Sagittal Balance in Adolescent Idiopathic Scoliosis Managed With Intraoperative Skull Femoral Traction
Study Design: This is a retrospective cohort, single-center quality improvement study. Objectives: To evaluate the effect of the intraoperative skull femoral traction (IOSFT) on sagittal balance in posterior spinal instrumentation (PSI) to manage scoliosis. Summary of Background Data: IOSFT has been used routinely as an adjunct technique for facilitating PSI to manage scoliosis in our institution since 2010. Previous studies have raised concerns regarding the negative effect of IOSFT on lumbar lordosis. Materials and Methods: The medical records and radiographs of 113 patients with adolescent idiopathic scoliosi...
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Incidence of Fusion Across Total Disc Replacement With Heterotopic Ossification: Are Ball and Socket Disk Replacements Fusing With and Without Radiographic Evidence
Conclusion: In this study, we have demonstrated radiographic fusion anterior to the ball and socket TDR as well as the uncovertebral joint. We postulate that with the use of a mobile core disk there is an increased potential for fusion leading to a nonfunctional disk replacement. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Tranexamic Acid in Thoracic and Lumbar Fusions and Perioperative Blood Loss
This study was a retrospective cohort design. Objective: The objective of this study was to examine the impact of tranexamic acid (TXA) on total perioperative wound output following thoracic and lumbar spinal fusions. Summary of Background Data: TXA has been extensively studied with regard to intraoperative blood loss and transfusion rates. Few studies have looked specifically at the effect of TXA on postoperative drain output. Materials and Methods: We examined blood loss patterns in 617 consecutive adult patients undergoing lumbar and/or thoracic fusions at a single institution from January 2009 to 2016. These p...
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

The Variability of Lumbar Facet Joint Synovial Cyst Recurrence Requiring Revision Surgery After Decompression-only and Decompression/Fusion
Conclusions: Decompression and cyst excision was the more common surgical treatment of lumbar spinal synovial cysts compared with decompression/fusion procedure in our study. The rate of synovial cyst recurrence and revision surgery in patients undergoing index decompression was relatively low and comparable to current literature. Symptomatic improvement of patients undergoing decompression versus decompression/fusion was similar in our study. Although the fusion may be required for the extent of pathology or coexisting instability, decompression and excision of spinal synovial cysts provide durable, effective treatment ...
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Patient Activation is Not Associated With Postoperative Outcomes Following Anterior Cervical Discectomy and Fusion
Conclusions: Although PAM has been associated with better postoperative recovery in lumbar spine patients and other orthopedic surgeries, our investigation suggests that preoperative PAM assessments are not an effective method to predict postoperative outcomes following an ACDF. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Outcomes of an Intraoperative Povidone-Iodine Irrigation Protocol in Spinal Surgery for Surgical Site Infection Prevention
Conclusion: In this study, 90 seconds of 1% PVP-I pooling every 1.5 hours followed by saline irrigation demonstrated the effectiveness of our protocol for the prevention of postoperative deep SSI after spinal surgery. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Sex Differences on Postoperative Pain and Disability Following Minimally Invasive Lumbar Discectomy
Conclusions: Our study demonstrated that sex does not affect immediate postoperative pain, narcotic consumption, and long-term recovery following MIS LD. Female individuals demonstrated similar preoperative back and pain scores compared with male individuals but reported greater disability before surgery. However, both sexes experienced similar improvements in pain and disability at all follow-up time points through 12 months. The results of this study may enable providers to better counsel patients regarding the expected improvement in pain and disability. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

The Effect of Tobacco Use on Postoperative Pain Following Anterior Cervical Discectomy and Fusion
Conclusions: Our study suggests that tobacco use does not influence inpatient pain scores, narcotic consumption, and improvements in PROs following ACDF. As such, tobacco users and nonusers should receive similar postoperative pain management protocols following surgery. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Defining Instability in Degenerative Spondylolisthesis: Surgeon Views
Study Design: Surgeon survey. Objective: To examine factors influencing surgeons’ definition of instability in grade 1 degenerative spondylolisthesis (DS) and assess treatment preferences for both stable and unstable DS. Summary of Background Data: DS treatment options are broadly classified as decompression with or without fusion. In surgical decision-making, “instability” is frequently considered as a key factor. However, no consensus on the definition of instability exists. Methods: A survey was conducted to ascertain the minimum amounts of static translation, dynamic translation, and angula...
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Minimally Invasive Lateral Lumbar Interbody Fusion for Clinical Adjacent Segment Pathology: A Comparative Study With Conventional Posterior Lumbar Interbody Fusion
Conclusions: Hybrid surgery for clinical ASP has advantages of segmental coronal and sagittal correction, and indirect decompression compared with conventional posterior surgery. However, LLIF-related complications such as endplate fracture and lower leg symptoms also developed. LLIF should be performed considering advantages and approach-related complications for the clinical ASP. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Contained-Delivery Route and the Administration of Postoperative Steroids Following Anterior Cervical Spinal Fusion With Low-dose rhBMP-2 Reduces the Magnitude of Respiratory Compromise
Conclusions: This study provides evidence that a tapered dose of steroids and a contained delivery route significantly decreases postoperative respiratory compromise incidence and magnitude following anterior cervical spine fusion using low-dose rhBMP-2. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Does an Uninstrumented Level Increase the Rate of Revision Surgery in a Multilevel Posterior Cervical Decompression and Fusion?
Study Design: This was a retrospective cohort study. Objective: The goal of this study is to determine if skipping a single level affects the revision rate for patients undergoing multilevel posterior cervical decompression and fusion (PCDF). Summary of Background Data: A multilevel PCDF is a common procedure for patients with cervical spondylotic myelopathy. With advanced pathology, it can be difficult to safely place screw instrumentation at every level increasing the risk of intraoperative and perioperative morbidity. It is unclear whether skipping a level during PCDF affects fusion and revision rates. Patients...
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Utility of Patient-reported Symptoms and Health Conditions for Predicting Surgical Candidacy and Utilization of Surgery via an Outpatient Spine Clinic Nomogram
Conclusions: Our results suggest that the results of standard clinic intake questions, such as review of systems, medical history, and chief complaints, may be predictive of surgical candidacy before evaluation by a surgeon. The present pilot study suggests a preliminary algorithm that can be further validated and expanded upon to help decide on optimal patient referrals to spine surgery specialists. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Wrong Site Spine Surgery in the Veterans Administration
Conclusions: Wrong level surgery of the spine is a significant safety issue facing the field that continues to occur despite surgical teams following guidelines. As poor radiograph quality and interpretability were the most common root causes of these events, interventions aimed at optimizing image quality and accurate interpretation would be a logical first action. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Evaluating the Concurrent Validity of PROMIS Physical Function in Anterior Cervical Discectomy and Fusion
Conclusions: Patients undergoing a primary 1–3 level ACDF experience significant improvements in PROMIS PF scores at 12-week and 6-month follow-up. Furthermore, PROMIS PF exhibits strong correlations to NDI and SF-12 at all preoperative and postoperative time points. These results suggest that PROMIS PF accurately measures PF and may be used in lieu of legacy PF instruments for patients undergoing ACDF. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

PHQ-9 Score Predicts Postoperative Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion
This study evaluates if an association exists between preoperative depression and postoperative outcomes following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Summary of Background Data: Few studies have quantified preoperative depression symptoms using Patient Health Questionnaire-9 (PHQ-9) to predict postoperative outcomes after lumbar fusion, especially MIS TLIF. Methods: A surgical database of patients undergoing primary, single-level MIS TLIF was retrospectively reviewed. Patients were stratified by predefined preoperative PHQ-9 scores: no depression ( (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Impact of Sickle Cell Anemia on Inpatient Morbidity After Spinal Fusion
Study Design: A retrospective study. Objective: To determine the impact of sickle cell anemia on perioperative outcomes and resource utilization in elective spinal fusion surgery. Summary of Background Data: Sickle cell anemia has been identified as an important surgical risk factor in otolaryngology, cardiothoracic surgery, general surgery, and total joint arthroplasty. However, the impact of sickle cell anemia on elective spine surgery is unknown. Methods: Hospitalizations for elective spinal fusion surgery between the years of 2001–2014 from the US National Inpatient Sample were identified using ICD-9-C...
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

30-Day Postoperative Morbidity and Readmission Following Revision Anterior Cervical Discectomy and Fusion (ACDF)
Conclusions: Using a national surgical database, the study is the first of its kind to report rates and risk factors associated with adverse outcomes after ACDFs. Providers should understand the need of preoperative risk stratification in these patients to reduce the risk of experiencing adverse outcomes. Level of Evidence: Level III—retrospective. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Patient Perceptions of Iliac Crest Bone Grafting in Minimally Invasive Transforaminal Lumbar Interbody Fusion
Conclusions: Approximately half of patients undergoing MIS TLIF with ICBG are able to correctly identify which side of their iliac crest was harvested. However, the majority of patients reporting pain were unable to correctly identify the side of harvest. This suggests that most patients are likely attributing other sources of pain to their ICBG. Therefore, rates of donor site pain may be over-reported in the current literature with contemporary harvesting techniques. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Primary Research Source Type: research

Dropped Head Syndrome: A Systematic Review
Conclusions: Treatment for DHS starts with accurate diagnosis of the underlying etiology and is often associated with neuromuscular disease. A treatment algorithm for appropriate management of these patients was proposed. A trial of medical management and/or immunomodulators is warranted. Failing nonoperative management, surgery is predictive of a positive outcome. Level of Evidence: Level V. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Systematic Review Source Type: research

Extradural Arachnoid Cyst Excision
Arachnoid cysts are an uncommon postoperative complication and can result in back pain, radiculopathy, and/or cauda equina syndrome. For symptomatic postoperative arachnoid cysts, surgical management is the accepted treatment. While excision of arachnoid cysts is the preferred surgical method, cysts with adhesions to nerve roots and/or dura can be treated with cyst fenestration to reduce morbidity of excision. Surgeons should be prepared for dural defects after cyst excision, which can require dural grafting and lumbar drains for cerebrospinal fluid diversion. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Surgical Technique Source Type: research

Mini Screws for Improving Accuracy in Navigation-assisted Spine Surgery
Conclusions: The technique presented allows for rapid and highly accurate initial referencing and can be used in all cases of navigation-assisted spine surgery. It also allows for hassle-free rereferencing in cases of disruption or accidental removal of the reference array. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Surgical Technique Source Type: research

Management of Herniated Lumbar Disk Disease and Cauda Equina Syndrome in Pregnancy
Lower back pain is a commonly reported symptom during pregnancy. However, herniated lumbar disk disease is an uncommon cause for such pain. Cauda equina syndrome (CES) during pregnancy is a rare clinical scenario. This review highlights the epidemiology, diagnostic and treatment strategies, and challenges encountered when managing herniated lumbar disk disease and CES in pregnancy. Magnetic resonance imaging is the diagnostic modality of choice. Nonoperative treatment strategies are successful in the vast majority of cases in patients with a herniated disk in the absence of CES. CES and progressive neurological deficits re...
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Narrative Review Source Type: research

Is the Use of Intraoperative Corticosteroids Harmful in Lumbar Decompression Surgery?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 28, 2019 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

Plastic Surgeon Closure of Index Spinal Cases: A Single-Institution Review of 928 Cases
Purpose: The role of the plastic surgeon in wound management following complications from prior spinal surgeries is well established. The present study evaluates wound complications following plastic surgeon closure of the primary spinal surgery in a large patient population. Methods: Spinal surgeries closed by a single plastic surgeon at a large academic hospital were reviewed. Descriptive statistics were applied and outcomes in this sample were compared with previously published outcomes using 2-sample z tests. Results: Nine hundred twenty-eight surgeries were reviewed, of which 782 were included. Seven hundred f...
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Improvements in Grip and Pinch Strength and Patient-reported Outcomes After Anterior Cervical Discectomy and Fusion
Conclusions: In this prospective, observational study, postoperative increase in grip and pinch strength demonstrated an association with improvement of pain and disability of the neck and overall quality of health regardless of the presence of cervical myelopathy. Preoperative grip strength weakness was found to be predictive of postoperative grip strength deficiency after ACDF. Our investigation suggests the recovery of hand function may be correlated with improvement of PROs after ACDF. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

How Does Screw Migration or Fracture After Anterior Cervical Plate Fixation Affect the Radiographic and Clinical Outcomes?
The objective of this article is to assess the effect of screw migration and fracture associated with anterior cervical plating on long-term radiographic and clinical outcomes. Background Data: Screw migration and breakage detected after anterior cervical discectomy/corpectomy and fusion with plating may cause various implant-related complications and reduce solid fusion rate. However, little is known about their long-term prognosis. Materials and Methods: Medical records and radiographic data of 248 consecutive patients who underwent anterior cervical discectomy and fusion or anterior cervical corpectomy and fusion ...
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Minimal Clinically Important Difference and Substantial Clinical Benefit Using PROMIS CAT in Cervical Spine Surgery
The objective of this study was to establish minimal clinically important difference (MCID) and substantial clinical benefit (SCB) thresholds for Patient-Reported Outcomes Measurement Information System (PROMIS) in cervical spine pathology. Summary of Background Data: PROMIS enables improved psychometric properties with reduced questionnaire burden through computer adaptive testing. Despite studies showing good correlation with “legacy” outcome measures, literature on the clinical significance of changes in PROMIS scores is scarce. Materials and Methods: Adult patients undergoing cervical spine surgery at...
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Does the Duration of Cervical Radicular Symptoms Impact Outcomes After Anterior Cervical Discectomy and Fusion?
Study Design: Retrospective cohort study. Objective: To compare clinical outcomes after anterior cervical discectomy and fusion (ACDF) based on preoperative duration of radiculopathy symptoms. Summary of Background Data: There is no clear indication of when outcomes after ACDF become less effective in the setting of acute versus chronic symptoms from cervical nerve root compression. Materials and Methods: A retrospective cohort study of consecutive patients who underwent an ACDF between 2008 and 2015 for radiculopathy was performed. Patients were divided into 3 groups: radicular symptoms lasting for (Source: Jou...
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Impact of K-Line (–) in the Neck-Flexion Position on Patient-reported Outcomes After Cervical Laminoplasty For Patients With Ossification of the Posterior Longitudinal Ligament
Conclusion: The f-K-line (–) was significantly associated with poorer functional recovery, higher pain intensity in the extremities, and lower patient satisfaction after cervical laminoplasty for patients with OPLL. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Crossing the Cervicothoracic Junction in Cervical Arthrodesis Results in Lower Rates of Adjacent Segment Disease Without Affecting Operative Risks or Patient-Reported Outcomes
Conclusions: Crossing the CTJ in cervical arthrodesis does not increase operative risk as measured by blood loss, operative time, and length of hospital stay. However, it leads to lower revision rates, likely because of the avoidance of ASD, and comparable PROs. Thus, crossing the CTJ may help prevent ASD without negatively affecting operative risk or long-term PROs. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

The Effect of Surgical Decompression on Functional Balance Testing in Patients With Cervical Spondylotic Myelopathy
Conclusions: Human motion video capture can be used to robustly quantify balance parameters in the setting of CSM. Compared with healthy controls, such patients exhibited increased standing sway and poorer performance on a tandem gait task. The surgical intervention resulted in significant improvement in many of the measures of functional balance, but overall profiles had not completely returned to normal when measured 3 months after surgery. These data reinforce the importance of operative intervention in the treatment of symptomatic CSM with the goal of halting disease progress but the expectation that balance may actu...
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Progression of Cervical Ossification of Posterior Longitudinal Ligament After Laminoplasty or Laminectomy With Posterior Fixation
Conclusion: The rate of progression of cervical OPLL was significantly higher after PF than after LP. Level of Evidence: Level III—a retrospective analysis. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Can the American College of Surgeons Risk Calculator Predict 30-Day Complications After Cervical Spine Surgery?
Conclusions: The ACS Risk Calculator accurately predicted complications in the categories of “any complication” (P (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Is Modified K-line a Powerful Tool of Surgical Decision Making for Patients With Cervical Spondylotic Myelopathy?
Study Design: Prospective observational single-center study. Objective: To evaluate anterior decompression and fusion (ADF) or posterior surgery (PS) for patients with cervical spondylotic myelopathy (CSM) using the modified K-line (mK-line) and to compare clinical and radiologic outcomes between these 2 techniques. Summary of Background Data: The authors have previously reported that insufficient posterior decompression is often seen after laminoplasty for CSM in patients with preoperative anterior clearance of the spinal cord (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Clinical and Radiographic Evaluation of Multilevel Lateral Lumbar Interbody Fusion in Adult Degenerative Scoliosis
We present our experience with utilizing LLIF to treat multilevel degenerative scoliosis. Methods: Clinical outcomes were evaluated using VAS, SF-12, and ODI. Radiographic outcomes included pelvic tilt, pelvic incidence, lumbar lordosis, pelvic incidence-lumbar lordosis mismatch, Cobb angle, and cage subsidence. Perioperative and long-term complications through the ≥1-year final-postoperative visit were reviewed; transient neurological disturbances were assessed independently. Demographic, comorbidity, operative, and recovery variables, including opioid use, were explored for association with primary outcomes. Resul...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Comparison of Posterior Lumbar Interbody Fusion and Microendoscopic Muscle-preserving Interlaminar Decompression for Degenerative Lumbar Spondylolisthesis With >5-Year Follow-up
Conclusions: PLIF and ME-MILD resulted in equivalent improvements in SF-36 and JOA scores. There were no differences in revision surgery rates among patients with single-level, mild DLS. Level of Evidence: Level III—a retrospective analysis. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Analysis of Outcomes and Cost of Inpatient and Ambulatory Anterior Cervical Disk Replacement Using a State-level Database
The objective of this study was to compare clinical outcomes and cost associated between inpatient and ambulatory setting ADR. Materials and Methods: Outcomes and cost were retrospectively analyzed for patients undergoing elective ADR in California, Florida, and New York from 2009 to 2011 in State Inpatient and Ambulatory Databases. Results: A total of 1789 index ADR procedures were identified in the inpatient database (State Inpatient Databases) compared with 370 procedures in the ambulatory cohort (State Ambulatory Surgery and Services Databases). Ambulatory patients presented to the emergency department 19 times (...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Comparison of the Effects of Milrinone, Sodium Nitroprusside, and Nitroglycerine for Induced Hypotension in Elderly Patients Undergoing Spine Surgery: A Randomized Controlled Trial
Background: The use of induced hypotension is limited because of concerns about hypoperfusion to major organs in elderly patients. The aim of this study was to compare the effects of milrinone with those of other vasodilating hypotensive agents on induced hypotension in elderly patients undergoing spine surgery. Methods: In total, 60 patients older than 60 years who underwent lumbar fusion surgeries were randomized to groups M (milrinone), S (sodium nitroprusside), and N (nitroglycerine). The study drug was infused after perivertebral muscle retraction until complete interbody fusion occurred. The infusion dose was ad...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Periapical-dropout Screws Strategy For 3-Dimensional Correction of Lenke 1 Adolescent Idiopathic Scoliosis in Patients Treated by Posterior Spinal Fusion
The objective of this study was to compare periapical-dropout screws strategy (PDSS) with traditional-multilevel pedicle screws strategy (TMSS) for 3-plane correction of Lenke 1 adolescent idiopathic scoliosis deformity. Summary of Background Data: There are limited data in 3-plane correction and the optimal pedicle screw (PS) configuration for Lenke 1 adolescent idiopathic scoliosis surgery. Materials and Methods: Sixty-one consecutive patients with Lenke 1 curves (range: 50–80 degrees), undergoing single-stage posterior spinal fusion with PS fixation, were included. Patients with a minimum follow-up of 1 year...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Decompression With or Without Fusion for Adjacent Segment Disease Without Instability: Erratum
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: ERRATUM Source Type: research

A Novel Anatomic Landmark to Assess Adequate Decompression in Anterior Cervical Spine Surgery: The Posterior Endplate Valley (PEV)
Study Design: A retrospective study. Objectives: (1) To assess the reliability of using the posterior endplate valley (PEV) to predict the cranial-caudal location of the cervical pedicle intraoperatively; (2) to assess the impact of age on the cervical PEV-pedicle relationship, interpedicular distance, and foraminal height. Summary of Background Data: The cervical pedicle, which is the anatomic landmark defining the boundaries of the foramen, is hidden from view intraoperatively in the anterior cervical approach, potentially leading to incomplete foraminal decompression. An intraoperative landmark which heralds the...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Recovery Process After Anterior Cervical Decompression in Patients With Cervical Spondylotic Myelopathy With Different Natural History
Study Design: An observational prospective cohort study. Objective: To investigate the influence of natural history on the recovery of patients with cervical spondylotic myelopathy (CSM) after anterior cervical decompression. Summary of Background Data: The natural history of CSM has not been clearly elucidated, it remains unclear whether the natural history of CSM is associated with the recovery process after surgical treatment. Materials and Methods: Patients with CSM (n=117) after anterior cervical decompression were stratified variously on the basis of natural history features. Baseline and postoperative neu...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Comparison Between Stable Sagittal Vertebra and First Lordotic Vertebra Instrumentation for Prevention of Distal Junctional Kyphosis in Scheuermann Disease: Systematic Review and Meta-analysis
This study was a systematic review and meta-analysis. Objectives: To compare stable sagittal vertebra (SSV) and first lordotic vertebra (FLV) instrumentation for prevention of distal junctional kyphosis (DJK) in Scheuermann disease. Summary of Background Data: The SSV has been increasingly chosen as the lowest instrumented vertebra to prevent DJK, and some studies have provided supportive results. However, other studies demonstrate that lowest instrumented vertebra located in the FLV has similar DJK incidence with the benefit of saving levels. Materials and Methods: Electronic searches of PubMed, Embase, the Cochr...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: SYSTEMATIC REVIEW Source Type: research

Percutaneous Unilateral Biportal Endoscopic Spine Surgery Using a 30-Degree Arthroscope in Patients With Severe Lumbar Spinal Stenosis: A Technical Note
Conclusion: UBESS using a 30-degree arthroscope can be an efficient and safe intervention in patients with severe LCCS. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: SURGICAL TECHNIQUE Source Type: research

Odontoid Fractures: A Critical Review of Current Management and Future Directions
Odontoid fractures represent one of the most common and controversial injury types affecting the cervical spine, being associated with a high incidence of nonunion, morbidity, and mortality. These complications are especially common and important in elderly patients, for which ideal treatment options are still under debate. Stable fractures in young patients maybe treated conservatively, with immobilization. Although halo-vest has been widely used for their conservative management, studies have shown high rates of complications in the elderly, and therefore current evidence suggests that the conservative management of thes...
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: NARRATIVE REVIEW Source Type: research

Are Epidural Steroid Injections Beneficial for Patients With Degenerative Lumbar Spondylolisthesis?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - October 1, 2019 Category: Surgery Tags: CONTROVERSIES IN SPINE SURGERY Source Type: research

Does Prophylactic Administration of TXA Reduce Mean Operative Time and Postoperative Blood Loss in Posterior Approach Lumbar Spinal Fusion Surgery Performed for Degenerative Spinal Disease?
Study Design: This is a level III retrospective cohort study. Objective: To investigate association between prophylactic tranexamic acid (TXA) administration before 1 and 2-level posterior lumbar interbody fusion operations and perioperative blood loss (including intraoperative blood loss and postoperative drain output), mean operative time, postoperative transfusion, and postoperative venous thromboembolic events. Summary of Background Data: TXA is a systemic antifibrinolytic that competitively inhibits lysine binding sites on plasminogen, reversibly blocking its binding to fibrin and impeding fibrinolysis and clo...
Source: Journal of Spinal Disorders and Techniques - July 30, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Association of Pain History and Current Pain With Sagittal Spinal Alignment and Muscle Stiffness and Muscle Mass of the Back Muscles in Middle-aged and Elderly Women
Conclusions: Our results suggest that LBPH is associated with increased stiffness of the lumbar multifidus muscle in the prone position, and that LBP is associated with the decreased lumbar lordosis in the standing position in community-dwelling middle-aged and elderly women. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - July 30, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

A Nano-Dose Protocol For Cobb Angle Assessment in Children With Scoliosis: Results of a Phantom-based and Clinically Validated Study
This study aimed to validate a new ultra–low-dose full-spine protocol for reproducible Cobb angle measurements—the “nano-dose” protocol. Summary of Background Data: Scoliosis is a 3-dimensional (3D) deformity of the spine characterized by 3D clinical parameters. Nevertheless, 2D Cobb angle remains an essential and widely used radiologic measure in clinical practice. Repeated imaging is required for the assessment and follow-up of scoliosis patients. The resultant high dose of absorbed radiation increases the potential risk of developing radiation-induced cancer in such patients. Micro-dose radiog...
Source: Journal of Spinal Disorders and Techniques - July 30, 2019 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research