The Modified 11-Item Frailty Index and Postoperative Outcomes in Patients Undergoing Lateral Lumbar Interbody Fusion
Conclusion.
An mFI-11 score was found to be independently associated with urologic complications in patients who underwent LLIF. Patients in all frailty categories experienced significant improvements in back pain, leg pain, and the ODI at 1 year and 2 years postoperatively. LLIF surgery may be useful for patients with high frailty index.
Level of Evidence: 4 (Source: Spine)
Source: Spine - February 8, 2022 Category: Orthopaedics Tags: SURGERY Source Type: research
Mismatch Between Pelvic Incidence and Lumbar Lordosis is the Key Sagittal Plane Determinant of Patient Outcome at Minimum 40 Years After Instrumented Fusion for Adolescent Idiopathic Scoliosis
Conclusion.
In a cohort of 35 patients with average follow-up of 46 years after posterior spinal instrumentation with Harrington rods (PSIF) for AIS, spinal-pelvic mismatch as identified by (PI-LL > 9°) was associated with inferior HRQoL outcomes. Other spinal-pelvic measures (SVA and PT) were not reliably associated with inferior HRQoL.
Level of Evidence: 4 (Source: Spine)
Source: Spine - February 8, 2022 Category: Orthopaedics Tags: DEFORMITY Source Type: research
The Effect of Preoperative Nutritional Intervention for Adult Spinal Deformity Patients
Study Design.
A prospective nutritional intervention study for adult spinal deformity (ASD) patients.
Objective.
To investigate how a nutritional intervention affects the incidence of postoperative medical complications and the nutritional status.
Summary of Background Data.
The medical complication rate in ASD surgery is very high, and one risk factor is malnutrition. Nutritional intervention may improve the patient's nutritional status and reduce risk, but this is unexplored regarding ASD surgery.
Methods.
Malnourished patients (i.e., a prognostic nutritional index [PNI] score of (Source: Spine)
Source: Spine - February 8, 2022 Category: Orthopaedics Tags: DEFORMITY Source Type: research
Ambulatory Neuromuscular Scoliosis Patients Have Superior Perioperative Results Than Nonambulatory Neuromuscular Scoliosis Patients and Can Approach Adolescent Idiopathic Scoliosis Outcomes After Posterior Spinal Fusion
This study aims to identify differences in perioperative outcomes between ambulatory patients with neuromuscular scoliosis (ANMS) and adolescent idiopathic scoliosis (AIS) following spinal fusion.
Summary of Background Data.
NMS patients have severe curves with more comorbidities and procedural complexity. These patients require extensive fusion levels, increased blood loss, and suffer increased periop complications. However, NMS patients have a variable severity spectrum, including ambulation status.
Methods.
Chart and radiographic review of NMS and AIS patients undergoing PSF from 2005 to 2018. NNMS include...
Source: Spine - February 8, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Comparison of Mid- to Long-term Follow-up of Patient-reported Outcomes Measures After Single-level Lumbar Total Disc Arthroplasty, Multi-level Lumbar Total Disc Arthroplasty, and the Lumbar Hybrid Procedure for the Treatment of Degenerative Disc Disease
Study Design.
Prospective cohort study.
Objective.
The aim of this article is to compare the mid- to long-term patient-reported outcome measures (PROMs) between single-level total disc arthroplasty (TDA), multi-level TDA, and hybrid constructs (combination of TDA and anterior lumbar interbody fusion [ALIF] across multiple levels) for symptomatic degenerative disc disease (DDD).
Summary of Background Data.
The treatment of single-level DDD is well documented using TDA. However, there is still a paucity of published evidence regarding long-term outcomes on multi-level TDA and hybrid constructs for the treat...
Source: Spine - February 8, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Distribution and Polarization of Hematogenous Macrophages Associated with the Progression of Intervertebral Disc Degeneration
Conclusion.
During the disc degeneration process, BMDMs were observed mainly around the endplate and outside area of the annulus fibrosus, with few in the inside area of annulus fibrosus and nucleus pulposus. Compared to other IVD area, macrophage polarity and cytokine expression is concomitantly M2-dominant in endplate. Increased hematogenous M2-phenotype macrophages in endplate with progression of IVD degeneration could enhance our understanding of the underlying mechanisms of disc degeneration.
Level of Evidence: N/A (Source: Spine)
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research
Bicortical Short C2 Pars Screw Fixation for High-Riding Vertebral Artery Provided Sufficient Biomechanical Stability: A Finite Element Study
Conclusion.
For a patient with HRVA, bicortical short C2 pars screw fixation provides sufficient stability and exhibited a smaller von Mises distribution on the screw-rod construct, indicating it could be an effective C2 internal fixation method for HRVA to promote C1-C2 stability and avoid the vertebral artery injury.
Level of Evidence: N/A (Source: Spine)
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: BIOMECHANICS Source Type: research
Association Between Sleep Disturbance and Low Back Pain: A 3-Year Longitudinal Study After the Great East Japan Earthquake
Conclusion.
Sleep disturbance is associated with LBP in a dose-dependent manner. Attention should be paid to sleep disturbance for the treatment and prevention of LBP, especially with regard to the duration and frequency of sleep disturbance.
Level of Evidence: 3 (Source: Spine)
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
Concurrent Treatment with Vitamin K2 and D3 on Spine Fusion in Patients with Osteoporosis-Associated Lumbar Degenerative Disorders
Conclusion.
Administration of vitamin K2 and vitamin D3 can increase lumbar interbody fusion rates, improve clinical symptoms, promote bone information, and avoid further decline in BMD within six months after TLIF or PLIF.
Level of Evidence: 3 (Source: Spine)
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Age as a Risk Factor for Complications Following Anterior Cervical Discectomy and Fusion: Analysis From the Michigan Spine Surgery Improvement Collaborative (MSSIC)
Study Design.
Retrospective analysis of prospectively collected registry data using multivariable analyses of imputed data
Objective.
We sought to demonstrate that age would not be associated with complications in patients undergoing anterior cervical discectomy and fusion (ACDF).
Summary of Background Data.
Elderly patients (≥70 yrs) undergoing ACDF are considered a higher risk for complications. However, conclusive evidence is lacking. The Michigan Spine Surgery Improvement Collaborative (MSSIC) is a quality improvement collaborative with 30 hospitals across Michigan.
Methods.
The study inclu...
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Initial Choice of Spinal Manipulation Reduces Escalation of Care for Chronic Low Back Pain Among Older Medicare Beneficiaries
The objective of this study was to compare longterm outcomes for spinal manipulative therapy (SMT) and opioid analgesic therapy (OAT) regarding escalation of care for patients with chronic low back pain (cLBP).
Summary of Background Data.
Current evidence-based guidelines for clinical management of cLBP include both OAT and SMT. For long-term care of older adults, the efficiency and value of continuing either OAT or SMT are uncertain.
Methods.
We examined Medicare claims data spanning a five-year period. We included older Medicare beneficiaries with an episode of cLBP beginning in 2013. All patients were cont...
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
External Validation of the Minimum Clinically Important Difference in the Timed-up-and-go Test After Surgery for Lumbar Degenerative Disc Disease
Conclusion.
This study confirms the ordinally reported TUG MCID values in patients undergoing surgery for lumbar. A TUG test time change of 2.1 seconds (or TUG z score change of 1.5) indicates an objective and clinically meaningful change in functional status. This report facilitates the interpretation of TUG test results in clinical routine as well as in research.
Level of Evidence: 3 (Source: Spine)
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research
Single-Site Retrospective Assessment of Surgical Outcomes in Non-Ambulatory Patients with Degenerative Cervical Myelopathy
Study Design.
A retrospective study of surgical outcomes in patients with degenerative cervical myelopathy (DCM).
Objective.
To better characterize outcomes following cervical decompression in those with severe, non-ambulatory forms of DCM.
Summary of Background Data.
DCM represents a collection of age-related degenerative processes of the cervical spine that can result in motor, sensory, and autonomic dysfunction, leading to significant reductions in quality of life. Individuals with severe, non-ambulatory forms of DCM are often treated with spinal decompression although the extent of neurological improv...
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
Comparing Mid-Term Outcomes Between ACDF and Minimally Invasive Posterior Cervical Foraminotomy in the Treatment of Cervical Radiculopathy
Study Design.
Retrospective cohort study.
Objective.
To compare minimally invasive posterior cervical foraminotomy (MI-PCF) and anterior cervical discectomy and fusion (ACDF) in the treatment of unilateral cervical radiculopathy.
Summary of Background Data.
MI-PCF has been shown to be equally effective as ACDF in treating cervical radiculopathy due to foraminal stenosis and similar pathologies. Additionally, it has been hypothesized that preserving motion and avoiding fusion reduces risk for adjacent segment disease, but potentially increases risk for subsequent revision to an ACDF. With similar short-ter...
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
Evaluation of Gait and Functional Stability in Preoperative Cervical Spondylotic Myelopathy Patients
Study Design.
Prospective cohort study.
Objective.
The aim of this study was to 1) determine postural stability and spatiotemporal gait parameters and 2) characterize dynamic stability and variances in angular momentum (AM) of preoperative cervical spondylotic myelopathy (CSM) patients compared with healthy controls.
Summary of Background Data.
CSM is the most common cause of spinal cord dysfunction in the world and can lead to significant functional deficits including proprioception and gait disturbances. Biomechanical feedback mechanisms compensating for these deficits, specifically AM regulation, have ...
Source: Spine - February 1, 2022 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
