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Introduction: A significant breadth of literature has documented the potential fall risk of patients with neurological diseases including stroke, dementia and Parkinson’s disease.  Slowed velocity, unsteady/neuropathic gait, increased double support time and shorter strides have all been linked to an increase risk in falls. However, no studies to date have assessed the frequency and impact of falls in patients with cervical myelopathy. Knowledge of the fall risk and resultant injuries of patients with gait abnormalities can play a pivotal role in determining treatment of the gait disturbance as the morbidity of repeated falls may outweigh the morbidity associated with an operative intervention.

Introduction: High neurologic level of injury, high Injury Severity Score (ISS), and low Glasgow Coma Scale (GCS) have been shown to predict tracheostomy in patients with cervical spinal cord injury. The objective of this study was to evaluate the ability of the American Spinal Injury Association (ASIA) impairment scale and neurological level of injury to predict the need for mechanical ventilation as well as tracheostomy.

Introduction: Few studies have evaluated the outcomes following C1-C2 fusion for atlanto-axial osteoarthritis (AAOA). Previous studies in rheumatoid arthritis (RA) patients with atlanto-axial instability have demonstrated unexpected development of subaxial kyphosis following C1-C2 fusion, however this complication in patients with AAOA remains unknown. Therefore, we set out to evaluate subaxial cervical sagittal alignment following C1-C2 fusion for AAOA. Methods: We performed a retrospective review of all patients following C1-C2 fusion from a single center, single-surgeon from 2002-2012.

Introduction: Surgical approach for cervical ossification of longitudinal ligament (OPLL) is still a matter of debate. Posterior decompression is a relatively safe method; however, the effect of indirect decompression of the spinal cord is limited for patients with massive OPLL. It has been previously reported that posterior laminoplasty for patients, who have massive OPLL with 50% canal-occupying ratio or more, can result in poor outcomes.  Therefore, we usually choose anterior decompression with fusion (ADF) or posterior decompression with fusion (PDF) to treat such patients.  However, it is unclear which procedure is more favorable for postoperative neurological improvement for massive OPLL.

Introduction: While increasing evidence points to a beneficial role for surgical decompression in CSM, key clinical issues and controversies remain. Approximately 5% of patients with CSM sustain perioperative neurological decline following decompression with the risk factors for this decline remaining unclear. Additionally, patients with significant cord compression on MRI but minimal clinical symptoms represent a significant management challenge. We hypothesize, based on recent work from preclinical animal CSM models, that circulating microRNAs could reflect the pathobiology of the disease and thus could serve as biomarkers of CSM. We report the results of a prospective clinical series that sought to evaluate the potential role of microRNAs as biomarkers for CSM.

Introduction: It is well known that the use of anticoagulants or antiplatelet agents is associated with perioperative risk of blood loss in orthopedic surgery. However, the recommendation about discontinuation of such medications before cervical spine surgery and its specific effect on blood loss are still controversial.

Introduction: Studies have shown that workers’ compensation subjects have poorer functional outcomes compared to the general population. Cervical decompression and fusion have provided great results with relieving radicular symptoms. However, decompression and fusion for degenerative disc disease (Axial neck pain without radiculopathy) remains controversial. Our purpose was to compare RTW rates after single level cervical fusion between subjects diagnosed with radiculopathy and subjects diagnosed with degenerative disc disease (DDD) before fusion. Methods: ICD-9 and CPT codes were used to collect administrative data from Ohio Bureau of Workers’ Compensation (BWC) between 1993 and 2011.

Introduction: Spondylectomy has been demonstrated to prolong cancer-free survival in many patients with locally aggressive spinal tumors. However, the challenging nature of this surgical procedure and associated severe complications often limit its application in the upper cervical spine. This study examines the link between major complications, surgical techniques, and peri-operative care in the intralesional spondylectomy of the upper cervical spine. Methods: This study was a retrospective review of nineteen patients with primary upper cervical tumors were treated surgically with spondylectomy from March 2005 to August 2009 at a single institution, using either the anterior-posterior or posterior-anterior approach.