{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T20:21:20Z","timestamp":1767990080520,"version":"3.49.0"},"reference-count":14,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tourette syndrome is a condition characterized by involuntary motor tics that are often managed with a combination of medication and behavioral therapy. This condition has also been associated with cervical spinal injuries and has been documented as causing multiple cases of progressive myelopathy. In these patients, surgical stabilization may be effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Case Description:<\/jats:title>\n                    <jats:p>We present a case of a patient with progressive cervical myelopathy with a chronic type II odontoid fracture and Tourette syndrome who had significant hardware failure within 1 month postoperatively due to uncontrolled tics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A failure to sufficiently control the Tourette syndrome led to a failure of the surgical stabilization hardware. Patient education may lead to increased treatment compliance. Treatment guidelines are needed to help practitioners and patients develop individualized and effective treatment programs that not only address the myelopathy but also the tics that contribute to their development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_686_2025","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T15:13:01Z","timestamp":1767971581000},"page":"18","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tourette syndrome with cervical instability and expeditious instrumentation failure: A case report and review of the literature"],"prefix":"10.25259","volume":"17","author":[{"given":"Stephen","family":"Jaffee","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network Neuroscience Institute, Pittsburgh, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance","family":"Valls","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network Neuroscience Institute, Pittsburgh, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network Neuroscience Institute, Pittsburgh, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinelo","family":"Onyiah","sequence":"additional","affiliation":[{"name":"College of Medicine, Drexel University, Philadelphia, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trenton","family":"Kite","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network Neuroscience Institute, Pittsburgh, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Allegheny Health Network Neuroscience Institute, Pittsburgh, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"10.25259\/SNI_686_2025\/ref-1","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1212\/01.WNL.0000064285.98285.CF","article-title":"Cervical myelopathy secondary to violent tics of Tourette\u2019s syndrome","volume":"60","author":"Dobbs","year":"2003","journal-title":"Neurology"},{"key":"10.25259\/SNI_686_2025\/ref-2","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1002\/mds.25797","article-title":"Cervical myelopathy secondary to Tourette\u2019s syndrome managed by urgent deep brain stimulation","volume":"29","author":"Huasen","year":"2014","journal-title":"Mov 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Psychiatry"},{"key":"10.25259\/SNI_686_2025\/ref-9","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jpsychires.2013.12.009","article-title":"A meta-analysis of behavior therapy for Tourette syndrome","volume":"50","author":"McGuire","year":"2014","journal-title":"J Psychiatr Res"},{"key":"10.25259\/SNI_686_2025\/ref-10","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1186\/1752-1947-6-223","article-title":"Multiple neck operations in a patient with severe motor tics because of Tourette\u2019s syndrome: A case report","volume":"6","author":"Miyashita","year":"2012","journal-title":"J Med Case Rep"},{"key":"10.25259\/SNI_686_2025\/ref-11","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s00381-002-0563-6","article-title":"Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord","volume":"18","author":"Muroi","year":"2002","journal-title":"Childs Nerv 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