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Jayme Augusto Bertelli, Marcos Flávio Ghizoni and Cristiano Paulo Tacca

I n patients with tetraplegia, elbow extension reconstruction is of paramount importance. The ability to extend the elbow results in functional gains, including an increase in workspace, the ability to perform pressurerelief maneuvers, better manual wheelchair propulsion, and independent transfers. Elbow extension against gravity also enables activity above the shoulder level, such as retrieving objects from an elevated shelf. 1 , 6 With conventional methods—transferring either the posterior deltoid or biceps muscle to the triceps muscle—the vast

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Jayme A. Bertelli and Marcos F. Ghizoni

general are the predominant causes of spinal cord trauma. 26 Most individuals affected are young men (21–30 years of age), and in at least half of these cases the injury is to the cervical spinal cord. 10 , 26 Cervical spinal cord injuries can result in tetraplegia with severely compromised function of the upper limbs in addition to paralysis of the trunk and lower extremities. Affected patients often survive for a long time, with the estimated survival ranging from 23 to 40 years according to different studies. 25 Cure of paralysis is still not possible because of

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Edward A. Engle and F. Donald Cooney

✓ This is the report of a case of vertebral sarcoidosis causing collapse of cervical vertebrae with resulting tetraplegia. The patient was successfully treated by decompression and subsequent anterior removal of the invaded three vertebral bodies, followed by an autologous bone graft.

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Sukhvinder Kalsi-Ryan, Armin Curt, Mary C. Verrier and Michael G. Fehlings

practice could be problematic, as existing clinical outcome measures may not be adequate to detect the spectrum of changes associated with biological experimental therapeutics. The purpose of the current paper is to review the available clinical outcome measures specific to the upper limbs in tetraplegia and to focus on the development of the GRASSP version 1.0. The GRASSP was developed to fill an identified gap in the field of clinical outcome measures, with the specific aim of creating a measure suitable for testing natural recovery and outcomes in clinical trials

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Masashi Neo, Takeshi Sakamoto, Shunsuke Fujibayashi and Takashi Nakamura

. F ig . 2. Postoperative CT scans obtained 7 days after laminoplasty. Left: An axial image at C4–5. Right: A sagittal reconstruction. The dural tube is well decompressed and there is no sign of a hematoma. The patient was constipated after the operation. While straining to defecate on the 9th postoperative day, he suddenly felt severe neck and shoulder pain. Tetraplegia rapidly developed, and no voluntary motion of four extremities was possible after 30 minutes (Frankel Grade B function). After an intravenous 250-mg injection of methylprednisolone

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Jayme Augusto Bertelli and Marcos Flávio Ghizoni

T he global incidence of spinal cord injury has been estimated to be between 10 and 80 per million individuals each year. The mean age of patients sustaining such injuries is 33 years old. One-third of these injuries results in tetraplegia. 19 In a survey of patients with tetraplegia, 49% ranked reconstitution of upper-limb function as their first priority in rehabilitation, with no other priority surpassing 13%. 1 In the US, despite more than 100,000 citizens living with tetraplegia, fewer than 400 upper-extremity reconstructive procedures are performed

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Jan Fridén and Andreas Gohritz

T o T he E ditor : With astonishment we read in your journal the recent case report by Mackinnon et al. 9 (Mackinnon SE, Yee A, Ray WZ: Nerve transfers for the restoration of hand function after spinal cord injury. Case report. J Neurosurg 117: 176–185, July 2012). A 71-year-old male tetraplegic patient classified as International Classification for Surgery of the Hand in Tetraplegia (ICSHT) Group 5 with severe finger joint stiffness received a selective bilateral brachialis to anterior interosseous nerve transfer 22 months after spinal cord injury

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without surgery. The patient without preoperative spinal cord dysfunction is also at some risk to his spinal cord when he has an anterior cervical discectomy and fusion. The literature does not reveal whether the complication of tetraplegia has ever occurred following an anterior cervical fusion in a patient without myelopathy, although many neurosurgeons have heard of isolated cases. The events leading to these disasters have not been documented. Has a recognizable accident occurred during the operation? Were there anesthetic or postoperative nursing problems? Can

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Jawad M. Khalifeh, Christopher F. Dibble, Anna Van Voorhis, Michelle Doering, Martin I. Boyer, Mark A. Mahan, Thomas J. Wilson, Rajiv Midha, Lynda J. S. Yang and Wilson Z. Ray

S pinal cord injury (SCI) constitutes a considerable portion of the global injury burden, necessitating specialized and expensive medical care. 24 , 40 , 47 The annual global incidence of SCI is estimated to be between 40 and 100 cases per million population and disproportionately affects young and otherwise healthy individuals. 24 , 36 , 40 , 47 Greater than 50% of SCIs occur in the cervical spine, which causes sensory loss and motor paralysis in the trunk and upper and lower limbs (i.e., tetraplegia). 1 , 36 As recovery from a complete SCI is exceedingly

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Jawad M. Khalifeh, Christopher F. Dibble, Anna Van Voorhis, Michelle Doering, Martin I. Boyer, Mark A. Mahan, Thomas J. Wilson, Rajiv Midha, Lynda J. S. Yang and Wilson Z. Ray

S pinal cord injury (SCI) has devastating consequences for the physical, social, and vocational well-being of patients. 2 , 34 It is estimated that every year, between 250,000 and 500,000 people around the world experience an SCI, with injuries more likely to occur in young adults (20–29 years) and to a lesser extent in the elderly (≥ 70 years). 18 , 34 Injury to the cervical segments of the spinal cord results in varying degrees of functional loss in the arms, body, and legs (i.e., tetraplegia). 1 , 25 , 34 As recovery from a complete SCI is exceedingly rare