{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T22:08:43Z","timestamp":1769724523703,"version":"3.49.0"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,8,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>A 76-year-old female presented with rigid cervical sagittal plane deformity, myelopathy, chronic aspiration, and dysphonia. This was complicated by a past medical history of partial laryngectomy and neck irradiation for oropharyngeal squamous cell carcinoma. Severe rigid cervical kyphosis resulted in impaired horizontal gaze and progressive myelopathy. She had worsening chronic aspiration and dysphonia secondary to an esophageal fistula into the prevertebral space.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>The authors performed a two-stage, multidisciplinary surgery combining neurosurgical and otolaryngological expertise. Stage 1 involved anterior neck exposure, laryngopharyngectomy with pectoralis major myocutaneous conduit reconstruction, C3\u20136 corpectomy, anterior column reconstruction, and C2\u20137 anterior fixation and fusion. Stage 2 entailed posterior instrumented fusion from C1 to T3. Postoperatively, the patient experienced significant clinical improvement and symptom resolution. Follow-up imaging at 18 months confirmed maintenance of sagittal plane correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case highlights the value gained from multidisciplinary collaboration in complex cervical deformity management. Despite the patient\u2019s \u201crigid\u201d deformity on CT, intraoperative traction proved valuable to achieve sagittal plane correction, which optimized the anterior neck corridor for the ear, nose, and throat team. The authors also discuss key techniques that allowed them to overcome the challenges of this complex case, such as creating a parallel landing zone to prevent cage subsidence.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25203\">https:\/\/thejns.org\/doi\/10.3171\/CASE25203<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25203","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T23:43:52Z","timestamp":1754955832000},"source":"Crossref","is-referenced-by-count":0,"title":["Laryngo-pharyngeal-vertebral extirpation: a radical multidisciplinary surgical approach to managing complications from oropharyngeal squamous cell carcinoma treatment. Illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Wilson A. M.","family":"Fisher","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Faraj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deveney","family":"Franklin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew C.","family":"Prince","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey M.","family":"Blumberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Galgano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"bib1","series-title":"Semin Arthritis Rheum","first-page":"10","article-title":"Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics","volume":"39","author":"Mylona","year":"2009","unstructured":"Mylona ESamarkos MKakalou EFanourgiakis PSkoutelis A.Pyogenic vertebral osteomyelitis: a systematic review of clinical characteristics. Semin Arthritis Rheum. 2009;39(1):10-17."},{"issue":"11","key":"bib2","series-title":"N Engl J Med","first-page":"1022","article-title":"Clinical practice. Vertebral osteomyelitis","volume":"362","author":"Zimmerli","year":"2010","unstructured":"Zimmerli W.Clinical practice. Vertebral osteomyelitis. N Engl J Med. 2010;362(11):1022-1029."},{"issue":"1","key":"bib3","series-title":"Br Med Bull","first-page":"121","article-title":"Vertebral osteomyelitis in adults: an update","volume":"117","author":"Nickerson","year":"2016","unstructured":"Nickerson EKSinha R.Vertebral osteomyelitis in adults: an update. Br Med Bull. 2016;117(1):121-138."},{"issue":"1","key":"bib4","series-title":"Infect Dis Res","first-page":"3","article-title":"Osteomyelitis of the spine: treatments and future directions","volume":"3","author":"Mehkri","year":"2022","unstructured":"Mehkri YFelisma PPanther ELucke-Wold B.Osteomyelitis of the spine: treatments and future directions. Infect Dis Res. 2022;3(1):3."},{"issue":"7","key":"bib5","series-title":"Clin Infect Dis","first-page":"913","article-title":"The management and outcome of spinal implant infections: contemporary retrospective cohort study","volume":"44","author":"Kowalski","year":"2007","unstructured":"Kowalski TJBerbari EFHuddleston PMSteckelberg JMMandrekar JNOsmon DR.The management and outcome of spinal implant infections: contemporary retrospective cohort study. Clin Infect Dis. 2007;44(7):913-920."},{"issue":"11","key":"bib6","series-title":"Am J Med","first-page":"1287","article-title":"Spontaneous pyogenic vertebral osteomyelitis and endocarditis: incidence, risk factors, and outcome","volume":"118","author":"Pigrau","year":"2005","unstructured":"Pigrau CAlmirante BFlores XSpontaneous pyogenic vertebral osteomyelitis and endocarditis: incidence, risk factors, and outcome. 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Am J Med. 2005;118(11):1287."},{"issue":"9","key":"bib7","series-title":"South Med J","first-page":"854","article-title":"Hematogenous vertebral osteomyelitis due to Staphylococcus aureus in the adult: clinical features and therapeutic outcomes","volume":"98","author":"Priest","year":"2005","unstructured":"Priest DHPeacockJE Jr.Hematogenous vertebral osteomyelitis due to Staphylococcus aureus in the adult: clinical features and therapeutic outcomes. South Med J. 2005;98(9):854-862."},{"issue":"4","key":"bib8","series-title":"Semin Arthritis Rheum","first-page":"271","article-title":"Spontaneous pyogenic vertebral osteomyelitis in nondrug users","volume":"31","author":"Nolla","year":"2002","unstructured":"Nolla JMAriza JG\u00f3mez-Vaquero CSpontaneous pyogenic vertebral osteomyelitis in nondrug users. Semin Arthritis Rheum. 2002;31(4):271-278."},{"issue":"11","key":"bib9","series-title":"Spine J","first-page":"e17","article-title":"Fibular flap reconstruction of the cervical spine for repair of osteoradionecrosis","volume":"13","author":"Powell","year":"2013","unstructured":"Powell DKJacobson ASKuflik PLPersky MSSilberzweig JEKhorsandi AS.Fibular flap reconstruction of the cervical spine for repair of osteoradionecrosis. Spine J. 2013;13(11):e17-e21."},{"issue":"4","key":"bib10","series-title":"Plast Reconstr Surg","first-page":"1361","article-title":"Simultaneous reconstruction of the posterior pharyngeal wall and cervical spine with a free vascularized fibula osteocutaneous flap","volume":"109","author":"Ng","year":"2002","unstructured":"Ng RLHBeahm EClayman GLHassenbusch SJMiller MJ.Simultaneous reconstruction of the posterior pharyngeal wall and cervical spine with a free vascularized fibula osteocutaneous flap. 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