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spinemonitor: Neck & Back Pain eNewsletter from January 14, 2009

In this edition of spinemonitor, Howard S. An, MD discusses a high morbidity case of atlanto-occipital dislocation resulting from a crush injury. Sharolyn Martin, RN, BSN, CEN and her co-authors demonstrate why the question of early versus late surgical stabilization remains controversial.

Featured Case Study
Atlanto-occipital Dislocation after a
Crane Accident
  Case Author:
Sharolyn Martin, RN, BSN, CEN
Trauma Research Nurse
Departments of Emergency Medicine & Trauma
JPS Health Network
Fort Worth, TX

A 54-year-old Hispanic male sustained a crush injury on a construction site after sticking his head out of the crane window and subsequently being struck by the crane boom. His head was briefly pinned between the body of the crane and the boom...

A rapid neurological assessment was performed prior to the administration of the rapid sequence intubation medications. Initial assessment findings in the emergency department included...

The opening axial CT scan of the brain revealed evidence of a subarachnoid hemorrhage surrounding portions of the brainstem and proximal cervical cord (Fig. 1), with an associated...

Read Complete Case, Vote for Treatment, and View Outcome

Atlanto-occipital Dislocation

How Would You Treat this Patient?
CME Event: Sharpening Your Spine Surgery Skills
The Fourth Annual Course on: Sharpening Your Spine Surgery Skills
The Spine Masters Institute – Burr Ridge, IL (Chicago suburbs) May 15-16, 2009 – 12.5 AMA PRA Category 1 Credits™

Spine Surgery SkilksCourse Chairmen:

  • Neel Anand, MD
  • Keith H. Bridwell, MD
  • Iain H. Kalfas, MD
  • Frank J. Schwab, MD
  • Harry L. Shufflebarger, MD

Course Goal:  To enhance the spine surgeon’s expertise and knowledge with the latest surgical techniques and technologies.

A distinguished faculty of 11 leading orthopaedic and neurological surgeons lead this course consisting of more than seven hours of cadaver labs, plus lectures and surgical videos.  Objectives include:

  • Discuss the indications, techniques, and potential complications associated with several minimally invasive spine techniques.
  • Assess fixation options and techniques at all levels of the spine.
  • Describe indications and techniques for spinal osteotomy options, including PSOs and VCRs.
  • Evaluate the rationale, indications, techniques, and outcome for cervical arthroplasty and anterior approaches skull to T4.
Download Course Brochure (PDF)
Online CME Opportunity
Pedicle Screw Fixation: Osteoporotic Bone
1.0 AMA PRA Category 1 Credit™

The surgical challenges and complications of Pedicle Screw
implanting pedicle screws into osteoporotic bone, or bone weakened by cancer, is explored with fenestrated screws presented as a viable solution.


  • Discuss the options for pedicle screw fixation in osteoporotic bone, including any complications associated with these techniques
  • Describe contributing factors to cases of extravasation and discuss tools and techniques available to minimize this complication
  • Explain patient selection criteria, technique options, outcomes, complications for current canalized techniques for pedicle screw fixation in osteoporotic bone

This online continuing education program is designed to provide orthopaedic and neurological spine surgeons with a review of pedicle anatomy, bone remodeling, and osteoporosis. Also presented are the characteristics of pedicle screws, use indications and contraindications, as well as surgical planning and intra-operative guidance.

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Past Spine Cases:
Below is a listing of previous spine case studies. Feel free to browse and vote for treatment options for each case.

Traumatic Sacral Dislocation
By Christopher I. Shaffrey, MD

Significant Back and Leg Pain in a 70-Year-old Female
By Timothy R. Kuklo, MD, JD

Trans-sacral Fusion of Spondylolisthesis at L5-S1
By Larry T. Khoo, MD

S1 Failure in an Elderly Female
By Christopher I. Shaffrey, MD

Debilitating Back Pain with Neurogenic Claudication
By Neel Anand, MD, Mch Orth

Progressive Back Pain in a 26-Year-old Male
By Jeffrey C. Wang, MD

View All Case Studies

Spine Surgery Videos
OR-Live Spine Surgery Videos

Visit the spine surgery video library courtesy of our partner OR-Live, Inc. Whatever your spine interest – innovations in chronic pain therapy, microdiscectomy, VEPTR, fusion, and more – find it here.
View Spine Surgery Library
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Every issue of spinemonitor is sent to thousands of registered spine professionals – neurosurgeons, orthopaedic surgeons, pain management specialists, physical therapists, physician assistants, nurses, and others.  By means of case presentations, spine specialists learn from one another while improving patient care.

SpineUniverse invites you to submit a case. To learn more about this opportunity, please view our submission guidelines or contact Susan Spinasanta at

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