The Significance of Upper Extremity Neuromonitoring Changes During Thoracolumbar Spine Surgery
Conclusions: UE SSEP signal changes during multilevel posterior thoracolumbar procedures are more likely to occur as the duration of the operation increases. The presence of UE signal changes does not coincide with clinically significant peripheral neuropathies. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Blood Loss Trends and Financial Implications in Adolescent Idiopathic Scoliosis
Study Design: This was a retrospective cohort study. Objective: The primary goal was to evaluate risk factors related to increased blood loss in adolescent idiopathic surgery (AIS) surgery with the secondary goal being to evaluate the financial implications around the use of intraoperative cell salvage (ICS) and the routine preallocation of autogenous blood products. Summary of Background Data: Deformity correction for AIS is a complex procedure and can be associated with significant blood loss. Methods: A retrospective cohort study was conducted on consecutive patients between the ages of 10 and 18 years who un...
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Validation of the Fusion Risk Score for Thoracic and Lumbar Spine Fusion Procedures
Conclusions: This study validated the association between the FRS and complications in the first 90 days after thoracolumbar spinal fusion surgery on the basis of patient and surgery characteristics. It also predicts the risk of intensive care unit admission, operative time, blood loss, and hospital length of stay. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Population-based Risk Factors for the Development of Degenerative Disk Disease
Conclusions: Our research failed to show a clinical significance association between military duty assignment and DDD. However, we were able to identify a significant association between concomitant hip and knee osteoarthritis, obesity, diabetes, and tobacco dependency with the development of DDD. Level of Evidence: Level IV. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Is there a Correlation Between Degree of Radiologic Lumbar Spinal Stenosis and its Clinical Manifestation?
Conclusions: LSS is a clinicoradiologic syndrome with complex relationships between degree of radiologic stenosis disclosed by MRI and clinical manifestations. Neurological impairment in the lower extremities reflects the degree of morphologic LSS on MRI. This study did not identify any association between the degree of stenosis and functional disability, pain intensity, or walking capacity. Level of Evidence: Level II. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Motion Analysis in Lumbar Spinal Stenosis With Degenerative Spondylolisthesis: A Feasibility Study of the 3DCT Technique Comparing Laminectomy Versus Bilateral Laminotomy
Conclusions: The 3D computed tomography technique proved to be a feasible tool in the evaluation of segmental motion in this group of older patients. There was negligible increase in segmental motion after decompressive surgery. LE with removal of the midline structures did not create a greater instability compared with when these structures were preserved. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Retrospective Analysis of EMG-evoked Potentials in Cortical Bone Trajectory Pedicle Screws
Conclusions: tEMG testing is effective for medial breaches in CBT screws. In addition, there is evidence that bicortical placement of these screws causes lower stimulation values due to distal breach. Importantly, it seems that this is due in part to stimulation of the exiting nerve root at the level above. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Facet Joint Osteoarthritis Affects Spinal Segmental Motion in Degenerative Spondylolisthesis
Conclusions: In this study, progressive FJOA and larger segmental motion in the distance between the craniocaudal edges of the facet joints were found in the Sp group. We clarified for the first time that DS involves ligament laxity due to FJOA that affects spinal segmental motion in vivo. We consider that a treatment method based on FJOA would be useful for treating patients with DS. Level of Evidence: Level IV. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Preferences of Spine Surgeons With Regard to Management of Intraoperative Durotomy: A Survey of Current Management
The objective of this study was to determine spine surgeons’ preferences for the intraoperative and postoperative management of intraoperative durotomy (IDT) in decompression and spinal fusion surgeries. Summary of Background Data: Management guidelines for IDT remain elusive. Traditionally, management consists of intraoperative suturing and postoperative bed rest. However, preferences of North American spine surgeons may vary, particularly according to type of surgery. Materials and Methods: Spine surgeons of AO Spine North America (AOSNA) were surveyed online anonymously to determine which techniques they pre...
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

What are the Rates, Reasons, and Risk Factors of 90-day Hospital Readmission After Lumbar Discectomy?: An Institutional Experience
Conclusions: Incidental durotomy, younger age, and discharge to nursing facility were associated with higher risk of 90-day hospital readmission after lumbar discectomy. As compared with extensive spine procedures, patient comorbidity burden may not be as significant in predicting readmission after this relatively less invasive procedure. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Predictors and Long-term Outcome of Sexual Function After Surgical Treatment for Single-level Lumbar Disk Herniation Among Patients in a German Spine Center
Conclusions: Lumbar disk surgery has a positive effect on sexual function. The majority of patients returned to their normal sexual activities in long-term follow-up. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Recurrent Surgical Site Infections in the Spine After Treatment With the Vacuum-assisted Closure (VAC) System
Conclusions: Among spine surgery patients with a SSI treated with the VAC system, those factors which predispose a patient to develop a recurrent SSI remain unknown. Level of Study: Level IV. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Payor Reform Opportunities for Spine Surgery: Part III Population Health Programs and Converging Strategies
As the cost of health care continues to rise, government and commercial payors are implementing strategies as a means of reducing the overall expenditure of health care dollars. The largest savings will be not just in more cost-effective treatments but in strategies that can avoid the need for treatments in the first place. Although the savings from popular payor reform strategies like bundled payments are tied to the initiation of the clinical episode, population health programs utilize a variety of tactics to decrease the need for health care utilization overall. However, the payor reform landscape is seeing some converg...
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Business of Medicine Source Type: research

How to Write Effective Discussion and Conclusion Sections
Discussion section. A research study can ask a pressing question, have a meticulous methodology and report compelling results; however, without a thoughtful and well-informed analysis of the meaning of the study’s findings and their potential influence on the field, the paper will be uninteresting and weak. Thus, formulating an effective Discussion section is crucial to improving the likelihood of the study’s publication and its impact. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Research Methodology Source Type: research

Vertebral Augmentation is Superior to Nonoperative Care at Reducing Lower Back Pain for Symptomatic Osteoporotic Compression Fractures: A Meta-Analysis
This study’s goal was to (i) assess the clinical outcomes with and without vertebral augmentation (VA) for osteoporotic vertebral compression fractures (VCFs) with versus without correlating signs and symptoms; and (ii) acute (symptoms 6 mo). Summary of Background Data: Previously, a randomized controlled trial in the New England Journal of Medicine concluded that vertebroplasty for osteoporotic VCFs provided no clinical benefit over sham surgery. However, the VCFs examined had no clinical correlation with symptom, physical examination, or imaging (magnetic resonance imaging/bone scan) findings. Nonetheless...
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Systematic Review Source Type: research

Minimally Invasive Cervical Laminectomy for Cervical Spondylotic Myelopathy
Objective: Cervical spondylotic myelopathy is a common cause of neurological disability, especially in aging populations. There are several approaches to decompress the cervical spinal cord, including anterior cervical discectomy and fusion, corpectomy and fusion, arthroplasty, posterior cervical laminectomy with or without fusion, and laminoplasty. Less well described is minimally invasive cervical laminectomy. The authors report their technique and results for minimally invasive cervical laminectomy. Materials and Methods: The authors describe in detail their surgical technique and results of 30 consecutive cases. P...
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Surgical Technique Source Type: research

Strategies for the Prevention and Treatment of Surgical Site Infection in the Lumbar Spine
Surgical site infection (SSI) following spine surgery can be devastating for both the patient and the surgeon. It leads to significant morbidity and associated health care costs, from readmissions, reoperations, and subsequent poor clinical outcomes. Complications associated with SSI following spine surgery include pseudarthrosis, neurological deterioration, sepsis, and death. Its management can be very challenging. The diagnosis of SSI involves the interpretation of combined clinical, laboratory, and occasionally radiologic findings. Most infections can be treated with an appropriate course of antibiotics and bracing if r...
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Narrative Review Source Type: research

Is Anterior Cervical Discectomy and Fusion for ≥4 Levels Safe and Effective for the Treatment of Degenerative Cervical Disease?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2018 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

Patient-reported Allergies are Associated With Preoperative Psychological Distress and Less Satisfying Patient Experience in a Lumbar Spine Surgery Population
Conclusions: These findings highlight the potential utility of PRAs to help identify patients with psychological distress who are at risk for a poor experience of lumbar spine surgery. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

Spinal Cord Swelling After Surgery in Cervical Spondylotic Myelopathy: Relationship With Intramedullary Gd-DTPA Enhancement on MRI
Conclusions: Surgical outcomes of patients with postoperative swelling should be evaluated separately according to the presence or absence of intramedullary Gd-DTPA enhancement on MRI. Spinal cord swelling associated with intramedullary Gd-DTPA enhancement was indicative of poor prognosis. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

Comparison of Freehand Sagittal Trajectories for Inserting Pedicle Screws Between C7 and T5
Study Design: Anatomic study using computed tomographic scans. Objective: The purpose of this paper was to determine the trajectory of pedicle screw insertions, in regard to posterior bony landmarks encountered during standard posterior exposure of the spine between the seventh cervical (C7) and the fifth thoracic (T5) vertebrae, when lateral fluoroscopic and radiographic guidance may be obstructed by the scapula and shoulders. Summary of Background Data: Only a few studies have evaluated the intraoperative sagittal trajectory of pedicle screw insertion. Materials and Methods: We assessed 64 participants of a he...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

A Prospective Comparative Study in Skin Antiseptic Solutions for Posterior Spine Surgeries: Chlorhexidine-Gluconate Ethanol Versus Povidone-Iodine
Conclusions: While CHG-ethanol and PD-I were equally effective at eliminating the bacterial flora from the surgical site, CHG-ethanol showed a more favorable long-lasting effect for skin antisepsis in posterior spine surgeries. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

Comparison of Decompression, Decompression Plus Fusion, and Decompression Plus Stabilization for Degenerative Spondylolisthesis: A Prospective, Randomized Study
Conclusions: Additional instrumentation operation for low-grade ( (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

The Impact of Sarcopenia on Cervical Spine Sagittal Alignment After Cervical Laminoplasty
Study Design: This was a prospective follow-up study. Objective: The main objective of this study was to evaluate the effects of sarcopenia on the sagittal alignment of the cervical spine after cervical laminoplasty in order to investigate the relationship between sarcopenia and spinal malalignment. Summary of Background Data: Sarcopenia, a progressive and all over loss of skeletal muscle mass and strength associated with aging, has been reported to be related to spinal malalignment. The causes of poor surgical outcome after cervical laminoplasty have been examined in recent years, including the sagittal malalignme...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

Upper Instrumented Vertebrae Distal to T2 Leads to a Higher Incidence of Proximal Junctional Kyphosis During Growing-rod Treatment for Early Onset Scoliosis
Conclusions: The prevalence of PJK was 28% during growing-rod treatment in EOS. The independent risk factors for PJK were UIV distal to T2 and postoperative UTS>50 degrees. It is important for spine surgeons to recognize these risk factors when planning surgeries, and counseling patients and families about this possible complication. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

Modic Changes in the Lumbar Spine are Common Aging-related Degenerative Findings that Parallel With Disk Degeneration
Study Design: This is a cross-sectional study. Objective: To determine the prevalence and distribution patterns of Modic changes (MCs) in the lumbar spine and their associations with disk degeneration in mainland Chinese using a sample of general population. Summary of Background Data: Previous studies reported that the prevalence of MCs in Hong Kong Chinese was much lower than in other populations. Moreover, their associations with disk degeneration need further study. Materials and Methods: The study sample consisted of 442 subjects (53.6±14.9 y; range, 20–88 y) randomly selected fro...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Primary Research Source Type: research

A Paradigm Shift Toward Terminally Sterilized Devices
Given the complexity of the sterilization process, and the risk involved in absence of strict adherence to the protocol described by the medical device manufacturers, terminally sterilized devices are emerging and being promoted in the field of medical practices. The characteristics associated with conventional reprocessing are demanding logistics, costs of delay, operations and adverse events, and unacceptable liability. Demanding logistics were a result of decoupled staff between the operating room and sterilize processing department, understaffed and high-volume processing with an additional burden due to inventory mana...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Business of Medicine Source Type: research

Approaching Spine Research in an Outreach Setting: What Type of Infrastructure is Conducive for Conducting Research?
This article will describe what encompasses an ideal outreach program as it relates to spine, how to manage cost in an outreach setting, collection of outcome data, and maintaining long-term follow-up. As one of the criticisms of medical outreach is the relative paucity of outcome data, this article discusses methods to collect and report outcomes abroad. We also discuss the value of translating outcome questionnaires to different languages and cross-cultural comparisons. In addition, relatively rare pathologies are often seen with greater frequency abroad. These patients are ideally suited for a focused case series than c...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Research Methodology Source Type: research

The Outcomes of Posterior Arthrodesis for Atlantoaxial Subluxation in Down Syndrome Patients: A Meta-Analysis
Study Design: This is a meta-analysis. Objective: To establish rates of (1) neurological complications, (2) bony-related complications, (3) complications delaying recovery, (4) reoperation, and (5) fatalities following posterior cervical arthrodesis in Down syndrome (DS) patients with atlantoaxial subluxation. To determine if presenting symptoms had any relationship to postoperative complications. Summary of Background Data: Posterior arthrodesis is commonly utilized to correct cervical instability secondary to atlantoaxial instability in DS patients. However, there has never been a global evaluation of postoperati...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Systematic Review Source Type: research

Fluoroscopically Guided Lumbar Transforaminal Epidural Steroid Injection: Procedural Technique
This article details proper equipment and medications, patient positioning and set-up, step-by-step instructions for multiplanar fluoroscopic visualization, needle advancement and medication instillation, and postoperative management. Pearls and pitfalls are also discussed. In addition, an instructional procedure video accompanies this paper. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Surgical Technique Source Type: research

Use of an Alternative Surgical Corridor in Oblique Lateral Interbody Fusion at the L5–S1 Segment: A Technical Report
Conclusions: When the central approach to the L5–S1 disk space poses a risk of vascular or superior hypogastric plexus injury, use of a lateral approach external to the left iliac vessels can be an alternative method to perform OLIF L5–S1. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Surgical Technique Source Type: research

Endoscopic Endonasal Approach to the Upper Cervical Spine for Decompression of the Cervicomedullary Junction Following Occipitocervical Fusion
In this report, we present a case of a patient with type 1 Chiari malformation with persistent symptoms despite adequate posterior decompression through suboccipital craniectomy and C1 laminectomy. A retroflexed odontoid and dorsal clival bone lip contributed to persistent cervicomedullary compression. To address this, we performed a 2-stage procedure: an occiput-to-C4 fusion followed by endoscopic endonasal approach for dorsal clivusectomy, C1 anterior arch resection, and odontoidectomy. In the associated video, Supplemental Digital Content 1 (http://links.lww.com/CLINSPINE/A52), we demonstrate the step-by-step approach f...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Surgical Technique Source Type: research

Atlas Fractures: Diagnosis, Current Treatment Recommendations, and Implications for Elderly Patients
Fractures of the C1 vertebrae (atlas) are commonly the result of falls and other trauma, which cause hyperextension, or axial compression of the cervical spine. Although historically thought as a benign injury with lower neurological risks, current data suggests that this may not hold true for geriatric patients (aged 65 y and older) who may be predisposed to these fractures even after lower-energy trauma such as ground-level falls. Advancements in orthopedic trauma care has increased our diagnostic abilities to identify and manage patients with C1 fractures and other upper cervical spine trauma. However, there are ...
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Narrative Review Source Type: research

Is Structural Allograft Superior to Synthetic Graft Substitute in Anterior Cervical Discectomy and Fusion?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

Is it Safe to Use Synthetic Grafts in Pyogenic Vertebral Osteodiskitis When Surgical Debridement is Required?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 31, 2018 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

Left Ventricular Mechanics Assessed by 2-dimensional Speckle Tracking Echocardiography in Children and Adolescents with Idiopathic Scoliosis: Errata
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Errata Source Type: research

Preoperative Risk Factors for Recurrent Lumbar Disk Herniation in L5–S1: Errata
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Errata Source Type: research

Novel Placement of Cortical Bone Trajectory Screws in the Lumbar Spine: A Radiographic and Cadaveric Study
Conclusions: Parameters of the actual CBT screw are slightly larger than the optimal trajectory measurements. The CAs and LAs are ∼25–30 and 10–16 degrees, respectively. L1 and L2 should be given considerable attention when using the CBT technique. And the trajectory measurements can only be used as a guide in clinical practice. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Primary Research Source Type: research

Spinopelvic Alignment in Subjects With Down Syndrome
Study Design: This was a cross-sectional study. Objective: The aim of this study was to describe the spinopelvic alignment of subjects with Down syndrome (DS). Summary of Background Data: Subjects with DS are known to suffer from a large prevalence of scoliosis. While scoliosis is known to significantly affect postural alignment, there are currently no studies on the spinopelvic alignment of subjects with DS. Materials and Methods: In total, 41 subjects (28 female subjects and 13 male subjects) with DS, age and sex-matched to 41 asymptomatic subjects, underwent biplanar x-rays with 3-dimensional reconstructions ...
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Primary Research Source Type: research

Outcomes in Thoracolumbar Burst Fractures With a Thoracolumbar Injury Classification Score (TLICS) of 4 Treated With Surgery Versus Initial Conservative Management
Conclusions: This is one of the largest studies examining TLICS 4 burst fracture patients, adjusting for both clinical and radiologic confounders and reporting patient outcomes with minimum 6-month follow-up. No differences were found in outcomes between patients treated either surgically or nonsurgically. Studies focusing on early postoperative differences or cost-effectiveness might help in decision making. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Primary Research Source Type: research

Chondrosarcoma of the Osseous Spine Treated by Surgery With or Without Radiotherapy: A Propensity Score Matched and Grade/Stage-stratified Study
Study Design: This was a longitudinal cohort study. Objective: The main objective of this study was to investigate the outcomes of surgery with or without radiotherapy during treatment of patients with chondrosarcoma of the osseous spine. Summary of Background Data: Chondrosarcoma is a primary spinal malignant tumor; chemotherapy and radiotherapy (RT) are generally unsuccessful, and thus, the main treatment of choice is complete en bloc resection. However, even with complete resection, these patients still have a significant rate of recurrence, morbidity, and mortality. Although there have been reports that the add...
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Primary Research Source Type: research

Instrumented Minimally Invasive Spinal-Transforaminal Lumbar Interbody Fusion (MIS-TLIF): Minimum 5-Year Follow-Up With Clinical and Radiologic Outcomes
Study Design: A retrospective study. Objective: To determine the clinical and radiologic outcomes of the long-term results of instrumented minimally invasive spinal-transforaminal lumbar interbody fusion (MIS-TLIF) in unstable, single-level, low-grade, isthmic spondylolisthesis (IS) or degenerative spondylosis (DS) including degenerative spondylolisthesis, foraminal stenosis with central stenosis, degenerative disk disease, and recurrent disk herniation. Summary of Background Data: MIS-TLIF is a common surgical procedure to treat lumbar spondylolisthesis. However, there are no studies that have documented the long-...
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Primary Research Source Type: research

Association Between Lumbar Spinal Degeneration and Anatomic Pelvic Parameters
The objective was to prove the association between anatomic pelvis parameters and specific types of lumbar spinal degeneration. Summary of Background Data: Different spinopelvic sagittal profile types are suggested to be associated with specific degenerative lumbar spine pathologies. Because pelvic morphology plays a key role defining the spinal shape as well as its load and function it thereby potentially predisposes the development of spinal degeneration. Materials and Methods: Patients with symptomatic lumbar spinal degeneration who were surgically treated in 2 spine departments from March 2011 until August 2016 w...
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Primary Research Source Type: research

Payor Reform Opportunities for Spine Surgery: Part II The Potential Emergence of Population Health
The pressures on spine surgery to adopt value-based reimbursement models are being seen in the increased implementation of bundled payment strategies. Given that bundled payment models typically link payments to the initiation of the surgical episode in question, despite their potential cost-saving attributes, financial incentives remain tied to the volume of services being provided. As payors and policy makers look to find savings by focusing on waste and variation of care, more comprehensive models such population health strategies are now being develop and deployed. The clinical delivery and cost variation currently see...
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Business of Medicine Source Type: research

Clinical Comparison of Surgical Constructs for Anterior Cervical Corpectomy and Fusion in Patients With Cervical Spondylotic Myelopathy or Ossified Posterior Longitudinal Ligament: A Systematic Review and Meta-Analysis
Conclusions: ACCF is a common surgical option for CM, despite carrying certain risks expected of any anterior cervical approach. Several constructs are available for ACCF, all with variable clinical and radiographic outcomes. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Systematic Review Source Type: research

Combining Bilateral Magnetically Controlled Implants Inserted Parallel to the Spine With Rib to Pelvis Fixation: Surgical Technique and Early Results
Spine-based fixation of magnetically controlled lengthening devices has been successfully performed for children with early-onset scoliosis. However, spinal manipulation may lead to ossifications, stiffness, and autofusion as previously described. To avoid these problems, a surgical technique combining bilateral externally controlled magnetic device implantation with a rib cradle and pelvic hook fixation was introduced by us in 2011. By using a bilateral single-rib or double-rib cradle fixation and a pelvic hook, the magnetic device is percutaneously inserted. The spine corrects indirectly without further manipulation. In ...
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Surgical Technique Source Type: research

Postoperative Infection in Patients Undergoing Posterior Lumbosacral Spinal Surgery: A Pictorial Guide for Diagnosis and Early Treatment
Surgical site infections after posterior spinal surgery may lead to spondylodiscitis, pseudarthrosis, correction loss, adverse neurological sequelae, sepsis, and poor outcomes if not treated immediately. Infection rates vary depending on the type and extent of operative procedures, use of instrumentation, and patients’ risk factors. Image evaluation is crucial for early diagnosis and should be complementary to clinical routes, laboratory survey, and treatment timing. Magnetic resonance imaging detects early inflammatory infiltration into the vertebrae and soft tissues, including hyperemic changes of edematous marrow,...
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Narrative Review Source Type: research

Should Nonsteroidal Anti-inflammatory Drugs be Contraindicated in the Perioperative Period After Spinal Fusion Surgery?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - June 29, 2018 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

The Prevalence of Incidental and Symptomatic Lumbar Synovial Facet Cysts
Study Design: This was a retrospective cohort study from 2 affiliated tertiary care referral centers for spine disease. Objective: The purpose of this article was to assess the prevalence of incidental (ie, asymptomatic) and symptomatic lumbar synovial facet cysts on magnetic resonance imaging. Secondarily, we assessed whether the prevalence increases with age. In addition, we assessed differences in patient and cyst characteristics between asymptomatic and symptomatic facet cysts. Summary of Background: The prevalence of symptomatic and asymptomatic synovial facet cysts in the lumbar spine has been incompletely es...
Source: Journal of Spinal Disorders and Techniques - June 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Does Day of Surgery Affect Hospital Length of Stay and Charges Following Minimally Invasive Transforaminal Lumbar Interbody Fusion?
Conclusions: The specific day on which a MIS TLIF procedure occurs is not associated with differences in length of inpatient stay or total hospital costs. This suggests that the postoperative course after MIS TLIF procedures is not affected by the differences in hospital staffing that occurs on the weekend compared with weekdays. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - June 1, 2018 Category: Surgery Tags: Primary Research Source Type: research