Rabadia1

ParthRabadia
JoshBrower
SeniorInternship
12/15/15
ActionResearch
Introduction
WhenIstartedmyinternshipattheSouthernCaliforniaInstituteofNeurologicalSurgery
(SCINS),Iwassuperinterestedinthehumannervoussystem.Ihavealwaysbeeninterested
aboutthehumannervoussystem,anditsroleinourhumanbody.Iwassuperexcitedformy
internship,becauseIwasgoingtobeabletolookatbrainandspinalproblems.Asmyinternship
progressedIrealizedthatIwasdealingwithalotmorepatientswithspinalproblemsratherthan
brainproblems.BecauseofthatIwasreallyinterestedinourspinalcords,anditspurposeinour
body.Atmyinternship,yougetthrownintoalotofdifferentcases.Mostofthetimesyouwill
gettheusualcasessuchasbackpain,andpainshootingdownyourbody.Butinthoseraretimes
yougetthosepatientsthathavespinaltumors,andlipomas.InmyheadIalwayswantedto
know,whatcausedalloftheseproblemsinournervoussystem?Whydowegetthepainswedo,
becauseofanexternalorinternalsource.TherolethatSCINSplayedwashugeinmyresearch
journey.WorkingatafirmlikeSCINS,Iwasableatlookatpatientsfilms,andthenmakingthe
judgementonthediagnosis.Alsobeingabletogotheoperationroomwithmymentorhelpedme
withmyresearch,becauseIwasabletolookfirsthandatwhattypeofsurgicaloptionthepatient
hadwiththistypeofinjury.WhatIwantedtolookforwithmyresearchwas,
Whatisthe
anatomicalbasisofspinalcordinjury?

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Background
Whenwethinkaboutthehumannervoussystem,thenumberonethingthatcomestoourmindis
thebrain.Yes,thebrainisreallyimportantforthenervoussystem,butitnottheonlyfactorin
thenervoussystem.Thespinalcord,isanimportantpartofthenervoussystem,anditisthe
mainmessengerofthebody.Everythingwedogoesthroughourspinalcord.whichbegins
fromourcerebellum,andendsatourlowback.Aroundthespinalcord,wehavevertebrae,and
intervertebraldisks.Ourspinalcordiscategorisedbyfivemajorparts,thecervical,thoracic,
lumbar,sacral,andthecoccyx.Thecervicalspinehavesevenvertebrae,andtheyareclassified
asC1C7.Thecervicalspinemakesupmostofyourneck,anditresponsibleforthemovement
ofyourneck.Thecervicalspine,alsocontainsthenervepaths,thatconnecttoyourarm.So
whenyourbrainsendsanervedownthespinalcanal,itwillleaveoneofthecervicalnerveroots.
ThenextcategoryisthethoracicspineortheTSpine.
ThethoracicspinehastwelvevertebraeT1T12.TheTSpineisknowntosupportyour
bodyinitsdailyactivities.Thethoracicspineisislocatedinyourmidback,anditisprotected
byyourribcage.Eventhoughthethoracicspinedoesntdomuchmuchmovementit,itismeant
tokeepeverythinginyourbodystable.Itconnectsyourcervicalspine,toyourlumbarspine,the
nextsectionofyourspinalcord.
Thelumbarspineconsistsoffivevertebrae,alsoknownasL1L5.Thelumbarspineis
knownforitspower,andflexibility.Whenyouliftheavyobjectsthelumbarspinedoesalotof
thework.Thelumbarspineissuperflexible,whichisnotthecasewiththeotherpartsofthe
spine.Thelumbarspine,hasfivenerverootswhichtraveldownyourlegs.Dependingonwhich
diskthenerveleavesfrom,itwilltraveltovariouspartsofyourlegs,foot,ortoes.Thesacral

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partofthespineisveryinterestingas.Allofthesedisksareverycomplexinthesenseof
functionality.
Withoutourspine,wewouldntbeabletostand,letalonefunction.Wedependonour
spinalcordtodeliverallofthemessagesfromourbrain,totherestofthebody.Sincethespinal
cordisroughlythirtyinchesitisverypronetoinjury.Therearemanyattributesthatcanaffect
spinalcordinanegativeway.Therearemanydiseasesthatarespecifictothespinalcord,andit
canbeverypainful.Forexample,let'stakedegenerativediskdisease(DDD),adiseasethat
affectsoverthreemillionpeopleeveryyear.Itsadiseasewherethedisksinyourspinebeginto
losetheirfluid,andcausethemtosquishlikeapancake.Withthediskflatteningoutlikea
pancake,yourbodybeginstofeelpain.ForexampleifyouhadDDDintheLumbarspine,you
willgetpainshootingdownyourleg.Thisisacommondisease,anditiseasilytreatable.But
therearemanymoresevereinjuriesthatcanhappentothespinalcord.Sincethespinalcordis
themessengerofthehumanbody,themessagecanmaybestop.Paralysisiswhenyoucantfeel
anythinginthehumanbody,ormoveit.

Methods
MyseniorinternshipisattheSouthernCaliforniaInstituteofNeurologicalSurgery
(SCINS).SCINSisapediatricandanadultneurosurgeryfirm.Theyhavepatientscomingin
fromvariousages,andthetwodoctorsinchargeofthefirm.MymentorisSunilP.Jeswani,
M.D,andheisaboardcertifiedneurosurgeon.Mymentorisinprivatepractice,buthehas
privilegesinmultiplehospitals,wherehedoeshissurgeries.Atmyinternshipweusuallyget
patientsthathavespinalcordproblems.Eventhoughitisaneurologicalsurgeryfirm,walkin

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patientsareusuallyallspinalcordrelated.Atmyinternshipmymentor,andIlookatpatient
films.Thesefilmsarerangefromcatscans(CTs)tomagneticresolutionimaging(MRI).My
essentialquestionisaboutspinalcordinjuries,anditsanatomicalbasisaroundit.Thisisa
perfectplaceformyessentialquestion,sincemymentordoesalotofspinecases.Mymentoris
veryfamiliarwithspinalcordinjurysincehedidhisfellowshipattheUniversityofSouthern
Californiawherehespecializedinminimallyinvasivesurgeryinthespinalcord.Icollecteddata
formyseniorprojectthroughtwodifferentmethods.firstImadeobservations.SinceIhad
internedatSCINSbefore,Ihavepreviousdataalreadycollected.Formyjuniorinternship,I
madeanobservationjournalwhereIhighlightedasinglepatientfortheday.Havingthis
previousprojectwillhelpmycurrentprojectbyhavingolddatathatIcanuse.Theothermethod
thatIamusingarecasestudies.Iamlookingatcasesthatmymentorhad,thathadoneofthe
spinalcordsyndromes.WhatImeanbylookingisexaminingthescan,andmakingamedical
judgementonthediagnosis.DuringmyoldinternshipIwasabletocollectdataonpatientsin
general..IamusingthesemethodsarereallyimportantformyprojectsinceIneedtohaveraw
datathatIcanphysicallysee,soIcanbetterunderstandtheinjury.Mytimelineofmydata
collectionbeganinMaywhenIbeganmyjuniorinternship.WhenIbeganmyobservation
journal,andcollecteddata.InSeptemberIstartedtolookatcasestudiesofpatientswhohad
spinalcordsyndromes.Bytheendofmyinternship,IgotallofthedatathatIneeded.
Analysis
Whenamedicaldoctorlooksattheanatomicbasisspinalcordinjurytheywanttotakea
lotofaspectsintoconsideration.Forexample,theywanttolookatage,gender,andwhattypeof
workthepatientdoes.Thereasonsbeingisallofthisattributescontributestospinalcordinjury

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asawhole.Whenadoctorlooksatspinalcordinjurytheywanttolookatdifferentsyndromes
thataffectthefunctionofthespinalcord.Thefirstsyndromeiscentralcordsyndrome.Central
cordsyndromeisthemostbasic,andcommonspinalcordinjury.Centralcordsyndromeis
classifiedwhenyoulosefunctionorsensationinthearms.Thisisduetoinjuryinthecervical
spine.Aspreviouslymentionedwhenyourbraintellsyourbodytomoveacertainpartofthe
body,anervemovesdownthespinalcord,andtellsyourbodytodothefunction.
Approximately11,000patientsyearlygetcentralcordsyndrome.Therearealotofwaysto
preventcentralcordsyndrome,anditseffectonthehumanbody.Areallygoodwaytoprevent
centralcordsyndrome,isthroughworkingout.Whenyouareoverweight,orobeseyourspinal
cordtakesabigloadonyourspinalcord.Yourspinehastobearalloftheweightonyourbody,
andinresultyourspinaldiskstaketheload.Ifyoudogetcentralcordsyndrometherearealotof
waystofixtheproblem.Youcangothenonsurgicalroute,andjuststicktoepiduralinjections.
Anepiduralinjectioniswhentheyinjectsteroidsinyournervesinthespinalcord.Thisinresult
willequalintemporarypainrelief.Ifyougetthattemporarypainrelief,thesurgeoncan
perfectlydiagnosewherethepainiscomingfrom.ThesurgeonwillthengointotheOR,and
performadecompressioninthespinalcord.Aspinalcorddecompressioniswhenthesurgeon
drillsoffsomeboneoffyourvertebrae,sothenerveshavemorespacetoleavethecord.
Anteriorcordsyndromeiswhentheirisaupsetinthespinalcordduetoischaemiaor
infarction.Whenyouhaveanteriorcordsyndromepatientscanexpectcompletemotorparalysis
belowthelesion.Thereasonbeingisnobloodisbeingflowedtotheanythingbelowthelesion.
Youwillalsolosethelossofpain,andtemperaturebelowthelesion,sincethereisnoblood
runningdownthebody.Therearealotofcausesofanteriorcordsyndrome.Therearesome

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externalcompressionsuchasaherniateddisc,oraneoplasticmass.Itcanalsobecausedbya
traumasuchadirectstab.Withsomethingasmajorasthisinjurythereisusuallya1020%that
thepatientwillgetmotorrecovery.Theseinjuriesarereallyserious,andtheycanultimately
resultinparalysis.Therearenoknowntreatmentforanteriorcordsyndromesinceinmostcases
thepatientsendsupwithparalysis.ThenextsyndromeisBrownSequard.
BrownSquardsyndromeanincompletespinalcordlesionthatischaracterizedbya
clinicalpicturethatrepresentsasectionofspinalcordinjuryusuallyintheCspine.Patientswho
sufferfrombrownsequardsyndromewillsufferfromupperneuronparalysis.BrownSequard
syndromeusuallypertainstoonesideofthespinalcord.Alotofhemorrhagesoccur,and
developofthegraymatter.Necrosis(whennervesdie)occursapproximatelyafterthetrauma.
Prognosisforrecoveryfrombrownsequardsyndromeissignificant.Abouthalfoftheoneyear
motorrecoveryhappensfromcoupleofmonths,followingthetrauma.Someofthetreatments
thatcanbedoneforbrownsequardsyndrome,arephysicaltherapy,andsurgery.Forphysical
therapypatientswillneedtomaintainstrengthneurologically.Patientswillalsoneedtokeepall
oftherangeofmotionintheirjoints.Byhavingalloftheseexercisesdonethepatientisableto
keepallofthemusclemass,andinresultmakingthehealingprocessthatmuchfaster.Having
strongmusclessupportthebody,andmakerecoverybetter.Thepatientcanalwaysconsider
surgerywithbrownsquardsyndrome.Surgicallythedoctorwillhavetoperforma
decompressiononthelevelofthewound.
Posteriorcordsyndromeisaconditionwhenyourbodyexperiencestrauma.Thebody
thendevelopsalesionintheposteriorpartofthespinalcord.Thepatientwillfeeloflostoflight

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touch.Posteriorcordsyndromeistherarestformofspinalcordinjury,andthereareno
treatmentsforthesyndrome.

ActionPlan
Sowhatcanwedotopreventspinalcordsyndromes?Therearewaystopreventinjuries.
Thebestthingyoucandoisworkoutandkeepyourbodyhealthy.Byhavingstrongmuscles
andanhealthybody,yourbodyisabletotakemoreload.Ifyoucankeepahealthybodyyour
lifestylewillbeeasiertolive.Theleadingcausetospinalcordinjuryisobesity.Bybeing
overweightorobese,yourspinalcordneedstotakealloftheload.SpinalCordanatomyisso
complex,andtheiraresoexternalsourcesthataffectsthecord.SpinalCordinjuriesarevery
dangerous,anditcanbelifethreatening.Anotherthingthatyoucandoiskeepiskeepyour
boneshealthy.Youcandomultiplethings,tokeepyourbonesnice,andstrong.Youcandrink
milktokeepyourboneshealthy.Anotherfoodthatyoucaneatgreens.Byeatingyourbroccoli,
kale,andspinach,youcanhavehealthybones.Doctorsalwayssaytohavedrinkyourmilk
because,youcanbuildstrongerbones.Oneimportantthingweneedtodoaboutspinalcord
syndromesiseducatethepubliconwhatthesesyndromesare.Medicineisoverlookedinthis
communityassomethingonlysmartpeoplecando.Theyhavethisnotionthattheycanjustgo
toadoctor,andtheywilltellyouwhatiswrongwiththem.Asthatistrue,weneedtoeducate
thepubliconsomemedicalsymptoms.Byeducatingthepublicwewillbeabletopreventspinal
cordinjury.Thepublicwillknowtoworkout,andgettheirbonestobethestrongest.

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Appendix
:
Observations
Day1:OnmyfirstdayofinternshipImeetAmiddleageman,withlowerbackproblems.The
patienthasbeenexperiencingbackpainforthepast2years.Thepatientisalsoexpectingsome
legpain.Thelegpainisgoingdowntherightleg,anditfeelslikeanelectricshock.Thepatient
hasareallygoodhistory,withtheirhealth.Dr.Jeswaniexaminesthepatient,andtalksaboutthe
MRIthathesaw.TheMRIshowsthatthediskinL4,isdegenerating.Thisexplainstheback
pain.Healsosawnarrowingofthedisk,sointurnthepatientisexperiencinglegpain.
Dr.Jeswanithentalksaboutoptionsofhowtogetridofthepain.Youcanalwaystryphysical
therapy.Thatwillmakethemusclesinyourbodystronger,whichinturnwillmakeyourhealing
faster.Youcanalwaystryanepiduralwhichiswhentheyinjectsteroidsintothespine.Youcan
alwaysgowiththesurgicaloptionwhichisdoingafusioninyourback,whichwillfusethedisk
tootherdisks.

DayII:Todayamid60yearoldladycameintotheofficetogetacheckinforapostoperation
checkin.Thispatienthadatumorinherbrain,andDr.Jeswaniwentinsideofthebraintogetit
out.Sowhenthepatientcameintheoffice,tomakesurethattheincisionwasnotaffected,and
thatthepatientwasfunctioning.Thepatientfeltreallywell,andshefeltlikethatshecando
anythingaftertherumorwasremovedfromthebrain.

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DayIII:TodaywasthedaythatIwouldbegoingtotheOperationRoom.Thisdaywasgoingto
bereallyinterestingformebecauseIwasdreamingaboutgoingtotheORforthelongesttime.
SoasnooncamearoundDr.Jeswani,andIdrovetothePMC,aftermeetingDr.Cochranformy
internshipcheckin.AsIgottothePMC,Dr.JeswaniredirectedmetotheMenslockerroomto
goscrubup,.OnceIscrubbedupIhadtogetahaircover.IthengointoOR#1akatheNeuro
Room,togoseethesurgery.Theladywasalreadyinthebedallpreppedup.Theothersurgeon
Dr.Nguyen,hadalreadypreppedtheladyforsurgery.Thesurgerythattheyweregoingto
conductwasamultiplelayerdiskfusion.Thisoperationusuallytakes23hours.Butbeingthe
greatsurgeonsthatDr.Jeswani,andDr.Nguyenwere,theyfinishedthesurgeryin1hour,and45
minutes.

DayIV:TodayImeetoneoftheoddestpatientintheworld.Thispatienthaddonethe
impossible,buttheydiditinsuchaway,thatnooneeverheardof.Thispatienthadgotteninto
amotorcycleaccident,nearlytenyearsago.Itwasntaminorone,andthepatienthadbeen
paralysedfromthewaistdown.Butthepatienthatedbeingparalysed,sohebegandoingthese
therapiesofputtingballsunderhisback.Healsoputalotofweightonhislegs.Andallhe
woulddoisstretch,andstretch.Hekeptondoingthisuntilonedayhegotfeelingbackintohis
legs.Butthethingishebecomesparalysedeverytimehedoesnotdohisdailystretching,and
putballsunderhisbackformultiplehours.ButthereasonhecametotheofficeisbecauseHe
wasdonewithallofthepain,sohewasreadyforsomeotheralternative.

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DayV:Todaywehadaclinicaldayintheoffice.Intheofficewegotapatientwhoneededto
checkupontheirSpinalCordStimulator(SCS)trial.WhatthisSimulatordoesiswhentheyput
asmalldeviceinthespine,whichwillturnstopsomesignalsbeingsenttothebrain.Thisis
usuallyusedwhenyouhavelegpainfromyourdiskbeingpushedagainstthespinalcanal.When
yourdisksarebeingpushedittendstosendpaininyourleg.ButafteryouputintheSCSthe
painshouldgoaway.ThereasonIamputtingquotationmark,isbecausethepainsignalsare
notgoingtoyourbrain,sointurnyouarenotinpain.TheSCSdoesnotworkoneverypatient,
soitalldependsonyourself.ButthethreepatientsIsawwiththetrail,itworked2/3times.So
forthepeoplewhofoundtheSCShelpful,theyaregoingtogettheofficialstimulatorputin
therebodyinthenearfuture.

DayVI:TodayIwenttotheORtogoseeareallyinterestingcase.ThesurgerythatDr.Jeswani
wasgoingtoperformwasaspinalcordtumorremoval.Thethingwasthetumorwasactually
insideofthespinalcord.Thissurgeryissuperhighrisk,becauseyouaregoingtobecuttingthe
spinalcord,whichisreallyrisky.ForthissurgeryDr.JeswanihadDr.Sternassistinthesurgery.
Oncethesurgeonsgottothespinalcord,thesurgerygotreallyserious.Theywerenotalking,
exceptforDr.Jeswaniaskingthetechforinstruments.Forthissurgerytheyhadtodoitundera
microscope.Youwouldthinkthatnooneelsecanseewhatshappeninginthesurgeryright?
WellnotheyhaveTvsintheOR,sowecanseewhatDr.Jeswani,andDr.Sternwereseeing.
OnceDr.Jeswani,cutasquareintothespinalcord,Isawthisblackfluidcomeoutofthespinal
cord.AtfirstIwasshockedwhenIsawitbutthesurgeonswerequicklydrainingit.Oncethey
gotallofthefluidIwasabletoseethetumor.OncetheysawthetumorDr.Jeswanislowlysliced

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itoutofthespine,thenaskinganotherdoctortorunamotortesttomakesuretheyaresafe.
Oncetheygotthetumoroutofthespinalcordtheystartedtostitcheverythingbackup.

DayVII:TodayIobservedyetanothersurgerytoday.Butthissurgerywasevenmorehighrisk,
thanthelastone.Forthispatienttheyhadaspinaldeformitynearthecoccyxregioninthespine.
Thespinewasreallymessedup,andtheonlythingthattheyhadtodoisfixit.Dr.Jeswani,and
Dr.Nguyenperformedthissurgery.Whattheyhadtodoisperformthissurgerythroughfussing
thediskoftheneckfirst.Oncetheydidthefusiontheycuta35degreewedgeintothepatient's
spineandreconstructitfromthere.Itwasareallyinterestingsurgerytowatch,plusitwasreally
longatthatto.Itwasan11hoursurgery.

DayVIII:Todaywasaclinicaldayintheoffice.Wejusthadacoupleofnewpatientswho
cameintoseeusfortheirspine.Theywerehavingalotofpainintheirneckandshoulderarea.
SoafterlookingattheirMRI,weconcludedthatthepatientwashavingdiskdegenerationin
therebody.Thestepstofixthisproblemistodophysicaltherapy,steroidinjections,orsurgery.

DayIX:TodayIhadachancetogototheORagain.ButtodayIwasgoingtobeabletoseea
brainsurgery.WhatDr.Jeswanihadtodowasgetridoftheexcessbloodinthebrain.This
patienthadanhemeragesothedoctorhadtogointothebrainandgetapumpandtakeitoutof
thebrain.Whatsinterestingisthatthispumpstaysinthebrainforacoupleofweekssothe
bloodisbeingconstantlybeingdrained.

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DayX:Todaywasanotherclinicaldayintheoffice.Wekeptongettingnewpatients,whichcan
beapaininthebutt.Wegotthisonelady,whowasreferredbyherprimarycaredoctor,tocome
seeDr.Jeswani.Thisladyhadsomeslightdiskdegenerationso,weknewthattheywouldhave
somepainintheirlegs.Sowhenwewentinsidetheroom,thepatientwassayingthatshehad
painalloverherbody,andnotsomuchthelegs.Soweknewthatthisproblemthepatienthad
wasnotneurological,butinsteadhadtodowiththetheimmunesystem.Sowereferredthe
patienttoaimmunologist

DayXI:Todayapatientcameintotheoffice,withapatientwhowashavingalotofpaininthe
lowerbackoftheirbody.ThepatientwasnewsoDr.Jeswani,andIlookedovertheMRIwhich
wasdoneacoupleofweeksago.Thedoctor,andIconcludedthatthepatienthaddisk
degenerationintheirL1,andL4disks.Thispatientwashavingalotofpainintheirback,and
somelegsradiatingtothethighsofthepatient.Thispatientwasinalotofpainwhen
Dr.Jeswani,didhisconsult,andexamination.SoDr.Jeswani,referredthepatienttoapain
specialist,andtogetaEMGtestdonetoseewherethepainiscomingfrom.

DayXII:TodaywewenttotheVistaoffice,sinceDr.Jeswani,hasthreeoffices.Inthemorning
wemeetapatientwhowashavingtroublewiththeirneck.Theonlyproblemisthepatienthas
alreadyaspinalfusionintheC3,C4,C5disks.Thatsurgeryshouldfixedtheneckproblems,but
thebonesdidnotgrowbackcorrectly.Sothepatienthasbeengettingalotofmigrainetypeof
headache,andtheywerehavingalotneckpain.SoanotherDoctordidanepiduralshotintheir

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neck,butthepatientdidnotrespondwiththesteroids,sothedoctorwastalkingaboutanother
surgery.

DayXIII:TodaySCINSgotareallyinterestingpatientcomein.Wegotapatientwhohada
reallybadback.Thiswasbecausethepatienthadahunchback.Havingapatientlikethisis
reallyhighrisk,becausetheirarealotofcomplicationsinthesurgerybecausethespineisnot
normal.SoDr.Jeswani,toldtheoldmanwhathisoptionswere.Theycantrytoeasethepain,
becauseheisveryold,anddoingasurgeryisveryhardforapatientofthisage.

DayXIV:TodayIhadthechancetoseeanothersurgery.Igottoseeanervedecompressionat
thebottomoftheback.Thissurgeryisreallyinterestingbecauseitisnotareallylongsurgery
butyouhavetoworkunderamicroscope.Withthissurgerytheyjustcutalittlepieceofthe
herniateddisk.Youhavetodothissurgeryunderamicroscopesoyoucanseediskperfectly.

DayXV:TodayIwenttothePalomarMedicalCentertoobserveacase,thatDr.Jeswani,and
Dr.Sternperform.Theyhadtodoa2levelfusionontheL4,L5,andS1level.Whatinteresting
aboutthiscasewasthattherewasmedicalrepsinsideoftheORtestingouttheirproduct.What
theseproductsthattheywereusingwasimageguidance.Itsreallyinterestingtoseehowimage
guidanceworks,becausetheyhavetheselittlesignalsbeingsenttotheinstrumentstheyuse,and
itrecreatesitina3Dversionanditshowshowscrewswouldlooklikeinthespine.

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WorksCited
"AnteriorCordSyndrome|RadiologyReferenceArticle|Radiopaedia.org."
RadiopaediaBlog
RSS
.N.p.,n.d.Web.15Dec.2015.
<http://radiopaedia.org/articles/anteriorcordsyndrome>.
"BrownSequardSyndrome."
:Background,Anatomy,Pathophysiology
.N.p.,n.d.Web.15Dec.
2015.<http://emedicine.medscape.com/article/321652overview>.
"CentralCordSyndromeClinicalPresentation."
CentralCordSyndromeClinicalPresentation:
History,Physical,Causes
.N.p.,n.d.Web.15Dec.2015.
<http://emedicine.medscape.com/article/321907clinical>.
"IncompleteSpinalCordInjuries."
Spine
.N.p.,n.d.Web.15Dec.2015.
<http://www.orthobullets.com/spine/2008/incompletespinalcordinjuries>.
"NINDSCentralCordSyndromeInformationPage."
CentralCordSyndromeInformationPage:
NationalInstituteofNeurologicalDisordersandStroke(NINDS)
.N.p.,n.d.Web.15Dec.
2015.<http://www.ninds.nih.gov/disorders/central_cord/central_cord.htm>.
N.p.,n.d.Web.15Dec.2015.
<https://rarediseases.org/rarediseases/brownsequardsyndrome/>.
N.p.,n.d.Web.<https://rarediseases.org/rarediseases/brownsequardsyndrome/>.