Smart glasses display device for fluoroscopically guided minimally invasive spinal instrumentation surgery: a preliminary study.
Abstract OBJECTIVE: Most surgeons are forced to turn their heads away from the surgical field to see various intraoperative support monitors. These movements may result in inconvenience to surgeons and lead to technical difficulties and potential errors. Wearable devices that can be attached to smart glasses or any glasses are novel visualization tools providing an alternative screen in front of the user's eyes, allowing surgeons to keep their attention focused on the operative task without taking their eyes off the surgical field. The aim of the present study was to examine the feasibility of using glasses equipp...
Source: Journal of Neurosurgery.Spine - October 13, 2020 Category: Neurosurgery Authors: Matsukawa K, Yato Y Tags: J Neurosurg Spine Source Type: research

Air migration through neural foramina in pneumorrachis: case illustration.
PMID: 33035997 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - October 9, 2020 Category: Neurosurgery Authors: Lasica N, Djilvesi D, Jelaca B, Vulekovic P Tags: J Neurosurg Spine Source Type: research

Obesity may be associated with adjacent-segment degeneration after single-level transforaminal lumbar interbody fusion in spinopelvic-mismatched patients with a minimum 2-year follow-up.
In this study, the authors' aim was to investigate whether obesity affects surgery rates for adjacent-segment degeneration (ASD) after transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis. METHODS: Patients who underwent single-level TLIF for spondylolisthesis at the University of California, San Francisco, from 2006 to 2016 were retrospectively analyzed. Inclusion criteria were a minimum 2-year follow-up, single-level TLIF, and degenerative lumbar spondylolisthesis. Exclusion criteria were trauma, tumor, infection, multilevel fusions, non-TLIF fusions, or less than a 2-year follow-up. Patient demograph...
Source: Journal of Neurosurgery.Spine - October 9, 2020 Category: Neurosurgery Authors: Duan PG, Mummaneni PV, Wang M, Chan AK, Li B, Mayer R, Berven SH, Chou D Tags: J Neurosurg Spine Source Type: research

A single-center retrospective analysis of 3- or 4-level anterior cervical discectomy and fusion: surgical outcomes in 66 patients.
Abstract OBJECTIVE: Anterior cervical discectomy and fusion (ACDF) is a safe and effective intervention to treat cervical spine pathology. Although these were originally performed as single-level procedures, multilevel ACDF has been performed for patients with extensive degenerative disc disease. To date, there is a paucity of data regarding outcomes related to ACDFs of 3 or more levels. The purpose of this study was to compare surgical outcomes of 3- and 4-level ACDF procedures. METHODS: The authors performed a retrospective chart review of patients who underwent 3- and 4-level ACDF at the University of Virg...
Source: Journal of Neurosurgery.Spine - October 9, 2020 Category: Neurosurgery Authors: McClure JJ, Desai BD, Shabo LM, Buell TJ, Yen CP, Smith JS, Shaffrey CI, Shaffrey ME, Buchholz AL Tags: J Neurosurg Spine Source Type: research

Comprehensive classification system for multirod constructs across three-column osteotomies: a reliability study.
CONCLUSIONS: MRCs across 3COs have variable rod configurations. Currently, no classification system or agreement on nomenclature exists to define the configuration of rods across 3COs. The authors present a new, comprehensive MRC classification system with good inter- and intraobserver reliability and a high degree of agreement that allows for a standardized description of MRCs across 3COs. PMID: 33036005 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - October 9, 2020 Category: Neurosurgery Authors: El Dafrawy MH, Adogwa O, Wegner AM, Pallotta NA, Kelly MP, Kebaish KM, Bridwell KH, Gupta MC Tags: J Neurosurg Spine Source Type: research

Does the Global Alignment and Proportion score overestimate mechanical complications after adult spinal deformity correction?
Abstract OBJECTIVE: The goal of this study was to validate the Global Alignment and Proportion (GAP) score in a cohort of patients undergoing adult spinal deformity (ASD) surgery. The GAP score is a novel measure that uses sagittal parameters relative to each patient's lumbosacral anatomy to predict mechanical complications after ASD surgery. External validation is required. METHODS: Adult ASD patients undergoing> 4 levels of posterior fusion with a minimum 2-year follow-up were included. Six-week postoperative standing radiographs were used to calculate the GAP score, classified into a spinopelvic state a...
Source: Journal of Neurosurgery.Spine - October 1, 2020 Category: Neurosurgery Authors: Baum GR, Ha AS, Cerpa M, Zuckerman SL, Lin JD, Menger RP, Osorio JA, Morr S, Leung E, Lehman RA, Sardar Z, Lenke LG Tags: J Neurosurg Spine Source Type: research

Consensus-based perioperative protocols during the COVID-19 pandemic.
os PV, Vail TP, Wienholz S, Gropper MA, Green A, Berger MS Abstract OBJECTIVE: During the COVID-19 pandemic, quaternary-care facilities continue to provide care for patients in need of urgent and emergent invasive procedures. Perioperative protocols are needed to streamline care for these patients notwithstanding capacity and resource constraints. METHODS: A multidisciplinary panel was assembled at the University of California, San Francisco, with 26 leaders across 10 academic departments, including 7 department chairpersons, the chief medical officer, the chief operating officer, infection control officers, ...
Source: Journal of Neurosurgery.Spine - October 1, 2020 Category: Neurosurgery Authors: Mummaneni PV, Burke JF, Chan AK, Sosa JA, Lobo EP, Mummaneni VP, Antrum S, Berven SH, Conte MS, Doernberg SB, Goldberg AN, Hess CP, Hetts SW, Josephson SA, Kohi MP, Ma CB, Mahadevan VS, Molinaro AM, Murr AH, Narayana S, Roberts JP, Stoller ML, Theodosopou Tags: J Neurosurg Spine Source Type: research

Economic analysis of 90-day return to the emergency room and readmission after elective lumbar spine surgery: a single-center analysis of 5444 patients.
CONCLUSIONS: Risk factors for 90-day ER visit and readmission after elective lumbar spine surgery include medical comorbidities and socioeconomic factors. Proper patient counseling, appropriate postoperative pain management, and optimization of modifiable risk factors prior to surgery are areas to focus future efforts to lower 90-day ER visits and readmissions and reduce healthcare costs. PMID: 33007753 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - October 1, 2020 Category: Neurosurgery Authors: Wiley MR, Carreon LY, Djurasovic M, Glassman SD, Khalil YH, Kannapel M, Gum JL Tags: J Neurosurg Spine Source Type: research

Odontoid screw placement for Anderson type II odontoid fractures: how do duration from injury to surgery and clinical and radiological factors influence the union rate? A multicenter retrospective study.
CONCLUSIONS: Although many factors have been reported as influencing the union rate after anterior odontoid screw placement for Anderson type II fractures, duration from injury to surgery> 7 days appears to be the most relevant, resulting in a 48 times higher risk for nonunion. Early surgery appears to be associated with better radiological outcomes, as reported by orthopedic surgeons in other districts. Prospective comparative clinical trials are needed to confirm these results. PMID: 33007754 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - October 1, 2020 Category: Neurosurgery Authors: Ricciardi L, Trungu S, Scerrati A, De Bonis P, Rustemi O, Mazzetto M, Lofrese G, Cultrera F, Barrey CY, Di Bartolomeo A, Piazza A, Miscusi M, Raco A Tags: J Neurosurg Spine Source Type: research

Spinal cord injury in the United States Army Special Forces.
CONCLUSIONS: A high number of SF soldiers self-reported an SCI diagnosis. Airborne operations landings were the leading cause of SCI, which coincided with warfare tactics employed during the Persian Gulf War, Operation Iraqi Freedom, and other conflicts. A majority of SCIs occurred while wearing headgear and no body armor, suggesting the need for improvements in protective equipment use and design. The low rate of medevac rescue for these injuries may suggest that medical rescue was not attainable at the time or that certain SCIs were deemed minor at the time of injury. PMID: 32977307 [PubMed - as supplied by publishe...
Source: Journal of Neurosurgery.Spine - September 24, 2020 Category: Neurosurgery Authors: Kessler RA, Bhammar A, Lakomkin N, Shrivastava RK, Rasouli JJ, Steinberger J, Bederson J, Hadjipanayis CG, Benzil DL Tags: J Neurosurg Spine Source Type: research

Long-term impact of obesity on patient-reported outcomes and patient satisfaction after lumbar spine surgery: an observational study.
This study aimed to examine the differences in patient-reported outcomes over the course of 12 and 24 months among BMI classifications of patients who underwent lumbar surgery. METHODS: A search was performed using the Quality Outcomes Database (QOD) Spine Registry from 2012 to 2018 to identify patients who underwent lumbar surgery and had either a 12- or 24-month follow-up. Patients were categorized based on their BMI as normal weight (≤ 25 kg/m2), overweight (25-30 kg/m2), obese (30-40 kg/m2), and morbidly obese (> 40 kg/m2). Outcomes included the Oswestry Disability Index (ODI) and the visual analog scale (VA...
Source: Journal of Neurosurgery.Spine - September 24, 2020 Category: Neurosurgery Authors: Park C, Garcia AN, Cook C, Shaffrey CI, Gottfried ON Tags: J Neurosurg Spine Source Type: research

Reference accuracy in spine surgery.
CONCLUSIONS: In order to advance medical treatment and patient care in spine surgery, detailed documentation and attention to detail are necessary. The results from this study illustrate that improved reference accuracy is required. PMID: 32977312 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - September 24, 2020 Category: Neurosurgery Authors: Montenegro TS, Hines K, Partyka PP, Harrop J Tags: J Neurosurg Spine Source Type: research

Omovertebral bone causing traumatic compression of the cervical spinal cord and acute neurological deficits in a patient with Sprengel's deformity and Klippel-Feil syndrome: case report.
Abstract The presence of an omovertebral bone with Sprengel's deformity and Klippel-Feil syndrome is a complex congenital anomaly that is not well understood. It most commonly manifests as cosmetic deformity, limited range of motion, and functional disability, although there are reports of the insidious development of cervical myelopathy. In this paper, the authors present the case of a 49-year-old man with acute neurological deficits after a low-energy mechanism of traumatic spinal cord compression, resulting from an impinging omovertebral bone through a traumatic laminar defect. The patient underwent resection o...
Source: Journal of Neurosurgery.Spine - September 24, 2020 Category: Neurosurgery Authors: Pompliano M, Changoor S, Mease S, Emami C, Sinha K, Hwang KS Tags: J Neurosurg Spine Source Type: research

Letter to the Editor. Alternative to the operating microscope.
PMID: 32947253 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - September 17, 2020 Category: Neurosurgery Authors: Garg K, Singh M Tags: J Neurosurg Spine Source Type: research

Development and validation of a clinical prediction score for poor postoperative pain control following elective spine surgery.
CONCLUSIONS: Inadequate pain control is common after spine surgery. The internally validated CAPPS score based on 7 easily acquired variables accurately predicted the probability of experiencing poorly controlled pain after spine surgery. PMID: 32932227 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - September 14, 2020 Category: Neurosurgery Authors: Yang MMH, Riva-Cambrin J, Cunningham J, Jetté N, Sajobi TT, Soroceanu A, Lewkonia P, Jacobs WB, Casha S Tags: J Neurosurg Spine Source Type: research

Editorial. Postoperative pain control after spinal surgery: an opportunity.
PMID: 32932228 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - September 14, 2020 Category: Neurosurgery Authors: Ghogawala Z Tags: J Neurosurg Spine Source Type: research

Letter to the Editor. The role of unilateral pallidotomy in cervical dystonia.
PMID: 32916647 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - September 10, 2020 Category: Neurosurgery Authors: Samala R, Agrawal M, Garg K, Singh M Tags: J Neurosurg Spine Source Type: research

To operate, or not to operate? Narrative review of the role of survival predictors in patient selection for operative management of patients with metastatic spine disease.
Abstract Accurate prediction of patient survival is an essential component of the preoperative evaluation of patients with spinal metastases. Over the past quarter of a century, a number of predictors have been developed, although none have been accurate enough to be instituted as a staple of clinical practice. However, recently more comprehensive survival calculators have been published that make use of larger data sets and machine learning to predict postoperative survival among patients with spine metastases. Given the glut of calculators that have been published, the authors sought to perform a narrative revie...
Source: Journal of Neurosurgery.Spine - September 10, 2020 Category: Neurosurgery Authors: Pennington Z, Ehresman J, Cottrill E, Lubelski D, Lehner K, Feghali J, Ahmed AK, Schilling A, Sciubba DM Tags: J Neurosurg Spine Source Type: research

Factors related to postoperative coronal imbalance in adult lumbar scoliosis.
CONCLUSIONS: Postoperative CIB negatively impacted patients' HRQOL. An imbalanced correction ratio between the TL/L and LS curves may cause postoperative CIB. Therefore, adequate correction of the LS curve may prevent postoperative CIB. PMID: 32886910 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - September 3, 2020 Category: Neurosurgery Authors: Matsumura A, Namikawa T, Kato M, Hori Y, Hidaka N, Nakamura H Tags: J Neurosurg Spine Source Type: research

The effect of simulation training on resident proficiency in thoracolumbar pedicle screw placement using computer-assisted navigation.
Abstract OBJECTIVE: Residency work-hour restrictions necessitate efficient, reproducible training. Simulation training for spinal instrumentation placement shows significant benefit to learners' subjective and objective proficiency. Cadaveric laboratories are most effective but have high cost and low availability. The authors' goal was to create a low-cost, efficient, reproducible spinal instrumentation placement simulation curriculum for neurosurgery and orthopedic surgery residents using synthetic models and 3D computer-assisted navigation, assessing subjective and objective proficiency with placement of thoraco...
Source: Journal of Neurosurgery.Spine - September 3, 2020 Category: Neurosurgery Authors: Gardeck AM, Pu X, Yang Q, Polly DW, Jones KE Tags: J Neurosurg Spine Source Type: research

Health-related quality-of-life improvement with lumbar fusion in patients with lower-extremity arthritis.
CONCLUSIONS: The presence of lower-extremity arthritis does not adversely affect the results of lumbar fusion in properly selected patients. Patients with lower-extremity arthritis who undergo lumbar fusion can achieve meaningful improvement in PROs similar to patients without arthritis. PMID: 32886920 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - September 3, 2020 Category: Neurosurgery Authors: Djurasovic M, Glassman S, Gum JL, Crawford CH, Owens RK, Carreon LY Tags: J Neurosurg Spine Source Type: research

Early fixation of traumatic spinal fractures and the reduction of complications in the absence of neurological injury: a retrospective cohort study from the American College of Surgeons Trauma Quality Improvement Program.
CONCLUSIONS: In the absence of clear contraindications, surgeons should strive to stabilize traumatic spinal fractures without SCI within 24 hours. Early fixation can be expected to reduce major complications by 25%-30%. PMID: 32858512 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 27, 2020 Category: Neurosurgery Authors: Guttman MP, Larouche J, Lyons F, Nathens AB Tags: J Neurosurg Spine Source Type: research

An analysis of preoperative shoulder and neck balance and surgical outcome in 111 adolescent idiopathic scoliosis patients with two subtypes of Lenke 1 curves.
The objective of this retrospective study was to identify differences in preoperative shoulder balance and to report the surgical outcome of two subtypes of Lenke 1 curves (flexible vs stiff) in patients with adolescent idiopathic scoliosis (AIS). METHODS: The authors grouped patients' curves as Lenke 1-ve (flexible) when their preoperative proximal thoracic side bending (PTSB) Cobb angle was
Source: Journal of Neurosurgery.Spine - August 27, 2020 Category: Neurosurgery Authors: Wei Chan CY, Chiu CK, Ng YH, Goh SH, Ler XY, Ng SJ, Chian XH, Tan PH, Kwan MK Tags: J Neurosurg Spine Source Type: research

Noninvasive patient tracker mask for spinal 3D navigation: does the required large-volume 3D scan involve a considerably increased radiation exposure?
Abstract OBJECTIVE: Intraoperative 3D imaging and navigation is increasingly used for minimally invasive spine surgery. A novel, noninvasive patient tracker that is adhered as a mask on the skin for 3D navigation necessitates a larger intraoperative 3D image set for appropriate referencing. This enlarged 3D image data set can be acquired by a state-of-the-art 3D C-arm device that is equipped with a large flat-panel detector. However, the presumably associated higher radiation exposure to the patient has essentially not yet been investigated and is therefore the objective of this study. METHODS: Patients were ...
Source: Journal of Neurosurgery.Spine - August 27, 2020 Category: Neurosurgery Authors: Klingler JH, Hubbe U, Scholz C, Volz F, Hohenhaus M, Vasilikos I, Masalha W, Watzlawick R, Naseri Y Tags: J Neurosurg Spine Source Type: research

Surgical management of atlantoaxial dislocation and cervical spinal cord injury in craniopagus twins.
Abstract A case of cervical spinal cord injury in 12-year-old angular craniopagus twins is presented, with a description of the planning and execution of surgical treatment along with subsequent clinical outcome. The injury occurred following a fall from a standing position, resulting in quadriparesis in one of the twins. Imaging revealed severe craniocervical stenosis resulting from a C1-2 dislocation, and T2-weighted hyperintensity of the cervical spinal cord. After custom halo fixation was obtained, a posterior approach was utilized to decompress and instrument the occiput, cervical, and upper thoracic spine wi...
Source: Journal of Neurosurgery.Spine - August 27, 2020 Category: Neurosurgery Authors: Wemhoff MP, Swong K, Li D, Mugve N, Gramlich LA, Nockels RP Tags: J Neurosurg Spine Source Type: research

Accuracy of fluoroscopic guidance with the coaxial view of the pedicle for percutaneous insertion of lumbar pedicle screws and risk factors for pedicle breach.
CONCLUSIONS: Percutaneous pedicle screw placement using the coaxial fluoroscopic view of the pedicle carries a low risk of superior facet violation. The screws should be placed carefully considering the level and side of insertion, canal shape, and pedicle angle. PMID: 32858519 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 27, 2020 Category: Neurosurgery Authors: Murata K, Fujibayashi S, Otsuki B, Shimizu T, Masamoto K, Matsuda S Tags: J Neurosurg Spine Source Type: research

Publication rate of abstracts presented at the annual meetings of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves.
The objective of this study was to determine the publication rate of abstracts presented at the annual meetings of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves (Spine Summit). METHODS: The authors used a search algorithm in PubMed to determine the publication rate of abstracts presented at the Spine Summit from 2007 to 2012. The variables assessed were presentation modality, topic, meeting year, publication year, destiny journal and its 5-year impact factor (IF), country, and citation count (retrieved from the Scopus database). RESULTS: One thousand four hundred thirty-six abstracts were a...
Source: Journal of Neurosurgery.Spine - August 20, 2020 Category: Neurosurgery Authors: Ramos MB, Matté Dagostini C, Rabau O, Navarro-Ramirez R, Ouellet JA, Falavigna A, Teles AR Tags: J Neurosurg Spine Source Type: research

A short-segment fusion strategy using a wide-foot-plate expandable cage for vertebral pseudarthrosis after an osteoporotic vertebral fracture.
CONCLUSIONS: This short-segment fusion procedure is relatively minimally invasive, and local reconstruction and bone fusion have been achieved. This procedure is considered to be attempted for the surgical treatment of osteoporotic vertebral pseudarthrosis after OVF. PMID: 32823261 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 20, 2020 Category: Neurosurgery Authors: Taiji R, Takami M, Yukawa Y, Hashizume H, Minamide A, Nakagawa Y, Nishi H, Iwasaki H, Tsutsui S, Okada M, Okada S, Teraguchi M, Murata S, Kozaki T, Yamada H Tags: J Neurosurg Spine Source Type: research

The Institute for Healthcare Improvement-NeuroPoint Alliance collaboration to decrease length of stay and readmission after lumbar spine fusion: using national registries to design quality improvement protocols.
Abstract OBJECTIVE: National databases collect large amounts of clinical information, yet application of these data can be challenging. The authors present the NeuroPoint Alliance and Institute for Healthcare Improvement (NPA-IHI) program as a novel attempt to create a quality improvement (QI) tool informed through registry data to improve the quality of care delivered. Reducing the length of stay (LOS) and readmission after elective lumbar fusion was chosen as the pilot module. METHODS: The NPA-IHI program prospectively enrolled patients undergoing elective 1- to 3-level lumbar fusions across 8 institutions....
Source: Journal of Neurosurgery.Spine - August 20, 2020 Category: Neurosurgery Authors: Zuckerman SL, Devin CJ, Rossi V, Chotai S, Dyer EH, Knightly JJ, Potts EA, Foley KT, Bisson EF, Glassman SD, Mummaneni PV, Bydon M, Asher AL Tags: J Neurosurg Spine Source Type: research

Neurological events due to pedicle screw malpositioning with lateral fluoroscopy-guided pedicle screw insertion.
CONCLUSIONS: Lateral fluoroscopy-assisted lumbosacral screw placement results in low rates of novel postoperative neurological events caused by screw malposition. In the majority of patients suffering from novel postoperative neurological events, these events could not be attributed to screw malpositioning, but rather were due to postoperative neurapraxia of peripheral nerves, neuropathy, or intraoperative traction of nerve roots. PMID: 32823268 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 20, 2020 Category: Neurosurgery Authors: Caelers IJMH, Rijkers K, van Kuijk SMJ, van Santbrink H, de Bie RA, van Hemert WLW Tags: J Neurosurg Spine Source Type: research

Vertebral body fracture rates after stereotactic body radiation therapy compared with external-beam radiation therapy for metastatic spine tumors.
CONCLUSIONS: Patients with metastatic cancer undergoing SBRT had higher rates of vertebral body fractures compared with patients undergoing EBRT, and this difference held up after survival analysis. SBRT also had higher rates of initial local control than EBRT but this difference did not hold up after survival analysis, most likely because of a high percentage of radiosensitive tumors in the EBRT cohort. PMID: 32796141 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 13, 2020 Category: Neurosurgery Authors: Vargas E, Susko MS, Mummaneni PV, Braunstein SE, Chou D Tags: J Neurosurg Spine Source Type: research

Under-contouring of rods: a potential risk factor for proximal junctional kyphosis after posterior correction of Scheuermann kyphosis.
CONCLUSIONS: Under-contouring of the proximal part of the rods (lower than 10°) is a risk factor for PJK after posterior correction of SK. PMID: 32764172 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 6, 2020 Category: Neurosurgery Authors: Grelat M, Du CZ, Xu L, Sun X, Qiu Y Tags: J Neurosurg Spine Source Type: research

How do high preoperative pain scores impact the clinical course and outcomes for patients undergoing lumbar microdiscectomy?
Abstract OBJECTIVE: Preoperative pain assessment is often used to gauge the amount of disability in patients with lumbar disc herniation. How high preoperative pain scores impact the clinical course and outcomes of patients after lumbar microdiscectomy is not always clear. Here, the authors aimed to determine whether patients reporting higher preoperative pain scores have worse outcomes after lumbar microdiscectomy than those reporting lower preoperative scores. METHODS: The authors performed a retrospective review of patients with symptomatic lumbar disc herniations that had failed to improve with nonsurgica...
Source: Journal of Neurosurgery.Spine - August 6, 2020 Category: Neurosurgery Authors: Virk S, Vaishnav AS, Mok JK, McAnany S, Iyer S, Albert TJ, Gang CH, Qureshi SA Tags: J Neurosurg Spine Source Type: research

Microendoscopic decompression for lumbosacral foraminal stenosis: a novel surgical strategy based on anatomical considerations using 3D image fusion with MRI/CT.
Abstract OBJECTIVE: Persistent lumbar foraminal stenosis (LFS) is one of the most common reasons for poor postoperative outcomes and is a major contributor to "failed back surgery syndrome." The authors describe a new surgical strategy for LFS based on anatomical considerations using 3D image fusion with MRI/CT analysis. METHODS: A retrospective review was conducted on 78 consecutive patients surgically treated for LFS at the lumbosacral junction (2013-2017). The location and extent of stenosis, including the narrowest site and associated pathology (bone or soft tissue), were measured using 3D image...
Source: Journal of Neurosurgery.Spine - August 6, 2020 Category: Neurosurgery Authors: Murata S, Minamide A, Iwasaki H, Nakagawa Y, Hashizume H, Yukawa Y, Tsutsui S, Takami M, Okada M, Nagata K, Yoshida M, Schoenfeld AJ, Simpson AK, Yamada H Tags: J Neurosurg Spine Source Type: research

Impact of sufficient contact between the autograft and endplate soon after surgery to prevent nonunion at 12 months following posterior lumbar interbody fusion.
CONCLUSIONS: A lower occupancy rate of the autograft and the presence of a translucent zone between the autograft and endplate immediately after the surgery were associated with nonunion at 12 months after PLIF. It may be important to achieve sufficient contact between the autograft and endplate intraoperatively for osseous union enhancement and to avoid excessive absorption of the autograft. The achievement of complete intervertebral union may decrease the incidence of cage subsidence or screw loosening. PMID: 32764175 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 6, 2020 Category: Neurosurgery Authors: Ushirozako H, Hasegawa T, Ebata S, Ohba T, Oba H, Mukaiyama K, Shimizu S, Yamato Y, Ide K, Shibata Y, Ojima T, Takahashi J, Haro H, Matsuyama Y Tags: J Neurosurg Spine Source Type: research

Asymmetrical pedicle subtraction osteotomy for correction of concurrent sagittal-coronal imbalance in adult spinal deformity: a comparative analysis.
Abstract OBJECTIVE: Rigid multiplanar thoracolumbar adult spinal deformity (ASD) cases are challenging and many require a 3-column osteotomy (3CO), specifically asymmetrical pedicle subtraction osteotomy (APSO). The outcomes and additional risks of performing APSO for the correction of concurrent sagittal-coronal deformity have yet to be adequately studied. METHODS: The authors performed a retrospective review of all ASD patients who underwent 3CO during the period from 2006 to 2019. All cases involved either isolated sagittal deformity (patients underwent standard PSO) or concurrent sagittal-coronal deformit...
Source: Journal of Neurosurgery.Spine - August 6, 2020 Category: Neurosurgery Authors: Lau D, Haddad AF, Deviren V, Ames CP Tags: J Neurosurg Spine Source Type: research

Evaluation of the 6-minute walking test as a smartphone app-based self-measurement of objective functional impairment in patients with lumbar degenerative disc disease.
CONCLUSIONS: The smartphone app-based self-measurement of the 6WT is a convenient, reliable, and valid way to determine OFI in patients with lumbar DDD. The 6WT app facilitates the digital evaluation and monitoring of patients with lumbar DDD. PMID: 32764182 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - August 6, 2020 Category: Neurosurgery Authors: Maldaner N, Sosnova M, Zeitlberger AM, Ziga M, Gautschi OP, Regli L, Weyerbrock A, Stienen MN, International 6WT Study Group Tags: J Neurosurg Spine Source Type: research

Residual numbness of the upper extremity after cervical surgery in patients with cervical spondylotic myelopathy.
Abstract OBJECTIVE: Although numbness is one of the chief complaints of patients with cervical spondylotic myelopathy (CSM), preoperative factors relating to residual numbness of the upper extremity (UE) and impact of the outcomes on cervical surgery are not well established. The authors hypothesized that severe preoperative UE numbness could be a risk factor for residual UE numbness after surgery and that the residual UE numbness could have a negative impact on postoperative outcomes. Therefore, this study aimed to identify the preoperative factors that are predictive of residual UE numbness after cervical surger...
Source: Journal of Neurosurgery.Spine - July 30, 2020 Category: Neurosurgery Authors: Iwamae M, Suzuki A, Tamai K, Terai H, Hoshino M, Toyoda H, Takahashi S, Ohyama S, Hori Y, Yabu A, Nakamura H Tags: J Neurosurg Spine Source Type: research

Mechanical failure of the Mobi-C implant for artificial cervical disc replacement: report of 4 cases.
Abstract Cervical spondylosis is one of the most commonly treated conditions in neurosurgery. Increasingly, cervical disc replacement (CDR) has become an alternative to traditional arthrodesis, particularly when treating younger patients. Thus, surgeons continue to gain a greater understanding of short- and long-term complications of arthroplasty. Here, the authors present a series of 4 patients initially treated with Mobi-C artificial disc implants who developed postoperative neck pain. Dynamic imaging revealed segmental kyphosis at the level of the implant. All implants were locked in the flexion position, and a...
Source: Journal of Neurosurgery.Spine - July 30, 2020 Category: Neurosurgery Authors: DiCesare JAT, Tucker AM, Say I, Patel K, Lanman TH, Coufal FJ, Millard J, Deckey JE, Shetgeri S, McBride DQ Tags: J Neurosurg Spine Source Type: research

Pseudarthrosis in anterior cervical discectomy and fusion with a self-locking, stand-alone cage filled with hydroxyapatite: a retrospective study with clinical and radiological outcomes of 98 levels with a minimum 2-year follow-up.
Abstract OBJECTIVE: The goal of this study was to evaluate the incidence of pseudarthrosis after the treatment of cervical degenerative disc disease (CDDD) with anterior cervical discectomy and fusion (ACDF) in which self-locking, stand-alone intervertebral cages filled with hydroxyapatite were used. METHODS: The authors performed a retrospective cohort study of 49 patients who underwent 1- to 3-level ACDF with self-locking, stand-alone intervertebral cages without plates, with a minimum 2 years of follow-up. The following data were extracted from radiological and clinical charts: age, sex, time and type of p...
Source: Journal of Neurosurgery.Spine - July 30, 2020 Category: Neurosurgery Authors: Iunes EA, Barletta EA, Belsuzarri TAB, Onishi FJ, Aihara AY, Cavalheiro S, Joaquim AF Tags: J Neurosurg Spine Source Type: research

Drivers for nonhome discharge in a consecutive series of 1502 patients undergoing 1- or 2-level lumbar fusion.
Abstract OBJECTIVE: Unexpected nonhome discharge causes additional costs in the current reimbursement models, especially to the payor. Nonhome discharge is also related to longer length of hospital stay and therefore higher healthcare costs to society. With increasing demand for spine surgery, it is important to minimize costs by streamlining discharges and reducing length of hospital stay. Identifying factors associated with nonhome discharge can be useful for early intervention for discharge planning. The authors aimed to identify the drivers of nonhome discharge in patients undergoing 1- or 2-level instrumented...
Source: Journal of Neurosurgery.Spine - July 30, 2020 Category: Neurosurgery Authors: Ogura Y, Gum JL, Steele P, Crawford CH, Djurasovic M, Owens RK, Laratta JL, Brown M, Daniels C, Dimar JR, Glassman SD, Carreon LY Tags: J Neurosurg Spine Source Type: research

Patterns of neurological deficits and recovery of postoperative C5 nerve palsy.
Abstract OBJECTIVE: Paresis of the C5 nerve is a well-recognized complication of cervical spine surgery. Numerous studies have investigated its incidence and possible causes, but the specific pattern and character of neurological deficits, time course, and relationship to preoperative cord signal changes remain incompletely understood. METHODS: Records of patients undergoing cervical decompressive surgery for spondylosis, disc herniation, or ossification of the longitudinal ligament, including the C4-5 level, were reviewed from a 15-year period, identifying C5 palsy cases. Data collected included age, sex, di...
Source: Journal of Neurosurgery.Spine - July 30, 2020 Category: Neurosurgery Authors: Houten JK, Buksbaum JR, Collins MJ Tags: J Neurosurg Spine Source Type: research

Institutional databases may underestimate the risk factors for 30-day unplanned readmissions compared to national databases.
CONCLUSIONS: Overall, significant differences were seen among all 3 cohorts with regard to top predictors of 30-day unplanned readmissions following ACDF and PLF. The higher quantity of significant predictors found in the national databases may suggest that looking at single-institution series for such analyses may result in underestimation of important variables affecting patient outcomes, and that big data may be helpful in addressing this concern. PMID: 32736365 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - July 30, 2020 Category: Neurosurgery Authors: Kurian SJ, Yolcu YU, Zreik J, Alvi MA, Freedman BA, Bydon M Tags: J Neurosurg Spine Source Type: research

Predictors of 2-year reoperation in Medicare patients undergoing primary thoracolumbar deformity surgery.
Abstract OBJECTIVE: This was a retrospective cohort study in which the authors used a nationally representative administrative database. Their goal was to identify the risk factors for reoperation in Medicare patients undergoing primary thoracolumbar adult spinal deformity (ASD) surgery. Previous literature reports estimate that 20% of patients undergoing thoracolumbar ASD correction undergo revision surgery within 2 years. Most published data discuss risk factors for revision surgery in the general population, but these have not been explored specifically in the Medicare population. METHODS: Using the Market...
Source: Journal of Neurosurgery.Spine - July 23, 2020 Category: Neurosurgery Authors: Varshneya K, Jokhai RT, Fatemi P, Stienen MN, Medress ZA, Ho AL, Ratliff JK, Veeravagu A Tags: J Neurosurg Spine Source Type: research

Hypofractionated spinal stereotactic body radiation therapy for high-grade epidural disease.
CONCLUSIONS: In carefully selected patients, treatment of grade 2 ESCC disease with hypofractionated SBRT alone offers a 1-year cumulative incidence of LRF similar to that in low-grade ESCC and postseparation surgery adjuvant hypofractionated SBRT. Use of SBRT alone has a favorable safety profile and a low cumulative incidence of progressive disease requiring open surgical intervention (14.5%). PMID: 32707555 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - July 23, 2020 Category: Neurosurgery Authors: Rothrock RJ, Li Y, Lis E, Lobaugh S, Zhang Z, McCann P, Santos PMG, Yang TJ, Laufer I, Bilsky MH, Schmitt A, Yamada Y, Higginson DS Tags: J Neurosurg Spine Source Type: research

Effects of preoperative obesity and psychiatric comorbidities on minimum clinically important differences for lumbar fusion in grade 1 degenerative spondylolisthesis: analysis from the prospective Quality Outcomes Database registry.
CONCLUSIONS: MCID thresholds were similar for ODI, EQ-5D, NRS-BP, and NRS-LP in patients with and without preoperative diagnoses of anxiety or depression and obesity undergoing spinal fusion for grade 1 degenerative spondylolisthesis. Preoperative clinical and shared decision-making may be improved by understanding that preoperative medical comorbidities may not affect the way patients experience and assess important clinical changes postoperatively. PMID: 32707556 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - July 23, 2020 Category: Neurosurgery Authors: Laratta J, Carreon LY, Buchholz AL, Yew AY, Bisson EF, Mummaneni PV, Glassman SD Tags: J Neurosurg Spine Source Type: research

Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data.
CONCLUSIONS: Among the patients who were followed up for at least 10 years after CDR, the incidence of postoperative bone formation was relatively high. The study results indicate that the degree of degeneration in the target level before surgery has a positive correlation with the incidence of postoperative ossification. Rigorous indication criteria for postoperative ossification should be applied in patients for whom CDR may be a treatment option. PMID: 32679563 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - July 16, 2020 Category: Neurosurgery Authors: Zhou F, Li S, Zhao Y, Zhang Y, Ju KL, Zhang F, Pan S, Sun Y Tags: J Neurosurg Spine Source Type: research

A high-definition 3D exoscope as an alternative to the operating microscope in spinal microsurgery.
CONCLUSIONS: A 3D exoscope seems to be a safe alternative for common spinal procedures with the unique advantage of excellent comfort for the surgical team, but the drawback is the still slightly inferior visualization/illumination quality compared with the OM. PMID: 32650307 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - July 9, 2020 Category: Neurosurgery Authors: Siller S, Zoellner C, Fuetsch M, Trabold R, Tonn JC, Zausinger S Tags: J Neurosurg Spine Source Type: research

Editorial. Adult spinal deformity surgery: is there a need for a second attending?
PMID: 32650314 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)
Source: Journal of Neurosurgery.Spine - July 9, 2020 Category: Neurosurgery Authors: Buell TJ, Smith JS Tags: J Neurosurg Spine Source Type: research

Single- versus dual-attending strategy for spinal deformity surgery: 2-year experience and systematic review of the literature.
Abstract OBJECTIVE: Adult spinal deformity (ASD) surgery is complex and associated with high morbidity and complication rates. There is growing evidence in the literature for the beneficial effects of an approach to surgery in which two attending physicians rather than a single attending physician perform surgery for and oversee the surgical care of a single patient in a dual-attending care model. The authors developed a dual-attending care collaboration in August 2017 in which a neurosurgeon and an orthopedic surgeon mutually operated on patients with ASD. METHODS: The authors recorded data for 2 years of ex...
Source: Journal of Neurosurgery.Spine - July 9, 2020 Category: Neurosurgery Authors: Cheng I, Stienen MN, Medress ZA, Varshneya K, Ho AL, Ratliff JK, Veeravagu A Tags: J Neurosurg Spine Source Type: research