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Among all research categories, fixation and fusion were the most common areas discussed. The screw-rod system described in the most-cited article (cited 823 times) appeared to be the most popular fixation method. EKI785 With the development of C1 and C2 screw technology, the screw-rod system is becoming increasingly popular. CONCLUSIONS The atlantoaxial spine surgery literature has grown continuously in recent years. The United States is the largest contributor in this field. Fixation and fusion are the most common areas, and fixation-related studies should be closely followed. The screw-rod fixation system is becoming increasingly popular. BACKGROUND Injury of the iliac vessels is a rare complication of lumbar spine surgery with potentially life-threatening consequences. We present 2 cases of iliac vessel injury that were treated with minimally invasive techniques. CASE DESCRIPTION The first case was a laceration of the common iliac artery during a simple L4-L5 discectomy in which the injured artery was secured by stent implantation. The second case was an example of injury to the left iliac common vessel leading to acute lower limb ischemia and arteriovenous fistula formation after lumbar spinal canal stenosis surgery. The patient was treated in 2 steps. First, a temporary femorofemoral bypass was implanted to revascularize the right lower limb. The second step involved stent implantation in the right common iliac artery to close the arteriovenous fistula. Both patients were treated without extensive laparotomy and had good clinical outcomes. CONCLUSIONS This case series emphasizes the benefit of quick minimally invasive vascular repair available in multidisciplinary centers. OBJECTIVE The risk for developing posttraumatic hydrocephalus (PTH) is higher when patients undergo decompressive craniectomy as part of their treatment. The purpose of this study is to determine the prevalence of PTH after decompressive craniectomy in pediatric patients and determine associated risk factors that may lead to PTH. METHODS A retrospective analysis was conducted by searching the Puerto Rico neurologic surgery database from 2010 to 2019. All pediatric patients (1-18 years old) at the University Pediatric Hospital of the Puerto Rico Medical Center who had traumatic brain injury and had a decompressive craniectomy were included in the study. Data were reviewed to determine if time to decompressive craniectomy, side of decompressive craniectomy, gender, mechanism of trauma, amount of subarachnoid hemorrhage, and time to cranioplasty were risk factors for the development of PTH. RESULTS Incidence of PTH after decompressive craniectomy was 21%. Neither gender, side of decompressive craniectomy, mechanism of trauma, amount of subarachnoid hemorrhage, time from trauma to decompressive craniectomy, nor cranioplasty intervention had statistical significance for developing PTH. Time from decompressive craniectomy to cranioplasty was significant for development of PTH. CONCLUSIONS Longer time to cranioplasty was associated with an increased likelihood of PTH. We recommend performing cranioplasty as soon as possible to reduce hydrocephalus development. BACKGROUND Elevation of bone for the treatment of depressed skull fractures overlying venous sinuses is rarely required or performed. The neurosurgical literature only describes a handful of cases of surgical intervention in which the posterior two-thirds of the superior sagittal sinus was involved. Clinical course is variable, signs and symptoms suggest increased intracranial pressure, and all conservative measures should be exhausted before proceeding with the surgical route. CASE DESCRIPTION A 27-year-old man presented with a self-inflicted gunshot wound to posterior head. On presentation, there were no neurologic complaints. On imaging, the bullet fragment was associated with a comminuted anteriorly displaced fracture over the torcula. Vessel imaging showed tapering of the superior sagittal sinus and transverse sinuses near the torcula, suggesting narrowing due to mass effect. The patient did not respond to initial conservative management and developed worsening diplopia and papilledema concerning for increased intracranial pressure. Occipital/suboccipital craniectomy was performed with elevation of depressed skull fracture, decompression of dural venous sinus, removal of bullet, and mesh cranioplasty. Repeat ophthalmology examination postoperatively showed improvement in optic disc edema and diplopia. CONSLUSIONS This case confirms that the approach of surgical management of superior sagittal venous sinus injuries associated with skull fractures described in the literature also can be used successfully for injuries over the torcula if conservative management does not help alleviate the symptoms and results in good outcome. It was felt that delayed surgery also plays an important role, as it gives time for scar tissue to form, which may help to protect the sinus from injury during surgery. OBJECTIVE The predictive ability of ECI and CCI have been compared in orthopaedic and gastrointestinal surgery, however their predictive ability for complications secondary to spine surgery and posterior cervical decompression and fusion (PCDF) specifically is understudied. This study examines the predictive ability of the Elixhauser Comorbidity Index (ECI) and Charlson Comorbidity Index (CCI) for complications and morbidity following PCDF. METHODS ECI and CCI were retrospectively computed for all PCDF cases in the National Inpatient Sample database from 2013 to 2014 and complications or morbidity were identified. C-statistics were used to analyze ECI and CCI predictive ability in a range of complications and compared to a base comorbidity model that included age, sex, race, and primary payer. RESULTS PCDF was performed in 46,700 hospitalizations between 2013 and 2014. The complications for which ECI was found to be a significantly better predictor included airway complications (69.16% superior to CCI), hemorrhagic anemia (79.04% superior), cardiac arrest (72.39% superior), pulmonary embolism (83.01% superior), sepsis (62.44% superior), septic shock (78.90% superior), UTI (63.53% superior), death (74.28% superior), any minor complication (75% superior), any major complication (133% superior), and any complication at all (63.72% superior). The complications for which neither the ECI Index nor the CCI proved superior were acute kidney injury, myocardial infarction, cerebrovascular accident, deep vein thrombosis, pneumonia, wound dehiscence, and superficial surgical site infection following PCDF. CONCLUSIONS ECI showed superior predictive ability to the CCI in predicting 8 of the 18 complications that were analyzed and inferior in none.