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 16, 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 16, 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 16, 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 16, 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. Mul...
Source: Spine - January 16, 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 16, 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 16, 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
