Fresh frozen plasma-to-red blood cell ratio is an independent predictor of blood loss in patients with neuromuscular scoliosis undergoing posterior spinal fusion
In major trauma with massive blood loss, higher fresh frozen plasma (FFP)-to-red blood cell (RBC) ratios have been associated with improved morbidity and mortality. Our population of patients with neuromuscular scoliosis undergoing posterior spinal fusion (PSF) often lose volumes of blood considered massive, i.e., half a blood volume in three hours. In this retrospective cohort study, we examined the association of FFP ratio with blood loss in this elective surgical population. (Source: The Spine Journal)
Source: The Spine Journal - September 13, 2019 Category: Orthopaedics Authors: Kesavan Sadacharam, B. Randall Brenn, Youwen Zhang, Zhaoping He Tags: Clinical Study Source Type: research

SRS-22r Legacy Scores Can Be Accurately Translated to PROMIS Scores in Adult Spinal Deformity Patients
Patient-Reported Outcomes Measurement Information System (PROMIS) facilitates comparisons of treatment effectiveness across populations and diseases. In adult spinal deformity (ASD), the disease-specific Scoliosis Research Society-22r (SRS-22r) tool assesses outcomes. Existing data must be translated to PROMIS to make comparisons. (Source: The Spine Journal)
Source: The Spine Journal - September 13, 2019 Category: Orthopaedics Authors: Alvaro Ibaseta, Rafa Rahman, Richard L. Skolasky, Jay S. Reidler, Khaled M. Kebaish, Brian J. Neuman Tags: Clinical Study Source Type: research

Development of an unsupervised machine learning algorithm for the prognostication of walking ability in spinal cord injury patients.
Traumatic spinal cord injury can have a dramatic effect on a patient's life. The degree of neurological recovery greatly influences a patient's treatment and expected quality of life. This has resulted in the development of machine learning algorithms (MLA) that use acute demographic and neurological information to prognosticate recovery. The van Middendorp et al. (2011) (vM) logistic regression (LR) model has been established as a reference model for the prediction of walking recovery following spinal cord injury as it has been validated within many different countries. (Source: The Spine Journal)
Source: The Spine Journal - September 13, 2019 Category: Orthopaedics Authors: Zachary DeVries, Mohamad Hoda, Carly Rivers, Audrey Maher, Eugene Wai, Dita Moravek, Alexandra Stratton, Stephen Kingwell, Nader Fallah, J érôme Paquet, Philippe Phan, The RHSCIR Network Tags: Clinical Study Source Type: research

Can Knee Flexion Contracture Affect Cervical Alignment and Neck Tension? A Prospective Self-Controlled Pilot Study
The coordination of the alignment between the lower extremities and cervical spine helps to achieve balance and horizontal gaze during standing and walking. Malalignment in any segment can disturb the global balance, causing compensation in another segment. Knee flexion contracture (KFC) can cause spine inclination with increased C7 tilt or C7 SVA (sagittal vertical axis). Cervical alignment and the posterior muscles are essential for maintaining the horizontal gaze which are closely related to neck tension (NT). (Source: The Spine Journal)
Source: The Spine Journal - September 13, 2019 Category: Orthopaedics Authors: Yi Ding, Baoge Liu, Hui Qiao, Lu Yin, Wen He, Fangda Si, Dian Wang Tags: Clinical Study Source Type: research

Impact of cervical range of motion on the global spinal alignment in ankylosing spondylitis patients with thoracolumbar kyphosis following pedicle subtraction osteotomy
The head's center of gravity (COG) plumb line (PL) and C7 PL could be simultaneously positioned over the pelvis in adult spinal deformity (ASD) with normal cervical mobility. However, the position of the head in relation to the global spinal alignment has yet to be investigated in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis. (Source: The Spine Journal)
Source: The Spine Journal - September 13, 2019 Category: Orthopaedics Authors: Shi-zhou Zhao, Bang-ping Qian, Yong Qiu, Bin Wang, Ji-chen Huang, Mu Qiao Tags: Clinical Study Source Type: research

Clinical Prevalence and Population Incidence of Serious Pathologies Amongst Patients Undergoing Magnetic Resonance Imaging for Low Back Pain
In rare cases low back pain (LBP) may be caused by underlying serious pathology such as fracture, malignancy, cauda equina syndrome or spinal infection. The lack of evidence regarding either the clinical prevalence or population incidence of serious pathologies in the lumbar spine makes it difficult for clinicians to adequately assess a patient's risk of serious pathology. (Source: The Spine Journal)
Source: The Spine Journal - September 10, 2019 Category: Orthopaedics Authors: Katy J. Street, Dr Steve G. White, Alain C. Vandal Source Type: research

Optimizing biomechanics of anterior column realignment for minimally invasive deformity correction
Anterior column realignment (ACR) is a powerful but destabilizing minimally invasive technique for sagittal deformity correction. Optimal biomechanical design of the ACR construct is unknown. (Source: The Spine Journal)
Source: The Spine Journal - September 10, 2019 Category: Orthopaedics Authors: Jakub Godzik, Bernardo de Andrada Pereira, Anna G.U.S. Newcomb, Jennifer N. Lehrman, Gregory M. Mundis, Randall J. Hlubek, Juan S. Uribe, Brian P. Kelly, Jay D. Turner Tags: Basic Science Source Type: research

Effect of Local Retropharyngeal Steroids on Fusion Rate after Anterior Cervical Discectomy and Fusion
Anterior cervical discectomy and fusion (ACDF) is considered the gold standard surgical intervention for cervical myelopathy and radiculopathy. Obtaining a solid fusion is an important goal of ACDF, and doing so has correlated with favorable clinical outcomes. A common complication after surgery is post-operative dysphagia. Multiple techniques have been utilized in attempt to prevent and treat dysphagia, including use of retropharygeal steroids. (Source: The Spine Journal)
Source: The Spine Journal - September 7, 2019 Category: Orthopaedics Authors: Sapan D. Gandhi, Steven T. Wahlmeier, Philip Louie, Ryan Sauber, Trevor R. Tooley, Kevin C. Baker, Daniel K. Park Tags: Clinical Study Source Type: research

External Validation of the SORG 90-day and One-Year Machine Learning Algorithms for Survival in Spinal Metastatic Disease
Pre-operative survival estimation in spinal metastatic disease helps determine the appropriateness of invasive management. The SORG ML ninety-day and one-year machine learning algorithms for survival in spinal metastatic disease were previously developed in a single institutional sample but remain to be externally validated. (Source: The Spine Journal)
Source: The Spine Journal - September 7, 2019 Category: Orthopaedics Authors: Aditya V. Karhade, Ali K. Ahmed, Zach Pennington, Alejandro Chara, Andrew Schilling, Quirina C.B.S. Thio, Paul T. Ogink, Daniel M. Sciubba, Joseph H. Schwab Tags: Clinical Study Source Type: research

Opioid-Limiting Legislation Associated with Decreased 30-Day Opioid Utilization Following Anterior Cervical Decompression and Fusion
Since 2016, 35 of 50 U.S. states have passed opioid-limiting laws. The impact on postoperative opioid prescribing and secondary outcomes following ACDF remains unknown. (Source: The Spine Journal)
Source: The Spine Journal - September 2, 2019 Category: Orthopaedics Authors: Daniel B.C. Reid, Shyam A. Patel, Kalpit N. Shah, Benjamin H. Shapiro, Jack H. Ruddell, Edward Akelman, Mark A. Palumbo, Alan H. Daniels Tags: Clinical Study Source Type: research

DEXA Sensitivity Analysis in Patients With Adult Spinal Deformity
Adult spinal deformity (ASD) is a debilitating condition that commonly requires surgical intervention. However, ASD patients may also present with osteoporosis, predisposing them to surgical complications and failure of instrumentation. As a result, proper detection of low bone mineral density (BMD) is critical in order to ensure proper patient care. Typically DEXA scans are performed on the hip and spine. Unfortunately, in ASD patients, the latter is often inaccurate. (Source: The Spine Journal)
Source: The Spine Journal - September 1, 2019 Category: Orthopaedics Authors: Anmol Gupta, Shivam Upadhyaya, Anuj Patel, Harold A. Fogel, Thomas Cha, Joseph Schwab, Chris Bono, Stuart Hershman Tags: Clinical Study Source Type: research

Sarcopenia, but not Frailty predicts Early Mortality and Adverse Events after Emergent Surgery for Metastatic Disease of the Spine
Frailty and sarcopenia variably predict adverse events (AE's) in a number of surgical populations. (Source: The Spine Journal)
Source: The Spine Journal - September 1, 2019 Category: Orthopaedics Authors: Étienne Bourassa-Moreau, Anne Versteeg, Eryck Moskoven, Raphaële Charest-Morin, Alana Flexman, Tamir Ailon, Turker Dalkilic, Charles Fisher, Nicolas Dea, Michael Boyd, Scott Paquette, Brian Kwon, Marcel Dvorak, John Street Tags: Clinical Study Source Type: research

Utility of Motor Evoked Potentials to Diagnose and Reduce Lower Extremity Motor Nerve Root Injuries During 4,386 Extradural Posterior Lumbosacral Spine Procedures
Motor evoked potentials (MEPs) have excellent sensitivity for monitoring the functional integrity of the lateral corticospinal tract of the spinal cord. The sensitivity for nerve root function, however, is not as well established; consequently, MEPs are often not utilized for posterior extradural spine procedures distal to the conus. Spontaneous electromyography (sEMG) and somatosensory evoked potentials (SSEPs) are often included for these procedures, but their limited sensitivity has been well documented. (Source: The Spine Journal)
Source: The Spine Journal - August 31, 2019 Category: Orthopaedics Authors: W. Bryan Wilent, Eric A. Tesdahl, James S. Harrop, William C. Welch, Andrew F. Cannestra, Kornelius A. Poelstra, Thomas Epplin-Zapf, Taylor Stivali, Jeffrey Cohen, Anthony K. Sestokas Tags: Clinical Study Source Type: research

Comparison of brain structure between pain-susceptible and asymptomatic individuals following experimental induction of low back pain
Peripheral differences often do not adequately account for variation in reports of pain intensity in people with musculoskeletal pain. (Source: The Spine Journal)
Source: The Spine Journal - August 31, 2019 Category: Orthopaedics Authors: Jeff Boissoneault, Charles W Penza, Steven Z George, Michael E Robinson, Mark D Bishop Tags: Basic Science Source Type: research

Severity of degenerative lumbar spinal stenosis affects pelvic rigidity during walking
To understand the role of compensation mechanisms in the development and treatment of symptomatic degenerative lumbar spinal stenosis (DLSS), pelvic stability during walking should be objectively assessed in the context of clinical parameters. (Source: The Spine Journal)
Source: The Spine Journal - August 31, 2019 Category: Orthopaedics Authors: Helen Bumann, Corina N üesch, Stefan Loske, S. Kimberly Byrnes, Balázs Kovacs, Ruben Janssen, Stefan Schären, Annegret Mündermann, Cordula Netzer Tags: Clinical Study Source Type: research

1. Comparison of serum cytokine concentrations in patients with acute sciatica secondary to lumbar disc herniation choosing surgery with those choosing nonoperative treatment
The interpretation of research studies comparing clinical outcomes from surgical and nonoperative treatment of patients with acute sciatica secondary to herniated nucleus pulposus (AS/ HNP) remain controversial. Recent studies have concluded that a subset of AS/HNP patients have identifiable biological characteristics that may predict favorable clinical nonoperative treatment outcomes. The mechanism of spinal nerve root injury associated with AS/HNP is mediated at least in part, through an acute inflammatory response that involves the up regulation of specific inflammatory cytokines (eg, TNF α, IL-1β, IL-8 and R...
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Paul B. Bishop, John Street, Jeffrey A. Quon, Brian E. Arthur, Gabriella M. Petrollini, Melissa Nadeau, Tamir Ailon, Nicolas Dea, Charles G. Fisher, Brian K. Kwon Tags: Wednesday, September 25, 2019 7:30 – 8:55 Biomechanics and Basic Science I Source Type: research

2. 3D-printed titanium: a surface optimization analysis
Titanium was first used as an orthopaedic implant material in the 1950s and has been widely used in the decades following. Due to recent advancements in 3D-printing technology, titanium implants are now able to be manufactured with macroscopic, microscopic, and even nanoscopic precision. With this precision, surface optimization analysis can better elucidate the ideal implant interface for osseointegration. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Antonio T. Brecevich, Christina Dowe, Frank P. Cammisa, Celeste Abjornson Source Type: research

3. Fatigue analysis of multilevel anterior cervical fusion with stand-alone anchored spacer vs interbody cage with anterior plate
Anterior cervical discectomy and fusion (ACDF) is the surgical standard for treating anterior based cervical spine pathology with interbody spacers and plating most common. Complications are more prevalent in multilevel cases. Stand-alone anchored spacers were designed to resolve these issues. For 1-level ACDF they provide similar clinical results, fewer implant related complications and decreased compensatory motion at adjacent levels. Reporting on fatigue analysis of multilevel plating vs anchored spacers is limited. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Aymen Rashid, Nathaniel R. Ordway, James B. Allen, Satyajit Marawar, William F. Lavelle Source Type: research

4. Lumbosacral TLIF but not ALIF increases proximal junction motion in long-segment constructs
Proximal junctional kyphosis and lumbosacral (LS) pseudoarthrosis/instrumentation failure are relatively common complications following long instrumentation constructs to the sacrum. Methods to improve fusion rates and decrease instrumentation failure include LS anterior column support (ALIF or TLIF), iliac screw fixation, and accessory rods. The impact of these lumbosacral augmentation strategies on the proximal junction is not clear. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Randall J. Hlubek, Jakub Godzik, Anna G. Newcomb, Jennifer Lehrman, Bernardo De Andrada Pereira, Brian Kelly, Jay D. Turner Source Type: research

5. A biomechanical investigation of the sacroiliac joint in the setting of lumbosacral fusion: the impact of pelvic fixation vs sacroiliac joint fixation
This study is a biomechanical investigation to understand the effect of pelvic vs sacroiliac joint fixation on the sacroiliac joint in lumbosacral fusion. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Harry M. Mushlin, Gerald Hayward, Daina M. Brooks, Bryan Ferrick, Stephen Carbine, Brandon Bucklen, Charles A. Sansur Source Type: research

6. Biomechanical investigation of the potential development and prevention of scoliosis following various sizes of chest wall resection
Chest wall resection is used to treat several thoracic disorders including tumor removals. A well-known problematic sequela of chest wall resections is development of scoliosis. Literature shows that the degree of the induced curvature correlates to the number of resected ribs. Despite the seriousness and frequency of scoliosis following chest well resection, the etiology and biomechanical information needed to understand this deformity development are not well-known. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Zackery W. Witte, Jonathan M. Mahoney, Jonathan Harris, Hassaan P. Sheikh, Brandon Bucklen, Rex A. Marco, Varan Haghshenas Source Type: research

7. Eccentric kinematic patterns of the sacroiliac junction following lumbopelvic reconstruction
The unique biomechanical properties of the sacroiliac joint (SIJ) presents formidable challenges in spinal reconstructive surgery. Controversy exists as to effective surgical management of this joint. Abnormal motion across the joint is believed to lead to pain, dysfunction and instrumentation complications, but few data are available on the kinematic response. This investigation was performed to quantify and compare the sacroiliac kinematics of lumbosacral fixation and unilateral and bilateral iliac screw configurations. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Daina M. Brooks, Bryan W. Cunningham, P. Justin Tortolani Source Type: research

8. The immune response of two separate polymer spinal interbody device materials
Osteoimmunology, the study of the relationship between the musculoskeletal system and immune system, has emerged as an important consideration in biomaterial research. Based on the current understanding of the immune system, both the innate and adaptive components, a combination of tests on current design materials in spinal implant devices may help understand potential clinical complications and thus reduce the potential adverse events associated with specific design materials. Studies involving macrophages facilitate the understanding behind the mechanism of fibrous capsule formation anecdotally reported with PEEK implan...
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Boyle C. Cheng, Isaac Swink, Daniel T. Altman Source Type: research

9. Insulin protects intervertebral discs stimulated with diabetes-related cytokines
Neck and back pain caused by intervertebral disc (IVD) degeneration is a frequent cause of referral to spine surgeons. This is a multifactorial disease process caused by aging, injury, obesity, and mechanical stress. Recently, an association between IVD degeneration and diabetes has been identified, but the mechanisms underlying this relationship are unclear. Furthermore, the effects of insulin levels on cytokines known to be elevated in diabetics have not previously been delineated. Uncontrolled diabetes results in chronic systemic inflammation with increased circulating levels of IL-6 and IL-18. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Mark Lambrechts, Anna E. Skrade, Emma C. LePage, Aaron M. Stoker, Christina L. Goldstein, Theodore J. Choma, James L. Cook Source Type: research

10. Cervical decompression surgery improves dynamic balance in cervical spondylotic myelopathy patients
Difficulties with balance and gait are common manifestations of cervical spondylotic myelopathy (CSM). These patients present with altered balance and more trunk and lower extremity muscle activity when compared to healthy controls. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Ram Haddas, Rajesh G. Arakal, Theodore A. Belanger, Akwasi Boah Tags: Wednesday, September 25, 2019 7:30 – 8:55 Cervical Spine Surgery I Source Type: research

11. Predicting disability and pain outcomes one year after elective surgery for degenerative cervical diseases: analysis from quality outcomes database
In the current era of value-based health care reform, engaging patients in shared decision-making for treatment planning is imperative. Predictive models capable of providing individualized predictions of patient-reported outcomes (PROs) following cervical spine surgery have the potential to be valuable tools for a shared decision-making process. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Inamullah Khan, Clinton J. Devin, Hui Nian, Frank E. Harrell, Jacquelyn S. Pennings, Mohamad Bydon, Ahilan Sivaganesan, Kristin R. Archer Source Type: research

12. Angiotensin-II type-1 receptor blockade decreased T2 signal intensity in spinal cord compression in symptomatic cervical spondylotic myelopathy
Cervical spondylosis may lead to spinal cord compression, poor vascular perfusion, and ultimately cervical myelopathy. The process whereby chronic compression may cause spinal cord damage has not been fully understood. However, multiple mechanisms such as inflammation, apoptosis, and vascular variations, are thought to be responsible for the neuronal loss, axonal degeneration, and myelin impairment seen in cervical spondylotic myelopathy (CSM). Studies reported a beneficial effect of renin-angiotensin system (RAS) blockers in the central nervous system, particularly in brain inflammation and stroke, but data on their influ...
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Alexander Perdomo-Pantoja, Alejandro Chara, Joshua Casaos, Samuel Kalb, Corinna Zygourakis, Zach Pennington, Ethan Cottrill, Amir Manbachi, Timothy F. Witham, Nicholas Theodore Source Type: research

13. Minimally invasive posterior cervical foraminotomy as an alternative to anterior cervical discectomy and fusion for unilateral cervical radiculopathy
Unilateral cervical radiculopathy refractory to conservative treatment is one of the most common pathologies that spine surgeons treat surgically. Anterior cervical discectomy and fusion (ACDF) has long been considered standard treatment for cervical radiculopathy secondary to lateral disc herniation or foraminal stenosis. Recent studies suggest minimally-invasive posterior cervical foraminotomy (MI-PCF) to be an alternative to ACDF, but not without concern for reoperation and magnitude of patient outcome improvement. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Nikhil K. Sahai, Stuart Changoor, Conor J. Dunn, Kimona Issa, Michael J. Faloon, Kumar G. Sinha, Ki Soo Hwang, Arash Emami Source Type: research

14. Day surgery anterior cervical discectomy and fusion at one, two and three levels is safe and effective in a public health system: experience from 273 patients at a single Canadian institution
Anterior cervical discectomy procedures (ACD) are amongst the most common procedures performed for cervical myeloradiculopathy. Outpatient single- or 2-level ACDs have become popular in recent years due to the high patient satisfaction outcomes and efforts to improve cost-effectiveness in health care. The safety and efficacy of 1, 2, or 3 level procedures in the public health care setting has not been reported in the literature. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Jamie R. Wilson, Hetshree Joshi, Jessica P. Bauer, Fan Jiang, Eric M. Massicotte Source Type: research

15. Surgical treatment of lower cervical fracture dislocation with spinal cord injuries using the anterior approach: a 10-year case review with minimum five-year follow-up
Lower cervical fracture-dislocations are often caused by flexion-stretch injuries and frequently combine with spinal cord injuries which can cause serious damage. To date, there is no clear consensus on the best treatment option for lower cervical fracture-dislocation. In recent years, anterior approach surgery with direct decompression and reduction has been widely accepted. However, a long-term follow-up study with a large sample size to assess the clinical efficacy of the anterior approach is rarely seen in the literature. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Biao Wang, Ding-Jun Hao Source Type: research

16. Discrepancies in the surgical management of central cord syndrome: assessment of nonoperative, surgical, and crossover to surgery patients
The efficacy of surgical intervention for central cord syndrome (CCS) is shown in the literature; however, it is unclear whether disparities in patient presentation and treatment exist between those who initially undergo operative treatment and those who delay operative treatment. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Peter G. Passias, Cole Bortz, Katherine E. Pierce, Haddy Alas, Avery Brown, Nicholas Shepard, Muhammad B. Janjua, Paul Park, Dimitrios C. Nikas, John A. Buza, Aaron Hockley, Anthony K. Frempong-Boadu, Dennis Vasquez-Montes, Bassel G. Diebo, Michael C. Ger Source Type: research

17. The impact of preoperative cannabis on outcomes following cervical spinal fusion: a propensity score-matched analysis
Cannabis is the most commonly used illicit drug in the United States with 4 million Americans meeting clinical criteria for cannabis dependence or abuse in 2015. With recent state-level legalization efforts and changing public perception, its use is expected to grow. Considering these changes and the reported medicinally beneficial effects, studies evaluating cannabis use and its impact on outcomes following cervical fusion (CF) are quite limited; further detailed study is warranted. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Neil V. Shah, Cameron R. Moattari, Joshua D. Lavian, Marine Coste, David Kim, Sirish Khanal, Joseph Scollan, George A. Beyer, Patrick J. Morrissey, Nathan S. Kim, Peter G. Passias, Renaud Lafage, Han Jo Kim, Carl B. Paulino, Frank J. Schwab, Virginie Lafa Source Type: research

18. Safety and efficacy of tranexamic acid use in posterior cervical decompression and fusion surgery
Posterior cervical decompression and fusion (PCDF) involves substantial blood loss, resulting in blood transfusions and associated complications, such as infections, hypotension and organ damage. The antifibrinolytic tranexamic acid (TXA), an inhibitor of the activation of plasminogen, has been shown to be beneficial in multiple surgical procedures without any apparent increase in postoperative complications. However, only a few studies report on TXA utilization in cervical spine surgery and there is currently no literature detailing the short-term safety of its use in this setting. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Joseph P. Gjolaj, Roberto J. Perez Roman, Karthik Madhavan, Julian Lugo-Pico Source Type: research

19. Adult symptomatic lumbar scoliosis patients have high orthopedic disease burden beyond their spinal deformities: results from a prospective multicenter study
Although the health impact of adult symptomatic lumbar scoliosis (ASLS) is substantial, these patients often have other orthopedic disease burden that may further negatively impact their health-related quality of life (HRQL) and recovery following ASLS treatment. This additional disease burden has not been well quantified in the ASLS population. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Justin S. Smith, Christopher I. Shaffrey, Christine R. Baldus, Michael P. Kelly, Elizabeth Yanik, Jon D. Lurie, Charles C. Edwards, Steven D. Glassman, Lawrence G. Lenke, Oheneba Boachie-Adjei, Jacob M. Buchowski, Leah Y. Carreon, Jeffrey L. Gum, Charles Tags: Wednesday, September 25, 2019 7:30 – 8:55 Spinal Deformity I Source Type: research

20. Cost-effectiveness of operative vs nonoperative treatment of adult symptomatic lumbar scoliosis an intent-to-treat analysis at 5-year follow-up
There continues to be uncertainty in the appropriate treatment approach for adult symptomatic lumbar scoliosis (ASLS). Nonoperative care has not been shown to improve outcomes. Surgical treatment has been shown to improve outcomes, but is costly with high revision rates. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Leah Y. Carreon, Steven D. Glassman, Jon D. Lurie, Christopher I. Shaffrey, Michael P. Kelly, Christine R. Baldus, Kelly R. Bratcher, Charles H. Crawford, Elizabeth Yanik, Keith H. Bridwell Source Type: research

21. Machine learning models to predict operative vs nonoperative management of adult spinal deformity patients
Adult spinal deformity (ASD) patients exhibit complex and highly variable pathology. The decision to manage patients operatively is subjective and varies based on training and experience. Machine learning algorithms have shown promise in supporting clinical decision-making. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Wesley Durand, Alan H. Daniels, D. Kojo Hamilton, Peter G. Passias, Gregory M. Mundis, Khaled M. Kebaish, Han Jo Kim, Themistocles S. Protopsaltis, Virginie Lafage, Justin S. Smith, Christopher I. Shaffrey, Munish C. Gupta, Eric O. Klineberg, Frank J. Sch Source Type: research

22. Subclinical infection as an etiology for pseudarthrosis in multilevel thoracolumbar spinal fusions
Pseudarthrosis is a common indication for revision spine operations. Clinical presentations of pseudarthrosis are heterogeneous. While the majority of patients present with pain, many can be symptomatic. Etiologies of pseudarthrosis also vary from structural to biologic, including infection. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Daniel A. Beckerman, John Ibrahim, Alexander Tenorio, Alexander A. Theologis, Sigurd H. Berven Source Type: research

23. Sacroiliac fusion surgery improves gait patterns of patients with sacroiliac joint dysfunction
The sacroiliac joint (SIJ) is an underappreciated pain generator in 15-30% of patients with low back pain. The SIJ functions as a primary structure which transfers loads of the upper body to the lower extremities. Sacroiliac joint dysfunction (SIJD) is characterized by SIJ laxity with symptoms manifesting primarily as low back and lower extremity pain. Additionally, there is growing evidence that gait patterns may also be affected by SIJD. Although there is still much controversy, minimally invasive sacroiliac fusion (SIF) is gaining interest as a procedure for SIJD patients with unremitting pain. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Damon E. Mar, Yoheli Perez, Scott C. Kutz, Thomas Kosztowski, Andrew R. Block, Ralph F. Rashbaum, Ram Haddas Source Type: research

24. Untreated adolescent idiopathic scoliosis in adulthood: how often do these patients require surgery?
Weinstein and Ponsetti demonstrated that despite increased pain, adults with previously unoperated adolescent idiopathic scoliosis (AIS) typically lead normal functioning lives. The Oswestry Disability Index (ODI) is a validated questionnaire for assessing back disability with 0-20 indicating minimal disability. A score of>30 has been used in past FDA trials as an inclusion criterion for surgical studies. We predict that increasing ODI scores will correlate with age, curve size, curve location and progression to surgery. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Jace Erwin, Brandon B. Carlson, Joshua Bunch, Robert S. Jackson, Douglas C. Burton Source Type: research

25. Use of precontoured titanium alloy rods to induce thoracic kyphosis after sequential posterior release: a cadaveric spine study
Implications for failure to restore normal thoracic kyphosis (TK) in treating adolescent idiopathic scoliosis are just beginning to be understood. Techniques for releasing the rigid spine have included ligamentous releases and discectomy procedures, as well as bony resection; however, the extent these releases improve the ability for a precontoured rod to induce thoracic kyphosis has been lacking. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Jinhui Shi, Nathaniel R. Ordway, Mike H. Sun, Stephen A. Albanese, Swamy Kurra, William F. Lavelle Source Type: research

26. Posterior ligamentous reinforcement does not prevent proximal junctional kyphosis in adult spinal deformity
Violation of the posterior soft tissues is believed to contribute to the development of proximal junctional kyphosis (PJK). Clinical and biomechanical studies have suggested that augmentation of the posterior ligamentous structures (PLS) may help prevent PJK. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Sravisht Iyer, Francis C. Lovecchio, Jonathan Elysee, Renaud Lafage, Frank J. Schwab, Virginie Lafage, Han Jo Kim Source Type: research

27. Costs and utility of postdischarge acute inpatient rehabilitation following adult spinal deformity surgery
As the United States' health care system transitions to a value-based approach, defining costs for entire episodes of care is fundamental to determining value. This is particularly important for adults with spinal deformity (ASD) who undergo surgical intervention. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Alexander A. Theologis, Darryl Lau, Cecilia L. Dalle Ore, Vedat Deviren, Christopher P. Ames Source Type: research

28. Evaluation of three commercially available synthetic bone grafts in a clinically relevant ovine model of instrumented lumbar posterolateral fusion
Synthetic bone grafts are important tools for spinal surgeons who wish to avoid the invasive harvesting of autologous bone graft for spinal fusions. Various synthetic bone grafts are available on the market, including materials based on bioglass, calcium phosphate or a combination of both. Side-by-side comparisons of synthetic bone grafts in relevant preclinical study models can provide valuable insights that can aid in the selection of treatment options. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Lukas A. van Dijk Tags: Wednesday, September 25, 2019 7:30 – 8:55 Thoracolumbar Surgery I Source Type: research

29. Understanding surgeon decision-making and current surgical practice regarding the DSIC scheme and DLS treatment: a CSORN study
Degenerative lumbar spondylolisthesis (DLS) is a spinal pathology involving the slip of one or more lumbar spinal vertebrae. It is most common in women and African-Americans above the age of 50, and usually involves the anterior slip of the fourth lumbar vertebra of up to 30% of its vertebral body width due to the more sagittally-oriented facet joints, and therefore, high force concentration at that level. Despite its worldwide prevalence of about 6%, the classification and treatment of DLS is not standardized. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Audrey Maher Source Type: research

30. Declining trend in osteoporosis screening and medical management following primary vertebral compression fractures: a national analysis of commercial and Medicare advantage beneficiaries
Despite its increasing national incidence, osteoporosis and its associated co-management often remain an overlooked issue in the orthopedic world. In the majority of the scenarios, screening and associated management of osteoporosis is only considered by providers when patients present with multiple fragility fractures. Current evidence with regards to the trends in screening and medical co-management/antiresorptive therapy of osteoporotic vertebral compression fractures (VCFs) remains limited. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Azeem T. Malik, Sheldon Retchin, Frank M. Phillips, Wendy Xu, Kaleigh Peters, Jeffery Kim, Elizabeth Yu, Safdar N. Khan Source Type: research

31. Development of clinical prognostic models for postoperative survival and quality of life in patients with surgically treated metastatic epidural spinal cord compression
Surgery is generally considered for patients with metastatic epidural spinal cord compression (MESCC) with a life expectancy of at least 3 months. No existing clinical prognostic models (CPMs) of survival are consistently used, and no CPMs exist which predict quality of life (QoL) following surgical treatment. These knowledge gaps are important given the challenges involved in managing MESCC. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Anick Nater, Michael G. Fehlings Source Type: research

32. Does the number of patient-reported allergies impact clinical outcomes after lumbar spinal fusion?
A gap in the literature exists regarding the association of clinical and radiographic outcomes with specific number of allergies for patients undergoing lumbar spinal fusions; which is necessary to close in order to better understand the prognostic value of patient-reported allergies. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Jannat M. Khan, Bryce Basques, Dong Gue Oh, Zayd Hayani, Jennifer Hwang, Konstantin A. Tchalukov, Peter B. Derman, Howard S. An, Matthew Colman Source Type: research

33. Comparison of bone morphogenetic protein and allogeneic stem cells in lateral interbody lumbar fusion
Lateral interbody fusion (LLIF) is often performed with biologic adjuvants to promote fusion. Commercially available bone allograft containing allogeneic stem cells (ASC) and bone morphogenetic protein-2 (BMP) are designed to promote fusion while avoiding the morbidity of iliac crest autograft; however, no study to date has directly compared the two in LLIF. The ASC studied is Osteocel Pro (NuVasive, Inc). (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Elizabeth L. Lord, Jordan H. Manning, Erik Wang, Dennis Vasquez-Montes, Deeptee Jain, Themistocles S. Protopsaltis, Charla R. Fischer, Aaron J. Buckland, Jeffrey A. Goldstein, Peter G. Passias, Yong H. Kim, John A. Bendo Source Type: research

34. Timing of surgery for thoracolumbar spine trauma: patients without neurological injury
Over 100,000 traumatic thoracolumbar fractures occur annually in North America. Previous investigations have examined timing of surgery, but consensus is still lacking regarding the ideal timing for thoracolumbar trauma surgery for optimization of patient outcomes. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Jack H. Ruddell, John M. DePasse, Oliver Y. Tang, Alan H. Daniels Source Type: research

35. How many screws are necessary to be considered an experienced surgeon for freehand placement of thoracolumbar pedicle screws? Analysis of the learning curve using the cumulative summation test for learning curve (LC-CUSUM)
Several studies have demonstrated the learning curve for freehand pedicle screw placement (PSP) in residents, spinal fellows, and young surgeons. Also, the authors have suggested the numbers of required screws for PSP. Despite advances in statistical analysis for the learning curve, there is no study investigating how many screws are required to reach an adequate performance level in freehand PSP. (Source: The Spine Journal)
Source: The Spine Journal - August 23, 2019 Category: Orthopaedics Authors: Sang-Min Park, Jonghun Jung Source Type: research