Summary of Key Points The upper cervical spine presents many unique challenges to successful stabilization, including complex anatomy and limited access corridors. Because of the high degree of mobility at these levels, internal screw fixation is often required to achieve…
Summary of Key Points Instability of the craniocervical junction can result in severe neurological compromise. Instability can result from traumatic, neoplastic, rheumatological, infectious, congenital, or iatrogenic etiologies. The dorsal approach is most commonly used when fusion of the occipitocervical region…
Summary of Key Points Spine constructs should be patient- and pathology-specific. Constructs require supplementation with adequate bone grafting to provide long-term stability. Cervical spine constructs may be applied in situations of clinical instability, for maintenance or correction of alignment, or…
Summary of Key Points Identification of predictors of readmission and reoperation is important to help address perioperative management and potentially both decrease readmissions and improve outcomes. The risk of spine instability, neural damage, and infection increases with revision surgery; and…
Summary of Key Points Implant wear remains a concern for arthroplasty devices, and with the increase in spinal disc arthroplasty it is essential to conduct comprehensive assessments of the implant mechanical integrity, bearing surface, and host tissue interactions, as well…
Summary of Key Points Postoperative spinal deformity manifests as an inability of the spine to maintain an adequate loadbearing capacity or withstand dynamic forces, which may occur because of iatrogenic reasons intraoperatively (decompression, instrumentation), pseudarthrosis, or the inevitable phenomenon of…
Summary of Key Points Soft tissue and vascular complications related to spinal surgery are usually predictable and vary depending on the region being operated upon. Cervical spine surgery–related soft tissue complications frequently include dysphagia, hoarseness, and vocal fold motion impairment.…
Summary of Key Points Posttraumatic and idiopathic syringomyelia represent a heterogenous group of neurological conditions characterized by fluid collections in the parenchyma of the spinal cord. Obtaining a detailed history and examining the entire neuraxis is required for effective treatment…
Summary of Key Points Syringomyelia is the formation of a fluid cavity within the spinal cord thought to result from a pathophysiological disruption of cerebrospinal fluid flow. Arachnoiditis is the scaring of the arachnoid and pia resulting from multiple etiologies,…
Summary of Key Points Arachnoiditis is a nonspecific inflammatory process of the arachnoid layer of the spinal cord or cauda equina. There are three stages in the progression of arachnoiditis, including inflammation, fibroblast proliferation, and collagen deposition. There are many…