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We inserted autologous bone chips in the distracted C1-2 facet joint for facet joint fusion, and the C1 vertebra was pulled out by a rod reducer.  After surgery, the patient's symptoms disappeared, and no vertebral artery injury was identified in postoperative 3-dimensional computed tomography angiography.  Patient consent was obtained prior to performing the procedure.

Computerized neuropsychological testing is a cornerstone of sport-related concussion assessment. Female soccer players are at an increased risk for concussion as well as exposures to repetitive head impacts from heading a soccer ball. Our primary aim was to examine factorial validity of the Automated Neuropsychological Assessment Metrics (ANAM) neuropsychological test battery in computing the multiple neurocognitive constructs it purports to measure in a large cohort of interscholastic female soccer players.

Study participants included 218 interscholastic female soccer players (age = 17.0±0.7year; mass = 55.5±6.8kg; height = 164.7±6.6cm) drawn from a large (850+) prospective database examining purposeful heading from four area high schools over a 10-year period. The ANAM-2001 measured neurocognitive performance. Three methods were used to identify integral constructs underlying the ANAM (a) exploratory factor analysis (EFA), (b) first-order confirmatory factor analysis (CFA), and (c) hierarchical CFA.

Neuropsychological phenomena measured by the ANAM-2001 were best reproduced by a hierarchical CFA organization, composed of two lower level factors (Simple Reaction Time, Mental Efficiency) and a single, general composite. Although the ANAM was multidimensional, only the composite was found to possess sufficient construct dimensionality and reliability for clinical score interpretation. Olaparib cost Findings failed to uphold suppositions that the ANAM measures seven distinct constructs, or that any of its seven tests provide unique information independent of other constructs, or the composite, to support individual interpretation.

Outcomes infer the ANAM possesses factorial-validity evidence, but only scores from the composite appear to sufficiently internally valid, and reliable, to support applied use by practitioners.

Outcomes infer the ANAM possesses factorial-validity evidence, but only scores from the composite appear to sufficiently internally valid, and reliable, to support applied use by practitioners.

Functional preoperative planning for resection of intrinsic brain tumors in eloquent areas is still a challenge. Predicting subcortical functional framework is especially difficult. Direct electrical stimulation (DES) is the recommended technique for resection of these lesions. A reliable probabilistic atlas of the critical cortical epicenters and subcortical framework based on DES data was recently published.

To propose a pipeline for the automated alignment of the corticosubcortical maps of this atlas with T1-weighted MRI.

To test the alignment, we selected 10 patients who underwent resection of brain lesions by using DES. We aligned different cortical and subcortical functional maps to preoperative volumetric T1 MRIs (with/without gadolinium). For each patient we quantified the quality of the alignment, and we calculated the match between the location of the functional sites found at DES and the functional maps of the atlas.

We found an accurate brain extraction and alignment of the functional maps multimodal planning through integrating this functional information with other neuroradiological and neurophysiological techniques.The anterior decompression technique, including vertebral body sliding osteotomy1 and anterior controllable antedisplacement fusion (ACAF),2 treats ossified posterior longitudinal ligament (OPLL) without actual excision of the OPLL.3 The fundamental strategy is to separate the mid-portion of the vertebral body along with the OPLL using bilateral anterior osteotomies followed by controllable antedisplacement. These techniques restore the space of the spinal canal anteriorly by anterior translation of the OPLL, avoiding excision and dural manipulation.4 We illustrate the case of a patient who had failed laminoplasty and the surgical decision making for ACAF. We discuss the other surgical options regarding patient selection, present preoperative and postoperative imaging, to demonstrate the efficacy of ACAF and show strategies of ACAF to make it a safe and effective procedure. We demonstrate our technique of ACAF using the intraoperative microscope and models in this video to illustrate the steps of ACAF. A written consent to the procedure was obtained from the patient.This surgical video demonstrates the technique for correcting degenerative cervical kyphosis using an anterior cervical discectomy and fusion (ACDF). Degenerative cervical kyphosis can cause radiculopathy, myelopathy, and difficulty holding up one's head. The goal of surgical intervention is to alleviate pain, improve the ability for upright gaze, and decompress the spinal cord or nerve roots. Posterior-only approaches and anterior corpectomies are alternative treatments to address cervical kyphosis. However, an ACDF allows for sequential induction of lordosis via distraction over multiple segments and for further lordosis induction by sequential screw tightening, pulling the spine towards a lordotic cervical plate.1 This video shows 2 cases demonstrating a technique of correcting severe cervical degenerative kyphosis. The video illustrates our initial kyphotic Caspar pin placement coupled with sequential anterior distraction to correct kyphosis. The technique is most useful in patients who have good bone density, nonankylosed facets, and degenerative cervical kyphosis. We have received informed consent of this patient to submit this video.Juvenile nasopharyngeal angiofibroma (JNA) is a highly vascular benign tumor that originates in the sphenopalatine foramen and often spreads to adjacent compartments.1 Microsurgical resection with preoperative embolization remains the treatment of choice.2 We present a case of a large JNA involving multiple compartments. The patient is a 20-yr-old male who presented with long-term right nasal congestion. The MRI demonstrated a large enhancing mass that extended from the right nasal cavity and nasopharynx into the right pterygopalatine fossa (PPF), infratemporal fossa (ITF), and parapharyngeal space. Preoperative angiogram for embolization showed a highly vascular tumor with blood supply mainly from the internal maxillary artery and about 10% from a persistent mandibular branch of the internal carotid artery. Based on the UPMC JNA staging system, this tumor was a stage IV.2 A combined anterior transmaxillary (Caldwell-Luc) with an endoscopic endonasal transpterygoid approach was performed. The addition of the anterior transmaxillary approach increases the surgical freedom for traditional bipolar devices and improves the view and trajectory to more lateral structures like the PPF and ITF.