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Rani Nasser, Sanjay Yadla, Mitchell G. Maltenfort, James S. Harrop, D. Greg Anderson, Alexander R. Vaccaro, Ashwini D. Sharan and John K. Ratliff

T he incidence of complications in spinal surgery remains unclear. Authors of previous reports have surmised that between 10 and 20% of patients undergoing surgical spinal procedures suffer adverse events or complications. 29 , 51 , 53 Most spinal literature consists of retrospective analyses that are assumed to underestimate the complication incidence. In the present study we assessed the different rates of complications reported in prospective and retrospective analyses of spine surgery complications through a systematic review of the spine surgery

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Gwynedd E. Pickett, Lali H. S. Sekhon, William R. Sears and Neil Duggal

with those of ACDF. 1 , 17 We describe complications observed following implantation of the Bryan disc prosthesis in a cohort of 74 patients treated at two tertiary care centers. Clinical Material and Methods All patients presenting with cervical disc herniation or spondylosis producing radiculopathy and/or myelopathy, for whom ACD was recommended, were considered candidates for Bryan disc arthroplasty as an alternative to fusion. Patients with single- and multilevel disease were eligible for treatment. Exclusion criteria included radiographically documented

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Henry W. S. Schroeder, Wulf-Rüdiger Niendorf and Michael R. Gaab

R ecently , ETV has become the preferred procedure for the treatment of noncommunicating hydrocephalus. 22, 35, 36, 38, 43, 59, 76 The popularity of this procedure is due to the fact that valve-regulated shunts are still associated with high failure rates and numerous complications, despite major improvements in shunt technology. 2, 11, 53, 56, 57, 67, 74 Data from several series of ETVs have been published, but complications have not yet been specifically addressed. 4, 34, 37, 38, 43, 77 We report on the complications encountered in our series of ETVs

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Emily M. Lindley, Matthew A. McCullough, Evalina L. Burger, Courtney W. Brown and Vikas V. Patel

disruption of the anulus. Furthermore, these approaches are associated with risk of injury to the abdominal viscera, nerve roots, ureter, and great vessels. To avoid the complications associated with open lumbar surgery, minimally invasive techniques have been developed to mimic those of open approaches, but through smaller incisions and portals. 22 These techniques are associated with reduced blood loss, postoperative pain, hospital stays, and narcotic requirements. 3 , 14 , 16 However, these approaches still require some dissection of tissue around the surgical site

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Seung-Ki Kim, Kyu-Chang Wang, Yong-Seung Hwang, Ki Joong Kim, Jong Hee Chae, In-One Kim and Byung-Kyu Cho

E pilepsy surgery is a viable option for intractable epilepsy, which comprises 10–20% of the cases of pediatric epilepsy. 14 , 18 Experience derived from such surgery shows that children present with different features than adults. Children have a higher proportion of neoplastic and malformation lesions in the epileptogenic substrate and more frequent extratemporal foci of epileptogenesis, and they require surgical treatment of the developing brain. 8 , 11 , 14 , 15 , 19 , 27 Evaluation of surgical outcome and complications is important when selecting

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Peter G. Campbell, Sanjay Yadla, Rani Nasser, Jennifer Malone, Mitchell G. Maltenfort and John K. Ratliff

presence of comorbidities correlates with an increased risk of perioperative complications has not been conclusively demonstrated in spine surgery. The use of comorbidities to predict the incidence of complications has not been validated through a prospective assessment in patients undergoing spine surgery. The prospective assessment of spine surgery complications and their relationship to comorbidities has not been described. A significant problem is the poor quality of the spine surgery literature in reporting perioperative complications; most published reports are

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Shinji Matsuda, Toru Serizawa, Makato Sato and Junichi Ono

G amma knife radiosurgery has been reported to be an effective mode of treatment for TN with minimal invasiveness and few complications. In our center the incidence of complications has been relatively high, and we have come to recognize a characteristic complication, namely the “dry eye” symptom, in addition to the previously reported facial numbness. The purpose of this paper is to present our preliminary results on GKS for TN and describe the nature and causal factors of the “dry eye” complication. Clinical Material and Methods Between August 1998 and

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Peter G. Campbell, Sanjay Yadla, Jennifer Malone, Mitchell G. Maltenfort, James S. Harrop, Ashwini D. Sharan and John K. Ratliff

the rate of cervical surgeries performed in the general adult US population. 19 Similar studies investigating the use of instrumentation in Medicare patients with lumbar stenosis affirmed that rates of fusion increased 3.6-fold from 1992 to 2003, 25 whereas complex fusion surgery increased 15-fold from 2002 to 2007. 9 Given the increase in the number and complexity of spine fusions, the contributions of these procedures to overall complications are of greater consequence to collective clinical outcomes. The results of mining data from several administrative

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Khoi D. Than, Anthony C. Wang, Shayan U. Rahman, Thomas J. Wilson, Juan M. Valdivia, Paul Park and Frank La Marca

patients by Mc-Donnell et al. 21 found that 11% of patients experienced major complications and 24% experienced minor complications after anterior surgical approaches to the spine. This set of complications is atypical in the realm of more standard neurosurgical procedures, and include injuries to abdominal viscera, the abdominal wall, great vessels, ureter, and numerous nerve plexuses. The goal of our study was not to review the literature for the incidence of complications from ALIF, but rather to evaluate strategies for avoiding and treating those complications. By

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Joseph Hong, James A. Sanfilippo, Jeffrey Rihn, Carmella Fernandez, Corbett D. Winegar, Brian Friel, Steven Ludwig, Daniel Gelb and Alexander R. Vaccaro

well as nontraumatic causes such as spinal tumors, tabes dorsalis, and syringomyelia. 3 While patients with Charcot spine may be managed operatively or nonoperatively, patients with symptomatic, severe instability have been shown to be treated successfully with combined anterior and posterior fusion techniques. 1 , 5 The long-term outcomes, however, and potential complications of surgical treatment for Charcot spine are not well reported. We present 2 such cases of Charcot spinal arthropathy, one (Case 1) in which the initial injury resulted from a traumatic event