Migration of a Lumbar Spinal Fusion Rod Into the Posterolateral Knee: A Case Report
Conclusion. Spinal implant migration is a rare complication most often due to implant failure from pseudoarthrosis. In the case presented, this phenomenon was likely attributed to the use of unilateral instrumentation coupled with Marfan syndrome, shown to lead to insufficient implant stability and poorer fusion rates, respectively. Level of Evidence: 5 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: CASE REPORT Source Type: research

Use of Higher-strength Opioids has a Dose-Dependent Association With Reoperations After Lumbar Decompression and Interbody Fusion Surgery
Study Design. A retrospective cohort study. Objective. The aim of this study was to identify an association between preoperative opioid use and reoperations rates. Summary of Background Data. Chronic opioid use is a public health crisis in the United States and has been linked to worse outcomes after lumbar spine surgery. However, no studies have identified an association between preoperative opioid use and reoperations rates. Methods. A retrospective cohort study was conducted using patients from one private insurance database who underwent primary lumbar decompression/discectomy (LDD) or posterio...
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Do Preoperative Epidural Steroid Injections Increase the Risk of Infection After Lumbar Spine Surgery?
Study Design. Retrospective study. Objective. To elucidate an association between preoperative lumbar epidural corticosteroid injections (ESI) and infection after lumbar spine surgery. Summary of Background Data. ESI may provide diagnostic and therapeutic benefit; however, concern exists regarding whether preoperative ESI may increase risk of postoperative infection. Methods. Patients who underwent lumbar decompression alone or fusion procedures for radiculopathy or stenosis between 2000 and 2017 with 90 days follow-up were identified by ICD/CPT codes. Each cohort was categorized as no preoperative...
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Novel Simultaneous Decompression Through Single-stage Mini-thoracotomy for Concurrent Ossification of the Posterior Longitudinal Ligament and Ossification of the Ligamentum Flavum at the Same Thoracic Level: A Technical Report and Literature Review
Conclusion. This novel surgical technique is considered to be able to be a safe and effective alternative to the conventional treatment of selective cases of thoracic myelopathy caused by concurrent OPLL and OLF at the same thoracic level. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: SURGERY Source Type: research

Complication Rates After Elective Lumbar Fusion Procedures in Patients With Oral Preoperative Corticosteroid Use
Level of Evidence: 3 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: RESEARCH LETTER Source Type: research

Fragility Analysis of Statistically Significant Outcomes of Randomized Control Trials in Spine Surgery: A Systematic Review
Conclusion. Statistically significant dichotomous outcomes reported in spine surgery RCTs are more often fragile and outcomes of the patients lost to follow-up could have changed the significance of results and hence it needs caution before transcending their results into clinical application. The addition of FI in routine reporting of RCTs would guide readers on the robustness of the statistical significance of outcomes. RCTs with FI ≥5 without any patient lost to follow-up can be considered to have clinically robust results. Level of Evidence: 1 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research

Does Duration of Pain at Baseline Influence Longer-term Clinical Outcomes of Low Back Pain Patients Managed on an Evidence-Based Pathway?
Study Design. Nonrandomized longitudinal observational study. Objective. The aim of this study was to evaluate the association between baseline pain duration and medium-to-long term clinical outcomes, in low back pain (LBP) patients enrolled on the North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP). Summary of Background Data. The NERBPP is based upon National Institute for Health and Care Excellence (NICE) guidelines. These guidelines no longer differentiate management of LBP patients based on pain duration. Medium-to-long term data from the NERBPP is lacking. Methods. Be...
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

The Impact of Preoperative Depression on Patient Satisfaction With Spine Surgeons in the Outpatient Setting
Conclusion. Preoperative depression is independently associated with lower OPR and satisfaction with spine surgeon communication in the outpatient setting after lumbar surgery. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Usefulness of Trabecular CT Attenuation Measurement of Lumbar Spine in Predicting Osteoporotic Compression Fracture: Is the L4 Trabecular Region of Interest Most Relevant?
Study Design. Retrospective study Objective. The aim of this study was to evaluate the usefulness of computed tomography (CT) attenuation in defining trabecular region-of-interest (t-ROI) at lumbar vertebral body in the assessment of osteoporotic compression fracture (OCF) compared to spinal dual x-ray absorptiometry (DXA). Summary of Background Data. Even though osteoporosis was not diagnosed in the bone mineral density measurement using DXA, we often experienced cases where the screw was weakly inserted due to low bone quality during screw insertion. Methods. A total of 188 patients who met the i...
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Do Thoracic Spinal Deformities Affect Outcomes of Spinal Cord Stimulators: A Retrospective Chart Review
Conclusion. SCSs can be effective options for treating lumbar back pain and radiculopathy. Our study suggests that the presence of mild structural deformities does not adversely affect outcomes of permanent SCS placement and as such should not preclude this population from benefiting from such therapies. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Preoperative Hounsfield Units at the Planned Upper Instrumented Vertebrae May Predict Proximal Junctional Kyphosis in Adult Spinal Deformity
Study Design. Retrospective cohort study. Objective. To investigate the association between Hounsfield units (HU) measured at the planned upper instrumented vertebra (UIV) and UIV+1 and proximal junctional kyphosis (PJK) in patients with adult spinal deformity (ASD). Summary of Background Data. PJK is a common complication following surgery for ASD and poor bone quality is noted to be one of the risk factors. HUs from standard computed tomography (CT) scans can be used for evaluating regional bone quality. Methods. Sixty-three patients were included from a single institution. The demographic charac...
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Lumbar Adding-on of the Thoracic Spine After Selective Fusion in Adolescent Idiopathic Scoliosis Lenke Types 1 and 2 Patients: A Critical Appraisal
Conclusion. The incidence of lumbar curve adding-on was 6.2%. Patients who were hypokyphotic and skeletally immature are nine times and six times more likely to have lumbar adding-on, respectively. This article examines adding-on in patients who had either anterior or posterior approach scoliosis surgeries, with follow-up stretching up to 10 years. This offers the rare opportunity to examine the natural history of the adding-on phenomenon. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Risk Factors for Proximal Junctional Kyphosis Following Surgical Deformity Correction in Pediatric Neuromuscular Scoliosis
Conclusion. Twenty-seven percent of patients with NMS developed PJK, and 7% had revision surgery. Those treated with halo gravity traction or with greater postoperative C2 sagittal translation, loss of primary curve correction, and smaller preoperative proximal kyphosis had the greatest risk of developing PJK. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: DEFORMITY Source Type: research

A Novel Clinical Scoring System for Perioperative Morbidity in Metastatic Spinal Tumor Surgery: The Spine Oncology Morbidity Assessment Score
Study Design. Retrospective cohort study. Objective. To evaluate a scoring system to predict morbidity for patients undergoing metastatic spinal tumor surgery (MSTS). Summary of Background Data. Multiple scoring systems exist to predict survival for patients with spinal metastasis. The potential benefits and risks of surgery need to be evaluated for patients with disseminated cancer and limited life expectancy. Few scoring systems exist to predict perioperative morbidity after MSTS. Methods. We reviewed records of patients who underwent MSTS at our institution between 2013 and 2019. All perioperati...
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Accuracy of Patient-Specific 3D-Printed Drill Guides for Pedicle and Lateral Mass Screw Insertion: An Analysis of 76 Cervical and Thoracic Screw Trajectories
Conclusions. 3D virtual planning and 3D-printed patient-specific drill guides appear to be safe and accurate for pedicle and lateral mass screw insertion in the cervical and upper-thoracic spine. The quantitative 3D deviation analyses confirmed that screw positions were accurate with respect to the 3D-surgical plan. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Comparison of Clinical Outcomes and Sagittal Alignment After Different Levels of Anterior Cervical Discectomy and Fusion in Patients With Cervical Spondylotic Myelopathy: From One-level to Three-level
Conclusion. ACDF with different levels had similar postoperative clinical outcomes. Three-level ACDF has an apparent advantage in restoring lordosis, a poor ability to maintain lordosis, and a higher incidence of complications compared to one-level or two-level ACDF. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Long-term Radiographic Outcome of Occipitocervical Fixation: An Analysis of Fusion Rate and Spontaneous Subaxial Alignment Change at an Average 7-year Follow-up
Conclusion. The CT-confirmed fusion rate of OCF was 77.2% over an average 89.7-month follow-up. Compensatory sagittal alignment change can occur in the unfused subaxial segments in conjunction with the alignment change in the instrumented OC segments, whereas the horizontal gaze was maintained. Strong consideration for the intraoperative measurement of the OC2A should be given during OCF to minimize both early and long-term complications. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Artificial Intelligence-enabled, Real-time Intraoperative Ultrasound Imaging of Neural Structures Within the Psoas: Validation in a Porcine Spine Model
Conclusion. This study demonstrates that a combination of AI-derived image processing and machine learning algorithms can be developed to enable real-time ultrasonic detection, segmentation, classification, and display of critical anatomic structures, including neural tissue, during spine surgery. AI-enhanced ultrasound imaging can provide a visual map of important anatomy in and adjacent to the psoas, thereby providing the surgeon with critical information intended to increase the safety of LLIF surgery. Level of Evidence: N/A (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

2021 Young Investigator Award Winner: Anatomic Gradients in the Microbiology of Spinal Fusion Surgical Site Infection and Resistance to Surgical Antimicrobial Prophylaxis
Study Design. Retrospective hospital-registry study. Objective. To characterize the microbial epidemiology of surgical site infection (SSI) in spinal fusion surgery and the burden of resistance to standard surgical antibiotic prophylaxis. Summary of Background Data. SSI persists as a leading complication of spinal fusion surgery despite the growth of enhanced recovery programs and improvements in other measures of surgical quality. Improved understandings of SSI microbiology and common mechanisms of failure for current prevention strategies are required to inform the development of novel approaches to pre...
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: YOUNG INVESTIGATOR AWARD Source Type: research

There's More to Consider Than Thoracic Spine Height—The Case for Primary Spine Fusion in Older Early-onset Scoliosis Patients
No abstract available (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: EDITORIAL Source Type: research

“Glacier River in Zermatt, Switzerland”
No abstract available (Source: Spine)
Source: Spine - January 12, 2021 Category: Orthopaedics Tags: IMAGERY Source Type: research

Diagnostic Accuracy of Thresholds Less Than or Equal to 8 mA in Pedicle Screw Testing During Lumbar Spine Procedures to Predict New Postoperative Lower Extremity Neurological Deficits
Conclusion. Patients with pedicle screw stimulation thresholds less than or equal to 8 mA are 4.34 times more likely to have neurological clinical manifestations. Smoking and LE deficits were shown to be significantly correlated with pedicle screw stimulation thresholds less than or equal to 8 mA. Low stimulation thresholds result in a high specificity of 90%. Pedicle screw stimulation less than or equal to 8 mA can serve as an accurate rule in test for postoperative neurological deficit, warranting reevaluation of screw placement and/or replacement intraoperatively. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

Risk Factors Associated With Development of Urinary Retention Following Posterior Lumbar Spinal Fusion: Special Attention to the Use of Glycopyrrolate in Anesthesia Reversal
Conclusion. Glycopyrrolate use, benign prostate hyperplasia, and postoperative urinary tract infection were independent risk factors for postoperative urinary retention. The use of glycopyrrolate is a potentially modifiable risk factor for postoperative urinary retention. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

A Nationwide Analysis of Geriatric Odontoid Fracture Incidence, Complications, Mortality, and Cost
Study Design. Retrospective database analysis. Objective. To identify nationwide temporal trends in management of geriatric odontoid fractures and to compare comorbidities, inpatient complications, hospital characteristics, and cost between patients receiving operative versus nonoperative management. Summary of Background Data. The treatment of geriatric odontoid fractures remains controversial with some studies demonstrating decreased mortality and improved functional outcomes associated with operative management and significant morbidity associated with halo devices during nonoperative management. Me...
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

The Politics of Chronic LBP: Can We Rely on a Proxy-Vote? Linking Multifidus Intra-Myo-Cellular Lipid (IMCL) Fatty Infiltration With Arthrogenic Muscle Inhibition (AMI)-induced Chronic Nonspecific Low Back Pain
Conclusions. It may be possible for IMCLs to serve as a ‘proxy’ prognostic marker of lumbar MF-AMI in CLBP patients. Further, if this assertion were correct, then reductions in IMCLs could potentially quantify recovery and the efficacy of rehabilitation management strategies directed at lumbar MF activation. Level of Evidence: 5 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: SPINE UPDATE Source Type: research

One Year Outcomes From a Prospective Multicenter Investigation Device Trial of a Novel Conformal Mesh Interbody Fusion Device
Conclusion. 12-month outcomes demonstrated excellent patient compliance and positive outcomes for pain, function, fusion, and device safety. Clinical improvements were observed by 6-weeks post-op and appear durable up to 1 year later. A novel mesh interbody device may provide an alternative means of interbody fusion that reduces connective tissue disruption. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: OUTCOMES Source Type: research

Asymptomatic Degenerative Changes in the Lumbar Spine Among Professional Soccer Players
Conclusion. Elite professional soccer players demonstrate a high prevalence of asymptomatic degenerative lumbar spinal degenerative changes, which are significantly associated with age. These conditions might lead to the development of symptomatic lower back pain, given the high-intensity exercise required in professional soccer. It is presently unclear what measures might be applied for the primary prevention of these degenerative spinal conditions. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: OCCUPATIONAL HEALTH/ERGONOMICS Source Type: research

Measurement Properties of the Oswestry Disability Index in Recipients of Lumbar Spine Surgery
Study Design. This is an observational study on the measurement properties of the Oswestry Disability Index (ODI) version 1.0. Objectives. To (1) determine the construct validity of the tool, specifically structural validity; (2) analyze the criterion validity of the tool, specifically concurrent validity against proxy measures of pain, function, and quality of life and predictive validity of each item to proxy measures of disability; and (3) reliability of the tool, specifically internal consistency. Summary of Background Data. We endeavored to investigate the measurement properties of the ODI on a spine...
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Reliability and Validity of the Simplified Chinese Early-onset Scoliosis Quality of Life 24-item Questionnaire
Conclusion. The simplified Chinese version of the EOSQ-24 scale has acceptable reliability and construct validity, and it can be used for the assessment of health-related quality of life (HRQL), caretaker burden, and satisfaction for children with EOS in mainland China. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Biomedical Beliefs Explain the Clinical Decisions Made by Exercise-Based Practitioners for People With Chronic Low Back Pain
Conclusion. Biomedical attitudes and beliefs regarding CLBP influence clinical decision making in exercise-based practitioners, regardless of profession. AEPs reported higher biomedical scores, suggesting more frequent choice of conservative care. Thus, patients may receive inconsistent care and advice from practitioners within the same field. Based on clinical practice guidelines and the positive associations on clinical decision making of the biopsychosocial model, it is necessary to understand how best to provide exercise-based practitioners with education on how to apply a biopsychosocial approach to CLBP. Level...
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Responsiveness of the PROMIS-29 Scales in Individuals With Chronic Low Back Pain
Conclusion. The PROMIS-29 scale scores assessing pain intensity, physical function, and anxiety evidenced the most responsivity in the study sample. The results, when considered in light of the findings from other investigators, support 5.0 points as a reasonable MCID for most of the PROMIS-29 scales. Further studies are needed to determine the generalizability of the findings. Level of Evidence: 2 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Complication Events After Spinal Surgery Performed by American Board of Orthopaedic Surgery (ABOS) Part II Candidates (2008–2017)
Conclusions. Our analysis of ABOS Part II candidates demonstrates that reported complication rates may be increasing while mortality is decreasing. The etiologies behind these findings are likely multifactorial. Encouragingly, we believe that observed reductions in mortality suggest overall improvements in patient safety following spine surgery. At a minimum, our data provide benchmarks through which spine surgeons, hospitals, and residency or fellowship programs can evaluate performance. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Automated Detection of Spinal Schwannomas Utilizing Deep Learning Based on Object Detection From Magnetic Resonance Imaging
Conclusion. Automated object detection of spinal schwannoma was achieved. The proposed system yielded a high accuracy that was comparable to that of the doctors. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Three-Dimensional Analysis of Preoperative and Postoperative Rib Cage Parameters by Simultaneous Biplanar Radiographic Scanning Technique in Adolescent Idiopathic Scoliosis: Minimum 2-Year Follow-Up
This study aimed to investigate the changes in rib cage deformity in adolescent idiopathic scoliosis (AIS) by comparing the preoperative and postoperative three-dimensional (3D) reconstruction images using simultaneous biplanar radiographic scanning technique (EOS) (EOS Imaging, Paris, France). Summary of Background Data. EOS data are limited for the analyses of preoperative and postoperative rib cage deformity. Methods. A total of 67 Lenke type 1 or 2 AIS patients who underwent surgery (59 females and 8 males) were enrolled in this study. The mean patient age was 14.4 years (range: 11–17 yr). In all pa...
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Presurgical Short-Term Halo-Pelvic Traction for Severe Rigid Scoliosis (Cobb Angle >120°): A 2-Year Follow-up Review of 62 Patients
Conclusion. For severe rigid scoliosis with a Cobb angle greater than 120°, a combination of short-term presurgical HPT and posterior surgery is an effective and safe solution. After 4 to 6 weeks of presurgical HPT the Cobb angle can be decreased by approximately 50%, providing a favorable condition for spine corrective surgery. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Accuracy of EOS Imaging Technology in Comparison to Computed Tomography in the Assessment of Vertebral Rotational Orientation in Instrumented Spines in Adolescent Idiopathic Scoliosis
Conclusion. EOS 3D morphological analysis of VRD in the instrumented levels of the spine demonstrated significant difference and unacceptable variance in comparison to CT measurement. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Predictive Probability of the Global Alignment and Proportion Score for the Development of Mechanical Failure Following Adult Spinal Deformity Surgery in Asian Patients
Conclusion. In this multicenter study, in an Asian ASD patient cohort, the GAP score was not associated with the incidence of MF or revision surgery. Additional studies on the predictive ability of the GAP score in different patient cohorts are warranted. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Relationship Between Pulmonary Function and Thoracic Morphology in Adolescent Idiopathic Scoliosis: A New Index, the “Apical Vertebra Deviation Ratio”, as a Predictive Factor for Pulmonary Function Impairment
Study Design. A retrospective study. Objective. The aim of this study was to investigate the relationship between thoracic morphology (TM) and pulmonary function (PF) in patients with adolescent idiopathic scoliosis (AIS) and the feasibility of the “apical vertebra deviation ratio (AVDR)” as a predictor of PF impairment. Summary of Background. The PF of AIS is one of the key focuses of clinicians’ attention. Early identification of AIS patients who are at risk of developing impaired PF is important for improving patient management. Methods. Preoperative PF and radiographic examina...
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Preoperative Opioid Weaning Before Major Spinal Fusion: Simulated Data, Real-World Insights
Study Design. Retrospective cohort. Objective. To identify gaps in opioid prescription immediately prior to spinal fusion and to study the effect of such simulated “opioid weaning/elimination” on risk of long-term postoperative opioid use. Summary of Background Data. Numerous studies have described preoperative opioid duration and dose thresholds associated with sustained postoperative opioid use. However, the benefit and duration of preoperative opioid weaning before spinal fusion has not been elaborated. Methods. Humana commercial insurance data (2007-Q1 2017) was used to study primar...
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Cervical Extensor Muscles Play the Role on Malalignment of Cervical Spine: A Case Control Study With Surface Electromyography Assessment
Study Design. A case control study. Objective. The aim of this study was to identify the potential impact of cervical spine malalignment on muscle parameters. Summary of Background Data. Muscular factors are associated with cervical alignment. Nevertheless, only muscle dimensions or imaging changes have been evaluated, function of cervical muscles has scarcely been investigated. Methods. Thirty-four patients diagnosed as cervical spine degeneration associated with cervical malalignment and 32 control subjects were included in this case control study. Visual analogue scale (VAS) and the neck disabil...
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

The Impact of Anterior Spondylolisthesis and Kyphotic Alignment on Dynamic Changes in Spinal Cord Compression and Neurological Status in Cervical Spondylotic Myelopathy: A Radiological Analysis Involving Kinematic CT Myelography and Multimodal Spinal Cord Evoked Potentials
Conclusion. Exhibiting more severe spinal cord compression during neck flexion was associated with a small C2–7 angle and anterior spondylolisthesis. The neurological status of the patients in Group F was characterized by severe lower limb dysfunction because of a disturbed blood supply to the anterior column. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

It is Time to Change Our Mindset and Perform More High-quality Research in Low Back Pain
No abstract available (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: EDITORIAL Source Type: research

“The Night View of Bund in Shanghai, China”
No abstract available (Source: Spine)
Source: Spine - December 29, 2020 Category: Orthopaedics Tags: IMAGERY Source Type: research

Impact of Preoperative Platelet Count on Bleeding Risk and Allogeneic Transfusion in Multilevel Spine Surgery
Conclusion. Preoperative thrombocytopenia significantly contributes to intraoperative transfusion in multilevel thoracic lumbar spine surgery. Identifying factors that may increase the risk for transfusion could be of great benefit in better preoperative counseling of patients and in reducing overall cost and postoperative complications by implementing strategies and techniques to reduce blood loss and blood transfusions. Level of Evidence: 2 (Source: Spine)
Source: Spine - December 15, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

A Comparative Study Between Minimally Invasive Spine Surgery and Traditional Open Surgery for Patients With Spinal Metastasis
Conclusion. MISS is a safe and effective technique that could be considered the optimal treatment for patients with spinal metastasis and myelopathy and thus is an excellent alternative in managing thoracolumbar spine metastasis. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 15, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

The Prevalence of Back and Leg Pain and the Cross-sectional Association With Adverse Health Outcomes in Community Dwelling Older Adults in England
Conclusion. Back and leg pain is a common problem for older adults and associated with reduced quality of life and adverse health states. Findings suggest a need to develop more effective treatment for older adults with BP especially for those with neurogenic claudication. Level of Evidence: 2 (Source: Spine)
Source: Spine - December 15, 2020 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

Improvement in Gait Pattern and its Relationship With Preoperative Pelvic Compensation After Surgery in Patients With Sagittal Plane Deformity
Conclusion. Preoperative abnormal stooping gait, and progressive worsening of sagittal imbalance in patients with sagittal plane deformity improved after corrective surgery. Patients with preoperative dynamic sagittal imbalance could have similar surgical results to those without it after corrective surgery. Level of Evidence: 3 (Source: Spine)
Source: Spine - December 15, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Limited Cost Benefit of Lateral Interbody Fusion for Adult Spinal Deformity Surgery
Study Design. Retrospective case series. Objective. The aim of this study was to compare the utility and cost-effectiveness of multilevel lateral interbody fusion (LIF) combined with posterior spinal fusion (PSF) (L group) and conventional PSF (with transforaminal lumbar interbody fusion) (P group) in adult spinal deformity (ASD) surgery. Summary of Background Data. The clinical and radiographic outcomes of multilevel LIF for ASD have been reported favorable; however, the cost benefit of LIF in conjunction with PSF is still controversial. Methods. Retrospective comparisons of 88 surgically treated ...
Source: Spine - December 15, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

A Multidisciplinary Spine Surgical Indications Conference Leads to Alterations in Surgical Plans in a Significant Number of Cases: A Case Series
Study Design. Case series. Objective. To evaluate the impact of a multidisciplinary spine surgery indications conference (MSSIC) on surgical planning for elective spine surgeries. Summary of Background Data. Identifying methods for pairing the proper patient with the optimal intervention is of the utmost importance for improving spine care and patient outcomes. Prior studies have evaluated the utility of multidisciplinary spine conferences for patient management, but none have evaluated the impact of a MSSIC on surgical planning and decision making. Methods. We implemented a mandatory weekly MSSIC ...
Source: Spine - December 15, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Novel Nomograms as Aids for Predicting Recurrence and Survival in Chordoma Patients: A Retrospective Multicenter Study in mainland China
Conclusion. Based on the multicenter case series of chordoma with a relative long follow-up, we proposed two nomograms to predict the prognosis on the basis of recurrence- and death-relevant factors. These findings could be referenced in the clinical decision-making process and provide additional prognostic information for risk stratification. Level of Evidence: 4 (Source: Spine)
Source: Spine - December 15, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research