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Michael P. Steinmetz, Christopher D. Kager and Edward C. Benzel

T he development of cervical deformity such as kyphosis may be secondary to advanced degenerative disease, trauma, neoplastic disease, or postsurgical changes. 12 Postoperative cervical kyphosis may develop after either ventral or dorsal approaches. After ventral cervical surgery, kyphosis may result from pseudarthrosis 6, 8, 18 or the failure to restore adequate lordosis during surgery. 8 Following dorsal surgery, kyphosis may develop and progress in response to disruption of the natural stabilizing structures, such as the tension band, of the dorsal

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Yuki Yamamuro, Satoru Demura, Hideki Murakami, Satoshi Kato, Noritaka Yonezawa, Noriaki Yokogawa and Hiroyuki Tsuchiya

A dolescent idiopathic cervical kyphosis (AICK) is defined as a cervical kyphotic deformity without any cause such as congenital disease, postlaminectomy syndrome, posttraumatic deformity, neuromuscular disorders, tumor, or psychiatric disease. 1 , 5 , 6 , 8 , 10 , 11 AICK has a risk of progression to cervical kyphosis and myelopathy; therefore, surgical treatments are occasionally required. Herein, we present a case of progressive AICK successfully treated with perioperative halo-gravity traction followed by combined anterior-posterior collective fusion and

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James M. Herman and Volker K. H. Sonntag

A lthough the development of anterior approaches to the cervical spine has reduced the need for posterior decompression procedures, the cervical laminectomy is still a frequently used procedure. 11 12, 14, 19, 27, 29 One complication that has plagued the procedure is progressive kyphosis ( Fig. 1 left ). In children, this complication is commonly associated with instability and can occur in up to 95% of those undergoing an extensive cervical laminectomy. The incidence is lower in adults, but when the condition is symptomatic and associated with instability

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Srinath Samudrala, Shoshanna Vaynman, Ty Thiayananthan, Samer Ghostine, Darren L. Bergey, Neel Anand, Robert S. Pashman and J. Patrick Johnson

S evere kyphotic deformity at the CTJ distorts the sagittal balance of the upper spine and results in significant morbidity and problems of forward gaze, hygiene, chewing and swallowing, chronic neck pain, and myelopathy. 5 , 32 Cervicothoracic junction kyphosis is a variable disorder with the most severe cases presenting as chin-on-chest deformities. Kyphotic deformity of the CTJ is an extremely rare but rapidly progressive condition that requires surgical intervention. In such cases the goal of corrective surgery is to restore forward gaze and reduce pain

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Yahui Bai, Xinglong Zhi, Fengzeng Jian, Hongqi Zhang and Feng Ling

P erimedullary AVF is a relatively rare spinal vascular malformation, most commonly affecting the conus medullaris or cauda equina. 6 Its clinical manifestations include chronic progressive myelopathy and sudden subarachnoid or intramedullary hemorrhage, which are caused by intradural venous hypertension due to venous congestion or aneurysmal dilation of vessels. It has usually been considered to be a congenital lesion, but some cases reported in adults indicate it may be an acquired condition. Stabbing injury as the cause and subsequent kyphosis as the

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Vincent Y. Wang, Henry Aryan and Christopher P. Ames

T he cervical spine generally maintains a lordotic curve with a mean lordosis angle of 16–22° in men and 15–25° in women. 7 Kyphotic deformity of the cervical spine can occur due to advanced degenerative disease, trauma, neoplasm, systemic arthritides, and, most commonly, iatrogenic or postsurgical causes. 15 The cervical spine is more prone to develop kyphosis due to its biomechanical properties. Unlike the thoracic and lumbar vertebrae, the anterior vertebral column of the cervical spine bears only 36% of the load. 4 , 12 Thus, the posterior facets

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Paul Park, Anthony C. Wang, Jaypal Reddy Sangala, Sung Moon Kim, Shawn Hervey-Jumper, Khoi D. Than, Amin Farokhrani and Frank LaMarca

I n the treatment of symptomatic kyphosis of the cervical or cervicothoracic spine, surgery is indicated for significant neurological symptoms and severe functional disability such as loss of horizontal gaze. 6 , 17 , 21 One of the major risks of deformity surgery, however, is the potential for neurological injury, with reported complication rates ranging from 4.8% to 62.5% including radiculopathy and/or spinal cord injury. 1 , 2 , 11 , 13 , 15 , 17 , 21 Intraoperative monitoring of SSEPs has been shown to decrease the rate of neurological complications

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Matthew J. Grosso, Roy Hwang, Thomas Mroz, Edward Benzel and Michael P. Steinmetz

T he normal lordotic curvature of the cervical spine is critical to maintaining sagittal alignment and spinal balance. 9 , 17 , 18 The reversal of normal cervical curvature, as seen in kyphosis, can occur through a variety of mechanisms and can lead to mechanical pain, neurological dysfunction, and functional disabilities. 1 , 2 , 4 , 11 , 12 When patients present with sufficient symptomatic deformity, surgical intervention may be warranted. It is believed that the neurological symptoms seen in cervical kyphosis are a result of deformity

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Jochen Weber, Alfred Czarnetzki and Carsten M. Pusch

Stone Age have never been found. The first skeletal evidence of this infection was demonstrated in a specimen from the Late Stone Age. 2, 3, 9 Examination of one of those three skeletons—obtained in a 15-year-old boy dated between 4000 and 3500 BC—showed sharply angulated 90° thoracolumbar kyphosis secondary to complete destruction of the T-11 and T-12 VBs (and partial destruction of T-9, T-10, L-1, and L-2), with minimal new bone formation; features of Pott disease were also documented. 9 Spinal TB infrequently involves more than one to three vertebrae in

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J. J. Verlaan and F. C. Oner

T o T he E ditor : We read the article by Wang and coworkers (Wang XY, Dai LY, Xu HZ, et al: Kyphosis recurrence after posterior short-segment fixation in thoracolumbar burst fractures. J Neurosurg Spine 8: 246–254, March 2008) with great interest. The authors describe the recurrence of kyphosis after removal of instrumentation in patients with traumatic thoracolumbar burst fractures treated with posterior short-segment fixation. The authors hypothesize that creeping of the intervertebral disk through the depressed endplate(s) is responsible for disk