input conveyed through the upper cervical nerves (C1–3) that converge on the spinal trigeminal nucleus, causing referred cranial pain