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Osteotomy of the Cervical Spine Report of a Case of Ankylosing Rheumatiod Spondylitis
MARSHALL R. URIST
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Department of Surgery, Division of Orthopaedic, University of California, Los Angeles
1958 by The Journal of Bone and Joint Surgery, Incorporated
The Journal of Bone & Joint Surgery.  1958; 40:833-843 
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Abstract

Corrections of a severe flexion deformity and slight hyperextension of the cervical spine was produced safely at the level between the seventh cervical vertebra and first thoracic vertebra in a woman, forty-four years old. The osteotomy was performed posteriorly under local anaesthesia; the ossified annulus fibrosis was ruptured anteriorly by manipulation under nitrous oxide and oxygen anaesthesia while the spinal canal was exposed and protected by the surgeon. Full correction of the deformity was attempted only under controlled conditions after the patient was fully awake and after the spine was securely immobilized in a full spinal brace equipped with a jury-mast and a turnbuckle to raise the chin. The turnbuckle was unthreaded slowly and the cervical spine was extended in stages while the patient was closely observed and frequently examined to test her sensory perceptions, reflexes, and muscle power.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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