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Risk Factors Associated With Failure to Reach Minimal Clinically Important Difference in Patient-reported Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion for Spondylolisthesis
Study Design: Retrospective cohort. Objective: To determine risk factors associated with failure to reach the minimal clinically important difference (MCID) in patient-reported outcomes (PROs) for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) for spondylolisthesis. Summary of Background Data: The MCID of PROs are often utilized to determine the benefit of spinal procedures. However, negative predictive factors for reaching MCID in patients surgically treated for lumbar spondylolisthesis have been difficult to elucidate. Materials and Methods: A prospectively maintained ...
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Is Body Mass Index a Risk Factor for Revision Procedures After Minimally Invasive Transforaminal Lumbar Interbody Fusion?
Study Design: Retrospective cohort study. Objective: To determine if an association exists between body mass index (BMI) and the rate of revision surgery after single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Summary of Background Data: MIS TLIF is an effective treatment for lumbar degenerative disease. Previous studies in the orthopedic literature have associated increased BMI with increased postoperative complications and need for revision. Few studies have evaluated the association between BMI and the risk for revision after minimally invasive spinal procedures. Materials and M...
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

The Difference in Clinical Outcomes After Anterior Cervical Fusion, Disk Replacement, and Foraminotomy in Professional Athletes
Study Design: Retrospective case series. Object: To compare postoperative outcomes of professional athletes treated for cervical disk herniation after anterior cervical discectomy and fusion (ACDF) and posterior foraminotomy (PF), or total disk replacement (TDR). Summary of Background Data: ACDF, PF, and TDR have all led to excellent outcomes in the general population but the unique demands in the professional athlete necessitate specific study. Methods: Athletes of 4 major American professional sports leagues—National Football League, Major League Baseball, National Hockey League and National Basketball A...
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Treatment of Degenerative Lumbar Spondylolisthesis With Fusion or Decompression Alone Results in Similar Rates of Reoperation at 5 Years
Conclusions: Our study suggests that treatment of degenerative spondylolisthesis with fusion or decompression alone results in similar rates of reoperation at 5 years. This medium term data indicate that decompression alone may be a viable treatment for some patients with degenerative spondylolisthesis. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Reliability and Clinical Utility of the CARDS Classification for Degenerative Spondylolisthesis
Conclusions: The CARDS classification system represents a reliable method for classifying cases of DS. Our results indicate that kyphotic segmental alignment (CARDS D) may be a less common, yet clinically distinct subset of DS characterized by worse preoperative back pain. CARDS type D cases may also show a greater degree of improvement in multiple outcome measures following surgical intervention. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

The Impact of L5 Sacralization on Fusion Rates and Clinical Outcomes After Single-level Posterior Lumbar Interbody Fusion (PLIF) at L4–L5 Level
Conclusions: Patients with type II or III L5 sacralization may have worse fusion rates after L4–L5 PLIF surgery than those with type I or no sacralization. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Patient Factors Contributing to Prolonged Postoperative Length of Stay and Increased Rate of Readmission After Elective Posterior Cervical Fusion
Study Design: This is retrospective study of prospectively collected data. Objective: To identify patient factors that are independently associated with prolonged length of stay (LOS) and readmission after posterior cervical fusion (PCF) utilizing a large national database. Summary of Background Data: A number of studies have investigated the morbidity and mortality after PCF; however, little is known about the factors that are associated with prolonged LOS and readmission, both of which incur increased costs for patients and hospitals. Methods: The American College of Surgeons National Surgical Quality Improvem...
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Symptomatic Adjacent Segment Disease After Anterior Cervical Discectomy for Single-level Degenerative Disk Disease
Conclusions: The annual rate of symptomatic ASD after an anterior cervical discectomy procedure was estimated to be 0.7%. This seems to be related to the procedure, although firm conclusions cannot be drawn. Level of Evidence: Level 2—prospective cohort. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

The Impact of Cage Dimensions, Positioning, and Side of Approach in Extreme Lateral Interbody Fusion
Conclusions: Cage anterior-posterior diameter is the determining factor in restoration of foraminal height in ELIF. Cage height, type, positioning, and side of approach do not have a determining role in radiographic outcome in the present study. Sustainable foraminal height restoration is achieved by implantation of wider cages. Level of Evidence: Level 3. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Superior Segment Facet Joint Violation During Instrumented Lumbar Fusion is Associated With Higher Reoperation Rates and Diminished Improvement in Quality of Life
Conclusions: FJV was independently associated with a higher reoperation rate and diminished improvement in QOL. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Does Age Influence the Efficacy of Demineralized Bone Matrix Enriched with Concentrated Bone Marrow Aspirate in Lumbar Fusions?
Conclusions: Elderly patients undergoing PLF using DBM enriched with BMA achieved lower radiographic fusion success compared with their nonelderly counterparts and compared with elderly patients that had fusion with ICBG. This may be partly due to the effect of advanced age on MSC potential. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Predictive Factors for Postoperative Follow-up: Which Patients are Prone to Loss to Follow-up After Spinal Surgery?
Conclusions: Our study shows that patients who underwent decompression alone were less likely to attend follow-up than were patients who underwent fusion surgery. Whereas the factors correlated with loss to follow-up after laminectomy alone were sex, marital status, and number of comorbidities, the only predictor after fusion was male sex. Sex was the only shared risk factor for loss to follow-up. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Preoperative Opioid Use: A Risk Factor for Poor Return to Work Status After Single-level Cervical Fusion for Radiculopathy in a Workers’ Compensation Setting
The objectives of this study are: (1) How preoperative opioid use impacts RTW status after single-level cervical fusion for radiculopathy? and (2) What are other postsurgical outcomes affected by preoperative opioid use? Summary of Background Data: Opioid use has increased significantly in the past decade. The use of opioids has a drastic impact on workers’ compensation population, an at-risk cohort for poorer surgical and functional outcomes than the general population. Methods and Materials: Data was retrospectively collected from Ohio Bureau of Workers’ Compensation between 1993 and 2011. The study pop...
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Sensitivity of Computed Tomography Compared With that of Magnetic Resonance Myelography in the Presurgical Diagnosis of Foraminal or Extraforaminal Entrapment at the Lumbosacral Junction
Conclusions: CT has comparable sensitivity to MRM for the presurgical diagnosis of L5 nerve entrapment at the lumbosacral junction. Level of Evidence: Level II. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

A Posterior Oblique Approach to the Lumbar Disk Spaces, Vertebral Bodies, and Lumbar Plexus: A Cadaveric Feasibility Study
Conclusions: A posterior oblique approach seems to be less invasive than the transpsoas approach. Exposure of the anterior column structures above the iliac crest is comparable. The oblique approach offers direct access to the lumbar plexus and the extraforaminal segments of the nerve roots. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

The Influence of Histologic Subtype in Predicting Survival of Lung Cancer Patients With Spinal Metastases
The objective of the study was to study whether the expected survival in patients with lung cancer spinal metastases is affected by histolopathologic and molecular subtypes in the context of modern systemic therapy. Materials and Methods: We retrospectively reviewed all patients with histologically confirmed lung cancer treated for spinal metastases at our institution between 2001 and 2012. Patients’ demographics, histopathologic details, treatment modalities, and survival data were collected. The primary outcome was survival from time of spinal metastases diagnosis. The Cox regression analysis was used to evaluat...
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Comparing Short-term Complications of Inpatient Versus Outpatient Single-level Anterior Cervical Discectomy and Fusion: An Analysis of 6940 Patients Using the ACS-NSQIP Database
Conclusions: Patients undergoing outpatient single-level ACDF had a lower 30-day complication rates than those undergoing it in the inpatient setting. Outpatient surgery for single-level ACDF is safe and a favorable option for suitable patients. Level of Evidence: Level 3. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Five-Year Reoperation Rates of 2-Level Lumbar Total Disk Replacement Versus Fusion: Results of a Prospective, Randomized Clinical Trial
Conclusions: There were significantly fewer reoperations in TDR patients compared with fusion patients. However, most of the secondary surgeries were instrumentation removal in the fusion cohort. Discounting the instrumentation removals, there was no significant difference in reoperations between TDR and fusion. These results are indicative that lumbar TDR is noninferior to fusion. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Comparative Study of the Difference of Perioperative Complication and Radiologic Results: MIS-DLIF (Minimally Invasive Direct Lateral Lumbar Interbody Fusion) Versus MIS-OLIF (Minimally Invasive Oblique Lateral Lumbar Interbody Fusion)
Conclusions: In our report of L4/L5 level diseases, the OLIF technique may decrease approach-related perioperative morbidities by eliminating the risk of unwanted muscle and nerve manipulations. Using orthogonal maneuver, cage could be safely placed more posteriorly, resulting in better disk and foraminal height restoration. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Primary Research Source Type: research

Co-management Strategies for Hospitals and Orthopedic and Neurosurgery Practices
This article will review legal considerations, define basic co-management structure and goals, and suggest examples of metrics used to achieve success. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: The Business of Medicine Source Type: research

Obesity as a Risk Factor for Low Back Pain: A Meta-Analysis
Conclusions: Our findings consistently show that overweight and obesity are risk factors for LBP in men and women. Maintaining a healthy body weight may be one of the factors preventing the occurrence of LBP. Level of Evidence: Level 1. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Systematic Review Source Type: research

Mini-open Lateral Retropleural Approach for Symptomatic Thoracic Disk Herniations
Conclusions: Mini-open lateral retropleural approach is safe and effective to remove symptomatic TDH with minimal morbidities and fast patient recovery. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Surgical Technique Source Type: research

Cervical Total Disk Arthroplasty
In the United States, cervical total disk arthroplasty (TDA) is US Federal Drug Administration (FDA) approved for use in both 1 and 2-level constructions for cervical disk disease resulting in myelopathy and/or radiculopathy. TDA designs vary in form, function, material composition, and even performance in?vivo. However, the therapeutic goals are the same: to remove the painful degenerative/damaged elements of the intervertebral discoligamenous joint complex, to preserve or restore the natural range of spinal motion, and to mitigate stresses on adjacent spinal segments, thereby theoretically limiting adjacent segment disea...
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Narrative Review Source Type: research

Laminoplasty is the Preferred Procedure for a Posteriorly Based Multilevel Surgery in a Patient With a Neutral Spine and Cervical Spondylotic Myelopathy: True or False?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - February 1, 2018 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

The Timing of Surgery Affects Return to Work Rates in Patients With Degenerative Lumbar Stenosis in a Workers’ Compensation Setting
Conclusions: Overall, time to surgery had a significant impact on clinical outcomes in WC subjects receiving lumbar decompression for DLS. Patients who received their operation within 1 year had a higher RTW rate, lower medical costs, and lower costs accrued over 3 years after index surgery. The results presented can perhaps be used to guide surgical decision-making and provide predictive value for the WC population. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Initial Experience With Real-Time Continuous Physical Activity Monitoring in Patients Undergoing Spine Surgery
Study Design: Multicenter prospective pilot study. Objective: To evaluate if continuous physical activity monitoring by a personal electronic 3-dimensional accelerometer device is feasible and can provide objective data that correlates with patient-reported outcomes following spine surgery. Summary of Background Data: Self-reported health-related quality-of-life (HRQOL) metrics are inherently limited by being very subjective, having a low frequency of data collection, and inconsistent follow-up. Methods: Inclusion criteria: adults (18+), thoracolumbar deformity or degenerative disease, and regular access to a co...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Role of Posterior Stabilization and Transpedicular Decompression in the Treatment of Thoracic and Thoracolumbar TB: A Retrospective Evaluation
Study Design: A retrospective study. Objective: To evaluate the results of posterior pedicle-screw fixation with transpedicular decompression in 21 cases of thoracic and thoracolumbar spinal tuberculosis (TB) in terms of functional, neurological, and radiologic outcomes. Summary of Background Data: Spinal TB is predominantly an anterior disease that can lead to kyphotic deformity. Hence, anterior debridement and fusion was considered as the gold standard. However, with remarkable improvements in chemotherapy regimens and diagnostic tools, it is possible to detect the disease process early and treat them with less r...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Minimally Invasive Posterior Cervical Foraminotomy: Freiburg Experience With 34 Patients
Conclusions: Minimally invasive cervical foraminotomy is an effective procedure for decompression of cervical nerve roots regardless the type of the stenosis. Even employing minimally invasive technique still causes neck pain in the long term affecting up to 25% of patients. More randomized control studies are required to clarify the benefits of minimally invasive PCF. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Clinical Outcomes After Posterior Lumbar Interbody Fusion: Comparison of Cortical Bone Trajectory and Conventional Pedicle Screw Insertion
Conclusions: Both procedures were comparable in terms of clinical outcomes and fusion rates, but CBT-PLIF provided the additional benefits of less blood loss, less intraoperative muscle damage, less perioperative pain, and earlier recovery to normal activities. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

The Utility of Routinely Obtaining Postoperative Laboratory Studies Following a Minimally Invasive Transforaminal Lumbar Interbody Fusion
Study Design: This is a retrospective analysis. Objective: To test the hypothesis that there is limited utility in routinely obtaining postoperative laboratory values following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Background Data: At many institutions, it is routine to obtain a complete blood count and basic metabolic profile (BMP) following a MIS TLIF. However, the utility of this practice has not been well characterized. Methods: A total of 332 consecutive patients who underwent a primary, 1-level MIS TLIF for degenerative spinal pathology between 2007 and 2013 were identified....
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Comparison of Decompression With and Without Fusion for Patients With Synovial Facet Cysts
Study Design: This is a retrospective study. Objective: To compare (1) recurrence of radiculopathy and (2) back pain after decompression with and without fusion for patients with a symptomatic synovial cyst. Background: Previous work described favorable outcomes following cyst excision with and without fusion. Because of the association of facet cysts with spinal instability it is hypothesized that a decompression with fusion will lead to better outcomes. However, previous studies present contradicting results. Methods: We included 314 consecutive patients that underwent operative treatment for a facet cyst betw...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Impact of Inpatient Venous Thromboembolism Continues After Discharge: Retrospective Propensity Scored Analysis in a Longitudinal Database
Study Design: Propensity score matched retrospective study using a nationwide longitudinal database. Objective: To quantify the longitudinal economic impact of venous thromboembolism (VTE) complications in spinal fusion patients. Summary of Background Data: VTE is a rare and serious complication that may occur after spine surgery. The long-term socioeconomic impact understanding of these events has been limited by small sample sizes and a lack of longitudinal follow-up. We provide a comparative economic outcomes analysis of these complications. Methods: We identified 204,308 patients undergoing spinal fusion pro...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Preoperative Mental Health is not Predictive of Patient-reported Outcomes Following a Minimally Invasive Lumbar Discectomy
Study Design: This is a retrospective cohort study. Objective: To determine if preoperative mental health is associated with patient-reported outcomes (PROs) following a minimally invasive lumbar discectomy. Summary of Background Data: PROs are commonly used to quantify a patient’s perceived health status. Recently, mental health has been theorized to directly affect patients’ perception of their disability and pain after spine surgery. Materials and Methods: A registry of patients who underwent a primary, single-level minimally invasive lumbar discectomy was reviewed. The association between preoper...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Nerve Root and Lumbar Plexus Proximity to Different Extraforaminal Lumbar Interbody Fusion Trajectories: A Cadaver Study
Study Design: Cadaver study. Objective: To investigate the safety of the extraforaminal lumbar interbody fusion approach. Summary of Background Data: Over the last decade the number of techniques available for lumbar interbody fusion has increased. Recent interest has developed in an extraforaminal approach to the intervertebral disc to reduce the morbidity associated with facetectomy. The safety of this extraforaminal corridor with regards to the exiting nerve root and lumbar plexus has yet to be assessed. Methods: With the cadaver prone, the C-arm was positioned over the disc of interest and aligned perpendicu...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Complications, Readmissions, and Revisions for Spine Procedures Performed by Orthopedic Surgeons Versus Neurosurgeons: A Retrospective, Longitudinal Study
Conclusions: Few significant associations between surgeon type and patient outcomes exist in the context of spine surgery. Those which do are small and unlikely to be clinically meaningful. Level of Evidence: Level 3. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

The Influence of Single-level Versus Multilevel Decompression on the Outcome in Multisegmental Lumbar Spinal Stenosis: Analysis of the Lumbar Spinal Outcome Study (LSOS) Data
Conclusions: Our study showed that in multisegmental stenotic cases a single-level decompression was associated with a significantly more favorable SSM symptoms and function score, respectively, as compared with multilevel decompression. This study provides evidence that in multisegmental stenotic cases a single-level decompression might be sufficient to improve patient’s symptoms and function. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Reliability and Criterion Validity of the Smartphone Inclinometer Application to Quantify Cervical Spine Mobility
Conclusions: This study confirms that the tested smartphone is valid and reliable to measure ACROM on the frontal and the sagittal planes; furthermore, it also demonstrates its usefulness for rotation movement analysis, using the inclinometric application. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Eligibility of Outpatient Spine Surgery Candidates in a Single Private Practice
Conclusions: Outpatient spine surgery is feasible in 79% of patients in this single-surgeon private practice. On the basis of these results, a majority of spine procedures can be performed in an outpatient setting following our eligibility criteria. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Posterior or Single-stage Combined Anterior and Posterior Approach Decompression for Treating Complex Cervical Spondylotic Myelopathy Coincident Multilevel Anterior and Posterior Compression
Study Design: A single-center, retrospective, longitudinal matched cohort clinical study of prospectively collected outcomes. Objective: To compare retrospectively the clinical outcomes and complications of the posterior approach laminoplasty and single-stage anterior approach laminoplasty combined with anterior cervical corpectomy and fusion and anterior cervical discectomy and fusion for treating patients with cervical spondylotic myelopathy coincident multilevel anterior and posterior compression, known as complex cervical spondylotic myelopathy (cCSM) here. Summary of Background Data: The optimal surgical manag...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Impact of Anemia and Transfusion on Readmission and Length of Stay After Spinal Surgery: A Single-center Study of 1187 Operations
Study Design: Retrospective cohort study. Objective: To determine whether receipt of blood transfusion and preoperative anemia are associated with increased rates of 30-day all-cause readmission, and secondarily with a prolonged hospital stay after spinal surgery. Summary of Background Data: Increased focus on health care quality has led to efforts to determine postsurgical readmission rates and predictors of length of postoperative hospital stay. Although there are still no defined outcome measures specific to spinal surgery to which providers are held accountable, efforts to identify appropriate measures and to d...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Incidental Durotomy in Open Versus Tubular Revision Microdiscectomy: A Retrospective Controlled Study on Incidence, Management, and Outcome
Study Design: Retrospective case-control study. Objective: To compare the incidence, management, and outcome of incidental durotomy in revision microdiscectomy with open and minimal-access surgery. Summary of Background Data: Incidental durotomy occurs with a variable incidence of 3%–27% in spine surgery. The highest rate occurs in revision microdiscectomy. The intraoperative and postoperative management of dural tears varies in the literature and the definite impact on clinical outcome has to be clarified. Methods: This is a retrospective study of medical records of 135 patients who underwent revision mic...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Minimally Invasive Cervical Pedicle Screw Fixation by a Posterolateral Approach for Acute Cervical Injury
This study included 56 consecutive patients who received surgery for cervical fractures. We inserted a total of 203 cervical pedicle screws. Nineteen patients were treated by conventional methods. Thirty-seven patients were treated by MICEPS fixation. According to the MICEPS fixation, 12 patients were treated by unilateral fusion, 25 patients by bilateral fusion. All pedicle screws were inserted using spinal navigation system in the both groups. Results: The average surgical time was 217 minutes with the conventional pedicle screw fixation and 165 minutes with the MICEPS fixation (P=0.0014). The average intraoperative b...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Radiologic and Functional Outcomes in Unstable Thoracolumbar Fractures Treated With Short-segment Pedicle Instrumentation
Conclusions: SSPI shows good results in fracture reduction, with good functional outcomes despite the loss of correction seen at the final follow-up. Although no investigated variable was found to be predictive of radiographic failure, a trend was identified (P=0.07) that patients with a higher LSC had an increased loss of correction. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Primary Research Source Type: research

Subsidizing the Sick: How Community Rating Works
Insurance premium rates have typically been calculated using a variety of rating algorithms. Passage of the Patient Protection and Affordable Care Act mandated that all individual and small group plans must use the community rating method. This method gives the same insurance rate to all members of a community, with adjustments only being allowed based on age, geography, and tobacco use. This effectively raises rates on low-risk individuals to subsidize high-risk individuals. With President Trump and Congressional Republicans vowing to repeal the Patient Protection and Affordable Care Act, this lesser-known but controversi...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: The Business of Medicine Source Type: research

Treatment of Axis Body Fractures: A Systematic Review
Conclusions: High rates for fracture union are reported in the literature for axis body fractures with nonoperative treatment. High-quality prospective studies are required to develop consensus as to which C2 body fractures require operative fixation. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Systematic Review Source Type: research

Iliac Crest Bone Graft: A Minimally Invasive Harvesting Technique
Typical sources for graft material utilized in minimally invasive transforaminal lumbar interbody fusion include both autograft and allograft. Autograft is frequently utilized due to its theorized benefits in promoting fusion. During minimally invasive transforaminal lumbar interbody fusion, autograft is often obtained locally during the laminectomy and facetectomy. However, this locally obtained bone graft has exhibited questionable osteoconductive properties, often necessitating the addition of biologics to improve fusion rates. Iliac crest bone graft (ICBG) has previously been reported to be a safe and efficacious sourc...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Surgical Technique Source Type: research

Lateral Atlantoaxial Osteoarthritis: A Narrative Literature Review
Lateral atlantoaxial osteoarthritis (AAOA), or C1-C2 lateral mass arthritis (LMA), is an unfamiliar degenerative cervical disease with a clinical presentation that markedly differs from subaxial spondylosis. The prevalence of LMA in the nonsurgical outpatient setting is 4%. Risk factors include age and occupation. The typical patient is between 50 and 90 years old, presents with upper cervical or occipital pain, has limited rotation, and has pain provocation during passive rotation to the affected side. Pain stems from degeneration of the lateral C1-C2 articulation and may be referred or radicular, through the greater occi...
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Narrative Review Source Type: research

Should TLIF be Routinely Used in a 60-Year-Old Man With a Mild Degenerative Spondylolisthesis?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2017 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

The Timing of Surgery Affects Return to Work Rates in Patients With Degenerative Lumbar Stenosis in a Workers’ Compensation Setting
Conclusions: Overall, time to surgery had a significant impact on clinical outcomes in WC subjects receiving lumbar decompression for DLS. Patients who received their operation within 1 year had a higher RTW rate, lower medical costs, and lower costs accrued over 3 years after index surgery. The results presented can perhaps be used to guide surgical decision-making and provide predictive value for the WC population. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 21, 2017 Category: Surgery Tags: Primary Research Source Type: research

Initial Experience With Real-Time Continuous Physical Activity Monitoring in Patients Undergoing Spine Surgery
Study Design: Multicenter prospective pilot study. Objective: To evaluate if continuous physical activity monitoring by a personal electronic 3-dimensional accelerometer device is feasible and can provide objective data that correlates with patient-reported outcomes following spine surgery. Summary of Background Data: Self-reported health-related quality-of-life (HRQOL) metrics are inherently limited by being very subjective, having a low frequency of data collection, and inconsistent follow-up. Methods: Inclusion criteria: adults (18+), thoracolumbar deformity or degenerative disease, and regular access to a co...
Source: Journal of Spinal Disorders and Techniques - November 21, 2017 Category: Surgery Tags: Primary Research Source Type: research