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Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease. RA often causes cervical spine instabilities such as atlantoaxial subluxation (AAS), vertical subluxation (VS) of the atlas, and subaxial subluxation (SAS), which can induce serious compression myelopathy. Identification of predictors for the development of instabilities is essential for the clinical follow-up of patients with RA. Our objective was to elucidate predictive risk factors of cervical spine instabilities in RA. Methods: According to lateral cervical spine radiographs, cervical spine instability was defined as AAS with the anterior atlantodental interval (ADI) > 3 mm, VS with the Ranawat value ...

Introduction: Significant controversy exists regarding the optimum treatment of geriatric patients with type-II odontoid fractures. Operative treatment leads to lower rates of non-union, but carries surgical risks. Non-operative treatment does not carry the risks of surgery, but has higher rates of non-union. The objective of this study is to examine the cost-effectiveness of operative vs. non-operative treatment of type-II odontoid fractures in patients over 64 years old. Materials/Methods: A decision-analytic model as seen in Figure 1, was created to compare operative and non-operative treatment of type-II odontoid fractures among three different age cohorts (65–74, 75–84, over-84) based on expected costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (cost per QALY gained).

Introduction: Cervical retraction position after occipito-cervical fixation is dangerous because of post-operative dysphagia. Reduction of the occipito-C2 angle makes the mandible shift posteriorly, resulting in oropharyngeal airway stenosis. In normal position, the cervical spine moves to reduce physiological lordosis during swallowing. To our knowledge, there are no data demonstrating an association between cervical posture change and cervical spine motion/angle during swallowing. The purpose of the study was to investigate influence of the neck postural change on cervical spine motion and angle during swallowing.

Introduction: PROMIS is a National Institutes of Health (NIH) funded adaptive, responsive assessment tool that measures patient-reported health status. Cervical spine disorders are common, often debilitating conditions that are treated surgically. The objective of this project is to validate the PROMIS pain behavior, pain interference, and physical function CATs in patients undergoing cervical spine surgery against historical outcomes that include the Neck Disability Index (NDI), and the Short-Form 12 (SF-12).

Introduction: Central cord syndrome (CCS) is an incomplete spinal cord injury (SCI) pattern characterized by an ASIA Impairment Scale (AIS) C/D grade and a lower motor score in the upper extremities than lower extremities (UEMS < LEMS). CCS has been defined neurologically when UEMS is 5 to 10 points lower than LEMS. The morphology of CCS spans the spectrum from unstable injuries to more stable hyper-extension injuries in a spondylotic spine. While neurologic recovery is generally favourable, there is a wide spectrum of outcomes following CSS. We analyzed how neurologic outcome in patients with incomplete cervical SCI was influenced by the injury morphology (stable vs. unstable) and the difference in baseline motor score between upper and lower extremities.

Introduction: Degenerative cervical myelopathy (DCM) is an umbrella term that includes cervical spondylotic myelopathy, ossification of the posterior longitudinal ligament (OPLL) and other forms of degenerative changes to the spinal axis. The surgical management of OPLL can be technically challenging for spine surgeons and may result in a higher incidence of perioperative complications than surgery for other forms of DCM.  It is unclear whether surgery is equally effective and safe in patients with OPLL as it is in other forms of DCM. This study aims to compare the impact of cervical decompressive surgery on functional status and Quality of Life (QOL) outcomes in patients with OPLL and those with other forms of DCM.

Introduction: The aim of our study was to assess the influence of postoperative changes in spinopelvic parameters on cervical alignment in adult spinal deformity patients Methods: This was a retrospective review of prospectively collected multicenter database.  171 ASD patients ≥ 18 years were assessed for changes from baseline to the 2-year followup (base-2yr) in the: C2-C7 sagittal vertical axis (C2-C7 SVA), T1-slope (T1S), and C2-C7 lordosis (C2-C7Lord). Multivariate models were constructed to analyze the influence of:  UIV selection (T9 and below vs. above T9), and operative changes from baseline to 6 weeks (base-6wk) in the following spinopelvic parameters: thoracic kyphosis (TK), lumbar lordosis (LL), C7-S1 SVA, pelvic incidence, pelvic tilt and sacral slope.

Introduction: Cervical spinal cord injury patient often face a complex inpatient course putting them at increased risk of hospital-acquired infections, including pneumonias. To date, risk factors and outcomes after hospital-acquired pneumonias (HAP) have not been studied in this patient population. Material/Methods: The 2011 and 2012 National Trauma Data Bank (NTDB) was utilized to identify all patients with cervical spinal cord injuries. NTDB is the largest national database of trauma patients with over 900 centers contributing annually.