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Douglas B. Humphreys, Christine B. Novak, and Susan E. Mackinnon

P eroneal nerve compression neuropathy is a well-recognized entity that results in a variety of symptoms, including foot drop due to paralysis of the affected musculature as well as sensory disturbances over the lateral side of the lower extremity extending onto the dorsum of the foot. The diagnosis of compression neuropathy is made based on an understanding of the anatomy of the peroneal nerve. Surgical decompression of the common peroneal nerve at the fibular head has been described but results of that decompression procedure are rarely found in the

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Kenji Masuda, Takayuki Higashi, Katsutaka Yamada, Tatsuhiro Sekiya, and Tomoyuki Saito

S everal surgical options are available for patients with degenerative lumbar scoliosis (DLS). 2 , 12 , 15 , 16 The recommended surgery for DLS with a coronal curve of less than 30° is posterior decompression and short fusion without correction of the curve. 15 For a coronal curve of more than 30° that requires correction of global coronal balance, a long corrective fusion should be performed. 16 The classification of adult spinal deformity (Schwab adult deformity classification) is well established, easy to use, and consistent with the treatment of adult

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Eugen J. Dolan, Charles H. Tator, and Laszlo Endrenyi

P revious studies in this laboratory and elsewhere have shown the importance of the duration of spinal cord compression upon subsequent functional recovery. 6, 8, 9 Increasing the duration of compression resulted in worsening of the functional recovery. The present work examines the relationships between the force of compression, the duration of compression, and subsequent functional recovery. Although Tarlov and colleagues 8–10 examined some of these relationships in their studies in the 1950's, there have been no studies of the value of decompression for

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Rajeev D. Sen, Isaac Josh Abecassis, Jason Barber, Michael R. Levitt, Louis J. Kim, Richard G. Ellenbogen, and Laligam N. Sekhar

B rain arteriovenous malformations (bAVMs) most commonly present with intracranial hemorrhage in approximately 50% of cases. 1 , 2 In rare cases, the intraparenchymal hemorrhage (IPH) is large and symptomatic, requiring emergent surgical decompression. In contrast to patients with spontaneous IPH, in whom craniectomy may include evacuation of the IPH, the presence of a ruptured bAVM makes IPH evacuation precarious, particularly without digital subtraction angiography (DSA), and the surgeon must decide whether or not to concurrently resect the bAVM. The

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Mario J. Cardoso, Tyler R. Koski, Aruna Ganju, and John C. Liu

is the patient's medical status? These questions aid in determining the optimal surgical approach and minimizing postoperative complications. However, decompression of the spinal cord in the setting of OPLL has a different complication profile and the preferred approach and/or technique remains controversial. This complication profile that includes CSF fistula, neurological injury, and myelopathic progression may need to be given greater thought during the decision process. In the following paper, we review the surgical OPLL literature and evaluate the

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Dara Bakar, Joseph E. Tanenbaum, Kevin Phan, Vincent J. Alentado, Michael P. Steinmetz, Edward C. Benzel, and Thomas E. Mroz

cancer patients. 26 Spinal cord compression can cause disability and significantly impair quality of life. 42 Although some patients with spinal metastases can be treated nonoperatively, patients who present with spinal cord compression often require surgical intervention to preserve neurological function. 14 Decompression surgery is the standard surgical technique used to treat metastatic disease of the thoracic and lumbar spine. 10 Location of metastatic disease determines the approach for decompression surgery. A ventral or dorsal approach, or both, can be used

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Koichi Sairyo, Shinsuke Katoh, Tadanori Sakamaki, Shinji Komatsubara, and Natsuo Yasui

G ill , et al., 5 were the first to describe nonfusion decompressive surgery in patients with lumbar spondylolysis. Subsequently, some authors reported that the operation reported by Gill, et al., would result in further vertebral slippage postoperatively; therefore, some surgeons recommended decompression with spinal fusion. 7, 9, 14 It was, however, also reported that long-term excellent or good results were observed in some patients after the Gill operation. 1, 2, 8, 10 They concluded that the Gill operation was of most benefit to the adult patient with

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Nicholas Dietz, Mayur Sharma, Ahmad Alhourani, Beatrice Ugiliweneza, Dengzhi Wang, Miriam Nuño, Doniel Drazin, and Maxwell Boakye

medical management, sepsis, neurological deficit, significant pain, need for open biopsy, or risk of spinal deformity may require more extensive surgical management for resolution and stabilization. 4 , 9 , 28 Spinal epidural abscess, another rare spinal infection, has traditionally been treated with surgical drainage to avoid neurological deterioration and complication. 1 , 5 Surgical treatment involves debridement of necrotic or infected tissue and irrigation with an antibiotic regimen tailored to treat the responsible pathogen. 33 Decompression of neural elements

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Naobumi Hosogane, Kota Watanabe, Hitoshi Kono, Masashi Saito, Yoshiaki Toyama, and Morio Matsumoto

, may need surgical intervention. Surgical options for DLS include decompression only, decompression with limited fusion, and decompression with extensive corrective fusion. Factors that should be considered when choosing a surgical method include the patient's age, general medical condition, symptoms, degree of osteoporosis, and expectations. Correction and fusion surgery in DLS has high complication rates, so it is reasonable to choose decompression alone when the patient's primary symptom is neurogenic claudication due to spinal canal stenosis. Decompression

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Rudolf A. Kristof, Ales F. Aliashkevich, Michael Schuster, Bernhard Meyer, Horst Urbach, and Johannes Schramm

I n the last 10 years, evidence has been presented that decompression with fusion (with or without placement of instrumentation), compared with decompression alone, may improve the outcome in patients who undergo surgery for DLS. 3, 5, 9, 15 The concept of performing fusion in all patients, however, has been criticized for the following reasons: clinical outcome in many patients following decompression alone is good; 11 progression of the spondylolisthesis, which might occur following decompression alone, is not necessarily associated with poor clinical