An Experimental Rat Model of C5 Palsy Following Posterior Decompression Surgery of the Cervical Spine
Conclusion. This model was thought to be appropriate for analyzing the pathogenesis of C5P since our findings were comparable to the clinical course of C5P subsequent to posterior cervical decompression. Although a future study for clarifying histological and molecular alterations will be needed, tethering of the anterior rootlets due to posterior cord shift was suggested to be a probable mechanism causing C5P. Level of Evidence: 5 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Cytokine Profile From the Ligamentum Flavum in Patients with Ossification of the Posterior Longitudinal Ligament in the Cervical Spine
Conclusion. Our findings suggest that specific changes in the cytokine profile during ossification promote osteoblast differentiation, thereby providing new insights into OPLL pathogenesis. Moreover, this work supports the development of a new therapeutic method for preventing OPLL progression by regulating the cytokine profiles. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Preoperative Lower Extremity Motor Weakness Affects Deep Vein Thrombosis During the Perioperative Period of Lumbar Surgery
Study Design. Prospective cohort study. Objective. The aim of this study was to assess preoperative factors in the development/exacerbation of deep vein thrombosis (DVT) in lumbar surgery and selectively perform lower-extremity venous ultrasonography (US) in patients at risk of perioperative deep vein thrombosis (DVT). Summary of Background Data. DVT is often present before lumbar surgery and also can develop or is exacerbated postoperatively. An elevated d-dimer level is predictive of DVT but not in all patients or during every operative period. The level of the thrombogenic marker soluble fibrin monomer...
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

The Association Between Different Trajectories of Low Back Pain and Degenerative Imaging Findings in Young Adult Participants Within The Raine Study
Conclusion. Lumbar disc degeneration and herniation may be important contributors to disabling LBP in young adults. Further investigation of their potential prognostic and causal roles is indicated. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

No Difference in Reoperation Rates for Adjacent Segment Disease (Operative Adjacent Segment Disease) in Posterior Cervical Fusions Stopping at C7 Versus T1/T2: A Cohort of 875 Patients—Part 1
Conclusion. A large cohort of 875 patients with PCFs stopping at –C7 or –T1/T2 with an average follow-up of more than 4 years found no statistical difference in reoperation rates for ASD (operative ASD). Level of Evidence: 3 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Integrated Custom Composite Polyetheretherketone/Carbon fiber (PEEK/CF) Vertebral Body Replacement (VBR) in the Treatment of Bone Tumors of the Spine: A Preliminary Report From a Multicenter Study
Conclusion. This is the first series to describe the use of a fully-radiolucent, integrated, PEEK/CF implant system for spinal tumor reconstruction. The use of a PEEK/CF VBR system integrated to either the anterior plate, or posterior screw-rod system is feasible and allows for superior postoperative surveillance imaging and effective delivery of postoperative adjuvant radiotherapy. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Development of Tuberculosis Spine Instability Score (TSIS): An Evidence-Based and Expert Consensus-Based Content Validation Study Among Spine Surgeons
Conclusion. TSIS is a comprehensive scoring system integrating demographic, anatomical, clinical, and radiological factors aimed at diagnosing instability in TB spine. The classification determines indications for surgical stabilization in patients with TB spine, with no or little neurological deficit. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Influences of Thoracic Spinal Deformity on Exercise Performance and Pulmonary Function: A Prospective Study of 168 Patients with Adolescent Idiopathic Scoliosis
Study Design. A prospective study. Objective. The aim of this study was to investigate the factors associated with cardiopulmonary exercise testing (CPET) measurements in patients with adolescent idiopathic scoliosis (AIS). Summary of Background Data. Patients with AIS display restrictive pulmonary dysfunction on pulmonary function testing (PFT). It remains unknown whether thoracic spinal deformity affects exercise performance. Methods. One hundred and sixty-eight patients with AIS from January 2014 to December 2019 were included. They underwent preoperative spinal radiological assessment, PFT, and...
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Selective Anterior Fusion Surgery Does Not Influence Global Spinal Sagittal Alignment in Lenke Type 5 Adolescent Idiopathic Scoliosis Patients
Conclusion. Selective ASF did not influence various GSSA parameters postoperatively and could maintain excellent correction for coronal deformity with satisfactory final functional and clinical outcomes confirmed by long-term follow-up. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Examination of Adult Spinal Deformity Patients Undergoing Surgery with Implanted Spinal Cord Stimulators and Intrathecal Pumps
Study Design. Retrospective cohort study of a prospectively collected multi-center database of adult spinal deformity (ASD) patients. Objective. We hypothesized that patients undergoing ASD surgery with and without previous spinal cord stimulators (SCS)/ intrathecal medication pumps (ITP) would exhibit increased complication rates but comparable improvement in health-related quality of life. Summary of Background Data. ASD patients sometimes seek pain management with SCS or ITP before spinal deformity correction. Few studies have examined outcomes in this patient population. Methods. Patients under...
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: DEFORMITY Source Type: research

A Matched Cohort Analysis of Drain Usage in Elective Anterior Cervical Discectomy and Fusion: A Michigan Spine Surgery Improvement Collaborative (MSSIC) Study
This study was designed to analyze the impact of drain use following elective anterior cervical discectomy and fusion (ACDF) surgeries. Summary of Background Data. After ACDF, a drain is often placed to prevent postoperative hematoma. However, there has been no high quality evidence to support its use with ACDF despite the theoretical benefits and risks of drain placement. Methods. The Michigan Spine Surgery Improvement Collaborative database was queried to identify all patients undergoing elective ACDF between February 2014 and October 2019. Cases were divided into two cohorts based on drain use. Propensity-...
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Spinal Cord Medial Safe Zone for C2 Pedicle Instrumentation: An MRI Measurement Analysis
Study Design. Retrospective observational study. Objective. The aim of this study was to investigate the spinal cord safety margins for C2 instrumentation. Summary of Background Data. Intraoperative spinal cord injury during C2 spine surgery is a rare, but potentially life-threatening complication. Preoperative planning for C2 instrumentation mainly focuses on C2 pedicle bony dimensions on CT and the vertebral artery location and few studies have evaluated C2 spinal cord safety margins. Methods. We measured two distances in C2 bilaterally: C2 pedicle to dura distance (P-D), defined as a transverse ...
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Length of Cervical Stenosis, Admission ASIA Motor Scores, and BASIC Scores Are Predictors of Recovery Rate Following Central Cord Syndrome
This study aims to determine whether quantitative magnetic resonance imaging (MRI) parameters and radiological scoring systems could be used as a reliable assessment tool for predicting neurological recovery trajectory following acute traumatic central cord injury syndrome (CCS). Summary of Background Data. Controversy remains in whether CCS should be managed conservatively or by early surgical decompression. It is essential to understand how clinical and radiological parameters correlate with neurological deficits and how they predict recovery trajectories. Methods. We identified patients with CCS admitted b...
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study
Conclusion. Our study shows that the MRI degenerative findings we examined, individually or in combination, do not have clinically important associations with LBP, with almost all effects less than one unit on a 0 to 10 pain scale. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Lower Neurological Risk with Anterior Operations Compared to Posterior Operations for Thoracic Disc Herniations: Analysis of 697 Patients
Study Design. Retrospective cohort study. Objective. Compare rates of postoperative neural deficits between surgical approaches for thoracic disc herniations (TDHs). Summary of Background Data. Anterior and posterior approaches for TDH carry high reported neurological risk, albeit comparative risk is not well defined. Methods. Health Care Utilization Project (HCUP) state inpatient databases (NY, FL, CA; 2005–2014) were queried for patients who underwent TDH operation. Demographics, operative details, surgical approach, neural injury, length of stay (LOS), and discharge location were assessed....
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: SURGERY Source Type: research

Propensity-Matched Comparison of 90-Day Complications in Robotic-Assisted Versus Non-Robotic Assisted Lumbar Fusion
Conclusion. In propensity-matched cohorts, patients undergoing 1- to 3-level robotic-assisted posterior lumbar fusion for degenerative conditions did not have increased 90-day complication rate, and had a shorter length of stay compared with non-robotic-assisted patients. There findings differ from a prior administrative database study as the robotic-assisted group in the current study had 0% return to OR for malpositioned screws and 0.8% return to OR for infection. Level of Evidence: 2 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: SURGERY Source Type: research

Adjunctive Topical Tranexamic Acid for Blood Salvage Does Not Reduce Postoperative Blood Loss Compared with Placebo in Patients Who Undergo Palliative Decompressive Spinal Metastasis Surgery: A Randomized Controlled Trial
Conclusion. We do not recommend tTXA as an adjunctive treatment for patients undergoing decompressive spinal metastasis surgery since it does not provide additional benefit to prophylactic intravenous TXA in postoperative blood loss and transfusion rate. Level of Evidence: 2 (Source: Spine)
Source: Spine - January 11, 2022 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

Power-assisted Pedicle Screw Technique Protects Against Risk of Surgeon Overuse Injury: A Comparative Electromyography Study of the Neck and Upper Extremity Muscle Groups in a Simulated Surgical Environment
Conclusion. Power-assisted technique protects against risk of overuse injury. Elevated muscle exertion of the extensor carpi radialis, biceps, upper trapezius, and neck extensors during manual technique directly correlate with surgeons’ self-reported diagnoses of lateral epicondylitis, rotator cuff disease, and cervical myelopathy. Level of Evidence: N/A (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Intraoperative Ultrasound in Spine Decompression Surgery: A Systematic Review
Conclusion. The systematic review examines the current literature on IOUS and spinal decompression surgery. We identified a common qualitative definition for adequate decompression involving a “free floating” spinal cord within the cerebrospinal fluid which indicates that the spinal cord is free from contact of the anterior elements. Level of Evidence: 1 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research

Clinical and Patient-reported Outcomes After Posterior Versus Transforaminal Lumbar Interbody Fusion—A Propensity Score-matched Cohort Study on 422 Patients with 2-year Follow-up
Conclusion. We found no significant difference in PRO at 2-year follow-up between PLIF and TLIF for the treatment of lumbar disc degeneration. PLIF is associated with a five times higher risk of dural tears. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Characteristics of Tc-MEP Waveforms for Different Locations of Intradural Extramedullary Tumors: A Prospective Multicenter Study of the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research
Study Design. Prospective multicenter study. Objective. To examine transcranial motor-evoked potential (Tc-MEP) waveforms in intraoperative neurophysiological monitoring in surgery for intradural extramedullary (IDEM) tumors, focused on the characteristics for cervical, thoracic, and conus lesions. Summary of Background Data. IDEM tumors are normally curable after resection, but neurological deterioration may occur after surgery. Intraoperative neurophysiological monitoring using Tc-MEPs during surgery is important for timely detection of possible neurological injury. Methods. The subjects were 233...
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Cervical Myelopathy Screening with Machine Learning Algorithm Focusing on Finger Motion Using Noncontact Sensor
Conclusion. Our binary classification model using a machine learning algorithm and Leap Motion could classify CM with high sensitivity and would be useful for CM screening in daily life before consulting doctors and telemedicine. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

The Association of Lumbosacral Transitional Vertebrae with Low Back Pain and Lumbar Degenerative Findings in MRI: A Large Cohort Study
Conclusion. LSTVs were a common finding within this study, and Castellvi type III LSTVs were associated with LBP. Degenerative findings were associated with LSTV anatomy and occurred more commonly above the transitional level. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

The Function Assessment Scale for Spinal Deformity: Validity and Reliability of a New Clinical Scale
Discussions between experts on the clinical relevance of selected items led to further item reduction. The FASD's discriminative ability was established between 43 patients and 19 controls, as well as between three deformity subgroups. For its responsiveness to treatment, 10 patients were reevaluated 6 months postoperatively. Concurrent validity was assessed through correlation analysis with radiographic parameters (pelvic tilt; sagittal vertical axis [SVA]; pelvic incidence minus lumbar lordosis [PI-LL]; coronal vertical axis) and patient-reported scores [Oswestry Disability Index]; Scoliosis Research Society outcome ques...
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Preoperative Radiographic Evaluation of Thoracic Flexibility and Compensation for Adult Spinal Deformity Surgery. How to Select Optimal Upper Instrumented Vertebra to Prevent Proximal Junctional Kyphosis
Conclusion. Because of their significantly high risk for PJK, in patients with ASD and prone ΔTK>11.5° and supine ΔTK>18.5°, the upper-thoracic spine should be considered for UIV. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Surgical Factors and Treatment Severity for Perioperative Complications Predict Hospital Length of Stay in Adult Spinal Deformity Surgery
Conclusion. Careful selection of surgical factors may help reduce hospital LOS following surgery for ASD. Classification of complications by treatment severity can help surgeons better understand and predict the implications of complications, in turn assisting with surgical planning and patient counseling. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Best Practice Guidelines for Assessment and Management of Osteoporosis in Adult Patients Undergoing Elective Spinal Reconstruction
Conclusion. Based on the consensus of a multidisciplinary panel of experts, we propose best practice guidelines for assessment and treatment of poor bone health prior to elective spinal reconstructive surgery. Patients above age 65 and those with particular risk factors under 65 should undergo formal bone health evaluation. We also established guidelines on perioperative optimization, utility of various diagnostic modalities, and the optimal medical management of bone health in this population. Level of Evidence: 5 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Prospective Randomized Control Pilot Study to Compare the Role of Injection Cerebrolysin in Operated cases of Degenerative Cervical Myelopathy
We present our pilot study which analyzes the role of cerebrolysin in patients of DCM managed by surgical modalities. Methods. This prospective randomized control trial was conducted at a tertiary care institute in Mumbai. Sixty operated cases of DCM were randomly divided into 2 groups. The first group was given Injection Cerebrolysin 5 mL diluted in 100 mL Normal Saline over 30 minutes once a day for 21 days postoperatively. The second group was given placebo. Modified Japanese Orthopedic Association scores (mJOA) and visual analog scale (VAS) were used to document functional outcomes at 3 weeks, 3 months, 6 mo...
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Single-level Cervical Arthroplasty with Prodisc-C Vivo Artificial Disc: Five-year Follow-up Results From One Center
Study Design. Retrospective study. Objective. The aim of this study was to evaluate the long-term clinical and radiographic outcomes of cervical arthroplasty using the ProDisc-C Vivo prosthesis. Summary of Background Data. Previous reports have shown that cervical arthroplasty with ProDisc-C artificial disc has acceptable clinical outcomes at 5-year and 10-year follow-ups. Methods. Clinical and radiographic evaluations, including dynamic flexion-extension lateral images, were performed at baseline and at the 5-year follow-up. Results. Twenty-eight patients who underwent single-level ProDisc-...
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Relationship Between Vertebral Bone Marrow Edema and Early Progression of Intervertebral Disc Wedge or Narrowing After Lumbar Decompression Surgery
Study Design. A retrospective study. Objectives. The aim of this study was to review clinical and imaging features in patients with lumbar spinal canal stenosis (LSS) with and without postoperative early progression of intervertebral disc degeneration (IDD) and to identify predictive factors. Summary of Background Data. Progression of IDD after lumbar decompression surgery can induce low back pain and leg pain, and may require revision surgery. However, risk factors for postoperative radiological changes indicating IDD linked to development of symptoms have not been described. Methods. We included ...
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Sarcopenia, Ectopic Fat Infiltration Into the Lumbar Paravertebral Muscles, and Lumbo-Pelvic Deformity in Older Adults Undergoing Lumbar Surgery
Conclusion. The volume loss of skeletal muscle, including lumbar PVM, and ectopic fat infiltration into the PVM, may cause the lumbo-pelvic deformity. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Cauda Equina Syndrome: Poor Recovery Prognosis Despite Early Treatment
Study Design. A prospective patient's database operated on a cauda equina syndrome (CES). Objective. The aim of our study was to identify prognosis factors for favorable functional recovery after CES. Summary of Background Data. CES is a neurologic impairment of variable symptoms associating urinary, bowel, and sexual dysfunctions with or without motor or sensitive deficits caused by nerve root compression of the cauda equina. The definition of CES remains debated, as well as the prognosis factors for favorable functional recovery and the benefit of early surgery. Methods. One hundred forty patient...
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Characterizing Health-Related Quality of Life by Ambulatory Status in Patients with Spinal Metastases
Conclusion. Patients with spinal metastases and independent ambulatory function have an HRQL similar to patients with primary cancers and no spinal involvement. Loss of ambulatory ability leads to a 22% decrease in HRQL for ambulation with assistance and an 82% reduction among nonambulators. Given prior studies demonstrate superior maintenance of ambulatory function with surgery for spinal metastases, our results support surgical consideration to the extent that it is clinically warranted. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Oral Is as Effective as Intravenous Tranexamic Acid at Reducing Blood Loss in Thoracolumbar Spinal Fusions: A Prospective Randomized Trial
Conclusion. Patients treated with IV and PO TXA experienced the same perioperative blood loss after small and large spinal fusions. In subgroup analysis, the intermediate (three to five level) spinal fusions had less blood loss with PO TXA than IV TXA. Given its lower cost, PO TXA represents a superior alternative to IV TXA in patients undergoing elective posterior thoracolumbar fusion and may improve health care cost-efficiency in the studied population. Level of Evidence: 1 (Source: Spine)
Source: Spine - December 17, 2021 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

Preclinical Safety of a 3D-Printed Hydroxyapatite-Demineralized Bone Matrix Scaffold for Spinal Fusion
Conclusion. The 3D-printed HA-DBM composite induces a significantly reduced host inflammatory response in a preclinical spinal fusion model relative to rhBMP-2. Level of Evidence: N/A (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

The Impact of Radiographic Lower Limb-Spinal Length Proportion on Whole-Body Sagittal Alignment
Conclusion. Larger radiographic lower limb-spinal length proportion results in naturally accentuated spinal curves. These patients balance with a larger lumbar lordosis that is closer to the PI and a higher T1-slope which should be considered for spinal realignment. SL differs from GLA and should be separately assessed. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Efficacy of Intraoperative Neuromonitoring Using Transcranial Motor-Evoked Potentials for Degenerative Cervical Myelopathy: A Prospective Multicenter Study by the Monitoring Committee of the Japanese Society for Spine Surgery and Related Research
Conclusion. Since Tc(E)-MEPs are excellent for detecting long tract injuries, surgeons need to consider appropriate interventions in response to alerts. The detection of acute onset segmental palsy by Tc(E)-MEPs was partially possible with OPLL, but may still be difficult with CSM. The rescue rate was higher than 50% and appropriate interventions may have prevented postoperative neurological complications. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Large Lumbar Lordosis Is a Risk Factor for Lumbar Spondylolysis in Patients with Adolescent Idiopathic Scoliosis
Conclusion. We should be vigilant for lumbar spondylolysis in AIS patients whose LL and SS are large, especially with LL larger than 56.5°. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

The Clinical Relevance of the Cervical Disc Prosthesis: Combining Clinical Results of Two RCTs
Conclusion. After combining data from two Randomized Controlled Trials it can be concluded that there is no clinical benefit for ACDA, when compared with ACDF or ACD 2 years after surgery. Preliminary subgroup analysis indicated outcomes were similar between treatment groups, and that no subgroup could be appointed that benefited more from either ACD, ACDF, or ACDA. Level of Evidence: 1 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Cervical Spine Injuries with Acute Traumatic Spinal Cord Injury: Spinal Surgery Adverse Events and Their Association with Neurological and Functional Outcome
Conclusion. SSAE are an important risk factor after acute traumatic cervical SCI with impact on neurological recovery, functional outcome, and healthcare costs. Reducing SSAE is a viable means to protect the limited intrinsic capacity for recovery from SCI. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Revision Surgery for Adjacent Segment Degeneration After Fusion for Lumbar Spondylolisthesis: Is there a Correlation with Roussouly Type?
Conclusion. We found that there may be a correlation between Roussouly type and revision surgery for ASD after L4-5 TLIF for spondylolisthesis, with type 2 spines having the highest rate. Spinopelvic parameters may also correlate with revision surgery for ASD after L4-5 TLIF. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Early Decompression and Short Transport Time After Traumatic Spinal Cord Injury are Associated with Higher American Spinal Injury Association Impairment Scale Conversion
Study Deign. Retrospective cohort study. Objectives. This retrospective cohort study aims to determine the association of early decompressive surgery and the impact of transport time on the neurological outcomes of traumatic spinal cord injury (tSCI) patients. Summary of Background Data. tSCI is a catastrophic event that may result in permanent disability or loss of function. To date, there remains significant controversy over the optimal time for surgical decompression in tSCI patients. The aim of this study is to evaluate the neurological outcomes of tSCI patients undergoing early versus late surgical d...
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Analysis of Factors Associated with Return-to-Work After Lumbar Surgery up to 2-Years Follow-up: A Michigan Spine Surgery Improvement Collaborative (MSSIC) Study
Conclusion. In patients inquiring about long-term return-to-work after lumbar surgery, insurance status represents the important determinant of employment status. Level of Evidence: 2 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

What Is the Comparison in Robot Time per Screw, Radiation Exposure, Robot Abandonment, Screw Accuracy, and Clinical Outcomes Between Percutaneous and Open Robot-Assisted Short Lumbar Fusion?: A Multicenter, Propensity-Matched Analysis of 310 Patients
Conclusion. Percutaneous robot-assisted spine surgery may increase radiation exposure, but can achieve a shorter operative time and lower risk for intraoperative blood loss for short-lumbar fusion. Percutaneous approaches do not appear to have an advantage for other short-term postoperative outcomes. Future multicenter studies on longer fusion surgeries and the inclusion of patient-reported outcomes are needed. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Reducing Postoperative Opioid-prescribing Following Posterior Lumbar Fusion Does Not Significantly Change Patient Satisfaction
Study Design. Retrospective comparative; LOE-3. Objective. The purpose of this study was to investigate what effect, if any, an institutional opioid reduction prescribing policy following one- or two-level lumbar fusion has on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results. Summary of Background Data. Previous research has demonstrated that high levels of opioid-prescribing may be related, in part, to a desire to produce superior patient satisfaction. Methods. A retrospective review of prospectively collected data was conducted on patients who underwent one...
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Patient Experiences of Telemedicine in Spine Care: A Mixed Methods Study
Study Design. Survey-based study. Objective. We performed a mixed methods study involving patients using telemedicine for spine care. We sought to understand factors influencing the utilization and evaluation of this modality. Summary of Background Data. Telemedicine has been integrated into routine spine care; its long-term viability will depend not only on optimizing its safety, efficiency, and cost-effectiveness, but also on understanding patient valuation of its benefits and limitations. Methods. We used a clinical registry to identify spine patients seen virtually by providers at our tertiary ...
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Mechanical Complications in Adult Spinal Deformity Surgery: Can Spinal Alignment Explain Everything?
Conclusion. The results point to the complexity of mechanical failure and the high likelihood that causative factors are multifactorial and not limited to alignment measures. GAP score should be used with caution as it may not explain or predict mechanical failure based on alignment in all populations as originally expected. Future studies should focus on etiology, surgical technique, and patient factors in order to generate a more universal score that can be applied to all populations. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Increasing Cost Efficiency in Adult Spinal Deformity Surgery: Identifying Predictors of Lower Total Costs
Study Design. Retrospective study of a prospective multicenter database. Objective. The purpose of this study was to identify predictors of lower total surgery costs at 3 years for adult spinal deformity (ASD) patients. Summary of Background Data. ASD surgery involves complex deformity correction. Methods. Inclusion criteria: surgical ASD (scoliosis ≥20°, sagittal vertical axis [SVA] ≥5 cm, pelvic tilt ≥25°, or thoracic kyphosis ≥60°) patients>18 years. Total costs for surgery were calculated using the PearlDiver database. Cost per quality-adjusted life year was ass...
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

A Randomized Controlled Trial to Evaluate the Clinical Effectiveness of 3D-Printed Orthosis in the Management of Adolescent Idiopathic Scoliosis
Study Design. Prospective randomized controlled trial. Objective. To compare clinical effectiveness and quality of life (QoL) of the 3D-printed orthosis (3O) and conventional orthosis (CO) for adolescent idiopathic scoliosis (AIS). Summary of Background Data. Using 3D printing technology to design and fabricate orthoses to manage AIS aiming to improve in-orthosis correction and patients’ compliance that are considered essential factors of effective treatment. Clinical evaluation was conducted to study the effectiveness of this innovative method. Methods. Thirty females with AIS who met the cr...
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

Does Engaging Patients with Relevant Education About Long-Term Opioid Use Before Spine Surgery Affect Long-term Opioid Use? A Randomized Controlled Trial
Conclusion. The video education session did not influence opioid use after spine surgery compared to the usual care control. There was no significant difference in individuals classified as long-term opioid users after surgery based on the intervention group. Prior opioid use was a strong predictor of future opioid use in this cohort. Strategies to improve education engagement, understanding, and decision- making continue to be of high importance for mitigating risk of long-term opioid use after spine surgery. Level of Evidence: 1 (Source: Spine)
Source: Spine - December 10, 2021 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research