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    CSRS
    The material presented at the CSRS Annual Meetings has been made available by the Cervical Spine Research Society for educational purposes only. The material is not intended to represent the only, nor necessarily best method or procedure appropriate for the medical situations discussed, but rather is intended to present an approach, view, statement or opinion of the faculty which may be helpful to others who face similar situations. The CSRS disclaims any and all liability for injury or other damages resulting to any individual attending the annual meeting and for all claims which may arise out of the use of the techniques demonstrated therein by such individuals whether these claims shall be asserted by physician or any other person.
  • Minimum Five-Year Follow-up Results for Occipitocervical Fusion Using the Screw-Rod System in Craniocervical Instability

    Introduction: Occipitocervical fusion surgery effectively treats severe neck pain and myelopathy from craniocervical instability and spinal cord compression. There has been no long term study with a consecutive series of patients treated by occipitocervical (OC) fusion using pedicle screws and rods. The purpose of this study was to evaluate the clinical outcome of patients who had undergone OC fusion using pedicle screws and rods over a minimum 5-year follow-up. Materials and Methods: Twenty-seven consecutive patients with OC disorders treated underwent posterior OC fusion using pedicle screws and rods over a minimum 5-year follow-up.
  • The Modified Japanese Orthopaedic Association Scale: Establishing Criteria for Mild, Moderate and Severe Disease in Patients with Degenerative Cervical Myelopathy

    Introduction: The modified Japanese Orthopaedic Association (mJOA) score is a validated, investigator-administered tool used to evaluate functional status in patients with degenerative cervical myelopathy (DCM). This scale is increasingly used in this population to measure baseline myelopathy severity, postoperative improvements and social independence. There is, however, no study that determines what scores on the mJOA constitute mild, moderate and severe disease. Patients in different severity categories are managed differently both intraoperatively and postoperatively; therefore, establishing this criteria has clinical value across the whole spectrum of care.
  • Prevalence and Imaging Characteristics of Asymptomatic and Symptomatic Spondylotic Cervical Spinal Cord Compression in General Population

    Introduction: Magnetic resonance imaging (MRI) is able to detect spondylotic cervical cord compression that could cause cervical spondylotic myelopathy (CSM) but could also remain asymptomatic (“asymptomatic spondylotic cervical cord compression” – ASCCC).  The prevalence of both ASCCC and CSM is not known and data in the literature differ widely. Cervical cord impingement or compression was previously found in 27% of subjects accidentally examined with MRI; in individuals older than 64 years the prevalence reached 30% (Teresi et al.1987). Aim of this study was to estimate the prevalence and MRI characteristics of both ASCCC and CSM in a general population above the age of forty.
  • Mechanism of Injury vs. AOSpine Classification: Is the Setting/Environment in which the Injury Occurs or the Morphology of the Spinal Column Injury the Better Predictor of Severity of Spinal Cord Injury?

    Introduction: The mechanism of injury (MOI-assault, sport, fall, transport, other) is often provided as a descriptor of study participants in traumatic spinal cord injury (tSCI) research, however, the MOI is more related to the milieu or setting of the injury. The newly described AO Spine Injury Cervical and Thoracolumbar Classifications were developed to describe morphologic features of the spinal column injury and includes 3 broad categories:  axial compression (A); distraction (B); and translation (C).
  • Altered Forelimb Neural Circuitry Associated with Impaired Manual Dexterity in Cervical Spondylotic Myelopathy (CSM)

    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.
  • Is it “In” or “Out”? The Optimal Fluoroscopic Views for Intraoperative Determination of Proper Lateral Mass Screw Placement

    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.
  • Clinical Outcomes following Surgical Management of Coexistent Parkinson’s Disease and Cervical Stenosis with Myelopathy

    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.