Persistent Use of Prescription Opioids Following Lumbar Spine Surgery: Observational Study with Prospectively Collected Data From Two Norwegian Nationwide Registries
Conclusion.
Patients with or at risk of developing persistent opioid should be identified and provided counseling and support to taper off opioid treatment.
Level of Evidence: 2 (Source: Spine)
Source: Spine - April 15, 2022 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
Factors Associated with Pain Intensity and Walking Disability After Lumbar Fusion: A Longitudinal Study
Conclusion.
A sizable proportion of patients had poor pain and walking outcomes even at 6 months post-surgery. Preoperative leg weakness and BMI were consistent risk factors and patients with greater depression symptoms may have poorer self-reported outcomes. Although requiring validation, our study has identified potentially modifiable risk factors which may give clinicians an opportunity to provide early (preoperative) and targeted intervention strategies to optimize postoperative outcomes.
Level of Evidence: NA (Source: Spine)
Source: Spine - April 15, 2022 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
Patient Reported Outcomes in Metastatic Spine Disease: Concurrent Validity of PROMIS with the Spine Oncology Study Group Outcome Questionnaire
Conclusion.
PROMIS PF, PI, and Depression appear to capture similar clinical insight as the SOSG-OQ. Spine surgeons can consider using these PROMIS domains in lieu of the SOSG-OQ in metastatic spine tumor patients.
Level of Evidence: NA (Source: Spine)
Source: Spine - April 15, 2022 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
Appropriate Telemedicine Utilization in Spine Surgery: Results From a Delphi Study
Conclusion.
Although telemedicine was initially introduced out of necessity, this technology most likely will remain due to evidence of high patient satisfaction and significant cost savings. This study was able to provide a framework for appropriate telemedicine utilization in spine surgery from a panel of experts. However, several questions remain for future research, such as whether or not an in-person consultation is necessary prior to surgery and which physical exam maneuvers are appropriate for telemedicine.
Level of Evidence: 4 (Source: Spine)
Source: Spine - April 15, 2022 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
Bone Mineralization and Spinal Fusion Evaluation of a Truss-based Interbody Fusion Device: Ovine Finite Element Analysis with Confirmatory: In Vivo: Outcomes
Study Design.
Finite element analysis (FEA) and in vivo ovine spinal interbody fusion study.
Objective.
To determine comparative load-induced strain amplitudes, bone mineralization and fusion outcomes associated with different diameter struts in a truss-based interbody fusion device.
Summary of Background Data.
Additive manufacturing technology has been employed to develop implants that actively participate in the fusion process. The truss device enables the optimal transfer of compressive and tensile stresses via the struts. Mechanobiologic principles postulate that strut diameter can be regulated to all...
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research
Disc and Vertebral Body Morphology From Birth to Adulthood
Conclusion.
The spine grows predominantly in the vertebral bodies. Thoracic discs increase in height only during the first years, whereas the transverse surface area continues to increase throughout growth, thus discs slenderness decreases. Relatively, female discs remained slenderer around growth-spurt. These measurements may assist future studies on the role of disc morphology in the etiology and treatment of spinal deformity.
Level of Evidence: 4 (Source: Spine)
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: ANATOMY Source Type: research
The Functional Rating Index: Twenty Years of Invalid Measurement
Conclusion.
The original FRI and alternative forms all fail failed crucial psychometric tests and fail to accurately measure more than one latent construct. It is thus unfit as a pain, function, and disability assessment. Only reducing the number of Likert choices improved the test. Other back pain assessments should be used instead, and all surveys would benefit from periodic item responses to adjust to shifts in grammar and meaning.
Level of Evidence: 3 (Source: Spine)
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research
Postoperative Glycemic Variability as a Predictor of Adverse Outcomes Following Lumbar Fusion
Conclusion.
Our study establishes a significant relationship between postoperative glycemic variability and inpatient complications, length of stay, and 90-day adverse outcomes. While HbA1c has classically been used as the principal marker to assess blood glucose control, our results show CV to be a strong predictor of postoperative adverse outcomes. Future high-quality, prospective studies are necessary to explore the true effect of CV, as well as its practicality in clinical practice. Nevertheless, fluctuations in blood glucose levels during the inpatient stay should be limited to improve patient results.
Level of...
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
Volumetric Changes in Cervical Disc Herniation: Comparison of Cervical Expansive Open-door Laminoplasty and Cervical Microendoscopic Laminoplasty
Conclusion.
Patients who underwent CMEL developed a postoperative reduction of CDH volume, with more popularity, greater degree and earlier-staged than EOLP-patients. Young females with longer follow-up time were more likely occur.
Level of Evidence: 4 (Source: Spine)
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
Is it Better to Stop at C2 or C3/4 in Elective Posterior Cervical Decompression and Fusion?
Study Design.
Retrospective cohort study.
Objective.
(a) Compare operative variables, complications, and patient-reported outcomes (PROs) in patients with an upper instrumented vertebrae (UIV) of C2 versus C3/4, and (b) assess outcomes based on C2 screw type.
Summary of Background Data.
When performing elective posterior cervical laminectomy and fusion (PCLF), spine surgeons must choose the upper instrumented vertebrae (UIV) at the subaxial cervical spine (C3/4) versus C2. Differences in long-term complications and PROs remain unknown.
Methods.
A single-institution, retrospective cohort study from ...
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
Scheuermann Kyphosis Patients Have a Similar Revision and Infection Rate to Adolescent Idiopathic Scoliosis Patients
Conclusion.
Contrary to previously published literature, our analyses indicate that in a matched population, postoperative complication rates (i.e., infection and revision rates) are not significantly different between SK and AIS patients.
Level of Evidence: 4 (Source: Spine)
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
How Decompression Surgery Improves the Lower Back Pain in Patient with Lumbar Degenerative Stenosis: A Propensity-score-matched Analysis
Study Design.
Multicenter retrospective case series of patients treated surgically for lumbar spinal stenosis (LSS)
Objective.
We investigated how laminectomy improves lower back pain (LBP) and the factors associated with poor improvement.
Summary of Background Data.
Lumbar laminectomy is effective for alleviating neurological symptoms caused by LSS, whereas its effect on LBP is still controversial.
Methods.
A retrospective review of prospectively collected data from 436 patients (age 72 yrs, 69% males) who underwent laminectomy for LSS with 2 years of follow-up. We analyzed the following risk ...
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Passive Recharge Burst Spinal Cord Stimulation Provides Sustainable Improvements in Pain and Psychosocial Function: 2-year Results From the TRIUMPH Study
Study Design.
Prospective, international, multicenter, single-arm, post-market study.
Objective.
The aim of this study was to assess long-term safety and effectiveness of spinal cord stimulation using a passive recharge burst stimulation design for chronic intractable pain in the trunk and/or limbs. Herein we present 24-month outcomes from the TRIUMPH study (NCT03082261).
Summary of Background Data.
Passive recharge burst spinal cord stimulation (B-SCS) uniquely mimics neuronal burst firing patterns in the nervous system and has been shown to modulate the affective and attentional components of pain proce...
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Growing Racial Disparities in the Utilization of Adult Spinal Deformity Surgery: An Analysis of Trends From 2004 to 2014
Conclusion.
Although Black and White patients undergoing ASD surgery do not differ significantly in terms of postoperative complications and length of hospital stay, there is a growing disparity in utilization of ASD surgery between White and Black patients from 2004 to 2014 in the United States. There is need for continued focus on identifying ways to reduce racial disparities in surgical selection and perioperative management in spine deformity surgery.
Level of Evidence: 3 (Source: Spine)
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: DEFORMITY Source Type: research
Selective Thoracic Fusion for Idiopathic Scoliosis: A Comparison of Three Surgical Techniques with Minimum 5-year Follow-up
Study Design.
Single-center retrospective review of outcomes among three surgical techniques in the treatment of thoracic idiopathic scoliosis (T-AIS) with a follow-up of at least 5 years.
Objective.
To investigate how outcomes compare in video-assisted anterior thoracic instrumentation (VATS), all hooks/hook-pedicle screw hybrid instrumentation (HHF), and all pedicle screw instrumentation (PSF) techniques for T-AIS.
Summary of Background Data.
Studies comparing outcomes for anterior versus posterior fusion for T-AIS are few and with short follow-up.
Methods.
Three groups of patients with T-AIS w...
Source: Spine - March 19, 2022 Category: Orthopaedics Tags: DEFORMITY Source Type: research
