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Shoji Yabuki and Shin-ichi Kikuchi

R ecently , endoscopy has been applied in the treatment of the various spinal diseases. 6, 11–15, 18–21 Foley and Smith 5 developed the MED system to treat lumbar disc herniation; this procedure is minimally invasive for posterior paraspinal muscles. 5 The MED procedure has been recently used to treat patients with cervical radiculopathy due to disc herniation and foraminal stenosis; 1, 3, 4 however, its application in the treatment of patients with cervical myelopathy has not been studied. If MED can be performed for cervical myelopathy, minimal release of

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Jason Man-kit Ho, Hing-Yuen Law, Shing-Chau Yuen, and Kwong-Yui Yam

O vershunting - associated myelopathy is a rare complication of CSF shunting. 4 Few case reports have been published over the years. Here we add 2 cases to the literature. Case Reports Case 1 History and Presentation This 64-year-old woman had undergone ventriculoperitoneal (VP) shunt placement for treatment of hydrocephalus after clipping of a ruptured posterior communicating artery aneurysm. A medium-pressure Pudenz valve had been used. Fourteen years after the initial shunt surgery, the patient complained of progressive “stiffness of

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Shigeru Kobayashi, Kenzo Uchida, Hisatoshi Baba, Kenichi Takeno, Takasi Yayama, Hideaki Nakajima, Eiki Nomura, and Hidezo Yoshizawa

chromosome 6p21 that leads to haploinsufficiency of core-binding factor transcription factor A1. 12 , 14 Although more than 700 cases have been reported in the medical and dental literature to date, 1 , 6 , 8 only two papers have dealt with the association between cleidocranial dysplasia and atlantoaxial subluxation, and there has been no discussion about the neurosurgical treatment of these patients. 11 , 16 In this report, we present a case of this entity associated with myelopathy induced by atlantoaxial subluxation. Case Report History This 27-year

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Michael T. Stechison and Charles H. Tator

D iffuse idiopathic skeletal hyperostosis (DISH) is a disorder affecting both the vertebral column and the extra-axial skeleton, and is characterized by ossification of ligaments, with hyperostosis at their points of attachment to bone. 5, 7, 8 The association of neurological symptomatology is unusual. 7 This report describes a patient with DISH who developed cervical myelopathy. The cause was a unilateral, focal fibrous mass with calcification in the ligamentum flavum and its laminar attachment. This patient had no underlying medical condition other than

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Thoracic myelopathy due to enlarged ossified yellow ligaments

Case report and review of the literature

Michael Payer, Elisabeth Bruder, Jan A. Fischer, and Arnaldo Benini

E nlarged ossified yellow ligaments are a rare and poorly understood cause of thoracic myelopathy. During the past two decades the condition has been reported mainly in Japanese patients, although recently six cases involving Caucasian and two involving African—American patients have been documented ( Table 1 ). We present the case of another Caucasian patient with thoracic myelopathy due to enlarged ossified yellow ligaments. TABLE 1 Review of the literature on patients with symptomatic thoracic myelopathy due to enlarged ossified yellow ligaments

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Simon Cudlip, Francis Johnston, and Henry Marsh

aware of only four patients in whom synovial cysts arose from the cervical facet joints and caused myelopathy; of these, two cases were associated with trauma to the affected level, and two were associated only with degenerative disease. We report an additional three patients treated for cervical myelopathy caused by degenerative synovial cysts arising from the facet joints of the cervical spine. Case Reports Case 1 This 61-year-old man presented to our institution with a 6-week history of progressive lower-extremity weakness and numbness. He also reported

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Brien Vlcek, Kim J. Burchiel, and Thomas Gordon

. Most reports of this condition antedate the 1960's. In 1947, Ransome and Montiero 15 first called attention to the possibility of tuberculous myelopathy occurring in the absence of Pott's disease in a report on four patients from Singapore. These patients presented with relatively rapidly developing paraplegia without other neurological manifestations of tuberculous meningitis. Yet, because of the rarity of this form of tuberculosis, this etiology is usually not considered in patients with progressive paraplegia. We present a case that exemplifies this disorder

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Hiroyuki Asakawa, Kiyoyuki Yanaka, Kiyoshi Narushima, Kotoo Meguro, and Tadao Nose

D evelopmental stenosis of the spinal canal is a recognized cause of cervical myelopathy; however, localized stenosis of the spinal canal due to an anomaly of the axis (C-2) is rare. We report the case of a patient who developed an anomaly of the axis with its lamina invaginating the cervical spinal canal and discuss the embryological development and the causes of this condition. Case Report History This 46-year-old man was admitted to our hospital with a 6-month history of numbness of both hands and stiffness of all four extremities. During the 2

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Matthew T. Mayr, Stephen Hunter, Scott C. Erwood, and Regis W. Haid Jr

-old man presented with progressive jerkiness in his lower extremities as well as worsening back pain for approximately 1 year. Physical examination demonstrated myelopathy with 3+ quadriceps and gastrocnemius reflexes, as well as several beats of clonus in the ankles. Plantar reflexes were extensor, and gait was slightly spastic. Magnetic resonance imaging revealed a posterior lesion at T10–12 with low signal attenuation on T 1 - and T 2 -weighted images. Minimal peripheral enhancement was present after administration of contrast material ( Fig. 1 ). A postmyelogram

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Paul G. Matz, Paul A. Anderson, Langston T. Holly, Michael W. Groff, Robert F. Heary, Michael G. Kaiser, Praveen V. Mummaneni, Timothy C. Ryken, Tanvir F. Choudhri, Edward J. Vresilovic, and Daniel K. Resnick

stenosis over many years are associated with demyelination of white matter and may result in necrosis of both gray and white matter leading to potentially irreversible deficit (quality of evidence Class III; strength of recommendation, D). It is recommended that operative therapy be offered to patients with severe and/or long lasting symptoms, because the likelihood of improvement with nonoperative measures is low (quality of evidence Class III; strength of recommendation, D). In patients with cervical stenosis without myelopathy who either have abnormal EMG findings