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Michael P. Kelly, Lawrence G. Lenke, Jakub Godzik, Ferran Pellise, Christopher I. Shaffrey, Justin S. Smith, Stephen J. Lewis, Christopher P. Ames, Leah Y. Carreon, Michael G. Fehlings, Frank Schwab, and Adam L. Shimer

A dult spinal deformity (ASD) surgery has become increasingly complex, with patients with severe deformities undergoing 3-column osteotomies (3COs), such as pedicle subtraction osteotomy or vertebral column resection (VCR). 1 , 2 , 4–6 , 9–11 , 13–16 , 20 , 22 , 32 Complication rates exceeding 50% have been reported in this patient population. 15–17 , 29 , 30 Neurological deficits, such as weakness and paralysis, are less common and have been estimated at 10% or lower. 8 , 10 , 21 These data come largely from retrospective cohort studies and are subject to a

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H. Michael Keyoung, Adam S. Kanter, and Praveen V. Mummaneni

necessitating removal, junctional segmental kyphosis, deep wound infection, pseudarthrosis, neurological deficit, and death. 3 , 4 , 6 , 12 , 13 There are many potential neurological risks associated with correction procedures for spinal deformity, particularly with hyperkyphosis correction. These are often related to vascular insufficiency to the spinal cord, neural element stretching, and direct mechanical trauma to the cord or nerve roots. Intraoperative MEP and/or SSEP monitoring may assist in detecting neurological changes during deformity correction surgeries. 14 , 23

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Kee-Yong Ha, Eung-Ha Kim, Young-Hoon Kim, Hae-Dong Jang, Hyung-Youl Park, Chang-Hee Cho, Ryu-Kyoung Cho, and Sang-Il Kim

–7 Compared to PJK, which generally indicates a radiographic postoperative phenomenon following long instrumented fusion, PJF includes structural failures of the bone, posterior ligaments, and/or disc, as well as kyphotic deformity at the junction. 8–10 Therefore, preoperative assessment of the risk factors for PJF is critical. However, many studies that have addressed this issue have reported inconsistent risk factors. Considering the severity of neurological deficits resulting from PJF following surgical correction for ASD, it is essential to understand its pathology

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Gursukhman S. Sidhu, Christopher K. Kepler, Katherine E. Savage, Benjamin Eachus, Todd J. Albert, and Alexander R. Vaccaro

occasions extravasation is responsible for severe complications. Cement leakage can result in severe neurological deficits 2 , 11 , 20 , 30 , 35 , 39–43 , 46 , 50 or a cement embolism to the lungs 25 and other organ systems. 1 , 15 The purpose of this article was to report a case of spinal cord compression resulting from PVP treatment for traumatic osteoporotic compression fractures. Additionally, we performed a qualitative systematic review of the literature to evaluate the nature of symptoms, clinical course, and various management options use after a neurological

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Chester K. Yarbrough, Alexander K. Powers, Tae Sung Park, Jeffrey R. Leonard, David D. Limbrick, and Matthew D. Smyth

neurological deficits including quadriparesis, balance difficulty, and hemiparesis over a 24- to 72-hour period. 3 , 9 , 36 Methods We reviewed clinical records, imaging studies, and operative notes from all patients undergoing posterior fossa decompression for CM-I at St. Louis Children's Hospital from 1990 to 2008. Approval by the Human Research Protection Office at Washington University in St. Louis was obtained prior to the initiation of this study. Of the 189 patients who underwent surgery, 6 (3.2%) were identified with acute onset of a neurological deficit at

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Maryam Rahman, Joseph Abbatematteo, Edward K. De Leo, Paul S. Kubilis, Sasha Vaziri, Frank Bova, Elias Sayour, Duane Mitchell, and Alfredo Quinones-Hinojosa

current tools, such as fluorescence-guided resection, 2 , 10 intraoperative awake mapping, 3 , 13 , 15 , 35 and intraoperative MRI, 28 , 39 achieving a gross-total or supratotal resection has become more feasible. However, devastating neurological deficits remain potential risks. In GBM, poor functional performance status (as measured with the Karnofsky Performance Scale [KPS]) is a strong predictor of a poor outcome, 31 and postoperative neurological deficits are associated with decreased overall survival. 5 Therefore, neurosurgeons are tasked with walking the

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Samyuktha R. Melachuri, Carolyn Stopera, Manasa K. Melachuri, Katherine Anetakis, Donald J. Crammond, James F. Castellano, Jeffrey R. Balzer, and Parthasarathy D. Thirumala

) and transcranial motor evoked potentials (TcMEPs) serves to detect and prevent injury, thereby preserving baseline neural function. IONM monitors the function of the spinal cord, nerve roots, lumbar plexus, and adequacy of vascular supply to these elements. 6 , 17–19 Our clinical studies and meta-analysis and systematic review of spinal procedures, including anterior and posterior cervical fusion and idiopathic scoliosis, have indicated that significant changes in SSEPs are associated with increased risk of postoperative neurological deficits. 17 , 19 Clinically

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Young-Hoon Kim, Chi Heon Kim, June Sic Kim, Sang Kun Lee, Jung Ho Han, Chae-Yong Kim, and Chun Kee Chung

, not all patients who undergo SMA resection experience postoperative neurological deficits. 18 , 20 Patients with motor weakness or speech impairments may face greater rehabilitative difficulties when compared with patients who do not experience these deficits. In addition, few studies have reported on factors associated with postoperative neurological deficits commonly experienced after SMA resection or why SMA syndrome occurs in only a subset of patients. Therefore, this study was performed to describe postoperative neurological impairments that follow SMA

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Tomokazu Takakura, Yoshihiro Muragaki, Manabu Tamura, Takashi Maruyama, Masayuki Nitta, Chiharu Niki, and Takakazu Kawamata

deficits such as hemiparesis/hemiplegia may occur. 14 Above all, supplementary motor area syndrome has been described most commonly as a result of resection of the cortex anterior to the precentral gyrus. 16 , 30 , 37 , 73 These postoperative deficits can be temporary or permanent; nevertheless, there is no established measure to predict the prognosis of these neurological deficits. Therefore, prognosis is uncertain after surgery, and thus both patient and surgeon feel insecure. The objective of the present study was to evaluate the prognostic value of nTMS in recovery

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Stephen M. Russell, Robert Elliott, David Forshaw, Patrick J. Kelly, and John G. Golfinos

A comprehensive evaluation of parietal lobe neurological deficits in patents with gliomas anatomically confined to the parietal lobe has not been previously reported. The only publications in which parietal lobe deficits have been discussed have either concentrated on the incidence of a specific deficit or syndrome 9, 19, 21 or contained evaluation of seizure control in patients with both tumoral and nontumoral parietal lobe epilepsy. 14, 23 Furthermore, because many patients in these studies harbored gliomas not confined to the parietal lobe, conclusions