Although venous structures are considered more radioresistant, endothelial damage accompanied by venous flow stasis might cause early venous thrombosis and premature venous occlusion after radiosurgery for AVMs. In our series, all patients had a favorable outcome except 1 with a fatal hemorrhage.

Study design: Prospective cohort study.Objective: The aim of the study was to compare clinical results and to determine differences in outcomes between anterior cervical discectomy and fusion (ACDF) and disc arthroplasty in patients treated for symptomatic cervical degenerative disc disease.Methods: Forty patients with cervical degenerative disc disease were treated with ProDisc-C disc arthroplasty and 40 patients with fusion using an intervetebral spacer with integrated fixation (Cervios chronoOS) implants without additional anterior fixation. Fifty disc prostheses were placed in the first group and 52 intervertebral spacers were implanted in the second group. Clinical outcomes were assessed before and 12 months following the procedure using the neck disability index (NDI) and visual analog scale (VAS) for neck and arm pain, with 15% improvement in NDI and 20% in VAS defined as a clinically significant.Results: Eighty patients with cervical degenerative disc disease with a mean age of 49.7 years were included in the study with a minimum follow-up of 12 months. The groups were similar at baseline both clinically and statistically (P > .05) except for age and VAS for arm pain. Both groups had a statistically significant improvement in NDI and VAS for neck and arm pain (P < .05) and the arthroplasty group had a better improvement according to NDI (74.3% of patients in the arthroplasty group achieved ≥15% improvement in NDI versus 65.7% of patients in ACDF group).Conclusions: Both ProDisc C and Cervios chronoOS prostheses resulted in significant pain reduction and functional outcome for the patients with slightly better results in the group treated with disc arthroplasty 12 months after the surgery.Methods evaluation and class of evidence (CoE)Methodological principle:Study Design RCT Cohort study• Case control Case seriesMethods Concealed allocation (RCT) Intent to treat (RCT) Blinded/independent evaluation of primary outcome• Follow-up ≥85%• Adequate sample size• Control for confoundingEvidence class:IIIThe definiton of the different classes of evidence is available on page 83.

Flexion injury and/or whiplash injury to the neck in car accidents are usually trivial injuries with no serious neurological deficits. Our intention was to point out the importance to proceed with diagnostic procedures if neurological deficits do occur in order to reveal the true cause of the deficit. The paper presents the case of a 35-year-old woman who sustained a flexion injury to the neck. A relatively trivial injury to the neck promoted a progressive neurological deterioration. The standard diagnostic procedures (x-ray, computed tomography scan) were normal. Further diagnostics with magnetic resonance imaging was required to reveal an underlying Chiari I malformation. Finally, the operative decompression of the craniocervical junction was performed. Following the surgical treatment, the patient's clinical symptoms regressed. One year after her discharge, she remains in good physical condition. To our knowledge, this case is the first report of the manifestation of Chiari I malformation in the adult as a result of a flexion or whiplash injury of the neck. This unusual case suggests that in a trivial flexion injury to the neck sustained in a car accident, which presents with serious neurological dysfunction, and where the standard diagnostic procedures are normal, the possibility of underlying congenital abnormality, such as Chiari I malformation should be considered.

Background: Degenerative disc disease is a progressive and chronic disorder with many open questions regarding its pathomorphological mechanisms. In related studies, in vitro organ culture systems are becoming increasingly essential as a replacement option for laboratory animals. Live disc cells are highly appealing to study the possible mechanisms of intervertebral disc (IVD) degeneration. To study the degenerative processes of the endplate chondrocytes in vitro, we established a relatively quick and easy protocol for isolating human chondrocytes from the vertebral endplates. Methods: The fragments of human lumbar endplates following lumbar fusion were collected, cut, ground and partially digested with collagenase I in Advanced DMEM/F12 with 5% foetal bovine serum. The sediment was harvested, and cells were seeded in suspension, supplemented with special media containing high nutrient levels. Morphology was determined with phalloidin staining and the characterisation for collagen I, collagen II and aggrecan with immunostaining. Results: The isolated cells retained viability in appropriate laboratory conditions and proliferated quickly. The confluent culture was obtained after 14 days. Six to 8 h after seeding, attachments were observed, and proliferation of the isolated cells followed after 12 h. The cartilaginous endplate chondrocytes were stable with a viability of up to 95%. Pheno- and geno-typic analysis showed chondrocyte-specific expression, which decreased with passages. Conclusions: The reported cell isolation process is simple, economical and quick, allowing establishment of a viable long-term cell culture. The availability of a vertebral endplate cell model will permit the study of cell properties, biochemical aspects, the potential of therapeutic candidates for the treatment of disc degeneration, and toxicology studies in a well-controlled environment.

Pneumocephalus is usually caused by injury that damages the brain meninges and thus allows air to enter the intracranial cavity. Our intention was to establish the importance of considering a stab wound in the neck as a possible cause of traumatic pneumocephalus. The paper presents the case of a 13-year-old girl who was accidentally stabbed in the neck with a kitchen knife by her brother. She had no neurological deficit but had developed headaches. An examination showed cerebrospinal fluid leaking from the neck wound and a CT scan revealed the pneumocephalus. Following surgical treatment, the patient’s clinical symptoms regressed. To our knowledge, this case is the first report of the manifestation of pneumocephalus as the result of a neck stab wound in a child; overall, there are only three reported cases of pneumocephalus caused by a neck stab wound.