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Introduction: Fixation at the craniovertebral junction (CVJ) is necessary in a variety of clinical situations, and many surgical approaches have been developed to achieve it.  Although the occipital squama (OS) is a general cephalad fixation point to connect the cranium to the cervical spine, there are several limitations to traditional OS fixation.  The occipital condyle (OC) may be a good alternative fixation point in occipito-cervical fusion. However, the risk of vertebral artery (VA) injury during OC fixation has not been adequately assessed. The purpose of this study was to establish the course of the VA (V3) and its relationship to nearby osseous structures to estimate the feasibility of OC fixation.

Introduction: Cervical spondylotic myeloradiculopathy (CSMR) is a disabling condition caused by the compression of cervical nerve roots as well as the spinal cord. The conventional laminoplasty is known to be useful to expand stenotic spinal canal; however it is still of limited use for the decompression of accompanying neural foraminal stenosis.  To compensate this limitation, additional posterior foraminotomy could be applied simultaneously, although this procedure implies the risk of segmental instability and kyphotic deformity because it impairs part of the posterior facet joint. The purpose of this study is to elucidate the long-term surgical outcomes of posterior foraminotomy additionally performed with laminoplasty for the CSMR patients.

Background: There is limited clinical data on the relationship between preoperative disc height and quantity and quality of postoperative motion after cervical total disc replacement (TDR). We investigated this relationship by analyzing the radiographic and clinical results of a prospective, FDA-regulated feasibility study of a compressible cervical disc prosthesis. Methods: The study included 30 patients: 12 single-level and 18 two-level implantations (C4-C5:7; C5-C6:27, C6-C7:14).  All patients received a 6mm-height compressible prosthesis (M6-C, Spinal Kinetics).

Introduction: Cervical deformity (CD) following surgical correction of adult spinal deformity (ASD) has been defined by the following measurements: CL > 20°, C2-C7 SVA > 40mm, or C2-C7 kyphosis >10°. While several studies have analyzed predictors of developing CD, few have defined and identified predictors of optimal cervical alignment (CA) following thoracolumbar corrective surgery. This study uses advanced predictive modeling to identify predictors of developing sub-optimal cervical alignment for surgical ASD patients.

Purpose: Conventional electrophysiological diagnostic techniques such as somatosensory evoked potentials, electromyography, and motor evoked potentials cannot be used to diagnose small lesions of the spinal cord or spinal nerves. Although nerve potential recordings using the inching technique can be used to reveal the position of lesions, electrodes must be placed close to the nerves to obviate distortion of currents by bone and other tissue. Thus, this invasive technique is typically used for only intraoperative measurements. In contrast, magnetic fields generated by neuronal currents are less affected by surrounding tissues and so may be used for high-resolution surface recordings of neural activity.

Background: Previously we have reported the efficacies of human iPS cell-derived oligodendrocyte precursor cells enriched neural stem/progenitor cells (hiPSC-OPCs enriched NS/PCs) transplantation for subacute spinal cord injury (SCI) in adult mice.  On the other hand, we have reported that there are limits to functional recovery by transplantation of NS/PCs for chronic SCI. It was partly because of inadequate remyelination of surviving axons by transplanted cells. It is well known that remyelination of demyelinated axons could be a viable target in transplantation therapy for chronic SCI.  Since hiPSC-OPCs enriched NS/PCs have potentials to differentiate into mature oligodendrocytes, these cells might be effective for the chronic SCI by remyelinating demyelinated axons in the injured spinal cord.

Introduction: Cervical facet dislocation in the pediatric population is rare. 10 total patients to date have been reported to date. When compared to the adult population, the distinctive anatomical and biomechanical differences lead to distinctive clinical manifestation in the setting of cervical facet injuries. The purpose of this study is to present a series of 21 pediatric patients with cervical facet dislocations that presented to our institution in order to identify the unique features of their injury. Method: Between 2004 and 2014, a retrospective review at Harborview Medical Center identified 141 patients with unilateral or bilateral dislocated facet(s). 21 pediatric patients were identified.

Objectives: Patients with cervical spondylotic myelopathy (CSM) may be severely impaired, have reduced quality of life and present with deleterious signs and symptoms.  Patients with severe myelopathy (mJOA < 12) often improve following surgery; however, some may not achieve a minimum clinically important difference (MCID), whereas others may have exceptional outcomes. Due to varying prognoses among this group, it is important to predict outcome in these patients and use this knowledge to manage expectations. This study aims to determine the most important clinical predictors of surgical outcome in patients with severe CSM.