Transpsoas Lumbar Interbody Fusion Without Psoas Stimulated Electromyography
Conclusion: An anatomic transpsoas approach to the interbody space without psoas sEMG demonstrated a rate of neurological and approach-related complications that was comparable or superior to the rate of complications reported using the traditional transpsoas approach with sEMG. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Pelvic Incidence Affects Age-adjusted Alignment Outcomes in a Population of Adult Spinal Deformity
Conclusions: Patients with high PI reached ideal postoperative age-adjusted PT alignment at a lower rate than patients with normative and low PI. Height had no impact on postoperative age-adjusted alignment outcomes. Current postoperative ideal alignment targets may warrant an adjustment to account for PI. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

How Does Smoking Influence Patient-reported Outcomes in Patients After Lumbar Fusion?
Study Design: A retrospective cohort study. Objective: The goal of this study was to determine the effect of smoking on patient-reported outcome measurements (PROMs) after lumbar fusion surgery. Summary of Background Data: Although smoking is known to decrease fusion rates after lumbar fusion, there is less evidence regarding the influence of smoking on PROMs after surgery. Methods: Patients undergoing between 1 and 3 levels of lumbar fusion were divided into 3 groups on the basis of preoperative smoking status: never smokers (NS); current smokers (CS); and former smokers (FS). PROMs collected for ...
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Processing and Handling Cost of Single-use Versus Traditional Instrumentation for 1 Level Lumbar Fusions
Conclusion: Single-use instrumentation provided greater cost savings and reduced time from the opening of instrumentation to use in surgery when compared with reusable instrumentation. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Is the Cranial Sagittal Vertical Axis (Cr-SVA) a Better Midterm Predictor of Clinical Results Than C7-SVA in Adult Patients Operated on Spinal Deformity After a Minimum 2-Year Follow-Up?
Conclusions: The Cr-SVA measured in full spine standing radiographs seems to be a better predictor of health-related quality of life outcomes than the C7-SVA for adults operated on spinal deformity>2 years after surgery. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Incidence and Risk Factors of Anterior Longitudinal Ligament Rupture After Posterior Corrective Surgery Using Lateral Lumbar Interbody Fusion for Adult Spinal Deformity
Conclusions: ALLR occurred in 10 patients (22%). XLIF and preexisting osteoporotic vertebral fracture were independent risk factors for ALLR. Overcorrection was observed in patients with ALLR. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Relationship Between Muscle Mass of the Lower Limbs and Falls Caused by Spinal Misalignment in Women Aged 70 Years: A Retrospective Study
This study aimed to investigate the association between lower-limb muscle mass and spinal misalignment-related falls in elderly women. Summary of Background Data: Poor spinal alignment affects gait and balance, reducing the quality of life. Negative correlations between age-associated skeletal muscle loss and spinal sagittal alignment have been reported. Materials and Methods: This study included 127 women with osteoporosis aged more than 70 years. The correlation between lower-limb skeletal muscle index (SMI) and sagittal vertical axis (SVA) was calculated using radiographic measurements. Spinopelvic paramet...
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Comparison of Clinical Outcomes Between Posterior Instrumented Fusion With and Without Interbody Fusion for Isthmic Spondylolisthesis
Conclusions: There were no significant differences in clinical outcomes at 1 year or in the number of early complications between patients who received posterolateral fusion or posterior/transformational lumbar interbody fusion. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Associations Between Preoperative Hyponatremia and 30-Day Perioperative Complications in Lumbar Interbody Spinal Fusion
Study Design: Retrospective population database study. Objective: To investigate the relationship of preoperative hyponatremia to postoperative morbidity and mortality in lumbar interbody fusion patients. Summary of Background Data: Optimization of preoperative patient selection and perioperative management can improve patient outcomes in spinal surgery. Hyponatremia, incidentally identified in 1.7% of the US population, has previously been tied to poorer postoperative outcomes in both the general surgery and orthopedic surgery populations. Materials and Methods: Using the National Surgical Quality...
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Readmission Rate After 2-level Lumbar Decompression: A Propensity-matched Cohort Study Comparing Inpatient and Outpatient Settings
Study Design: Retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database years 2012–2015. Objective: Compare the 30-day readmission and postoperative major complications rates of 2-level lumbar decompression performed in the ambulatory and the inpatient settings. Summary of Background Data: In recent years, there is an increasing trend toward ambulatory spine surgery. However, there remains a concern regarding risks of readmission and postoperative morbidity after discharge. Methods: The ACS-NSQIP database from 2012 to 2015 was ...
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Impact of High-intensity Zones on Their Corresponding Lumbar Spine Segments: A Propensity Score-matched Analysis
Conclusions: The presence of HIZ did not significantly affect spinal stability as measured by angular ROM and translational motion and was not associated with significant changes in several quantitative measurements of spine pathology. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Prevalence of Occult Infections in Posterior Instrumented Spinal Fusion
Conclusions: The results of this study indicate a positive culture rate of 38% in presumed aseptic patients who had previously undergone instrumented spine surgery. These results are consistent with other retrospective studies and are>6 times greater than any previous prospective study utilizing culture swabs. Level of Evidence: Level-III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Primary Research Source Type: research

Propensity Score Matching: A Powerful Tool for Analyzing Observational Nonrandomized Data
In using observational, nonrandomized data, there is often interest in studying the effect of a particular treatment on a specific outcome. However, the imbalance of potential confounding variables between the treatment groups can distort the relationship between treatment and outcome. Propensity score matching is one, increasingly utilized, method to help account for such imbalances, allowing for a more accurate estimation of the influence of treatment on outcome. In this paper, we provide the clinician with an overview of propensity score matching techniques and provide a practical example of how this has been used in cl...
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Research Methodology Source Type: research

Characterizing the Surgeon Learning Curve in Instrumented Minimally Invasive Spinal Surgery: Does the Evidence Account for Training and Experience? A Systematic Literature Review
Conclusions: Spine MIS learning curve studies for instrumented fusion procedures provide inadequate context/characterization of surgeon experience and training. Future efforts leveraging learning curve methodology utilized in other surgical specialties would be beneficial. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Systematic Reviews and Meta-analyses Source Type: research

Intra-Articular Sacroiliac Joint Injection: Technical Guide
Sacroiliac (SI) joint pathology has been an increasingly discussed pathology as a potential etiology for significant low back and lower extremity pain. While patient history and examination maneuvers can assist with identifying the SI joint as a potential cause of pain, an intra-articular SI joint injection is critical to properly diagnose the SI joint as a clinically relevant pain generator. In addition to the diagnostic information from the injection, SI joint intra-articular injections can be performed for therapeutic benefit as part of a multi-modal, conservative treatment approach for SI joint pathology. We discuss ou...
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Surgical Technique Source Type: research

Surgical Management of Thoracolumbar Burst Fractures: Surgical Decision-making Using the AOSpine Thoracolumbar Injury Classification Score and Thoracolumbar Injury Classification and Severity Score
The management of thoracolumbar burst fractures is controversial with no universally accepted treatment algorithm. Several classification and scoring systems have been developed to assist in surgical decision-making. The most widely accepted are the Thoracolumbar Injury Classification and Severity Score (TLICS) and AOSpine Thoracolumbar Injury Classification Score (TL AOSIS) with both systems designed to provide a simple objective scoring criteria to guide the surgical or nonsurgical management of complex injury patterns. When used in the evaluation and treatment of thoracolumbar burst fractures, both of these systems resu...
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Narrative Review Source Type: research

Are Industry-funded Studies of Cervical Disc Arthroplasty Versus Anterior Cervical Discectomy and Fusion Biased?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - January 28, 2021 Category: Surgery Tags: Controversies in Spine Surgery Source Type: research

Does Main Curve Flexibility Affect Screw Insertion Accuracy Using a CT-based Navigation System in Adolescent Idiopathic Scoliosis Surgery?
Conclusions: Main curve flexibility of ≥55% was significantly related to screw violation in AIS surgery. Greater care is thus advised for screw insertion using CT navigation in AIS with main curve flexibility ≥55%. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Two Doses of Tranexamic Acid Reduce Blood Loss in Primary Posterior Lumbar Fusion Surgery: A Randomized-controlled Trial
Conclusion: Two doses of TXA significantly reduced the total blood loss, the hidden blood loss and postoperative drainage, and decreased hemoglobin and hematocrit drop in patients undergoing posterior lumbar fusion without increasing the risk of complications. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Comparison of Perioperative Complications Between Anterior Fusion and Posterior Fusion for Osteoporotic Vertebral Fractures in Elderly Patients: Propensity Score–Matching Analysis Using Nationwide Inpatient Database
The objective of this study was to evaluate the perioperative complications post–anterior fusion (AF) and posterior fusion (PF) for osteoporotic vertebral fractures (OVFs) with a large National Inpatient Database. Summary of Background Data: OVF of the thoracolumbar spine often occur because of bone fragility and low-energy trauma in elderly patients. Though AF and PF are 2 representative surgical methods, there have been few studies focusing on perioperative complications of each method. Materials and Methods: The total 2446 (AF: 435 cases, PF: 2011 cases) patients who diagnosed thoracic or lumbar OVF ...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

BMI Does Not Affect Complications or Patient Reported Outcomes After Lumbar Decompression Surgery
The objective of this study was to identify the influence of body mass index (BMI) on postsurgical complications and patient reported outcomes measures (PROMs) following lumbar decompression surgery. Summary of Background Data: Current literature does not accurately identify the impact of BMI on postsurgical complications or outcomes. Materials and Methods: Records from a single-center, academic hospital were used to identify patients undergoing 1 to 3-level lumbar decompression surgery. Patients under 18 years of age, those undergoing surgery for infection, trauma, tumor, or revision, and those with (Source:...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Industry Payments to Orthopedic Spine Surgeons Reported by the Open Payments Database: 2014–2017
Conclusions: Many expected industry payments to surgeons to decrease under public scrutiny of the OPD, but the present study showed no net change in median payment (General, Research, and Ownership) over the years studied. In the age of greater transparency, these findings shed insight into the orthopedic spine surgeon-industry relationship. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Spinal Surgery for Parkinson Disease With Camptocormia: Propensity Score–Matched Cohort Study With Degenerative Sagittal Imbalance (DSI)
Conclusions: PD patients undergoing spinal surgery for camptocormia had global malalignment and higher rates of complications compared with DSI patients. Patients should be appropriately counseled regarding the increased risk of operative complications and closely followed for incipient failure. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Does Hypothyroidism Increase Complications, Lengths of Stay, Readmissions, and Costs Following Primary 1- to 2-Level Lumbar Fusion?
Study Design: Level III—retrospective review. Objective: To evaluate the impact of hypothyroidism in patients undergoing 1- to 2-level lumbar fusion (1–2LF). Summary of Background Data: Hypothyroidism is a common cause of morbidity and mortality following surgery. Studies have demonstrated the effects of hypothyroidism following orthopedic surgery, but not 1–2LF. Materials and Methods: Patients undergoing 1–2LF with hypothyroidism were identified within the Medicare population, and served as the study group. Study group patients were randomly matched to controls in a 1:5 rat...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Accuracy of the Gutter Position in Cervical Double-door Laminoplasty Using Intraoperative Computed Tomography Navigation and the Factors Associated With C5 Palsy
Conclusions: The accuracy of the gutter position using intraoperative CT navigation was good. The incidence of C5 palsy was higher in this study than in the previous reports. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

A Radiographic Analysis of Lumbar Fusion Status and Instrumentation Failure After Complex Adult Spinal Deformity Surgery With Spinopelvic Fixation: Two-Year Follow-up From the Scoli-Risk-1 Prospective Database
Conclusions: In this series of complex ASD surgeries often requiring 3-column osteotomies, 70.3% showed solid fusion of the entire lumbar spine, including the lumbosacral junction. The lumbosacral segments showed a relatively high fusion rate at a 2-year follow-up likely due to the frequent use of anterior column support and graft. The prevalence of rod breakage increased as follow-up proceeded to 9.8%, which was most commonly observed at the lumbosacral junction. Level of Evidence: Level IV. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Anterior Cervical Arthrodesis With Polyetheretherketone Spacers: What is the Role of the Grafting Material?
Conclusions: A PEEK interbody device filled with local autograft resulted in a higher radiographic fusion rate and a lower need for reoperation at the index level than an identical device filled with DBM. Caution is warranted in assigning fusion failure to the PEEK device alone in anterior cervical discectomy and fusion surgery. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Liposomal Bupivacaine Is Both Safe and Effective in Controlling Postoperative Pain After Spinal Surgery in Children: A Controlled Cohort Study
Study Design: Retrospective comparative cohort study. Objective: To evaluate: (1) pain relief efficacy; (2) opioid consumption; (3) length of stay (LOS); (4) discharge disposition (DD); and (5) safety and adverse effects of liposomal bupivacaine (LB) in pediatric patients who underwent spinal deformity correction. Summary of Background Data: LB is a long-acting, locally injectable anesthetic. Previous orthopedic studies investigating its use have been limited to adult patients. The use of LB as part of postoperative pain management in pediatric patients undergoing spine deformity correction surgery is yet...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Predictors of Outcomes After Single-level Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Myelopathy: A Multivariate Analysis
Conclusions: In general, the preoperative JOA score was the best predictor of outcomes after ACDF. A preoperative JOA cutoff value of 9.25–10.25 predicted satisfaction, expectation fulfilment, willingness to undergo same surgery, and RTF with at least 70% sensitivity and 50% specificity. These findings may aid surgeons in identifying patients at risk of a poor outcome and guide preoperative counseling to establish realistic expectations of the surgical outcome. Level of Evidence: Level III—Non-randomized controlled cohort/follow-up study. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Demographic and Perioperative Factors Associated With Patient-reported Outcomes Measurement Information System (PROMIS) Survey Completion
Conclusion: This study identified demographic and perioperative variables associated with PROMIS survey completion and response rates. Patients who underwent surgery in the outpatient setting and those with high preoperative radicular limb pain were less likely to complete surveys. Interestingly, patients with clinical signs of depression were more likely to fill out surveys. Understanding variables associated with survey completion may provide the clinician with insight into which demographic groups are the most at-risk for not responding to surveys. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Two-level Posterior Lumbar Interbody Fusion at the Lumbosacral Segment has a High Risk of Pseudarthrosis and Poor Clinical Outcomes: Comparison Between the Lumbar and Lumbosacral Segments
Study Design: This was a retrospective study. Objectives: The purposes of this study were to investigate the fusion rate and clinical outcomes of 2-level posterior lumbar interbody fusion (PLIF). Summary of Background Data: PLIF provides favorable clinical outcomes and a high fusion rate. However, most extant studies have been limited to the results of single-level PLIF. Clinical outcomes and fusion rate of 2-level PLIF are unknown. Materials and Methods: In total, 73 patients who underwent 2-level PLIF below L3 between 2008 and 2016 (follow-up period>2 y) were included. Patients were div...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Impact of L4/5 Posterior Interbody Fusion With or Without Decompression on Spinopelvic Alignment and Health-related Quality-of-Life Outcomes
The objective was to determine the impact of single-level interbody fusion at L4/5 with or without concomitant decompression on various spinopelvic parameters and health-related quality-of-life (HRQOL) outcomes. Summary of Background Data: Recently, focus has swayed from a regional concern to a global sagittal alignment, more comprehensive approach in multilevel, corrective fusion for adult spinal deformity. However, only a few comprehensive studies have investigated the relationships between the various related spinopelvic parameters and HRQOL outcomes using single-level interbody fusion. Materials and Methods: ...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Evaluation of the Minimum Clinically Important Differences of the Zurich Claudication Questionnaire in Patients With Lumbar Spinal Stenosis
Conclusions: This study showed that the MCID of the ZCQ for symptom severity varied from 0.75 to 0.84 and the MCID for functional disability varied from 0.60 to 0.76. In addition, each AUC was over 0.80, indicating that MCIDs of the ZCQ were found to have a high diagnostic performance. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Impact of Tobacco Smoking on Outcomes After Posterior Decompression Surgery in Patients With Cervical Spondylotic Myelopathy: A Retrospective Multicenter Study
Conclusions: Smokers exhibited functional restoration and neck pain reduction after cervical posterior decompression. Attention is required, however, for the postoperative complication of delirium, which could be caused by the acute cessation of tobacco smoking after admission. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Are Preoperative PHQ-9 Scores Predictive of Postoperative Outcomes Following Anterior Cervical Discectomy and Fusion?
Conclusions: Patients with worse preoperative mental health reported significantly greater preoperative disability and pain. However, both cohorts demonstrated similar clinical recovery at the 1-year follow-up. These findings suggest patients with worse preoperative mental health can expect significant improvements in PROs following surgery. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Anterior Decompression and Fusion Versus Laminoplasty for Cervical Myelopathy Caused by Soft Disk Herniation: A Long-term Prospective Multicenter Study
Conclusions: ADF and LP for cervical myelopathy caused by CDH achieve similarly favorable outcomes. Recurrence of myelopathy caused by adjacent segment degeneration is a disadvantage of ADF while residual neck pain is a disadvantage of LP. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

The Impact of Multiple Comorbid Mental Health Disorders on Health-related Quality of Life Following ACDF
Study Design: Retrospective comparative study. Objective: The goal was to determine whether comorbid depression and/or anxiety influence outcomes after anterior cervical discectomy and fusion (ACDF) for patients with degenerative cervical pathology. Background Data: The role preoperative mental health has on patient reported outcomes after ACDF surgery is not well understood. Methods: Patients undergoing elective ACDF for degenerative cervical pathology were identified. Patients were grouped based on their preoperative mental health comorbidities, including patients with no history, depression, anx...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Surgical Outcomes of Postural Instability in Patients With Cervical Myelopathy
Conclusions: Surgery significantly improved postural stability in CM patients; however, it did not reach the level observed in healthy controls, even postoperatively. A predictor of greater residual postoperative postural instability was a greater level of preoperative postural instability. In CM patients, to achieve better surgical outcome of postural stability, surgical intervention is recommended before the symptoms related to bodily imbalance deteriorate. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Does Obesity Affect Outcomes of Multilevel ACDF as a Treatment for Multilevel Cervical Spondylosis?: A Retrospective Study
Conclusions: Patients with a higher BMI, larger neck circumference, and shorter neck length may have a longer operation duration, more blood loss, and more postoperative complications. The authors recommended that the presence of obesity and neck circumference and length should be carefully considered in the perioperative risk assessment for a multilevel ACDF surgery. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Nonhome Discharge as an Independent Risk Factor for Adverse Events and Readmission in Patients Undergoing Anterior Cervical Discectomy and Fusion
Study Design: A retrospective study of a prospectively collected cohort. Objective: To characterize a cohort of patients who underwent anterior cervical discectomy and fusion (ACDF) and examine whether nonhome discharge (NHD) is associated with postdischarge adverse events (AEs) and readmission. Summary of the Background Data: Predictors of NHD have been elucidated in the spine surgery literature, and NHD has been tied to poor outcomes in the joint arthroplasty literature, but no such analysis exists for patients undergoing ACDF. Materials and Methods: All patients who underwent ACDF from 2012 to 2...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

The Frequency of Various “Myelopathic Symptoms” in Cervical Myelopathy: Evaluation in a Large Surgical Cohort
Conclusions: The most common CC in CM related to UE sensation, whereas the most common OS related to upper and lower motor function. UE pain was more common with more distal cord compression. Those with T2 hyperintensity had worse myelopathy and were less likely to have neck pain, but more likely to have LE symptoms. To our knowledge, this study is the largest to quantify the frequency of myelopathic symptom presentation in a surgical population. These findings provide valuable insight into the symptomatic presentation of CM in clinical practice and can be used to better inform diagnosis and treatment in this complex p...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Therapeutic Impact of Traction Release After C5 Nerve Root Motor Evoked Potential (MEP) Alerts in Cervical Spine Surgery
The objective of this study was to determine the clinical impact of interventions prompted by C5 spinal nerve root MEP alerts. Summary of Background Data: MEPs have been shown to diagnose acute C5 palsies, but additional data are needed regarding the clinical impact of interventions in response to C5 MEP alerts. Materials and Methods: Procedures with isolated C5 MEP alerts were categorized as fully resolved, partially resolved, or unresolved based on the status of signals at closure. Clinical outcomes were based on neurological assessment in the immediate postoperative period. The sensitivity, specificity, li...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Identifying the Most Appropriate ACDF Patients for an Ambulatory Surgery Center: A Pilot Study Using Inpatient and Outpatient Hospital Data
Study Design: Retrospective cohort analysis of prospectively collected data. Objectives: Using a national cohort of patients undergoing elective anterior cervical discectomy and fusion (ACDF) in an inpatient/outpatient setting, the current objectives were to: (1) outline preoperative factors that were associated with complications, and (2) describe potentially catastrophic complications so that this data can help stratify the best suited patients for an ambulatory surgery center (ASC) compared with a hospital setting. Summary of Background Data: ASCs are increasingly utilized for spinal procedures and rep...
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: PRIMARY RESEARCH Source Type: research

Therapeutic Facet Joint Interventions in the Lumbar Spine: An Economic Value Perspective
Conclusion: Consequently, there is a need for high-quality cost-effectiveness studies for facet joint interventions so that evidence-based and economically viable solutions can be used to optimize patient care at a societally affordable price. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: THE BUSINESS OF MEDICINE Source Type: research

Advantages and Design of PROMIS Questionnaires
This article discusses the rationale and design of this tool, as well as its advantages to both research and clinical practice. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: RESEARCH METHODOLOGY Source Type: research

3D-printed Patient-specific Spine Implants: A Systematic Review
Conclusions: Results of the systematic review indicate that 3DP technology is a viable means to fabricate patient-matched spinal implants. The effects on clinical and radiographic outcome measures are still in question, but these devices may produce favorable subsidence and pseudoarthrosis rates. Currently, the technology is ideally suited for complex tumor pathology and atypical bone defects. Future randomized controlled trials and cost analyses are still needed. Level of Evidence: IV—systematic review. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: SYSTEMATIC REVIEWS AND META-ANALYSES Source Type: research

The 2019 Cervical Spine Research Society (CSRS) Asia Pacific Traveling Fellowship
The Cervical Spine Research Society (CSRS) is dedicated to advancing the care of patients with cervical spine pathology. The authors present here highlights of the 2019 CSRS-Asia Pacific Traveling Fellowship. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: NARRATIVE REVIEW Source Type: research

What Is the Optimal Surgical Treatment for Low-Grade Isthmic Spondylolisthesis? ALIF or TLIF?
No abstract available (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - December 1, 2020 Category: Surgery Tags: CONTROVERSIES IN SPINE SURGERY Source Type: research

Patient Risk Factors Associated With 30- and 90-Day Readmission After Cervical Discectomy: A Nationwide Readmission Database Study
Conclusion: Our nationwide study identifies the 30- and 90-day readmission rates and several patient-related risk factors associated with unplanned readmission after common anterior cervical spine procedures. Level of Evidence: Level III. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2020 Category: Surgery Tags: Primary Research Source Type: research

Identification of Risk Factors for Readmission in Patients Undergoing Anterior Cervical Discectomy Fusion: A Predictive Risk Scale
Conclusions: Overall, 30-day readmission following ACDF surgery was 5%–6%. A novel risk scale based on factors associated with increased readmission rates may be helpful in identifying patients who require additional optimization to reduce perioperative morbidity. Level of Evidence: Level III—prognostic. (Source: Journal of Spinal Disorders and Techniques)
Source: Journal of Spinal Disorders and Techniques - November 1, 2020 Category: Surgery Tags: Primary Research Source Type: research