• Preexisting Severe Cervical Spinal Cord Compression is a Significant Risk Factor for Developing Severe Paralysis in Patients with Traumatic Cervical Spinal Cord Injury without Bone Injury: A Retrospective Cohort Study

    Introduction: Cervical spinal cord injury (CSCI) without bone injury occurs as a result of various factors, including dynamic factor (i.e., traumatic external force) and static factor (i.e., preexisting cervical spinal cord compression). As for dynamic factor, high energy trauma is a well-known predictor of neurologic outcomes in patients with CSCI. As for static factor, the influence of preexisting canal stenosis on the severity of paralysis remains controversial. Several studies have reported that the degree of preexisting canal stenosis is not associated with the severity of the paralysis. Studies focusing on the impact of preexisting severe cervical canal stenosis in patients with CSCI without bone injury are limited. Therefore, the objective of this study was to investigate whether the presence of preexisting severe cervical canal stenosis affects the neurological outcomes in patients with traumatic CSCI without bone injury.
  • Most 30-Day Readmissions after Anterior Cervical Discectomy and Fusion are not due to Surgical Site-related Issues: An Analysis of 10,006 Patients

    Introduction: The anterior cervical discectomy and fusion (ACDF) is a relatively safe and effective surgical procedure. However, as hospital quality-based reimbursements begin to be tied to readmissions within the 30 days after discharge, understanding the reasons that patients are readmitted after surgery is important for both practitioners and administrators. Methods and Materials: All patients undergoing ACDF were identified in the 2012 and 2013 American College of Surgeons National Surgical Quality Improvement Program (NSQIP).
  • Changes in Sagittal Cervical Alignment after Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: An Evaluation of 141 Patients

    Introduction: Loss of normal thoracic kyphosis (TK: T2-T12 Cobb) is often seen in patients with adolescent idiopathic scoliosis (AIS). However, its effect on the cervical sagittal alignment before and after posterior spinal fusion (PSF) has been less well studied.  Cervical kyphosis (CK) is strongly associated with reduced health related quality of life measures and increased disability scores in adults, however its effects in the AIS population is unknown. Methods: A multicenter, prospective AIS database retrospectively identified 141 patients with minimum 2-year followup after PSF with preop, initial postop, and 2 year postop radiographs that included the skull to pelvis.
  • A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears

    Introduction: There have been 2 single-center studies that reported on the outcomes following the unintentional cervical dural tears, and have estimated the incidence of this complication to be 1%. Despite reviewing thousands of patients in these studies, the overall number of patients with a dural tear was low.  Because of the rarity of this complication, even experienced surgeons with large cervical spine practices may have limited experience with cervical dural tear management.
  • Disability and Impairment of the Upper Limb and how they define the Patient with Degenerative Cervical Myelopathy (DCM)

    Introduction: Individuals with degenerative cervical myelopathy (DCM) can present with profound disability. One main consequence of DCM is loss or reduction of upper limb function. Identifying and validating methods for assessment of DCM is imperative for management of this disease. The World Health Organization’s International Classification of Functioning defines impairment as loss of body structures and function, and disability as loss of ability. This study defines upper limb impairment as neurological deficit, characterized by sensory, motor and complex hand function tasks. Upper limb disability is defined as the inability to perform activities of daily living and characterized by the QuickDASH.
  • Cervical Intervertebral Disc and Paraspinal Muscle Deconditioning following Long-Duration Spaceflight and 30-Day Recovery

    Introduction: Exposure to microgravity during long-duration spaceflights lengthens the spine. Additionally, there is a 4-fold greater incidence of herniated nucleus pulposus particularly in the cervical region, compared with age-matched ground military flight controls. Concurrent muscle atrophy or deconditioning may also contribute to increased HNP risk. There is a paucity of spaceflight induced cervical spine deconditioning data.  We hypothesize cervical intervertebral disk (IVD) heights will increase following a 6-month International Space Station (ISS) mission and decrease after 30 days return to Earth. In addition, we hypothesize that spaceflight will result in paraspinal muscle atrophy but recover 30 days after flight.
  • Outcomes and Complications of Fusions from the Cervical Spine to the Pelvis: Series of 46 Cases with Average 2.7-Year Follow-up

    Introduction: The increasing incidence of adult deformity sometimes requires primary or revision operations with fusions extending up into the cervical spine. The purpose of this study is to determine outcomes in this subset of patients utilizing the Scoliosis Research Society 22 (SRS-22r) questionnaire, Oswestry Disability Index (ODI) and Neck Disability Index (NDI) health related quality of life measures (HRQOLs). Methods: A multicenter retrospective review was performed to identify patients with a UIV at any level in the cervical spine and an LIV in the sacrum/pelvis.
  • Risk Factors for Dysphagia in Acute Cervical Spinal Cord Injury

    Introduction: Dysphagia following traumatic cervical spinal cord injury (CSCI) is an under-recognized complication that can lead to aspiration pneumonia, which is a significant cause of morbidity and mortality. Several authors have investigated dysphagia associated with CSCI, however, risk factors for dysphagia are still not well understood. The objective of this study was to elucidate the incidence and risk factors of dysphagia in patients with acute CSCI. Methods: A total of 464 consecutive patients with traumatic cervical spinal injury with and without spinal cord damage were treated at our institute and were registered in a database from January 2007 to December 2014. All patients underwent CT, MRI, and neurological examination on admission.