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Introduction: CSM causes devastating neurological deficits, including significant impairment of hand function to varying degrees depending on the level and severity of compression. Although surgical treatment prevents further damage to the spinal cord and may reverse some of the neurological deficits, many patients still experience significant impairment of manual dexterity. Skilled motor function involves the descending commands to motor neurons as well as the cervical spinal circuits for rapid refinement of motor output for precise movements. We hypothesize that essential neuronal elements of the forepaw circuitry is lost in CSM resulting in impaired manual dexterity.

Introduction: Potential complications of cervical lateral mass screws (LMS) include subjacent facet joint and exiting nerve root violation. Single plane (eg, AP/lateral) intraoperative xrays are commonly used but are frequently inadequate for determining screw malposition due to the complex trajectory of LMS. Fluoroscopy can be taken in multiple planes and provides intraoperative feedback to allow for screw repositioning, but the ideal fluoroscopic view to assess malposition is not known: depending on the view, any given screw may look “in” or “out”. The purpose of this study was to determine the optimal fluoroscopic views for detecting LMS violations involving the facet and nerve root.

Introduction: The presentation of myelopathy in patients with concomitant cervical stenosis (CS) and Parkinson’s disease (PD) complicates diagnosis and treatment because of similarities in presentation and disease progression. While CS with myelopathy is treated with surgical decompression, PD patients suffer poor outcomes after spine surgery. No studies have examined this unique population, and the outcomes following decompression for myelopathic patients with coexisting PD and CS are unknown. The purpose of this study was to define the demographic features and presenting symptoms of patients with PD and CS and to investigate their outcomes following surgery.

Background: Dysphagia and/or dyspnea have been recognized as serious complications after posterior occipitocervical (O-C) fusion surgery. Previous reports showed that postoperative dysphagia/dyspnea occasionally occurred when patients’ O-C2 angle decreased after surgery. To avoid these complications, we performed intraoperative correction of the O-C2 angle.

Introduction: Cervical spine involvement is a common complication of rheumatoid arthritis (RA), and the resultant deformities may cause neurological deficits such as cervical myelopathy, paresis, and even death. Treatment paradigms for RA have recently undergone a major shift. Standard of care now entails initiating immediate treatment using aggressive therapy with disease-modifying antirheumatic drugs (DMARDs) or a combination of DMARDs plus biological agents (Bio). However, the effects of the dramatic shift in pharmacological treatment on cervical lesions are not elucidated. The purpose of this study is to elucidate morbidity rate and risk factors for cervical lesions in RA patients with onset after 2000 under current pharmacological treatment paradigm.

Background: With growing elderly population and increasing rates of cervical spinal surgery it is vital to understand the value of cervical surgery in this population. We set forth to determine the cost-utility following anterior cervical decompression and fusion (ACDF) for degenerative disease in elderly patients. Methods: 299 consecutive patients undergoing elective ACDF for degenerative diseases over a period of four-years were enrolled into prospective longitudinal registry.  Patient reported outcomes (NDI, NRS-neck and arm pain (NP, AP), EQ-5D, and SF-12) were recorded at baseline, 3-months, 12-months, and 24-months postoperatively.

Introduction: Intraoperative local steroid application has been theorized to reduce swelling and to improve swallowing in the immediate postoperative period following an anterior cervical discectomy and fusion (ACDF). As such, the purpose of this study is to quantify the impact of intraoperative local steroid application on patient-reported swallow function following ACDF procedures. Materials and Methods: As part of a prospective randomized trial, 28 patients undergoing primary 1- or 2-level ACDF procedures for degenerative spinal pathology were randomized via a computer number generator into depomedrol ...

Introduction: Damage of the spinal cord tends to be mild in SCIWOBI compared to severe fracture-dislocation. That is a reason that SCIWOBI have better ambulatory prognosis relative to those with bony injury. However, some patients are lead to a poor ambulatory prognosis. In spite of many reports analyzed ambulatory prognosis of SCIWOBI, the prognostic predictions are less well-established even now.