To the Editor:
No abstract available (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: LETTER Source Type: research

High, As Well As Low, Preoperative Platelet Counts Correlate With Adverse Outcomes After Elective Posterior Lumbar Surgery
Conclusion. The data-based cut-offs for abnormally high and low platelet counts closely mirrored those found in literature. Based on these definitions, abnormally high and low preoperative platelet counts were associated with adverse outcomes after elective posterior lumbar surgery. These findings facilitate risk stratification and suggest targeted consideration for patients with high, as well as low, preoperative platelet counts. Level of Evidence: 3 (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

Spinal Fusion Surgery and Local Antibiotic Administration: A Systematic Review on Key Points From Preclinical and Clinical Data
Conclusion. The results reported that the topical vancomycin application seem to represent a strategy to reduce SSI incidence in spine surgery. However, the use of local vancomycin as a preventive approach for SSIs in spine surgery is mostly based on retrospective studies with low levels of evidence and moderate/severe risk of bias that do not allow to draw a clear conclusion. This review also underlines that several key points concerning the local use of antibiotics in spinal fusion still remains to be defined to allow this field to make a leap forward that would lead to the identification of specific approaches to coun...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research

Profile of Patients With Acute Low Back Pain Who Sought Emergency Departments: A Cross-sectional Study
Conclusion. Identifying the profile of patients seeking care in EDs can help to define effective management for LBP in low- and middle-income countries. Patients with nonspecific acute LBP who seek EDs in Brazil present high levels of pain intensity and disability. Most patients were classified as having a high risk of developing an unfavorable prognosis. Level of Evidence: 2 (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Adult Spinal Deformity Surgery in Patients With Movement Disorders: A Propensity-matched Analysis of Outcomes and Cost
Study Design. This was a retrospective study using national administrative data from the MarketScan database. Objective. To investigate the complication rates, quality outcomes, and costs in a nationwide cohort of patients with movement disorders (MD) who undergo spinal deformity surgery. Summary of Background Data. Patients with MD often present with spinal deformities, but their tolerance for surgical intervention is unknown. Methods. The MarketScan administrative claims database was queried to identify adult patients with MD who underwent spinal deformity surgery. A propensity-score match was conducted to cre...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

American Society of Anesthesiologists’ Status Association With Cost and Length of Stay in Lumbar Laminectomy and Fusion: Results From an Institutional Database
The objective of this study was to characterize the costs associated with American Society of Anesthesiologists (ASA) class, and to determine the extent to which ASA status is a predictor of increased cost and LOS following lumbar laminectomy and fusion (LLF). Summary of Background Data. Spinal fusion accounts for the highest hospital costs of any surgical procedure performed in the United States, and ASA (American Society of Anesthesiologists) status is a known risk factor for cost and length of stay (LOS) in the orthopedic literature. There is a paucity of literature that directly addresses the influence of ASA status...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Decompression With or Without Fusion for Lumbar Stenosis: A Cost Minimization Analysis
Study Design. Retrospective database review. Objective. Compare 1-year episode of care costs between single-level decompression and decompression plus fusion for lumbar stenosis. Summary of Background Data. Lumbar stenosis is the most common indication for surgery in patients over 65. Medicare direct hospital costs for lumbar surgery reached $1.65 billion in 2007. Despite stenosis being a common indication for surgery, there is debate as to the preferred surgical treatment. Cost-minimization analysis is a framework that identifies potential cost savings between treatment options that have similar outcomes. We perfo...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Mortality and Cause of Death in Patients With Vertebral Fractures: A Longitudinal Follow-Up Study Using a National Sample Cohort
Study Design. A retrospective study using the Korean Health Insurance Review and Assessment Service—National Sample Cohort was performed. Objective. To determine the rate and causes of mortality in vertebral fracture patients. Summary of Background Data. Vertebral fractures are associated with increased mortality in prior studies. Methods. Of 1,125,691 patients, we collected data of 23,026 patients of all ages who experienced thoracic or lumber vertebral fractures between 2002 and 2013. The vertebral fracture participants were matched 1:4 with control participants, accounting for age, group, sex, income, a...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

Association Between Excessive Weight Gain During Pregnancy and Persistent Low Back and Pelvic Pain After Delivery
Study Design. Retrospective study. Objective. To investigate the association between gestational weight gain (GWG) during pregnancy and persistent low back and pelvic pain (LBPP) after delivery. Summary of Background Data. Persistent LBPP after delivery is a risk factor for developing depression and chronic pain as well as incurring sick leave. Women experience weight gain during pregnancy. Excessive weight gain places a greater burden on the musculoskeletal system. However, little is known about how GWG is associated with LBPP after delivery. Methods. After Ethics Committee approval, we analyzed 330 women at 4 ...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

Functional Connectivity Changes of the Visual Cortex in the Cervical Spondylotic Myelopathy Patients: A Resting-State fMRI Study
Study Design. Cross-sectional study. Objective To analyze altered functional connectivity (FC) in the visual cortex of cervical spondylotic myelopathy (CSM) patients using resting-state functional magnetic resonance imaging (fMRI). Summary of Background Data. We previously showed changes in visual cortex neural activity in CSM patients. Methods. Thirty CSM patients and 20 healthy controls were recruited. MR data were collected using a 3.0 T MR. FC of the regions of interest (ROI) (Brodmann areas [BA] 17/18/19/7) were calculated in a voxel-wise manner and compared between groups. Correlation analyses were perfo...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

A Practical Study of Diagnostic Accuracy: Scoliosis Screenings of Middle School Students by a Trained Nurse With a Smartphone Versus a Spine Surgeon With a Scoliometer
This study aimed to assess the accuracy of smartphone-aided diagnosis of scoliosis by a trained nurse compared with scoliometer-based diagnosis by a spine surgeon. Summary of Background Data. Many assessments have been developed to estimate the reliability of smartphone-aided measurements in diagnosing scoliosis. However, clinical studies assessing the accuracy of smartphone-aided diagnosis with radiographs or scoliometers are scarce. Methods. A total of 2702 grade 7 students (mean age 13.56 yrs, range 13–15) at 10 middle schools were first screened with a smartphone by a trained nurse from the orthopedics depa...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Utilization of Predictive Modeling to Determine Episode of Care Costs and to Accurately Identify Catastrophic Cost Nonwarranty Outlier Patients in Adult Spinal Deformity Surgery: A Step Toward Bundled Payments and Risk Sharing
Conclusion. The present study demonstrates that direct cost in ASD surgery can be accurately predicted. Collectively, these findings may not only prove useful for bundled care initiatives, but also may provide insight into means to reduce and better predict cost of ASD surgery outside of bundled payment plans. Level of Evidence: 3 (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Selecting the Last Substantially Touching Vertebra as Lowest Instrumented Vertebra in Lenke type 2A-R and 2A-L Curves
Study Design. A retrospective study. Objective. The aim of this study was to determine whether the last substantially touching vertebra (LSTV) can be selected as the optimal lowest instrumented vertebra (LIV) for Lenke 2A adolescent idiopathic scoliosis (AIS) with different lumbar modifiers (2A-R and 2A-L) and to investigate its relationship with the distal adding-on. Summary of Background Data. Previous studies have documented good outcomes in Lenke 1A curve when LSTV was selected as LIV. Methods. A total of 101 female patients were included with a minimum of 2-year follow-up after selective posterior surgery. ...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Rib Hyperostosis as a Risk Factor for Poor Prognosis in Cervical Spine Injury Patients With Diffuse Idiopathic Skeletal Hyperostosis
Conclusion. Reduced chest wall mobility associated with rib hyperostosis in cervical spine injury patients with DISH leads to a poor prognosis. Level of Evidence: 3 (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Lumbar Axial Rotation Kinematics in an Upright Sitting and With Forward Bending Positions in Men With Nonspecific Chronic Low Back Pain
Conclusion. The kinematic parameters of lumbar rotation were reduced in men with NSCLBP compared with controls both in an UP-sitting and FFB-sitting. In both groups, NSCLBP and controls, asymmetry in lumbar rotation kinematics was indicated as well as a decrease when moving from UP-sitting to FFB-sitting. Level of Evidence: 3 (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: BIOMECHANICS Source Type: research

17β-Estradiol Prevents Extracellular Matrix Degradation by Downregulating MMP3 Expression via PI3K/Akt/FOXO3 Pathway
Conclusion. E2 prevents the degradation of ECM by upregulating collagen II and aggrecan expression via reducing MMP-3 expression in HNPCs, and PI3K/Akt/FOXO3 pathway is dispensable for MMP-3 downregulated. Therefore, E2 protects against IDD by preventing ECM degradation. Level of Evidence: 3 (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Improved Accuracy of Cervical Spinal Surgery With Robot-Assisted Screw Insertion: A Prospective, Randomized, Controlled Study
Study Design. Prospective, randomized, controlled trial. Objective. To compare robot-assisted and conventional implantation techniques by evaluating the accuracy and safety of implanting screws in cervical vertebrae. Summary of Background Data. Cervical spinal surgery is difficult and dangerous as screw misplacement might lead not only to decreased stability but also neurological, vascular, and visceral injuries. A new robot-assisted surgical procedure has been introduced to improve the accuracy of implant screw positioning. Methods. We randomly assigned 135 patients with newly diagnosed cervical spinal disease ...
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

“Night Scene of Lujiazui, Shanghai”
No abstract available (Source: Spine)
Source: Spine - February 8, 2020 Category: Orthopaedics Tags: IMAGERY Source Type: research

The 100 Top-Cited Articles on Spinal Deformity: A Bibliometric Analysis
Conclusion. The current study attempted to develop a resource with detailed information on 100 top-cited articles on spinal deformity. It demonstrated the essential advances in spinal deformity. Although the most common spinal deformity is AIS, the adult spinal deformity is of greater impact. These insights into priorities and trends of the researches could help future academic pursuits. Level of Evidence: 5 (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research

The Influence of Preoperative Mental Health on PROMIS Physical Function Outcomes Following Minimally Invasive Transforaminal Lumbar Interbody Fusion
Study Design. Retrospective. Objective. To demonstrate whether preoperative mental health status can be predictive of postoperative functional outcomes as measured by Patient-Reported Outcome Measurement Information System Physical Function (PROMIS PF) following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Summary of Background Data. There is a paucity of scientific investigations into the association between preoperative mental health as evaluated by a validated questionnaire such as the Short Form-12 Mental Health Composite Score (SF-12 MCS) and postoperative outcomes following MIS TLIF. ...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Validation of PROMIS CATs and PROMIS Global Health in an Interdisciplinary Pain Program for Patients With Chronic Low Back Pain
Study Design. Retrospective cohort study. Objective. To (1) confirm validity of Patient-Reported Outcomes Measurement Information System (PROMIS) physical function and pain interference computer-adaptive tests (CATs) and (2) assess the validity of PROMIS Global Health (GH) and five additional PROMIS CATs: social role satisfaction, fatigue, anxiety, depression, and sleep disturbance in a population of patients with chronic low back pain (cLBP) who completed a 3-month Interdisciplinary Pain Program (IPP). Summary of Background Data. Recent recommendations for assessing outcomes in patients with cLBP have included PRO...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Extensive Spinal Fusion Surgery in Patients With Parkinson Disease or Atypical Parkinsonism: Time Course of Clinical Outcomes in 5 Years Progress Report
Conclusion. Surgical intervention in PD patients with spinal deformities leads to good short-term outcomes; however, the patients’ conditions deteriorated because of complications within 3 years and worsening of PD over 3 years after the surgery. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

The Effect of Parity on Age-Related Degenerative Changes in Sagittal Balance
Conclusion. This study established correlations between measures of spinal curvature in older women and parity for the first time. Longitudinal research is required to establish a causative relationship. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Pelvic Compensation in Sagittal Malalignment: How Much Retroversion Can the Pelvis Accommodate?
Study Design. Single-center retrospective study. Objective. Investigate how differing degrees of pelvic incidence (PI) modulate the recruitment of pelvic tilt (PT) in response to similar amounts of sagittal malalignment as measured by T1-Pelvic Angle (TPA). Summary of Background Data. Past research has shown that some patients do not recruit PT in response to sagittal malalignment. Given the anatomic relationship between PI and PT, we sought to determine whether differing PI is associated with variable recruitment of PT. Methods. Single-center retrospective study of 2077 patients undergoing full body radiographs...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Independent Association Between Type of Intraoperative Blood Transfusion and Postoperative Delirium After Complex Spinal Fusion for Adult Deformity Correction
Study Design. Retrospective cohort study. Objective. To determine whether type of intraoperative blood transfusion used is associated with increased incidence of postoperative delirium after complex spine fusion involving five levels or greater. Summary of Background Data. Postoperative delirium after spine surgery has been associated with age, cognitive status, and several comorbidities. Intraoperative allogenic blood transfusions have previously been linked to greater complication risks and length of hospital stay. However, whether type of intraoperative blood transfusion used increases the risk for postoperative...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Effective Prevention of Proximal Junctional Failure in Adult Spinal Deformity Surgery Requires a Combination of Surgical Implant Prophylaxis and Avoidance of Sagittal Alignment Overcorrection
Study Design. Propensity score matched analysis of a multi-center prospective adult spinal deformity (ASD) database. Objective. Evaluate if surgical implant prophylaxis combined with avoidance of sagittal overcorrection more effectively prevents proximal junctional failure (PJF) than use of surgical implants alone. Summary of Background Data. PJF is a severe form of proximal junctional kyphosis (PJK). Efforts to prevent PJF have focused on use of surgical implants. Less information exists on avoidance of overcorrection of age-adjusted sagittal alignment to prevent PJF. Methods. Surgically treated ASD patients (a...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Should Sagittal Spinal Alignment Targets for Adult Spinal Deformity Correction Depend on Pelvic Incidence and Age?
Study Design. Retrospective analysis. Objective. Determine whether deformity corrections should vary by pelvic incidence (PI). Summary of Background Data. Alignment targets for deformity correction have been reported for various radiographic parameters. The T1 pelvic-angle (TPA) has gained in applications for adult spinal deformity (ASD) surgical-planning since it directly measures spinal alignment separate from pelvic- and lower-extremity compensation. Recent studies have demonstrated that ASD corrections should be age specific. Methods. A prospective database of consecutive ASD patients was analyzed in conjunc...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Do Prophylactic Antibiotics Reach the Operative Site Adequately?: A Quantitative Analysis of Serum and Wound Concentrations of Systemic and Local Prophylactic Antibiotics in Spine Surgery
Conclusion. After prophylactic systemic administration of the antibiotics, the antibiotic drug concentrations in the wound are much lower than the serum concentrations at any given time. After local intra-wound application of antibiotics, the drug concentrations in the wound are well maintained even after 72 hours. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Is Initial Posterior Atlantoaxial Fixation and Fusion Applying Bilateral C1–2 Transarticular Screws and C1 Laminar Hooks Reliable for Acute Pediatric Atlantoaxial Instability?: A Minimal 10-Year Analysis of Outcome and Radiological Evaluation
Conclusion. The results showed that initial posterior atlantoaxial fusion accomplished with bilateral C1–2 transarticular screws, C1 laminar hooks fixation, and bony autograft is a reliable surgical technique for treating acute pediatric atlantoaxial instability without negative effects on vertical growth at the fused level or the stability of the subaxial spine. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

How Does Ossification of Posterior Longitudinal Ligament Progress in Conservatively Managed Patients?
Study Design. Retrospective cohort study. Objective. The aim of this study was to elucidate the progression of ossification of the posterior longitudinal ligament (OPLL) in conservatively managed patients and determine its risk factors Summary of Background Data. Although several studies have demonstrated how OPLL progresses after laminoplasty or fusion, its progression in conservatively managed patients remains unclear. Methods. The vertical length of the ossified mass and its thickness at each segment were evaluated on sagittal computed tomography images. Patients with vertical growth>2 mm were included i...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Increased Fibrogenic Gene Expression in Multifidus Muscles of Patients With Chronic Versus Acute Lumbar Spine Pathology
Conclusion. There is increased fibrogenic gene expression in individuals with chronic disease when compared to acute disease, without significant differences in atrophic, myogenic, adipogenic, or inflammatory pathways, suggesting increased efforts should be made to prevent or reverse fibrogenesis to improve patient function in this population. Level of Evidence: N/A (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

A Study of Critical Events That Lead to Spinal Cord Injury and the Importance of Rapid Reversal of Surgical Steps in Improving Neurological Outcomes: A Porcine Model
Conclusion. Compression spinal cord injury is the end of a cascade involving increasing intracanal pressure, decreasing canal volume, and hypoperfusion. Rapid relief of compression leads to MEP return. SCBF monitoring can detect ischemia preinjury, giving surgeons an opportunity for early intervention. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

A Novel Coding Variant in SLC39A8 Is Associated With Adolescent Idiopathic Scoliosis in Chinese Han Population
Study Design. A genetic case–control association study. Objective. The aim of this study was to investigate the association of SLC39A8 with the susceptibility of adolescent idiopathic scoliosis (AIS) in Chinese Han population. Summary of Background Data. A recent exome-wide association study identified a missense variant rs13107325 in SLC39A8 that was associated with AIS. However, there was a lack of study validating the association of this novel mutation with AIS in other populations. Methods. The variant rs13107325 was genotyped in 965 AIS patients and 976 healthy controls by allelic specific multiple li...
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Early Self-directed Home Exercise Program After Anterior Cervical Discectomy and Fusion: A Pilot Study
Conclusion. An early self-directed HEP program was acceptable to patients and has the potential to be safely administered to patients immediately after ACDF. Benefits were noted for short-term neck pain and long-term opioid utilization. However, larger trials are needed to confirm safety with standardized and long-term radiograph assessment and treatment efficacy. Level of Evidence: 2 (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

“Sunset on the Continental Divide, near Aspen, Colorado”
No abstract available (Source: Spine)
Source: Spine - January 29, 2020 Category: Orthopaedics Tags: IMAGERY Source Type: research

To the editor:
No abstract available (Source: Spine)
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: LETTERS Source Type: research

Outcomes of Surgery for Thoracic Myelopathy Owing to Thoracic Ossification of The Ligamentum Flavum in a Nationwide Multicenter Prospectively Collected Study in 223 Patients: Is Instrumented Fusion Necessary?
Study Design. Prospectively collected, multicenter, nationwide study. Objective. The aim of this study was to investigate recent surgical methods and trends, outcomes, and perioperative complications in surgery for thoracic ossification of the ligamentum flavum (T-OLF). Summary of Background Data. A prospective multicenter study of surgical complications and risk factors for T-OLF has not been performed, and previous multicenter retrospective studies have lacked details for these items. Methods. Surgical methods, pre- and postoperative thoracic myelopathy (Japanese Orthopedic Association [JOA] score), symptoms, ...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

Incidence of Surgical Site Infection After Spine Surgery: A Systematic Review and Meta-analysis
Conclusion. The pooled incidence of SSI following spine surgery was 3.1%. These figures may be useful in the estimation of the probability of SSI following spine surgery. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research

The Fremantle Neck Awareness Questionnaire in Chronic Neck Pain Patients: Turkish Version, Validity and Reliability Study
Conclusion. The FreNAQ-T is a valid, reliable, unidimensional scale in CNP and suitable for the assessment of neck-specified awareness-perception in Turkish population with CNP. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Are Outcomes of Anterior Cervical Discectomy and Fusion Influenced by Presurgical Depression Symptoms on the Mental Component Score of the Short Form-12 Survey?
Study Design. Retrospective comparative study. Objective. The purpose of this study was to investigate whether preoperative depressive symptoms, measured by mental component score of the Short Form-12 survey (MCS-12), influence patient-reported outcome measurements (PROMs) following an anterior cervical discectomy and fusion (ACDF) surgery for cervical degeneration. Summary of Background Data. There is a paucity of literature regarding preoperative depression and PROMs following ACDF surgery for cervical degenerative disease. Methods. Patients who underwent an ACDF for degenerative cervical pathology were identi...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

The Effect of an Educational and Interactive Informed Consent Process on Patients With Cervical Spondylotic Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament
In this study, an educational and interactive informed consent (EIC) program was proposed for patients with cervical spondylotic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL-CSM) to improve their comprehension level during the informed consent process. Summary of Background Data. OPLL-CSM is a slow progressive disease, and it is difficult for patients to understand the disease. Few studies have evaluated very specific programs to improve the informed consent process for these patients. Methods. This prospective study evaluated patients with OPLL-CSM who either underwent the proposed ...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

The Importance of C2 Slope, a Singular Marker of Cervical Deformity, Correlates With Patient-reported Outcomes
Study Design. Retrospective review of a prospectively collected database. Objective. To define a simplified singular measure of cervical deformity (CD), C2 slope (C2S), which correlates with postoperative outcomes. Summary of Background Data. Sagittal malalignment of the cervical spine, defined by the cervical sagittal vertical axis (cSVA) has been associated with poor outcomes following surgical correction of the deformity. There has been a proliferation of parameters to describe CD. This added complexity can lead to confusion in classifying, treating, and assessing outcomes of CD surgery. Methods. A prospectiv...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Rib Regeneration Morphology After Thoracoplasty in Adolescent Idiopathic Scoliosis
Study Design. A retrospective study. Objective. The purpose of this study was to evaluate the morphology of rib regeneration and to analyze the influence of demographics and curve characteristics on regeneration potential after thoracoplasty in the treatment of adolescent idiopathic scoliosis (AIS). Summary of Background Data. Studies on the physiological effects after thoracoplasty have been performed for several decades. However, rib cage anatomical regeneration patterns and reformation have been rarely studied. Methods. A total of 120 AIS patients who underwent thoracoplasty with deformity correction were inc...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Spinal Lengthening With Magnetically Controlled Growing Rods: Data From the Largest Series of Explanted Devices
Study Design. Laboratory analysis of explanted MAGnetic Expansion Control (MAGEC) rods. Objective. The aim of this study was to identify the in vivo lengthening of MAGEC rods. Summary of Background Data. Little data is available regarding the lengthening achieved by MAGEC rods. Methods. Cases were identified from the largest series of independently analyzed explanted MAGEC rods. The in vivo growth of rods was determined by the distance between the first “growth mark” and the actuator. The instrumented spinal lengthening was calculated for each construct. Constructs were considered functional if all r...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: DEFORMITY Source Type: research

The True Effect of a Lumbar Dural Tear on Complications and Cost
Study Design. Retrospective database analysis. Objective. The aim of this study was to match risk factors for complications in patients who did and did not sustain a dural tear while undergoing posterior lumbar spine surgery and compare local and systemic complications. Summary of Background Data. Current data do not adequately define whether the event of sustaining an isolated dural tear increases the risk for postoperative complications while controlling for other confounding risk factors. Methods. The PearlDiver Database was queried for patients who underwent posterior lumbar spine decompression and/or fusion...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Body Mass Index and Modified Glasgow Prognostic Score Are Useful Predictors of Surgical Site Infection After Spinal Instrumentation Surgery: A Consecutive Series
Conclusion. The risk factors for SSI after spinal instrumentation surgery were mGPS more than or equal to 1 and BMI less than or equal to 20.39 kg/m2. These findings could help to identify patients at higher risk of SSI after spinal instrumentation surgery. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Diagnostic Efficacy, Sensitivity, and Specificity of Xpert MTB/RIF Assay for Spinal Tuberculosis and Rifampicin Resistance
Conclusion. The Xpert MTB/RIF assay is an efficient technique for the rapid diagnosis of spinal TB; however, a clinician should not solely rely on it for starting ATT. As there are false results also with this test which should be read cautiously and be well correlated with culture and DST pattern to guide the start of sensitive drug regimen only. The purpose is to prevent exposure of the second line drugs to false cases found on the Xpert MTB/RIF assay and avoid emergence of new acquired drug resistance. Level of Evidence: 4 (Source: Spine)
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

The Course of Orofacial Pain and Jaw Disability After Whiplash Trauma: A 2-year Prospective Study
Conclusion. Orofacial pain and jaw disability related to neck pain are often present already at the acute stage after whiplash trauma and persist into the chronic stage for most individuals. Assessment following whiplash trauma should therefore include both the neck and the orofacial regions. More studies are needed to further evaluate risk factors for development of orofacial pain after whiplash trauma. Level of Evidence: 3 (Source: Spine)
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Solid Organ Transplant Is Associated With Increased Morbidity and Mortality in Patients Undergoing One or Two-level Anterior Cervical Decompression and Fusion
Study Design. Retrospective database review Objective. The aim of this study was to analyze the implications of solid organ transplant (SOT) on postoperative outcomes following elective one or two-level anterior cervical discectomy and fusion (ACDF). Summary of Background Data. Although SOTs have been associated with increased morbidity, postoperative outcomes in SOT recipients undergoing cervical spinal surgery are not well studied. Methods. A retrospective database review of Medicare patients younger than 85 years who underwent an elective one to two-level ACDF from 2006-2013 was conducted. Following our exclu...
Source: Spine - January 11, 2020 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research