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Introduction: Multilevel posterior cervical decompression and fusions are common procedures for patients with cervical spondylotic myelopathy. While often the neural elements can be decompressed adequately with a decompression and fusion ending at C7, many surgeons elect to extend the fusion into the upper thoracic spine rather than stopping a long construct at the cervicothoracic junction. The purpose of this study is to determine if there is a difference in either the revision rate or the cervical alignment in patients who undergo a multilevel posterior cervical fusions ending at C7 or the upper thoracic spine.

Introduction: Pseudarthrosis following anterior cervical discectomy and fusion (ACDF) is one of the most common complications that are related with unsatisfactory postoperative results. It may be an embarrassing situation if surgeons detect pseudarthrosis around 1 year after ADCF since little is known about long-term prognosis of this nonunion segment. The purpose of this study is to investigate what its fate is and what the appropriate management could be in that situation. Methods: One hundred and two consecutive patients who underwent ACDF for cervical spondylotic radiculopathy and/or myelopathy between 2007 and 2012 were screened for eligibility.

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.

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.

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.

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.

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.

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.