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    CSRS
    The material presented at the CSRS Annual Meetings has been made available by the Cervical Spine Research Society for educational purposes only. The material is not intended to represent the only, nor necessarily best method or procedure appropriate for the medical situations discussed, but rather is intended to present an approach, view, statement or opinion of the faculty which may be helpful to others who face similar situations. The CSRS disclaims any and all liability for injury or other damages resulting to any individual attending the annual meeting and for all claims which may arise out of the use of the techniques demonstrated therein by such individuals whether these claims shall be asserted by physician or any other person.
  • Operative Treatment in Patients with Suboccipital Spinal Metastasis: Is a Posterior Approach Alone Enough?

    Introduction: The incidence of suboccipital metastases is rare, but has increased due to longer life expectancy in patients with metastatic spine disease. Because of neighboring vital structures and anatomical complexity, operative treatment in this region remains a challenge. However, operative treatment can be successful in improving pain and/or neurological deficit. The purpose of this study was to examine clinical outcome and safety of operative treatment in suboccipital spinal metastasis.
  • Does Depression or Anxiety affect Patient-Reported Outcomes and Satisfaction following Operative Treatment for Cervical Myelopathy or Radiculopathy?

    Introduction: Preoperative depression and anxiety have been reported to lead to worse surgical outcomes. Better understanding of these factors as predictors for patient-reported outcomes (PROs) could improve selection of patients with the greatest opportunity for a successful outcome. This study evaluates the differences in PROs and patient satisfaction following surgery for cervical radiculopathy and myelopathy in patients with depression or anxiety. Methods: Patients undergoing surgery for cervical radiculopathy or myelopathy over a four-year period were enrolled into a prospective registry.
  • Collar Fixation is not Mandatory after Cervical Laminoplasty – A Randomized Controlled Study

    Background: Traditionally, it has been common to apply external fixation using a collar after cervical laminoplasty for the purpose of resting the wound. However, some reports have been made claiming that use of a collar for a long period may induce such problems as muscle atrophy and joint contracture, and increase risks of malalignment and axial pain, and that, therefore, postoperative fixation may be omitted. However, these reports were all based on retrospective studies, and controversy remains as to the benefit of postoperative use of a collar. We investigated the effect of collar-aided fixation on prognosis following laminoplasty for cervical myelopathy in this randomized controlled study.
  • Variations in Sagittal Alignment Parameters based on Age: A Prospective Study of Normal Patients using EOS Imaging

    Introduction: EOS allows for simultaneous capture of coronal and sagittal standing images from the occiput to the lower extremity without stitching or vertical distortion.  This provides an ideal method to evaluate measures of global alignment and relate measures of sagittal alignment to horizontal gaze. In the cervical spine, this new imaging modality allows for measurement of occipito-cervical parameters that are not ordinarily visible on traditional lateral cervical radiographs. It also allows us the opportunity to correlate cervicothoracic parameters such as the thoracic inlet angle (TIA) to occipitocervical alignment.
  • Preoperative Nomograms Predicting Patient-Specific Cervical Spine Surgery Clinical and Quality of Life Outcomes

    Introduction: Substantial clinical equipoise exists among surgeons regarding the optimal approach used to treat various cervical spine pathologies. Moreover, clinical and quality of life outcomes vary depending on the patient’s demographic characteristics, cov morbidities, combination of presenting symptoms, pathology, and surgical treatment used.  While there have been several single predictors identified, no comprehensive method incorporates a patient’s complex clinical presentation to predict the individual’s postv operative outcome.
  • Efficacy of Posterior Segmental Decompression Surgery for Pincer Mechanism in Cervical Spondylotic Myelopathy – A Retrospective Case-Control Study using Propensity Score Matching

    Introduction: Compression of the cervical spinal cord in cervical spondylotic myelopathy (CSM) consists of a pincer mechanism due to bulging discs and hypertrophied ligamentum flavum. Posterior decompression of the cervical spinal cord in CSM is sufficient to remove the elements of the articular segment, such as the ligamentum flavum and the superior or inferior edge of the lamina. The surgical procedures of this concept for posterior decompression include the segmental partial laminectomy or laminotomy. The authors have performed cervical microendoscopic laminotomy (CMEL) as a minimally invasive strategy for cervical posterior decompression surgery of the articular segment with a pincer mechanism in CSM patients.
  • Impact of Obesity on Cost per Quality Adjusted Life Years Gained following Anterior Cervical Discectomy and Fusion in Elective Degenerative Pathology

    Background: Obese patients are at increased risk of co-morbidities and complications after spine surgery, which might result in increased cost and lower quality of life compared to their non-obese counterparts. The aim of present study was to determine the cost-utility following anterior cervical discectomy and fusion (ACDF) in obese patients. Methods: A total of 299 consecutive patients undergoing elective ACDF for degenerative cervical pathology over a period of four-years were included in the study. One and twoyear medical resource utilization, missed work, and health state values (QALYs), calculated from the EQ-5D with US valuation using time weighted area under the curve approach) were assessed.