✓Chordomas are locally invasive, malignant bone tumors that rarely occur in the cervical spine. En bloc resection or even fully resecting the tumor along its margin offers improved patient survival and a potential disease cure. Complete resection of tumors involving the upper cervical vertebrae requires a combined anterior–posterior approach but is complicated by the presence of vertebral arteries (VAs). In addition, reconstruction of the postresection defect may be prone to failure. The authors present a case of a chordoma involving the axis that was treated using a single-stage total intralesional C-2 spondylectomy with preservation of both VAs because the patient did not tolerate a preoperative occlusion test. A three-column reconstruction technique is also presented.

Chordomas are locally invasive, malignant bone tumors that rarely occur in the cervical spine. En bloc resection or even fully resecting the tumor along its margin offers improved patient survival and a potential disease cure. Complete resection of tumors involving the upper cervical vertebrae requires a combined anterior-posterior approach but is complicated by the presence of vertebral arteries (VAs). In addition, reconstruction of the postresection defect may be prone to failure. The authors present a case of a chordoma involving the axis that was treated using a single-stage total intralesional C-2 spondylectomy with preservation of both VAs because the patient did not tolerate a preoperative occlusion test. A three-column reconstruction technique is also presented.

The primary purpose of this study was to identify the training needs of state vocational rehabilitation counselors. One hundred and sixty-seven vocational rehabilitation counselors completed the Rehabilitation Counseling Knowledge Inventory (Linkowski et al., 1993). The self-reported need for training across 10 components of rehabilitation counseling is described. A secondary purpose was to compare the self-perceived training needs of a sample of state vocational rehabilitation counselors with the self-perceived training needs of certified rehabilitation counselors (CRCs; Szymanski, Linkowski, Leahy, Diamond, & Thoreson, 1993a). The current sample reported significantly higher ratings of the need for training in foundations of rehabilitation, individual counseling and development, and assessment, whereas the CRC sample reported higher needs for training in the area of workers' compensation, employer services, and technology. A third purpose was to evaluate the relationship between counselor demographic variables and training needs. The highest earned degree was a significant predictor of perceived training need in the areas of group and family issues, foundations of rehabilitation, research, and individual counseling and development.

Purpose: The purpose of this article was to gather descriptive data on the professional use of social media in public rehabilitation settings and to analyze existing social media policies in those agencies through content analysis.Methods: The authors sent a survey to all state administrators or directors of these agencies (N = 50) in the United States, requesting frequency and other descriptive information, plus a copy of their social media policies (if available). The available policies were reviewed using content analysis procedures.Results: The results showed that although the frequency of social media use was high, training and inclusion of ethics was low. Regarding policy, approximately 42% reported a lack of an existing policy, and 38% were unsure about having a policy guide. The analysis of the available policies yielded 11 themes around which these policies were organized.Discussion: The authors offer a discussion of these results and its implications for policy and practice as well as future research. These include the need for more comprehensive social media policy creation in agencies and the role of clinical supervisors in ensuring ethical practice.

This study tested an eight-factor model of client actions/decisions in terms of the extent to which professionals counseling persons with HIV/AIDS believed that those actions/decisions presented ethical dilemmas, and the frequency with which they encountered such actions. A confirmatory factor analysis lent initial support for the hypothetical eight-factor ethical-dilemma model for the ratings regarding the extent to which the participants believed those items constituted ethical dilemmas. Similar results were obtained for the frequency ratings, but in this case a second, competing model was equally plausible. Several significant predictors of participant ratings were found and are discussed.