Search Our Scientific Publications & Authors

Spine J 2019 Mar 16. Epub 2019 Mar 16.

Department of Orthopaedics and Sport Medicine, Harborview Medical Center, 325 Ninth Avenue Seattle, WA 98104, USA. Electronic address:

Background: Ankylosing spinal disorder (ASD) patients are at a greater risk for spinal fractures due to osteoporosis and rigidity of the spinal column. These fractures are associated with a high risk of neurologic compromise resulting from delayed or missed diagnoses. Although computed tomography (CT) is usually the initial imaging modality, magnetic resonance imaging (MRI) has been proposed as mandatory to help identify spinal injuries in ASD patients with unexplained neck or back pain or known injuries to help identify noncontiguous fractures. Read More

Ital J Pediatr 2018 Nov 16;44(Suppl 2):119. Epub 2018 Nov 16.

Department of Neurosurgery, University of Milan-Bicocca, San Gerardo Hospital, via G.B. Pergolesi 33, 20900, Monza, Italy.

Background: Neurosurgical features of mucopolysaccharidosis (MPS) patients mainly involve the presence of cranio-vertebral junction (CVJ) abnormalities and the development of communicating hydrocephalus. CVJ pathology is a critical aspect that severely influences the morbidity and mortality of MPS patients. Hydrocephalus is slowly progressing; it must be differentiated from cerebral atrophy, and rarely requires treatment. Read More

World Neurosurg 2018 Oct 20;118:e938-e945. Epub 2018 Jul 20.

Division of Neurological Surgery, Azienda Universitaria Integrata di Trieste, Trieste, Trieste, Italy.

Background: Odontoid fractures are the most common acute cervical spinal fractures in the geriatric population. Their rate is increasing along with the rising age of the elderly population. Whereas conservative management with external immobilization is reported as the treatment of choice for type I and III odontoid fractures, there are no clear indications concerning the best treatment for type II fractures. Read More

Br J Radiol 2018 May 13;91(1085):20170744. Epub 2018 Feb 13.

1 Department of Radiology, Hacettepe University Faculty of Medicine , Ankara , Turkey.

Objective: To evaluate spinal MRI features of mucopolysaccharidosis (MPS) VI and to assess the correlation with clinical findings.

Methods: We retrospectively evaluated spinal MRI scans and clinical findings at the time of imaging in 14 patients (8 male, 6 female) with MPS VI. Craniometric measurements were performed and the images were assessed for bony anomalies, spinal stenosis and spinal cord compression. Read More

World Neurosurg 2017 Nov 4;107:194-201. Epub 2017 Aug 4.

Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.

Background: Various surgical techniques have been described for treating odontoid instability and achieving effective stabilization. The earliest technique to be described proposed a C1 lateral mass entry point including neurectomy of the C2 nerve roots to ensure hemostasis. Because C2 neurectomy remains controversial, preservation of the C2 nerve root as described in Goel-Harms technique can lead to intractable occipital neuralgia and significant blood loss. Read More

World Neurosurg 2017 Sep 1;105:145-152. Epub 2017 Jun 1.

Spinal Unit, Royal Victoria Infirmary, Newcastle, United Kingdom.

Objective: The prognosis in cervical spinal cord injury is poor, and surgical and neurointensive care management need further improvement. Monitoring of the intraspinal pressure (ISP) at an early stage after traumatic spinal cord injury (tSCI) is useful clinically.

Materials And Methods: Obtaining continuous spinal cord perfusion pressure (SCPP) measurements based on the difference between mean arterial pressure and ISP allows offering best medical and surgical treatment during this critical phase of tSCI. Read More

Spine J 2017 09 10;17(9):1319-1324. Epub 2017 May 10.

Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan.

Background Context: Several prognostic studies looked for an association between the degree of spinal cord injury (SCI), as depicted by primary magnetic resonance imaging (MRI) within 72 hours of injury, and neurologic outcome. It was not clearly demonstrated whether the MRI at any time correlates with neurologic prognosis.

Purpose: The purpose of the present study was to investigate the relationship between acute MRI features and neurologic prognosis, especially walking ability of patients with cervical spinal cord injury (CSCI). Read More

World Neurosurg 2017 May 16;101:623-632. Epub 2017 Feb 16.

Department of Neurosurgery of Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain.

Objective: Several studies have looked for an association between radiologic findings and neurologic outcome after cervical trauma. In the current literature, there is a paucity of evidence proving the prognostic role of soft tissue damage or bony integrity. Our objective is to determine radiologic findings related to neurologic prognosis in patients after incomplete acute traumatic cervical spinal cord injury, regardless of initial neurologic examination results. Read More

J Trauma Acute Care Surg 2017 02;82(2):263-269

From the Yale School of Medicine (A.A.M., D.C.J., K.B., K.A.D.), New Haven, Connecticut; Massachusetts General Hospital (T.P., T.M., G.C.V., K.L.B.), Boston, Massachusetts; Boston Medical Center (D.M., G.K.), Boston, Massachusetts; Baystate Medical Center (R.I.G.), Springfield, Massachusetts; Lahey Hospital and Medical Center (M.S.R.), Burlington, Massachusetts; Maine Medical Center (K.C.S., R.J.W.), Portland, Maine; Bridgeport Hospital (W.C.), Bridgeport, Connecticut; and Beth Israel Deaconess Medical Center (S.R.O.), Boston, Massachusetts.

Background: Although cervical spine CT (CSCT) accurately detects bony injuries, it may not identify all soft tissue injuries. Although some clinicians rely exclusively on a negative CT to remove spine precautions in unevaluable patients or patients with cervicalgia, others use MRI for that purpose. The objective of this study was to determine the rates of abnormal MRI after a negative CSCT. Read More

J Neurosurg Spine 2017 Mar 18;26(3):331-340. Epub 2016 Nov 18.

Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

OBJECTIVE The current management of atlantoaxial dislocation (AAD) focuses on the C1-2 joints, commonly approached through a posterior route. The distinction between reducible AAD (RAAD) and irreducible AAD (IrAAD) seems to be less important in modern times. The roles of preoperative traction and dynamic radiographs are questionable. Read More

J Neurotrauma 2017 11 20;34(21):3051-3057. Epub 2017 Jul 20.

1 Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine , Shanghai, China .

The mechanisms of late recurrent neurological deterioration after conservative treatment for acute traumatic central cord syndrome (ATCCS) remain unclear. Seventeen operative cases sustaining late recurrent neurological deterioration after conservative treatment for ATCCS were reviewed to investigate the mechanisms. The assessment of neurological status was based on International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Read More

World Neurosurg 2016 Sep 17;93:279-85. Epub 2016 Jun 17.

Intermountain Medical Center, Murray, Utah, USA; Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA. Electronic address:

Background: Acute complex C2 vertebral body fracture specifically does not involve the odontoid process or C2 pars interarticularis. External stabilization can be effective but may prolong healing and increase morbidity. Many traditional surgical techniques can achieve internal stabilization at the expense of normal cervical motion. Read More

A A Case Rep 2015 Jul;5(2):25-8

From the *Department of Anesthesia, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa; and †Division of Neuroradiology, Department of Radiology, The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa.

A 72-year-old patient with an acute traumatic Type III odontoid fracture presented to the operating room for an urgent orthopedic procedure with a history of uncontrolled gastroesophageal reflux, a full stomach, and active vomiting. Rather than fiberoptic intubation, a rapid sequence intubation with manual inline stabilization was performed using a videolaryngoscope. A lateral cervical spine radiograph immediately after intubation showed no change in alignment of the fracture of C1-C2. Read More

J Orthop Surg Res 2015 Jun 12;10:94. Epub 2015 Jun 12.

Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Sanggye-7 dong, 761-1, Nowon-gu, Seoul, 139-707, South Korea.

Background: Ossification of the posterior longitudinal ligament (OPLL) may increase the risk of spinal cord injury (SCI) with various neurological deficits after minor trauma. However, few studies have investigated the influence of OPLL on neurological outcome after acute cord injury. We examined whether severe spinal canal stenosis caused by OPLL affects neurological outcome after SCI based on intramedullary signal intensity (SI) changes on magnetic resonance imaging (MRI). Read More

J Med Assoc Thai 2015 Jan;98(1):100-5

Background: Acute distractive-flexion injury of subaxial cervical spine (C3-C7) results in facet subluxation or dislocation. However, when the injury is missed or neglected, it may cause serious complications including axial pain, deformity and neurological deficit.

Objective: To demonstrate the pathoanatomy, presentation and management of these injuries. Read More

Spine (Phila Pa 1976) 2015 Feb;40(3):E186-9

From the Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan.

Study Design: Case report.

Objective: To highlight the probability that lateral atlantoaxial subluxation (AAS) exists in patients with rheumatoid arthritis (RA) and induces vertebrobasilar infarctions that are more foregrounded than compressive myelopathy.

Summary Of Background Data: Although lateral subluxation is a well-known subtype of AAS, a case of cerebral ischemia associated with lateral AAS has not been reported before. Read More

J Trauma Acute Care Surg 2013 Nov;75(5):843-7

From the Division of Emergency Medicine (P.M.), Department of Pediatrics, Children's Hospital of Michigan and Wayne State University School of Medicine, Detroit; and Departments of Emergency Medicine (A.J.R.) and Pediatrics (A.J.R.), University of Michigan Medical Center and University of Michigan School of Medicine, Ann Arbor, Michigan; Department of Pediatrics (D.M.J., J.C.L.), St. Louis Children's Hospital (D.M.J., J.R.L., J.C.L.) and Washington University School of Medicine, St. Louis, Missouri; Department of Pediatrics (C.S.O.), University of Utah School of Medicine, Salt Lake City, Utah; Department of Neurosurgery (J.R.L.), Division of Emergency Medicine (L.E.N.), Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Departments of Emergency Medicine (N.K.) and Pediatrics(N.K.), University of California, Davis, School of Medicine, Davis, California.

Background: This study aimed to compare children diagnosed with cervical spinal cord injury without radiographic abnormality (SCIWORA) relative to whether there is evidence of cervical spinal cord abnormalities on magnetic resonance imaging (MRI).

Methods: We conducted a planned subanalysis of a cohort of children younger than 16 years with blunt cervical spine injury presenting to Pediatric Emergency Care Applied Research Network centers from January 2000 to December 2004 who underwent cervical MRI and did not have bony or ligamentous injury identified on neuroimaging. We defined SCIWORA with normal MRI finding as children with clinical evidence of cervical cord injury and a normal MRI finding and compared them with children with SCIWORA who had cervical cord signal changes on MRI (abnormal MRI finding). Read More

Trials 2013 Aug 7;14:245. Epub 2013 Aug 7.

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

Background: The optimal management of acute cervical spinal cord injury (SCI) associated with preexisting canal stenosis remains to be established. The objective of this study is to examine whether early surgical decompression (within 24 hours after admission) would result in greater improvement in motor function compared with delayed surgery (later than two weeks) in cervical SCI patients presenting with canal stenosis, but without bony injury.

Methods/design: OSCIS is a randomized, controlled, parallel-group, assessor-blinded, multicenter trial. Read More

Orthop Surg 2013 May;5(2):94-9

Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.

Objective: The Rule of Spence states that displacement of the C₁ lateral masses by >6.9-8.1 mm suggests loss of transverse ligament integrity. Read More

World J Surg 2013 Aug;37(8):1988-95

Department of Abdominal, Endocrine, and Vascular Surgery, St. Vincentius Kliniken, University of Freiburg, Südendstrasse 32, 76137 Karlsruhe, Germany.

Background: The odontoid lateral mass interspace (OLMI) is the space between the lateral aspect of the dens axis and the medial circumference of the massa lateralis atlantis. The position of OLMI asymmetry as a normal variant or pathologic finding is an area of debate and clinical interest in trauma patients. We designed this prospective study to lay a framework for proposing strategies for the appropriate use of OLMI. Read More

Spinal Cord 2013 Apr 4;51(4):331-3. Epub 2012 Dec 4.

Department of Orthopaedic Surgery, Spinal Injuries Center, Iizuka, Japan.

Study Design: Retrospective radiographic study.

Objective: To investigate the pincers effect on cervical spinal cord in the development of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation.

Setting: The Japan LHWO Spinal Injuries Center. Read More

Spine (Phila Pa 1976) 2012 Dec;37(25):E1560-6

Department of Orthopaedic Surgery, Spinal Injuries Center, Fukuoka, Japan.

Study Design: A retrospective imaging and clinical study.

Objective: To evaluate the extraneural soft-tissue damage and its clinical relevance in patients with traumatic cervical spinal cord injury (SCI) without major bone injury.

Summary Of Background Data: To date, various kinds of cervical discoligamentous injuries have been demonstrated on magnetic resonance images in patients with SCI without bony injury. Read More

J Trauma Acute Care Surg 2012 Mar;72(3):682-90

Faculty of Medicine, University of Oslo, Oslo, Norway.

Background: The purpose of this study was to determine the incidence of surgery for odontoid fractures and to study surgical mortality, surgical morbidity, and long-term outcome in a large, contemporary, consecutive, single-institution, surgical series of odontoid fractures.

Methods: This is a retrospective study of all odontoid fractures treated by open surgery at our hospital during 2002 to 2009. The fractures were classified according to Grauer. Read More

World Neurosurg 2012 Jul 1;78(1-2):191.E23-33. Epub 2011 Nov 1.

Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA.

Background: Dialysis-associated destructive spondyloarthropathy (DSA) is the major bony complication of end-stage renal disease, most commonly found in the lower cervical region. The risk factors for developing dialysis-associated DSA include duration of hemodialysis and patient age. Patients with DSA have a higher incidence of osteoporosis and poor bone mineral density, which may place them at greater risk of atraumatic fractures, instrumentation failure, and neurologic compromise. Read More

Clin Orthop Relat Res 2012 Jun;470(6):1602-13

Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.

Background: Craniocervical dislocations are rare, potentially devastating injuries. A diagnosis of craniocervical dislocations may be delayed as a result of their low incidence and paucity of diagnostic criteria based on CT and MRI. Delay in diagnosis may contribute to neurological injury from secondary displacement resulting from instability. Read More

Equine Vet J 2011 Nov 23;43(6):676-85. Epub 2011 Aug 23.

Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA, USA.

Reasons For Performing Study: To enhance understanding of the nature and pathogenesis of scapular fractures in racehorses.

Hypothesis: Scapular fractures in racehorses have a consistent configuration related to sites of pre-existing stress modelling and remodelling.

Methods: Fractured and intact scapulae collected post mortem were examined visually and with computed tomography (CT). Read More

J Trauma 2011 Sep;71(3):528-32

Division of Acute Care Surgery (Trauma, Emergency Surgery and Surgical Critical Care), Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033-4525, USA.

Background: A distracting injury mandates cervical spine (c-spine) imaging in the evaluable blunt trauma patient who demonstrates no pain or tenderness over the c-spine. The purpose of this study was to examine which distracting injuries can negatively affect the sensitivity of the standard clinical examination of the c-spine.

Methods: This is a prospective observational study conducted at a Level I Trauma Center from January 1, 2008, to December 31, 2009. Read More

Ideggyogy Sz 2010 Jan;63(1-2):25-37

Szegedi Tudományegyetem, Altalános Orvostudományi Kar, Idegsebészeti Klinika, Szeged.

Both acute and chronic instability of the cervical spine can be succesfully treated by anterior crevical fusion. The main goal is to create a spondylodesis through which the instable motion segments are fixed in the position defined by the surgeon. The spondylodesis is realised by the bone healing of the intervertebral space. Read More

J Orthop Trauma 2008 Aug;22(7):451-7

Department of Orthopaedic Surgery, Harborview Medical Center, Seattle, WA 98105, USA.

Objectives: To evaluate the results in patients with open AO/OTA type C3 pilon fractures with segmental bone loss who were treated with a standard treatment protocol.

Design: Retrospective case series.

Setting: Level I trauma center. Read More

Unfallchirurg 2008 Mar;111(3):167-72

Unfallchirurgische Abteilung, Landeskrankenhaus Klagenfurt, St. Veiter Str. 47, 9020 Klagenfurt, Osterreich.

Background: Transarticular dorsal screw fixation of atlantoaxial instability in the elderly is seldom described in the literature. This study presents the results of this technique in patients aged at least 70 years. A modified method of indirect screw fixation is used in which soft tissue dissection is reduced compared to the classic procedure. Read More

Pain Physician 2005 Oct;8(4):391-7

Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, 30 Bergen Street, ADMC 101, Newark, NJ 07103, USA.

Background: Although soccer has a lower injury rate than does American football, injuries to the head and neck do occur. Indeed, soccer is classified as a contact sport. The potential for cervical injuries from the maneuver known as "heading" are of particular concern. Read More

Zhonghua Wai Ke Za Zhi 2006 Feb;44(4):238-41

Department of Orthopaedics, Peking University Third Hospital, Beijing 100083, China.

Objective: To study the clinical characteristics and treatment of flexion-distraction stage I injuries in subaxial cervical spine.

Methods: Twelve cases of flexion-distraction stage I injuries with delayed symptoms, admitted in our hospital between January 1995 and December 2004, were studied retrospectively. In acute phase, all of 12 cases had neck pain and limited neck movements, neurological deficits were found in 6 of 12 cases. Read More

Facial Plast Surg 2005 Aug;21(3):191-8

Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia 30342, USA.

The complex facial trauma victim poses a genuine therapeutic challenge as a whole, and may be particularly challenging to the medical team. The literature on acute management of gunshot wounds to the face is scarce. We performed an extensive review of the English-language literature in an effort to better delineate the diagnosis and acute management of these injuries. Read More

Neurosurgery 2005 Oct;57(4):748-52; discussion 748-52

Division of Neurosurgery, University of California, San Diego, California, USA.

Objective: The incidence of spinal instability after penetrating gunshot wounds to the spine in adolescents is unknown. We describe our experience over a 15-year period.

Methods: Hospital records were reviewed retrospectively. Read More

South Med J 2005 Sep;98(9):896-901

Department of Neurosurgery, The Medical Center of Central Georgia, Mercer University, School of Medicine, Macon, GA, USA.

Objectives: In the present study, the authors comment on their experience with anterior odontoid screw fixation in the management of odontoid fractures, in an attempt to further assess the safety and the efficacy of this procedure.

Materials And Methods: A retrospective analysis of 50 consecutive patients with reducible type II or rostral type III odontoid fractures, operated at our hospital with anterior odontoid screw fixation. Radiographic bony fusion, complications, and clinical outcome were evaluated. Read More

Acta Chir Orthop Traumatol Cech 2005 ;72(2):105-10

Spondylochirurgické oddelení FN Motol, Praha.

Purpose Of The Study: Combined fractures of the atlas and epistropheus account for 3 % of all acute injuries to the cervical spine. In relation to all C1 and C2 injuries this is 43 % and 16 %, respectively. The aim of this study is to evaluate a group of patients with combined C1-C2 fractures and to suggest an effective therapeutic procedure. Read More

J Emerg Med 2005 Feb;28(2):147-52

Division of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, CA 95817, USA.

To describe the prevalence and types of distracting injuries associated with vertebral injuries at all levels of the spine in blunt trauma patients. A prospective cohort study was conducted at an urban Level I trauma center. All patients undergoing radiographic evaluation of the cervical, thoracic, or lumbar vertebrae after blunt trauma were enrolled. Read More

J S Afr Vet Assoc 2003 Dec;74(4):104-10

Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort 0110, South Africa.

The Boerboel is a South African large-breed dog resembling a Bullmastiff. The records of Onderstepoort Veterinary Academic Hospital were searched for dogs that had presented, between 1998 and 2003, with symptoms indicative of wobbler syndrome and had undergone survey radiographic and myelographic studies. Ten cases fitted the inclusion criteria. Read More

Spine J 2001 Jan-Feb;1(1):18-25; discussion 125

Department of Orthopaedic Surgery, University of Medicine and Dentistry, New Jersey-Robert Wood Johnson Medical School, 1527 Highway 27, Somerset, NJ 08873, USA.

Background Context: A comprehensive classification for spinal trauma has proved difficult to achieve as attested to by the number of systems in use today. In addition, few systems can be applied to all levels of the spine, and the first two cervical vertebrae are usually treated as altogether separate from the remainder of the spine. Consequently, outcome data and comparison of published data are difficult, at best. Read More

Neurosurgery 2002 Jun;50(6):1368-70; discussion 1370-1

Division of Neurosurgery, University of Missouri-Columbia, Columbia, Missouri 65212, USA.

Objective And Importance: We describe a unique case of multiple bilateral cervical root injuries without ligamentous or bony injury secondary to a sandblast accident.

Clinical Presentation: A 19-year-old man sustained a sandblast injury to his face, neck, chest, and upper extremities, with immediate loss of motor and sensory function occurring in both of his upper extremities. Cervical spine x-rays, computed tomography, and magnetic resonance imaging demonstrated no fracture, soft tissue abnormality, or malalignment. Read More

Z Orthop Ihre Grenzgeb 2001 Nov-Dec;139(6):481-4

Orthopädische Universitätsklinik Düsseldorf, Germany.

Introduction: An os odontoideum is mostly diagnosed coincidentally on the basis of neurological symptoms or painful movement of the cervical spine. Diagnostic work-up and therapy are currently subjects of controversial discussion in the literature.

Case: Our report is about an eleven-year-old boy with an unknown os odontoideum, who developed neurological symptoms with tetraparesis after a fall from 1. Read More

Ann Emerg Med 2001 Jul;38(1):8-11

Department of Emergency Medicine, Maricopa Medical Center, Phoenix, AZ, USA.

Study Objective: Flexion-extension (F/E) radiographs of the cervical spine are often used in patients with blunt trauma when the evaluating physician remains concerned about bony or ligamentous injuries despite negative or nondiagnostic standard radiographs. The use of this approach has never been addressed in a large prospective study. We sought to determine the clinical factors associated with ordering F/E views and the incidence of diagnostic F/E films in patients with a normal 3-view cervical spine series. Read More

Can J Neurol Sci 2000 Nov;27(4):297-301

Department of Clinical Neurosciences, University of Calgary, Alberta, Canada.

Background: Traditionally, odontoid fractures have been treated with different bracing techniques resulting in variable degrees of successful healing. Surgical intervention is becoming more widely practiced as a primary intervention. The purpose of this report was to survey our recent experience in southern Alberta to determine potential outcome differences in management strategies. Read More

Spine (Phila Pa 1976) 2000 Aug;25(16):2035-9

The University of Iowa Hospitals and Clinics, Division of Neurosurgery, Iowa City 52242, USA.

Study Design: Introduction of a posterior approach for internal fixation of fractures of the ankylosed cervical spine.

Objectives: To evaluate the clinical outcome of patients with ankylosing spondylitis and cervical spinal fractures treated with posterior instrumentation and a collar orthosis.

Summary Of Background Data: Cervical spinal fractures in patients with ankylosing spondylitis almost always extend completely across the vertebral segment to include both anterior and posterior elements. Read More

Spine (Phila Pa 1976) 2000 Feb;25(4):524-6

Department of Orthopaedic Surgery, Johns Hopkins Medical Institution, Baltimore, Maryland, USA.

Study Design: This is a retrospective case series of three patients, ages 9 1/2, 13, and 20 years old, with Marfan syndrome treated for atlantoaxial rotatory subluxation. In the first two cases, acute torticollis was noted postoperatively, following pectus excavatum repair. The diagnosis was made in the third patient after she presented to the emergency room with a week-long history of unresolved neck pain following minor trauma. Read More

J Bone Joint Surg Br 1999 Sep;81(5):830-4

Newcastle General Hospital, Newcastle upon Tyne, England.

We studied MR images of the spine in a consecutive series of 100 patients with acute compression of the spinal cord due to metastases. All patients had documented neurological deficit and histologically proven carcinoma. MRI was used to localise bony metastatic involvement and soft-tissue impingement of the cord. Read More

J Neurosurg 1999 Jul;91(1 Suppl):54-9

Division of Neurosurgery, Texas Tech University, Lubbock 79430, USA.

Object: Confirmation of cervical spine stability is difficult to obtain in the comatose or obtunded trauma patient. Concurrent therapies such as endotracheal intubation and the application of rigid cervical collars diminish the utility of plain radiographs. Bony as well as supportive soft-tissue structures must be evaluated before the cervical spine can be determined to be uninjured. Read More

Spine (Phila Pa 1976) 1998 Nov;23(22):2398-403

Department of Neurosurgery, Chang Gung Medical College, Taoyuan, Taiwan.

Study Design: A prospective study was conducted in 37 patients with cervical spondylosis with incomplete cord injury to assess the role of decompression in these patients.

Objectives: To evaluate surgical and nonsurgical outcomes in patients with pre-existing cervical spondylosis of the spine, in whom an incomplete spinal cord syndrome developed after a minor neck injury.

Summary Of Background Data: The benefits of surgical treatment of incomplete cord injury with cervical spondylosis is controversial but remains a treatment option. Read More

Am J Phys Med Rehabil 1998 May-Jun;77(3):262-6

JFK Rehabilitation Institute, the JFK Medical Center, Edison, New Jersey, USA.

Consultation in the acute care setting allows physiatrists to make significant contributions. In our case, a 90-year-old woman presented to the emergency room after falling down five stairs. Six view C-spine films taken at that time revealed no fracture. Read More