What was once a simple lumbar disc herniation treated with laminotomy and partial discectomy, with typically excellent results (25, 46), has evolved into a surprisingly complex clinical problem with a dazzling array of therapeutic alternatives. Much of this, of course, is based on clinical studies emphasizing the heterogeneity of disc disorders. Advances in biomechanics research focusing on the lumbar disc have provided valuable insights into the consequences of disc herniation and progressive degeneration in the lumbar spine complex. But in the end, what has this work meant to our patients?

Learning Objectives: After reading this article, the participant should be able to: List the surgical indications for asymptomatic and symptomatic carotid occlusive disease. Explain the risks and benefits of shunting during carotid endarterectomy and describe the surgical indications for selective shunting during carotid endarterectomy. Describe anesthetic and perioperative planning for carotid endarterectomy.

✓ The authors present the case of a 10-year-old girl with a history of cervical trauma in whom a cystic lesion was found to involve all three columns of C-7 with evidence of pathological fracture. Computerized tomography scanning revealed a lytic lesion with sclerotic margins involving the left vertebral body, pedicle, lateral mass, and lamina of C-7 with an associated pathological compression fracture. Magnetic resonance imaging demonstrated mixed signal on both T1- and T2-weighted sequences, with cystic and enhancing solid portions. Magnetic resonance angiography demonstrated anterior displacement of the left vertebral artery at C-7. The patient underwent C-7 subtotal corpectomy and posterior resection of the tumor mass; anterior and posterior fusion were performed in which instrumentation was placed. Histological examination disclosed cystic areas lined by fibromembranous tissue with calcification and osteoid deposits consistent with unicameral bone cyst. Of the four previously reported cases of unicameral bone cysts in the cervical spine, none involved all three columns simultaneously or was associated with pathological fracture. The most common differential diagnostic considerations for cystic lesions in the spine are aneurysmal bone cyst, osteoblastoma, or giant cell tumor of bone. Unicameral bone cyst, in this location, although rare, must be considered in the differential diagnosis and may require resection and spinal reconstruction.

The authors present the case of a 10-year-old girl with a history of cervical trauma in whom a cystic lesion was found to involve all three columns of C-7 with evidence of pathological fracture. Computerized tomography scanning revealed a lytic lesion with sclerotic margins involving the left vertebral body, pedicle, lateral mass, and lamina of C-7 with an associated pathological compression fracture. Magnetic resonance imaging demonstrated mixed signal on both T-1- and T2- weighted sequences, with cystic and enhancing solid portions. Magnetic resonance angiography demonstrated anterior displacement of the left vertebral artery at C-7. The patient underwent C-7 subtotal corpectomy and posterior resection of the tumor mass; anterior and posterior fusion were performed in which instrumentation was placed. Histological examination disclosed cystic areas lined by fibromembranous tissue with calcification and osteoid deposits consistent with unicameral bone cyst. Of the four previously reported cases of unicameral bone cysts in the cervical spine, none involved all three columns simultaneously or was associated with pathological fracture. The most common differential diagnostic considerations for cystic lesions in the spine are aneurysmal bone cyst, osteoblastoma, or giant cell tumor of bone. Unicameral bone cyst, in this location, although rare, must be considered in the differential diagnosis and may require resection and spinal reconstruction.

Cloransulam-methyl, N-(2-carbomethoxy-6-chlorophenyl)-5-ethoxy-7-fluoro[1,2,4] triazole[1,5-c]pyrimidine-2-sulfonamide, is a new broad-spectrum herbicide for use in soybeans. The U.S. Environmental Protection Agency requires that analytical methodology be developed to enforce tolerance levels of pesticides in food crops. This paper describes the method developed to enforce tolerance levels of cloransulam-methyl in soybeans and soybean forage, hay, and processed commodities. The method description includes validation data supporting a lower limit of quantitation of 0.01 mu g/g (10 ppb) for cloransulam-methyl in each matrix. Extracts of each matrix are purified using C-18 and neutral alumina solid phase extraction. Cloransulam-methyl is derivatized, using (trimethylsilyl)diazomethane, to the N-methylcloransulam-methyl. Quantitation and simultaneous confirmation of residues of cloransulam-methyl as N-methylcloransulam-methyl employ gas chromatography with mass spectrometric detection using electron impact ionization with selected ion monitoring.

This text provides insights into current trends and controversial issues regarding state-of-the-art techniques in neurosurgery, interventional neuroradiology, and endovascular surgery. The authors confront such questions as: Are unruptured aneurysms managed most effectively by neurosurgical clipping or endovascular coiling? Is surgery or endovascular coiling the best treatment for ruptured cerebral aneurysms of the anterior or posterior cerebral circulation? In managing arteriovenous malformations and fistulas, should clinicians use neurointerventional techniques or surgery, or a combination of both? Highlights: More than 240 excellent illustrations, figures, and radiological images reviewing key concepts Detailed coverage of treatments for ischemic diseases, including extracranial and intracranial atherosclerosis Discussion of the organizational issues of integrating subspecialties and training subspecialists This text also offers you the opportunity to earn valuable CME credits online. Neurosurgeons, neuroradiologists, neurologists, vascular surgeons, and specialists will find the book's balanced coverage of critical current issues in neurosurgery an indispensable aid in making informed decisions. (A co-publication of Thieme and the American Association of Neurological Surgeons)