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Bahram Chehrazi, Jacqualyn Parkinson and Richard Bucholz

Hospital. On admission he had no motor function below C-7, pin-prick sensation was decreased from C-7 to T-4, and was absent below T-4. He was able to lateralize deep pain in the lower extremities. There was decreased position sense at the right ankle, and retained anal reflex on the right side. Radiographs demonstrated a burst fracture of C-7 with posterior displacement of fragments into the spinal canal. Skeletal traction was unsuccessful in adequate reduction of fragments, and a cervical C-7 vertebrectomy and interbody strut fusion from C-6 to T-1 was performed by

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Franklin C. Wagner Jr. and Bahram Chehrazi

(dark line) with 95% confidence limits (light lines) in 26 patients with admission scores > 2 and severe canal narrowing. The regression line shows no significant relationship between these two variables. Surgery Surgery was performed in 22 patients. Thirteen patients underwent a vertebrectomy and strut-graft fusion, six a laminectomy, and three a laminectomy and fusion. Those patients who underwent surgery did not have significantly different admission scores from those not surgically treated (mean 4.3, SD 2.9 and mean 3.9, SD 2.8, respectively) (t = 0

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Robert L. Allen, Phanor L. Perot Jr. and Steven K. Gudeman

Skeletal Injury Neurological Injury Delay CTMM Findings Operation Neurological Outcome Injury to Reduction Injury to CTMM 1 31, M C6–7 fx-disl, BLF C-6, bilaminar C-5, C-7 unilaminar fx C-7 complete motor & sensory level 8 hrs 8 hrs ant & post bone compromise of canal at C-6 C-6 laminectomy, C4–T1 fusion no improvement 2 27, M C5–6 fx-disl, BLF C-7 ant cord, complete motor & partial sensory level 8 hrs 12 hrs C5–6 ant herniated disc with cord compression, possible smaller ant defect C6–7 C-6 vertebrectomy, C

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Richard L. Saunders

simplicity, safety, and minimal morbidity of the table-fixed retractor method. Figure 3 illustrates the exposure that is feasible in a three-level vertebrectomy and fusion procedure for anterior decompression. Unilateral posterior spinal procedures were refined simply by eliminating the midline post that was integral to the Scoville 1 and Williams 2 retractors for hemilamina exposure. The risk of avulsing the interspinous ligament was thereby obviated, as was crowding of the operating field that had been created by the additional retractor hardware. Fig. 3

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potentials in anesthetized cats Kyu Ho Lee Jun Kim Jin Mo Chung September 1986 65 3 392 397 10.3171/jns.1986.65.3.0392 Experimental model for induction of cerebral aneurysms in rats Fernando Alvarez José M. Roda September 1986 65 3 398 400 10.3171/jns.1986.65.3.0398 Neuroepithelial (colloid) cyst of the third ventricle in identical twins Abdel Wahab M. Ibrahim Hisham Farag Mohammed Naguib Ezzeldin Ibrahim September 1986 65 3 401 403 10.3171/jns.1986.65.3.0401 Vertebrectomy for treatment of vertebral

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Tony Feuerman, Paul S. Dwan and Ronald F. Young

tumor. Operation The thoracic cavity was entered anterolaterally through the T9-10 interspace, and the left lung was deflated with the aid of a double-lumen endotracheal tube. Following reflection of the pleura, an x-ray film was obtained to confirm the location of the tumor. On palpation, the body of T-10 was noted to be hyperostotic anteriorly and laterally with an irregularly raised cortical surface. The vertebrectomy was started by removing the entire left lateral aspect of the corpus with a high-speed drill and a 7-mm gouge. Immediately after the

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John A. Glaser, Richard Whitehill, Warren G. Stamp and John A. Jane

vertebral body fracture coexisted and the arthrodesis spanned the levels adjacent to the fracture. The attending surgeon considered that immediate postoperative stability was insufficient to use an orthosis less extensive than a halo-vest. Fifteen patients with incomplete quadriplegia had undergone vertebrectomy procedures for bursting fractures which resulted in significant bone retropulsion. In all of these, the anterior decompression defect involving one vertebral body had been bone-grafted by the application of an iliac-crest bicortical bone strut by the Bailey

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James L. Stone, George R. Cybulski, Justo Rodriguez, Martin E. Gryfinski and Ravi Kant

the graft is locked into place, the traction weight is decreased, and a lateral x-ray film is obtained to confirm position. Fig. 2. Fusion techniques for single interbody fusion (A) and a one-, two-, or three-level vertebrectomy (B). An alternative multilevel strut-graft technique is also shown (C). Thirteen patients were found to have a bacterial infection ( Pseudomonas or a related organism in eight, Staphylococcus aureus in three, alpha Streptococcus in one, Escherichia coli in one) and three patients had pathological evidence of

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Richard D. Bucholz and K. Charles Cheung

to chest precluding halo placement; nonreducible = unable to reduce with skeletal traction; pathology = fracture of spine caused by tumor or infection; compression = compression of spinal cord requiring surgery; delayed = delayed diagnosis of injury. ‡ For neurological grading scale see Table 1 . Fusion was performed posteriorly in 12 patients and anteriorly with a vertebrectomy in three. There were two surgical failures (13%) and no deaths. The treatment failures were successfully managed at subsequent surgery. Although the protocol called for

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Edward C. Benzel

along the spinous processes and laminae over the appropriate level for placement of dorsal instrumentation for stabilization (if indicated). Freedom of movement at the level of the involved disc interspaces, which is gained by partial vertebrectomy and disc interspace evacuation, allows an optimal spine reduction by whatever instrumentation technique is used. Following reduction and instrumentation, the spine should be fixed in its desired position. This allows the bone graft to be safely placed without fear of excessive compression or loosening of the graft