Single Distraction-Rod Constructs in Severe Early-Onset Scoliosis: Indications and Outcomes
Since the study of Thompson, et al in 2005, use of dual-growing rod constructs have become the gold standard for operative treatment in early-onset scoliosis. However, use of dual-growing rod constructs may not be possible, due to patient size and the type, location and severity of the spinal deformity. (Source: The Spine Journal)
Source: The Spine Journal - September 18, 2021 Category: Orthopaedics Authors: Scott J. Luhmann, David L. Skaggs, Joshua Pahys, Amer Samdani, Ron El-Hawary Source Type: research

What does the Patient with Back Pain Want? A Comparison of Patient Preferences and Physician Assumptions
Low back pain is extremely common and is the world's leading cause of disability. [1 –3] Its differential diagnosis is very broad, and a definitive diagnosis can be difficult to provide, leaving patients frustrated and confused during and after medical visits, [4] A substantial amount of frustration and anger is described by low back pain patients. They often feel misunderstood, s tigmatized and trapped within the medical system. [3] In a systemic review of 46 qualitative studies, it was noted that “people with low back pain are centered around the desire for a diagnosis… simple explanations like ‘...
Source: The Spine Journal - September 18, 2021 Category: Orthopaedics Authors: Matthew Smuck, Kevin Barrette, Agnes Martinez-Ith, Geoffrey Sultana, Patricia Zheng Source Type: research

Next Generation Sequencing (NGS) to Determine Microbiome of Herniated Intervertebral Disc
Low back pain is a very common complaint and up to 84% of the adult population will suffer from it at some point in their lives.[1] Degenerative disc disease has a strong relationship to chronic low back pain although it is mostly asymptomatic. Disc degeneration involves alterations to its microstructure, inability of the disc annulus and nucleous to share load, and loss of disc height.[2] This could lead to conditions such as disc herniation, ligaments and facet joints hypertrophy and nerve compression. (Source: The Spine Journal)
Source: The Spine Journal - September 18, 2021 Category: Orthopaedics Authors: Nelson Astur, Brenno Ferreira Bento Maciel, Andre Mario Doi, Marines Dalla Valle Martino, Marcela Souza Basqueira, Marcelo Wajchenberg, Mario Lenza, Delio Eulalio Martins Source Type: research

Relationship between systemic inflammation and recovery over 12 months after an acute episode of low back pain.
Recurrence and persistence of low back pain (LBP) are major health [81,39] and economic [25,112,19] issues. Disappointingly, despite considerable efforts, outcomes are worsening [32]. Understanding the etiological factors that underlie the transition from acute to recurrent/persistent LBP will likely aid reversal of this trend. Growing research points to involvement of a systemic inflammatory response. Studies have shown that inflammatory cytokines and mediators are systemically elevated in many chronic pain conditions, e.g., tumor necrosis factor (TNF) in chronic LBP [114,113], interleukin-6 (IL-6) in fibromyalgia [35], i...
Source: The Spine Journal - September 18, 2021 Category: Orthopaedics Authors: David M. Klyne, Mary F. Barbe, Paul W. Hodges Source Type: research

Prospective Comparison of Dysphagia Following Anterior Cervical Discectomy and Fusion (ACDF) with and without rhBMP-2
Previous studies have called into question the safety of using rhBMP-2 in anterior cervical fusion due to the possibility of airway compromise and dysphagia. A retrospective chart review identified a significant increase in the severity of dysphagia after 2-level ACDF with rhBMP-2 compared to patients who did not receive rhBMP-2. To date, this topic has not been studied prospectively. (Source: The Spine Journal)
Source: The Spine Journal - September 16, 2021 Category: Orthopaedics Authors: J. Taylor Bellamy, Eric Dilbone, Adam Schell, Ajay Premkumar, Benjamin Geddes, Steven Leckie, Bradley Moatz, Byron Stephens, Neeta V. Shenvi, John G. Heller Tags: Clinical Study Source Type: research

Prediction of long-term postoperative results of disc wedge and vertebral tilt with intraoperative prone radiograph in posterior correction of thoracolumbar/lumbar curve in adolescent idiopathic scoliosis: a minimum 5-year follow-up
When the structural thoracolumbar/lumbar (TLL) curve is involved in adolescent idiopathic scoliosis (AIS), appropriate correction of curvature, maintaining coronal balance, and saving as many mobile segments as possible are the chief goals.[1-8] However, debate remains regarding selection of fusion levels, correction method, and aims of surgery in correction of AIS due to the complex nature of the deformity and variable postoperative course.[1, 3, 9, 10] (Source: The Spine Journal)
Source: The Spine Journal - September 16, 2021 Category: Orthopaedics Authors: Choon Sung Lee, Kun-Bo Park, Chang Ju Hwang, Jae Hwan Cho, Dong-Ho Lee, Sehan Park Source Type: research

The Effect of Ketorolac on Posterior Minimally Invasive Transforaminal Lumbar Interbody Fusion: an interim analysis from a randomized, double-blinded, placebo-controlled trial
: Postoperative pain control following posterior lumbar fusion continues to be challenging and often requires high doses of opioids for pain relief. The use of ketorolac in spinal fusion is limited due to the risk of pseudarthrosis. However, recent literature suggests it may not affect fusion rates with short-term use and low doses. (Source: The Spine Journal)
Source: The Spine Journal - September 7, 2021 Category: Orthopaedics Authors: Chad F Claus, Evan Lytle, Michael Lawless, Doris Tong, Diana Sigler, Lucas Garmo, Dejan Slavnic, Jacob Jasinski, Robert W McCabe, Ascher Kaufmann, Gustavo Anton, Elise Yoon, Ammar Alsalahi, Karl Kado, Peter Bono, Daniel A Carr, Prashant Kelkar, Clifford H Source Type: research

Frailty is an Important Predictor of 30-day Morbidity in Patients Treated for Lumbar Spondylolisthesis Using a Posterior Surgical Approach
Traditionally, a non-operative approach has been favored for elderly patients with lumbar spondylolisthesis due to a perceived higher risk of morbidity with surgery. However, most studies have used an arbitrary age cut-off to define “elderly” and this research has yielded conflicting results. (Source: The Spine Journal)
Source: The Spine Journal - September 6, 2021 Category: Orthopaedics Authors: Vivien Chan, Christopher D Witiw, Jamie RF Wilson, Jefferson R Wilson, Peter Coyte, Michael G Fehlings Tags: Clinical Study Source Type: research

The Association Between Atlantoaxial Instability and Anomalies of Vertebral Artery and Axis
A screw-rod system is the most widely used technique for atlantoaxial instability (AAI). However, neglecting anomalies of the vertebral artery and axis could lead to fatal complications. Whether or not the presence of AAI is associated with a more complicated anatomy for instrumentation is unclear. (Source: The Spine Journal)
Source: The Spine Journal - September 6, 2021 Category: Orthopaedics Authors: Chan Woong Byun, Dong-Ho Lee, Sehan Park, Choon Sung Lee, Chang Ju Hwang, Jae Hwan Cho Tags: Clinical Study Source Type: research

Costs associated with potentially unnecessary post-operative healthcare encounters after lumbar spine surgery
Excessive use of post-operative imaging after lumbar surgery has been documented, becoming a target for cutting costs. This must be balanced with the patient's need for information and allay their post-operative concerns. (Source: The Spine Journal)
Source: The Spine Journal - September 3, 2021 Category: Orthopaedics Authors: Neda F. Gilmartin, Leah Y. Carreon, Jeffrey L. Gum, John R. Dimar, Morgan E. Brown, Steven D. Glassman Source Type: research

Development of a clinical prediction rule for patients with cervical spinal cord injury who have difficulty in obtaining independent living
A simple and easy to use clinical prediction rule (CPR) to detect patients with a cervical spinal cord injury (SCI) who would have difficulty in obtaining independent living status is vital for providing the optimal rehabilitation and education in both care recipients and caregivers. A machine learning approach was recently applied to the field of rehabilitation and has the possibility to develop an accurate and useful CPR. (Source: The Spine Journal)
Source: The Spine Journal - September 3, 2021 Category: Orthopaedics Authors: Tomonari Hori, Takeshi Imura, Ryo Tanaka Source Type: research

A Cross-sectional Analysis of 284 Complications for Lumbar Disc Replacements from Medical Device Reports Maintained by the United States Food and Drug Administration.
context: Lumbar disc replacement (LDR) is a motion sparing procedure for degenerative disc disease. When compared to lumbar fusion, this procedure may reduce complications, reoperations, operative time, and length of stay. However, the extent of overall complications related to LDR has not been well defined in the literature.Purpose: Demonstrate the complication profile of popular LDR implants reported to the Food and Drug Administration (FDA).Study Design:Retrospective database review. (Source: The Spine Journal)
Source: The Spine Journal - August 31, 2021 Category: Orthopaedics Authors: Petros Koutsogiannis, Safdar Khan, Frank Phillips, Sheeraz Qureshi, Thomas J. Dowling, Junho Song, Sohrab Virk Source Type: research

Development of a Machine Learning Algorithm for Predicting In-hospital and One-year Mortality after Traumatic Spinal Cord Injury
Current prognostic tools such as the Injury Severity Score (ISS) that predict mortality following trauma do not adequately consider the unique characteristics of traumatic spinal cord injury (tSCI). (Source: The Spine Journal)
Source: The Spine Journal - August 19, 2021 Category: Orthopaedics Authors: Nader Fallah, Vanessa Noonan, Zeina Waheed, Carly Rivers, Tova Plashkes, Manekta Bedi, Mahyar Etminan, Nancy Thorogood, Tamir Ailon, Elaine Chan, Nicolas Dea, Charles Fisher, Raphaele Charest-Morin, Scott Paquette, So Park, John Street, Brian Kwon, Marcel Source Type: research

Burst Spinal Cord Stimulation Can Attenuate Pain and its Affective Components in Chronic Pain Patients with High Psychological Distress: Results from the Prospective, International TRIUMPH Study
Chronic pain is endemic in modern society and represents one of the most common reasons an individual seeks medical care. Recent updates to the definition of pain by International Association for the Study of Pain include sensory, affective, and cognitive components[1]. Indeed, psychological disorders are amongst the most common comorbidities of chronic pain, affecting up to 50% of individuals, and their confluence influences the course and expression of chronic pain[2, 3]. It has been long agreed that several factors contribute to the chronicity of pain, including activity limitations, social isolation, and, crucially, em...
Source: The Spine Journal - August 19, 2021 Category: Orthopaedics Authors: Jonathan M. Hagedorn, Steven M. Falowski, Bram Blomme, Robyn A. Capobianco, James J. Yue Tags: Clinical Study Source Type: research

Failure in Cervical Total Disc Arthroplasty: Single Institution Experience, Systematic Review of the Literature, and Proposal of the RUSH TDA Failure Classification System
Although anterior cervical discectomy and fusion (ACDF) has long been the standard surgical treatment for cervical radiculopathy and myelopathy refractory to conservative management, fusion of cervical motion segments into non-mobile spinal units can place abnormal biomechanical strain on adjacent levels, and thus may precipitate degenerative changes.[1-4] In an effort to preserve natural kinematics at diseased cervical motion segments, attention has shifted towards cervical total disc arthroplasty (TDA). (Source: The Spine Journal)
Source: The Spine Journal - August 19, 2021 Category: Orthopaedics Authors: Athan G. Zavras, T. Barrett Sullivan, Kern Singh, Frank M. Phillips, Matthew W. Colman Tags: Clinical Study Source Type: research

Perioperative Subcutaneous Methylnaltrexone Does Not Enhance Gastrointestinal Recovery after Posterior Short-Segment Spinal Arthrodesis Surgery: A Randomized Controlled Trial
Postoperative ileus is a major barrier to gastrointestinal recovery following surgery. Opioid analgesics likely play an important causative role, particularly in spinal or orthopedic surgeries not involving bowel manipulation. Methylnaltrexone, a peripherally-acting µ-opioid receptor antagonist, is a potential prophylactic treatment. (Source: The Spine Journal)
Source: The Spine Journal - August 18, 2021 Category: Orthopaedics Authors: Connor Gifford, Benjamin McGahan, Shelby Miracle, Amy Minnema, Claire Murphy, Daniel Vazquez, Tristan Weaver, H. Farhadi Source Type: research

Natural language processing for prediction of readmission in posterior lumbar fusion patients: which free-text notes have the most utility?
The increasing volume of free-text notes available in electronic health records has created an opportunity for natural language processing (NLP) algorithms to mine this unstructured data in order to detect and predict adverse outcomes. Given the volume and diversity of documentation available in spine surgery, it remains unclear which types of documentation offer the greatest value for prediction of adverse outcomes. (Source: The Spine Journal)
Source: The Spine Journal - August 15, 2021 Category: Orthopaedics Authors: Aditya V. Karhade, Ophelie Lavoie-Gagne, Nicole Agaronnik, Hamid Ghaednia, Austin K. Collins, David Shin, Joseph H. Schwab Source Type: research

1. Early mobilization vs prolonged ( > 24hrs) bedrest for incidental durotomy
Incidence of unintended durotomy in thoracic and lumbar decompression procedures ranges from 3%-13%. An arbitrary length of flat bed rest is often prescribed as a tool to reduce cerebrospinal fluid (CSF) pressure on a compromised dural closure. Two popular thoughts are that flat bed rest>24 hours increases medical complications, but flat bed rest> 24 hours protects against CSF leaks/wound complications by reducing the hydrostatic pressure on dural repair. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Ketan Verma, Anne Freelin, Kelsey Atkinson, Robert S. Graham, William Broaddus Tags: Wednesday, September 29, 2021 7:35 AM – 8:35 AM Best Papers Source Type: research

2. Association between initial site of care and subsequent treatment patterns for back and neck pain
Nonspecific neck and back pain are highly variable conditions with hundreds of treatment options. Using standard analytical techniques, it is difficult to understand how patients seek and receive health care across service locations. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Katherine Bobroske, Margret Bjarnadottir, Christine Larish, Stefan Scholtes, Anita Cattrell, Lawrence Huan Source Type: research

3. Comparison of complications, outcomes and cost in frail vs nonfrail adult spinal deformity surgery patients
Frailty is a dynamic measure of physiological age that is a strong predictor of a patient's surgical risk. The purpose of this study is to investigate the impact of frailty on the perioperative outcomes and costs associated with operating on frail ASD patients. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Oscar Krol, Peter G. Passias, Lara Passfall, Nicholas Kummer, Katherine E. Pierce, Waleed Ahmad, Sara Naessig, Shaleen N. Vira, Brooke OConnell, Constance Maglaras, Carl B. Paulino, Rafael De la Garza Ramos, Renaud Lafage, Andrew J. Schoenfeld, Aaron J. B Source Type: research

4. Single-level cervical disc replacement using a PEEK-on-ceramic implant: Results of a multicenter FDA IDE trial with 24-month follow up
Many early cervical total disc replacements (TDRs) produced motion through a ball-and-socket action, with metal endplates articulating with a plastic core. PEEK is used increasingly for spinal implants due to its mechanical properties and lack of artifact on imaging. A cervical TDR was designed with commercially pure titanium-coated PEEK endplates and a biconvex zirconia toughened alumina ceramic core. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Richard D. Guyer, Domagoj Coric, Pierce D. Nunley, Rick C. Sasso, Michael J. Musacchio, Hyun W. Bae, John H. Peloza, Donna D. Ohnmeiss Source Type: research

5. Impact of racial and ethnic disparities on health outcomes following cervical spine surgery
Evidence suggests that Black non-Hispanic individuals are 39% to 44% more likely to have postoperative complications and prolonged length of stay after cervical spine surgery compared to White non-Hispanics. The long-term recovery of patient-reported health outcomes after cervical spine surgery among Hispanic and other non-Hispanic minorities (ie, Asian) remains unclear. Examining the postoperative recovery trajectory of Hispanic, Asian non-Hispanic, and Black non-Hispanic populations is important for identifying whether strategies are needed to reduce outcome disparities. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Hiral Master, Claudia Davdsion, Rogelio A. Coronado, Clinton J. Devin, Kristin R. Archer, Jacquelyn S. Pennings Source Type: research

6. Telemedicine visits generate accurate surgical plans in spine surgery
The role of telemedicine is rapidly evolving in all medical specialties, including orthopedic spine surgery. In particular, the utility of telemedicine to identify operative candidates and to determine surgical plans has yet to be demonstrated. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Alexander Crawford, Harry M. Lightsey, Grace Xiong, Brendan Striano, Andrew J. Schoenfeld, Andrew Simpson Source Type: research

7. An algorithm for using deep learning convolutional neural networks with 3-dimensional depth sensor imaging in scoliosis detection
Timely intervention in growing individuals, such as brace treatment, relies on early detection of adolescent idiopathic scoliosis (AIS). To this end, several screening methods have been implemented. However, these methods have limitations in predicting the Cobb angle. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Terufumi Kokabu, Noriak Kawakami, Koki Uno, Toshiaki Kotani, Teppei Suzuki, Hiroyuki Tachi, Yuichiro Abe, Hideki Sudo Source Type: research

8. Factors contributing to cost in management of spinal epidural abscesses
Spinal epidural abscesses (SEA) are increasing in incidence and may be associated with high rates of morbidity and mortality. While management classically consisted of urgent surgical decompression, advances in diagnostic imaging and antibiotic therapies have made possible earlier diagnosis and nonoperative management. Previous work examining the cost of surgically managed SEA demonstrates that this clinical entity is both expensive and associated with high mortality rates. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Grace Xiong, Brian C. Goh, Alexander Crawford, Brendan Striano, Andrew J. Schoenfeld Tags: Wednesday, September 29, 2021 7:35 AM – 8:35 AM Spinal Infections (Complications) Source Type: research

9. The impact of nasal screening for methicillin-resistant staphylococcus aureus on surgical site infection after primary lumbar fusion
Surgical site infections (SSI) constitute significant morbidity in spine surgery. Efforts at SSI prevention include preoperative methicillin-resistant Staphylococcus aureus (MRSA) screening and decolonization, with demonstrated success for arthroplasty patients along with vascular and cardiothoracic surgical patients. The variety of surgical approaches and anatomic regions within spine surgery can limit the impact of analyses at the subspecialty level. Despite the success of MRSA nasal screening and decolonization in reducing SSI rates in other disciplines, the impact on spine surgery is less understood. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Grace Xiong, Nattaly Greene, Stuart H. Hershman, Christopher M. Bono, Joseph H. Schwab, Daniel G. Tobert Source Type: research

10. The fate of patients with early postoperative surgical site infections following a lumbar decompression and instrumented fusion
Acute postoperative surgical site infections (SSI) following instrumented lumbar spine fusions are a relatively infrequent occurrence. Treatment of an SSI with prompt and aggressive surgical debridement along with prolonged postoperative parenteral antibiotics is generally effective and most often results in eradication of the infection and maintenance of the instrumentation. However, it is not clear what the long-term effect of an SSI may be on clinical outcome or more specifically the potential for development of a symptomatic nonunion or instrumentation loosening. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Arya Ahmady, Innocent Njoku, Zachary L. Gordon, Nicholas U. Ahn, Christopher G. Furey Source Type: research

11. Prophylactic use of local vancomycin does not decrease acute surgical site infection in adolescent idiopathic scoliosis
Perioperative surgical site infections for adolescent idiopathic scoliosis after posterior spinal fusion range from 0.3-1.6%. Morbidities associated with infections include hospital readmissions, reoperations, and long-term antibiotic use. Prophylactic and local administration of vancomycin powder into the wound has been shown to decrease rates of surgical site infections among the adult population, and many pediatric deformity surgeons have adopted its use in an effort to decrease infections in the adolescent idiopathic scoliosis population. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Stephen Stephan, De-An Zhang, Marilan Luong, Robert Cho, Selina Poon Source Type: research

12. Late spinal infections are more common among pediatric vs adult spinal deformity patients
Late-onset postoperative infections after surgical correction of spinal deformity represent an uncommon, but significant complication of spine surgery. The incidence of late infection following posterior spinal fusion (PSF) in pediatric patients with AIS has been reported to be up to 7.5%. However, there is limited literature on late infections following ASD surgery suggesting that this phenomenon may be less frequent in adults. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Ijezie Ikwuezunma, Adam Margalit, Amit Jain, Khaled M. Kebaish, Paul D. Sponseller Source Type: research

13. The diagnostic utility of biomarkers: spinal instability or underlying infection
Surgical site infection is a devastating complication of surgery that increases morbidity for patients undergoing spinal surgery. However, diagnosis in some cases remains challenging often requiring a trip to the operating room to obtain cultures. Current literature has provided evidence that preoperative blood markers are diagnostic of infection in patients undergoing hip arthroplasty and total knee replacement, but there has been limited investigation on biomarker diagnostic utility in patients undergoing spinal surgery. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Francis Sirch, Brian Karamian, Jose A. Canseco, Kristen Nicholson, Nicolas Dohse, Emily Schueppert, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder Source Type: research

14. Ambulatory neuromuscular scoliosis patients have similar rates of infection, perioperative complications and revision to adolescent idiopathic scoliosis patients
When examined as a collective group, NMS has a worse prognosis and surgical outcomes than its AIS counterpart. However, not all operative patients with diagnoses of cerebral palsy, Duchenne muscular dystrophy or other NMS pathology necessarily suffer similar poor outcomes associated with the class. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Vishal Sarwahi, Jesse M. Galina, Aaron M. Atlas, Sayyida S. Hasan, Yungtai Lo, Terry D. Amaral Source Type: research

15. Supplemental fixation of lateral mass screws: a strategy to improve fixation strength
Elderly patients are increasingly meeting the indications for spinal fusion and are more likely to have suboptimal bone quality. Patients with suboptimal bone quality who have undergone posterior cervical fusion have increased risk of fixation failure of up to 5.4% and may require stronger forms of fixation. Adding supplemental fixation to lateral mass screws (LMS) can increase fixation as measured by pullout strength. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Robert M. Havey, Muturi Muriuki, Suguna Pappu, Nader S. Dahdaleh, Kenneth R. Blank, Sarah Brownhill, Ben Johnston, Sean Selover, Shawn Harris, Robert Carruth, Avinash G. Patwardhan Tags: Wednesday, September 29, 2021 7:35 AM – 8:35 AM Spinal Implant Research Source Type: research

16. Evaluation of the cage subsidence performance of three porous lateral cage designs
Interbody cage subsidence remains a major complication after lumbar spine fusion surgery, particularly in lateral or other procedures that rely on indirect decompression. Porous cages are believed to reduce the risk of cage subsidence. Multiple porous cage designs exist, including 3D printed (3DP) titanium cages with body lattice and microporous endplates, 3DP titanium cages with a truss structure, and PEEK cages with surface porosity. Currently, there is a lack of carefully-controlled biomechanics studies to evaluate their relative performance. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Christian Yee-Yanagishita, Gregory Essayan, Brijesh Poojary, Nicholas Martin, Brooke Douglas, Yun Peng, Michael Jekir Source Type: research

17. Understanding proximal junctional kyphosis: New way of evaluating adjacent segment strain and vulnerability to failure after long segment instrumentation
Proximal junctional kyphosis (PJK) is a common and devastating complication of long segment fusions. Presumably, PJK occurs due to excessive or altered strain distribution at the proximal level above a fusion construct; however, this has not been previously studied or proven experimentally. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Jakub Godzik, Jennifer Lehrman, Bernardo De Andrada Pereira, Piyanat Wangsawatwong, Anna G. Sawa, Brian Kelly, Jay D. Turner Source Type: research

18. Do differences in segmental angle of single level posterior lumbar fixation affect adjacent level biomechanics: cadaveric study of range of motion and optical disc strain
The objective of this study was to quantify adjacent segment motion and disc surface strain changes with altered segmental angles. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Bernardo De Andrada Pereira, Piyanat Wangsawatwong, Jennifer Lehrman, Anna G. Sawa, Jakub Godzik, Juan S. Uribe, Brian Kelly, Jay D. Turner Source Type: research

19. Anterior lumbar interbody fusion with porous titanium interbody cages is associated with equivalent fusion rates and patient reported outcomes as bone morphogenetic protein-2
Although frequently used for anterior lumbar interbody fusion (ALIF), concerns regarding the use of recombinant human bone morphogenetic protein 2 (BMP-2) include off-label use, elevated cost and adverse outcomes such as osteolysis. The growing evolution of porous implant technology in promoting osseous integration via ingrowth provides an opportunity for a paradigm shift by relying less on biologic-assisted through-growth and leveraging implant on-growth and in-growth in similar fashion to porous metallic implants used in other orthopedic settings such as hip arthroplasty. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Athan Zavras, Zakariah Siyaji, Ali Piracha, Talha Qadri, Unzila Manzoor, Syeda Qadri, Michael T. Nolte, Arash Sayari, Matthew Colman Source Type: research

20. Biomechanical effect of facet joint violation on adjacent segment motion and disc strain following single level lumbar fusion with transpedicular screw and rod instrumentation
Facet joint violation (FV) is a complication occurring while placing pedicle screws at the upper-most level using an entry point and trajectory too close to the superior facet joint. The incidence of FV has been reported up to be as high as 50%. However, little is known about how FV affects superior adjacent level spinal stability and especially intervertebral disc (IVD) strain after lumbar fusion. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Piyanat Wangsawatwong, Anna G. Sawa, Bernardo De Andrada Pereira, Jennifer Lehrman, Juan S. Uribe, Jay D. Turner, Brian Kelly Source Type: research

21. Adoption of enhanced recovery after surgery (ERAS) protocol for lumbar fusion decreases in hospital postoperative opioid consumption
Enhanced recovery after surgery (ERAS) is an evidence-based multidisciplinary perioperative protocol intended to reduce surgical morbidity and improve recovery. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Ehsan Jazini, Alexandra Thomson, Andre Sabet, Leah Y. Carreon, Rita Roy, Colin M. Haines, Thomas C. Schuler, Christopher R. Good Tags: Wednesday, September 29, 2021 10:35 AM – 12:00 PM Preop, Intraop and Postop Considerations in Thoracolumbar Spine Surgery Source Type: research

22. Robotic assisted vs conventional posterior lumbar fusion: An analysis of 90-day complications and readmissions
Although robotic-assisted spinal fusion is gaining traction in the United States, little is known whether the robotic assistance during pedicle screw placement is associated with lower complication rates following elective posterior lumbar fusions. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Azeem T. Malik, Joseph Drain, James E. Brewster, Varun K. Singh, Robert C. Ryu, Safdar N. Khan, Elizabeth Yu Source Type: research

23. Outcomes of direct vs indirect decompression for lumbar spondylolisthesis: A propensity matched cohort analysis
Debate persists regarding the optimal surgical strategy to treat lumbar spondylolisthesis. The recent development of novel anterior approaches (direct lateral and oblique lumbar interbody fusion) has led to a rise in the utilization of anterior lumbar interbody fusion procedural codes. These new techniques rely on indirect decompression to treat the patient's neural compression, which is criticized by proponents of direct decompressive techniques. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Lydia McKeithan, Byron F. Stephens, Jacquelyn S. Pennings, Hui Nian, Hunter Waddell, Amir M. Abtahi, Mohamad Bydon, John J. Knightly, Kristin R. Archer, Clinton J. Devin Source Type: research

24. Lateral decubitus single position circumferential fusion (ALIF & PSF) improves perioperative outcomes compared to traditional anterior-posterior fusion
This study directly compares perioperative outcomes of SPS vs FLIP for degenerative pathologies. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Kimberly Ashayeri, Carlos Leon, Seth Tigchelaar, Parastou Fatemi, Matthew Follett, Ivan Cheng, J. Alex Thomas, Brett A. Braly, Brian Kwon, Mark Medley, Themistocles S. Protopsaltis, Aaron J. Buckland Source Type: research

25. Total psoas area does not associate with perioperative mortality or morbidity after lumbar spine surgery
In various surgical settings, single measures of frailty are increasingly used to guide patient selection and inform risk modification. Since a cardinal aspect of frailty is loss of functional capacity associated with loss of muscle mass, measures of sarcopenia have been looked to as indicators of frailty. Psoas muscle area (TPA) has emerged as a particularly practical and effective measure of sarcopenia. The present study aims to assess the utility of TPA as a predictor of perioperative morbidity and mortality. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Luke Wooster, Shiv Dewan, Edward Barksdale, Michael P. Steinmetz, Thomas E. Mroz Source Type: research

26. Occluding annular defects with a bone anchored closure device results in fewer procedure related readmissions after lumbar discectomy: Four-year data from a multicenter, prospective, randomized superiority study
Lumbar discectomy is typically successful in reducing pain and neurological dysfunction when conservative treatment fails; however, approximately 30% of patients experience readmissions from device- or procedure-related serious adverse events. Large defects ( ≥ 6 mm wide) in the annulus fibrosis are a significant risk factor for readmission. Early results with occluding such defects with an annular closure device (ACD) have been promising in reducing readmission rates, but long-term outcomes have not been reported. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Peter D. Klassen, Mark P. Arts, Michael J. Musacchio, Claudius Thome Source Type: research

27. Achievement of minimum clinically important differences in patient reported outcomes does not imply outright improvements in objective functional outcome measures for surgical treatment of adult spinal deformities
Patient reported outcome measures (PROMs) are commonly used to indicate functional status however, there is a lack of published literature on their relation to objective functional outcome measures (FOMs) among adult spinal deformity (ASD) patients. The minimum clinically important difference (MCID) is often used among spine PROMs as the standard benchmark by which outcome success is gauged however there is no data currently available describing the relation of PROM MCIDs to concurrent changes in FOMs for ASD surgery patients. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Damon E. Mar, Isador H. Lieberman, Ram Haddas Source Type: research

28. Does loss of spondylolisthesis reduction impact clinical and radiographic outcomes after minimally invasive transforaminal lumbar interbody fusion?
Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is the workhorse minimally invasive treatment for patients with degenerative lumbar stenosis and spondylolisthesis refractory to nonoperative care. While the basic tenets of surgical treatment do not differ between minimally invasive and open techniques, surgeons performing MI-TLIF are more likely to attempt reduction of spondylolisthesis in order to optimize restoration of canal dimensions due to a greater reliance on indirect decompression, which has been shown to be effective. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Michael E. Steinhaus, Avani S. Vaishnav, Sachin Shah, Nicholas Clark, Chirag Chaudhary, Yahya A. Othman, Andre Samuel, Francis C. Lovecchio, Evan Sheha, Steven J. McAnany, Catherine Himo Gang, Sheeraz A. Qureshi Source Type: research

29. Early postoperative anticoagulation after spinal fracture surgery decreases venous thromboembolism rates
Prophylactic anticoagulation effectively lowers venous thromboembolism (VTE) after operative treatment of spinal fractures. Optimal initiation has not been fully described. Early anticoagulation has been presumed to increase bleeding and wound complications. In 2017, our institutional protocol began initiating VTE chemoprophylaxis 72 hours after operative spinal fixation. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Khaled Taghlabi, Douglas C. Burton, Brandon B. Carlson, Robert S. Jackson, Joshua Bunch, Robert Winfield Source Type: research

30. Outcomes analysis of staged vs same day surgery patients undergoing identical cervical deformity corrective surgery
Surgical intervention aimed at addressing adult cervical deformity (ACD) is an invasive and complex procedure that surgeons often elect to perform on different days. Despite patients undergoing staged procedures being older, with more comorbidities, staged patients had superior short- and long-term outcomes while undergoing less osteotomies, possibly leading to the overall decrease in complications. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Oscar Krol, Nicholas Kummer, Lara Passfall, Waleed Ahmad, Katherine E. Pierce, Sara Naessig, Shaleen N. Vira, Bhaveen H. Kapadia, Volmir Zavodovsky, Renaud Lafage, Virginie Lafage, Bassel G. Diebo, Peter G. Passias Tags: Wednesday, September 29, 2021 10:35 AM – 12:00 PM Spinal Deformity Source Type: research

31. Evolution of proximal junctional kyphosis and proximal junctional failure rates over 10 years of enrollment in a prospective multicenter adult spinal deformity database
Proximal junctional kyphosis (PJK) is one of the most common complications following adult spinal deformity (ASD) surgery and has been intensively studied over the last decade. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Basel Sheikh Alshabab, Renaud Lafage, Justin S. Smith, Han Jo Kim, Gregory M. Mundis, Eric O. Klineberg, Christopher I. Shaffrey, Alan H. Daniels, Christopher P. Ames, Munish C. Gupta, Douglas C. Burton, Richard A. Hostin, Shay Bess, Frank J. Schwab, Virg Source Type: research

32. DJK and revision rates in multilevel posterior cervical fusions terminating at the cervicothoracic junction
Despite the consensus that posterior cervical fusion can be used to treat multiple cervical pathologies, questions remain as to if crossing the cervicothoracic junction (CTJ) influences the rate of revision and how radiographic outcomes may differ. Even less is known about how crossing the CTJ may predict the development of adjacent segment disease. A retrospective review of 91 posterior cervical fusion patients was performed comparing long constructs ( ≥3 levels) terminating at C7 vs T1-3. Revision and DJK rates were compared between the two groups. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Shahbaaz Sabri, Dylan Schoo, Clayton Hoffman, Parker Prusick, Jose H. Jimenez-Almonte, Vikas V. Patel, Christopher Kleck, David Ou-Yang Source Type: research

33. Biomechanical analysis of the novel active apex correction technique using a patient specific finite element approach with 6-month follow-up
Traditionally, SHILLA and growing rods have been the 2 mainstays for surgical treatment of early onset scoliosis (EOS) patients. Multiple studies have previously highlighted the shortcomings of both techniques; the SHILLA suffer a loss of correction or reappearance of deformity through crank-shafting or adding-on (eg, distal migration) and growing rods require multiple reoperation with additional complications. Newer techniques like the active apex correction (APC) provide an excellent surgical alternate; designed to reduce the prevalence of above complication by avoiding apical fusion amongst other benefits. (Source: The Spine Journal)
Source: The Spine Journal - August 11, 2021 Category: Orthopaedics Authors: Daksh Jayaswal, Alaaeldin A. Ahmad, Aakash Agarwal, Manoj Kodigudla, Amey Kelkar, Vijay K. Goel Source Type: research