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BACKGROUND The published two-year results of the pivotal U.S. Food and Drug Administration investigational device exemption trial with the use of the Bryan cervical disc arthroplasty compared with anterior cervical discectomy with fusion for treating single-level degenerative cervical disc disease revealed a significantly superior overall success rate in(More)
BACKGROUND CONTEXT To our knowledge, there is no clinical study analyzing the feasibility and complications of the routine insertion of the lateral mass screw via the posterior arch for C1 fixation in a live surgical setting. PURPOSE To evaluate the feasibility of routine insertion of the lateral mass screw via the posterior arch and related(More)
BACKGROUND The arcuate foramen is an important osseous anomaly of the first cervical vertebra (the atlas) that must be taken into consideration during placement of lateral mass screws into the atlas. METHODS The prevalence of this anomaly in our patient population was determined through a retrospective review of 464 lateral radiographs of the neck. The(More)
STUDY DESIGN A total of 709 skeletally mature atlas specimens were obtained from the Hamann Todd Collection at the Cleveland Museum of Natural History. Using digital caliper, the thickness of the vertebral artery groove was measured to determine the feasibility of potential screw placement. OBJECTIVE To determine the feasibility of screw insertion into(More)
BACKGROUND Surgical site infections are not uncommon following spinal operations, and they can be associated with serious morbidity, mortality, and increased resource utilization. The accurate identification of risk factors is essential to develop strategies to prevent these potentially devastating infections. We conducted a case-control study to determine(More)
BACKGROUND To decrease surgical site infections, we initiated a protocol of preliminary preparation of the skin and surrounding plastic drapes with alcohol foam, and the placement of a suprafascial drain in addition to a subfascial drain in obese patients in 2004. In 2008, we additionally placed 500 mg of vancomycin powder into the wound prior to closure.(More)
We reviewed the results of acute management of patients who had sustained a dural tear during an operation on the lumbar spine, and we attempted to determine the long-term sequelae of this complication. In the five years from July 1989 to July 1994, 641 consecutive patients had a decompression of the lumbar spine, performed by the senior one of us; of these(More)
BACKGROUND The purpose of the present study was to determine the effectiveness of selective nerve-root injections in obviating the need for an operation in patients with lumbar radicular pain who were otherwise considered to be operative candidates. Although selective nerve-root injections are used widely, we are not aware of any prospective, randomized,(More)
OBJECT Total joint arthroplasties most commonly fail because the implant becomes worn and a host inflammatory response subsequently develops. Both the material response to the biological environment and the host response to the device must be thoroughly evaluated to establish the efficacy of cervical arthroplasty. Analyses of devices explanted in humans(More)
Cervical myelopathy is a varied clinical syndromes resulting from spinal cord dysfunction. Underlying causes are numerous, but spondylosis at one or more levels is the most common etiology. Natural history studies have demonstrated a variable clinical course with gradual neurologic deterioration in a majority of patients. While prospective clinical(More)