Reporting and Tracking Objective Functional Outcome Measures: Implementation of a Summary Report for Gait and Balance Measures
The aim of this manuscript is to describe knowledge gaps in the literature, future directions, and emerging applications of gait and balance analysis in spine surgery with regard to functional outcomes measurement. Functional outcome measurement has been established as a useful clinical and research investigational tool in musculoskeletal disease. Evidence currently supports its use in the diagnosis, treatment, and outcome measurement of multiple musculoskeletal disease states, including spinal disease, and its usefulness continues to grow as literature develops. (Source: The Spine Journal)
Source: The Spine Journal - February 22, 2021 Category: Orthopaedics Authors: Ram Haddas, Addison Wood, Damon Mar, Peter Derman, Isador Lieberman Tags: Review Article Source Type: research

Antibacterial efficacy of quaternized chitosan coating on 3D printed titanium cage in rat intervertebral disc space
Infection around intervertebral fusion cages can be intractable because of the avascular nature of the intervertebral disc space. Intervertebral cages with antibacterial effects may be a method by which this complication can be prevented. (Source: The Spine Journal)
Source: The Spine Journal - February 20, 2021 Category: Orthopaedics Authors: Joe Kodama, Hongfang Chen, Tangjun Zhou, Junichi Kushioka, Rintaro Okada, Hiroyuki Tsukazaki, Daisuke Tateiwa, Shinichi Nakagawa, Yuichiro Ukon, Zeynep Bal, Haijun Tian, Jie Zhao, Takashi Kaito Tags: Basic Science Source Type: research

Dynamic sagittal alignment and compensation strategies in adult spinal deformity during walking
Radiographic evaluation in adult spinal deformity (ASD) offers no information on spinopelvic alignment and compensation during dynamic conditions. Motion analysis offers the potential to bridge the gap between static radiographic and dynamic alignment measurement, increasing our understanding on how ASD impacts function. (Source: The Spine Journal)
Source: The Spine Journal - February 20, 2021 Category: Orthopaedics Authors: Pieter Severijns, Lieven Moke, Thomas Overbergh, Erica Beaucage-Gauvreau, Thijs Ackermans, Kaat Desloovere, Lennart Scheys Tags: Clinical Study Source Type: research

Efficacy of Liposomal Bupivacaine in Spine Surgery: A Systematic Review
Spine surgery with posterior approaches may involve extensive manipulation of native structures, resulting in significant postoperative pain. Liposomal bupivacaine (LB) is an injectable analgesic that has demonstrated efficacy in decreasing postoperative pain and opioid requirements in patients across multiple surgical subspecialties. (Source: The Spine Journal)
Source: The Spine Journal - February 19, 2021 Category: Orthopaedics Authors: Tommy H. Nguyen, Cesar Iturriaga, Rohit Verma Tags: Review Article Source Type: research

Targeting Oxidative Stress with Amobarbital to Prevent Intervertebral Disc Degeneration
Mounting evidence that oxidative stress contributes to the pathogenesis of intervertebral disc (IVD) degeneration (IDD) suggests that therapies targeting oxidative stress may slow or prevent disease progression. (Source: The Spine Journal)
Source: The Spine Journal - February 18, 2021 Category: Orthopaedics Authors: Dongrim Seol, Mitchell C. Coleman, James A. Martin, Ino Song, LR Jaidev, Aliasger K. Salem, Tae-Hong Lim Tags: Basic Science Source Type: research

Dual Attending Surgeon Strategy Learning Curve in Single-staged Posterior Spinal Fusion (PSF) Surgery for 415 Idiopathic Scoliosis (IS) Cases
The implementation of a dual attending surgeon strategy had improved perioperative outcomes of idiopathic scoliosis (IS) patients. Nevertheless, the learning curve of a dual attending surgeon practice in single-staged posterior spinal fusion (PSF) surgery has not been established. (Source: The Spine Journal)
Source: The Spine Journal - February 18, 2021 Category: Orthopaedics Authors: Chris Yin Wei Chan, Chee Kidd Chiu, Pei Ying Ch'ng, Sin Ying Lee, Weng Hong Chung, Mohd Shahnaz Hasan, Mun Keong Kwan Source Type: research

Advanced Compressive Extension Injuries of the Subaxial Cervical Spine: Do we really understand the nuances of this injury?
The Allen and Ferguson classification of cervical spine injuries is widely used. They described compressive Extension (CE) injuries as having five progressive stages. Stage 4(CE4) and 5(CE5) have been described as having a posterior vertebral arch fracture involving two motion segments accompanied by displacement (dislocation) of the vertebral body at a single level. However, in their original work, CE4 was described only as a hypothetical stage, while CE5 was found in only 3 patients. Beyond this, little is understood about these injuries. (Source: The Spine Journal)
Source: The Spine Journal - February 18, 2021 Category: Orthopaedics Authors: Eric Rebich, Celeste Tavolaro, Jie Yao, Haitao Zhou, Julie Agel, Richard Bransford, Carlo Bellabarba Tags: Clinical Study Source Type: research

Risk Factors for Postoperative Dysphagia and Dysphonia following Anterior Cervical Spine Surgery: A Comprehensive Study Utilizing the Hospital for Special Surgery Dysphagia and Dysphonia Inventory (HSS-DDI)
Postoperative dysphagia and dysphonia (PDD) are prevalent complications after anterior cervical discectomy and fusion (ACDF). Identification of risk factors for these complications is necessary for effective prevention. Recently, patient reported outcome measures (PROM) have been used to determine PDD after ACDF. The Hospital for Special Surgery Dysphagia and Dysphonia Inventory (HSS-DDI) is a validated PROM that specifically assesses dysphagia and dysphonia after anterior cervical spine surgery. (Source: The Spine Journal)
Source: The Spine Journal - February 18, 2021 Category: Orthopaedics Authors: Ichiro Okano, Stephan N. Salzmann, Courtney Ortiz Miller, Yushi Hoshino, Jennifer Shue, Andrew A. Sama, Frank P. Cammisa, Federico P. Girardi, Alexander P. Hughes Tags: Clinical Study Source Type: research

Linking Oswestry Disability Index to the PROMIS Pain Interference CAT with Equipercentile Methods
: When different health care providers use different patient-reported outcome (PRO) instruments, it is challenging to integrate findings that describe particular patient groups or to establish treatment effectiveness across studies. It is therefore critical to develop accurate ways to convert scores between various instruments for clinicians and researchers to make comparisons across health outcomes. (Source: The Spine Journal)
Source: The Spine Journal - February 18, 2021 Category: Orthopaedics Authors: Xiaodan Tang, Benjamin D. Schalet, Man Hung, Darrel S. Brodke, Charles L. Saltzman, David Cella Tags: Clinical Study Source Type: research

Chronic Low Back Pain, bacterial infection and treatment with antibiotics
The contribution of bacterial infection to chronic low back pain and its treatment with antibiotics have generated considerable controversy in literature. If efficacious, antibiotics have the potential to transform the treatment of chronic low back pain in a significant subset of patients. Some microbiology studies of disc tissue from patients with CLBP have shown that bacteria are present, most likely due to infection, while others conclude they are absent or if found, it is due to surgical contamination. (Source: The Spine Journal)
Source: The Spine Journal - February 18, 2021 Category: Orthopaedics Authors: Christopher J. Gilligan, Steven P. Cohen, Vincent A. Fischetti, Joshua A. Hirsch, Lloyd G. Czaplewski Source Type: research

Using a national surgical database to predict complications following posterior lumbar surgery and comparing the area under the curve and F1-score for the assessment of prognostic capability
With spinal surgery rates increasing in North America, models that are able to accurately predict which patients are at greater risk of developing complications are highly warranted. However, the previously published methods which have used large, multi-centre databases to develop their prediction models have relied on the receiver operator characteristics curve with the associated area under the curve (AUC) to assess their model's performance. Recently, it has been found that a precision-recall curve with the associated F1-score could provide a more realistic analysis for these models. (Source: The Spine Journal)
Source: The Spine Journal - February 15, 2021 Category: Orthopaedics Authors: Zachary DeVries, Eric Locke, Mohamad Hoda, Dita Moravek, Kim Phan, Alexandra Stratton, Stephen Kingwell, Eugene Wai, Philippe Phan Tags: Clinical Study Source Type: research

Chordoma of the sacrum and mobile spine: a narrative review
Chordoma is a notochord-derived primary tumor of the skull base and vertebral column known to affect 0.08 to 0.5 per 100,000 persons worldwide. Patients commonly present with mechanical, midline pain with or without radicular features secondary to nerve root compression. Management of these lesions has classically revolved around oncologic resection, defined by en bloc resection of the lesion with negative margins as this was found to significantly improve both local control and overall survival. (Source: The Spine Journal)
Source: The Spine Journal - February 13, 2021 Category: Orthopaedics Authors: Zach Pennington, Jeff Ehresman, Edward F. McCarthy, A. Karim Ahmed, Patricia D. Pittman, Daniel Lubelski, C. Rory Goodwin, Daniel M. Sciubba Tags: NARRATIVE REVIEW Source Type: research

Lessons learned in two months of exclusive application of telephysiotherapy instead of classical physiotherapy during the lockdown in Italy
The world is changing due to the COVID-19 pandemic [1]. Beyond the high numbers of deaths and hospital and intensive care units (ICU) admissions [2], COVID-19 heavily impacts patients requiring rehabilitation [3]. There is also great impact on professional activities; many countries, individuals, and families are going in a deep economic crisis [4]. This is particularly true for professionals working in outpatient services. (Source: The Spine Journal)
Source: The Spine Journal - February 13, 2021 Category: Orthopaedics Authors: Michele Romano, Alessandra Negrini, Stefano Negrini Tags: Perspective Source Type: research

Cost-benefit analysis of surgical approaches for cervical spondylotic myelopathy
The World Federation of Neurosurgical Societies (WFNS) Spine Committee has recently recommended a cost-benefit analysis be conducted on different surgical approaches for cervical spondylotic myelopathy (CSM) [1]. Therefore, the article by Goh et al. [2], newly published online in The Spine Journal (July 28, 2020) and entitled “Laminoplasty versus laminectomy and fusion for cervical spondylotic myelopathy” is a pioneering study of significant value. However, in this study, patient neurological status assessments before and after surgery are not analyzed using various outcome measures including the Japanese Ortho...
Source: The Spine Journal - February 13, 2021 Category: Orthopaedics Authors: Naci Balak Tags: Letters to the editor Source Type: research

Editorial Board
(Source: The Spine Journal)
Source: The Spine Journal - February 13, 2021 Category: Orthopaedics Source Type: research

Table of Contents
(Source: The Spine Journal)
Source: The Spine Journal - February 13, 2021 Category: Orthopaedics Source Type: research

Meetings Calendar
(Source: The Spine Journal)
Source: The Spine Journal - February 13, 2021 Category: Orthopaedics Source Type: research

Did Hippocrates know spina bifida?
The historical medical reviews concerning the clinical detection, etiopathogenesis and symptoms of spina bifida rather hastily cite a passage of the Hippocratic treatise On Glands that seems to describe this condition in detail [1]. The work, that some consider pseudo-Hippocratic, dates back to the Hellenistic age; others place it between the end of the 5th and the beginning of the 4th century BCE. It proposes a description of the main glands of the body from an anatomical, physiological and pathological point of view. (Source: The Spine Journal)
Source: The Spine Journal - February 9, 2021 Category: Orthopaedics Authors: Marco Cilione, Valentina Gazzaniga Tags: Perspective Source Type: research

Favorable prognosis with nonsurgical management of type III acute odontoid fractures: a consecutive series of 212 patients
The recommended primary treatment for type III odontoid fractures (OFx) is external immobilization, except for patients having major displacement of the odontoid fragment. The bony fusion rate of type III OFx has been reported to be>85%. High compliance to treatment recommendations is favorable only if the treatment leads to a good outcome. (Source: The Spine Journal)
Source: The Spine Journal - February 9, 2021 Category: Orthopaedics Authors: Syed Ali Mujtaba Rizvi, Eirik Helseth, Mads Aarhus, Marianne Efskind Harr, Jalal Mirzamohammadi, P ål Rønning, Magnus Mejlænder-Evjensvold, Hege Linnerud Tags: Clinical Study Source Type: research

Expression and function of FGF9 in the hypertrophied ligamentum flavum of lumbar spinal stenosis patients
Ligamentum flavum (LF) hypertrophy plays a dominant role in lumbar spinal stenosis (LSS). A previous study found that fibroblast growth factor 9 (FGF9) was upregulated with mechanical stress in rabbit LF. However, the expression and function of FGF9 are not well understood in human LF. (Source: The Spine Journal)
Source: The Spine Journal - February 9, 2021 Category: Orthopaedics Authors: Hasibullah Habibi, Akinobu Suzuki, Kazunori Hayashi, Hamidullah Salimi, Hidetomi Terai, Yusuke Hori, Koji Tamai, Kumi Orita, Shoichiro Ohyama, Akito Yabu, Mohammad Hasib Maruf, Hiroaki Nakamura Tags: Basic Science Source Type: research

An independent inter- and intra-observer agreement assessment of the AOSpine sacral fracture classification system
The AOSpine sacral classification scheme was recently described. It demonstrated substantial inter-observer and excellent intra-observer agreement in the study describing it; however, an independent assessment has not been performed. (Source: The Spine Journal)
Source: The Spine Journal - February 9, 2021 Category: Orthopaedics Authors: Julio Urrutia, Arturo Meissner-Haecker, Nelson Astur, Manuel Valencia, Ratko Yurac, Gaston Camino-Willhuber, Marcelo Valacco Tags: Clinical Study Source Type: research

Sarcopenia Predicts Perioperative Adverse Events Following Complex Revision Surgery for the Thoracolumbar Spine
Sarcopenia is defined as a generalized decline in skeletal muscle mass and strength associated with physical disability and poor quality of life.[1] The measurement of sarcopenia has been performed through a multitude of techniques including bioimpedance spectroscopy, total or partial body potassium per fat-free soft tissue analysis, anthropometric measures, and through the use of imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI).[1-4] Within the surgical population, sarcopenia measured by psoas muscle index (PMI) has been shown to be a useful prognostic tool to predict perioperative m...
Source: The Spine Journal - February 6, 2021 Category: Orthopaedics Authors: Takashi Hirase, Varan Haghshenas, Rachel Bratescu, David Dong, Peggy H Kuo, Aymen Rashid, Venkat Kavuri, Darrell S Hanson, B Christoph Meyer, Rex AW Marco Tags: Clinical Study Source Type: research

Frailty adversely affects outcomes of patients undergoing spine surgery: A systematic review
With an aging population, there are an increasing number of elderly patients undergoing spine surgery. Recent literature in other surgical specialities suggests frailty to be an important predictor of outcomes. (Source: The Spine Journal)
Source: The Spine Journal - February 3, 2021 Category: Orthopaedics Authors: Vivien Chan, Jamie RF Wilson, Robert Ravinsky, Jetan H. Badhiwala, Fan Jiang, Melanie Anderson, Albert Yee, Jefferson R Wilson, Michael G Fehlings Tags: Review Article Source Type: research

The Association of Preoperative TNF-Alpha Inhibitor Use and Reoperation Rates in Spinal Fusion Surgery
Preoperative TNF-AI use has been associated with increased rate of postoperative infections and complications in a variety of orthopedic procedures. However, the association between TNF-AI use and complications following spine surgery has not yet been studied. (Source: The Spine Journal)
Source: The Spine Journal - February 2, 2021 Category: Orthopaedics Authors: Michael A. Gaudiani, Robert D. Winkelman, Pavitra Ravishankar, Nicholas M. Rabah, Thomas E. Mroz, Daniel J. Coughlin Tags: Clinical Study Source Type: research

Long-term clinical and radiological outcomes of anterior uncoforaminotomy for unilateral single-level cervical radiculopathy: retrospective cohort study
Anterior cervical discectomy and fusion is a common procedure for degenerative cervical radiculopathy. In 1996, Dr. H.D. Jho reported an operative technique allowing nerve root decompression via anterior uncoforaminotomy while avoiding fusion. (Source: The Spine Journal)
Source: The Spine Journal - February 2, 2021 Category: Orthopaedics Authors: Vladimir V. Klimov, Vladislav V. Kelmakov, Brent L. Clyde, Aleksey V. Evsyukov, Evgeniy A. Loparev, Evgenia V. Amelina, Anatoliy V. Bervitskiy, Anton P. Ponomarenko, Jamil A. Rzaev Tags: Clinical Study Source Type: research

International External Validation of the SORG Machine Learning Algorithms for Predicting 90-Day and 1-Year Survival of Patients with Spine Metastases using a Taiwanese Cohort
Accurately predicting the survival of patients with spinal metastases is important for guiding surgical intervention. The SORG machine-learning (ML) algorithm for the 90-day and 1-year mortality of patients with metastatic cancer to the spine has been multiply validated, with a high degree of accuracy in both internal and external validation studies. However, prior external validations were conducted using patient groups located on the east coast of the United States, representing a generally homogeneous population. (Source: The Spine Journal)
Source: The Spine Journal - February 2, 2021 Category: Orthopaedics Authors: Jiun-Jen Yang, Chih-Wei Chen, Mitchell S. Fourman, Michiel E.R. Bongers, Aditya V. Karhade, Olivier Q. Groot, Wei-Hsin Lin, Hung-Kuan Yen, Po-Hao Huang, Shu-Hua Yang, Joseph H. Schwab, Ming-Hsiao Hu Source Type: research

Young adults undergoing ACDF surgery exhibit decreased health-related quality of life in the long term in  comparison to the general population
The leading surgical treatment of cervical radiculopathy is anterior cervical discectomy and fusion (ACDF). However, it has been suggested that ACDF procedures could lead to accelerated degeneration of the adjacent cervical discs (adjacent segment disease, or ASD) and the effect of ACDF surgery on neck symptoms and quality of life in the long term is not fully understood. Patients operated on at young ages generally have a long life expectancy and a long number of working years ahead of them. Thus, this patient group is of special interest when considering the accumulation of cervical problems due to possible ASD, the over...
Source: The Spine Journal - February 1, 2021 Category: Orthopaedics Authors: Tuomas Hirvonen, Johan Marjamaa, Jari Siironen, Seppo Koskinen, Mika Niemel ä, Anniina Koski-Palkén Tags: Clinical Study Source Type: research

Motor-evoked potentials in the intraoperative decision-making of circumferential decompression via posterior approach for treating thoracic posterior longitudinal ligament ossification
Surgical treatment is indicated for symptomatic thoracic ossification of posterior longitudinal ligament (OPLL), and circumferential decompression (CD) is a promising option. However, the risk of postoperative paralysis in ventral decompression of CD is as high as 30%. Therefore, it is important to balance surgical outcomes and safety of ventral decompression. (Source: The Spine Journal)
Source: The Spine Journal - February 1, 2021 Category: Orthopaedics Authors: CHAOJUN ZHENG, YU ZHU, FEIZHOU LYU, JIANYUAN JIANG, XIAOSHENG MA Tags: Clinical Study Source Type: research

An algorithm for using deep learning convolutional neural networks with three 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 - February 1, 2021 Category: Orthopaedics Authors: Terufumi Kokabu, Satoshi Kanai, Noriaki Kawakami, Koki Uno, Toshiaki Kotani, Teppei Suzuki, Hiroyuki Tachi, Yuichiro Abe, Norimasa Iwasaki, Hideki Sudo Tags: Clinical Study Source Type: research

Indirect Decompression via Oblique Lateral Interbody Fusion for Severe Degenerative Lumbar Spinal Stenosis: A Comparative Study with Direct Decompression Transforaminal/Posterior Lumbar Interbody Fusion
Previous studies have shown that oblique lateral interbody fusion (OLIF) can improve neurological symptoms via “indirect decompression.” However, data are lacking in terms of its benefits when compared with conventional transforaminal lumbar interbody fusion (TLIF)/ posterior lumbar interbody fusion (PLIF) approach, especially in patients with severe central canal stenosis. (Source: The Spine Journal)
Source: The Spine Journal - February 1, 2021 Category: Orthopaedics Authors: Takayoshi Shimizu, Shunsuke Fujibayashi, Bungo Otsuki, Koichi Murata, Shuichi Matsuda Tags: Clinical Study Source Type: research

Does undercut macrostructure cage cause increase of subsidence incidence and decrease of disc height?
With great interest, we recently read the article by Walsh et al. in which they found that undercut macrostructures within the interbody cage could significantly improve the fusion and biomechanical stability of the spine [1]. In Figs. 4 and 5, sagittal and coronal μCT images show obvious fusion with continuous bone bridge formation within the undercut macrostructure of the test cage at both 6 and 12 weeks, but no fusion was seen in the control cage group [1]. However, both sagittal and coronal μCT images show a decrease of the disc height at the fused L4– L5 level which may be due to cage subsidence. (Source: The Spine Journal)
Source: The Spine Journal - January 26, 2021 Category: Orthopaedics Authors: Huiliang Yang, Camilo Osorio, Chunguang Zhou Tags: Letters to the editor Source Type: research

Authors reply to “does undercut macrostructure cage cause increase of subsidence incidence and decease of disc height?”
Reply to SPINEE-D-20-00800. (Source: The Spine Journal)
Source: The Spine Journal - January 26, 2021 Category: Orthopaedics Authors: William R. Walsh, Matthew Pelletier, Dan Wills, Tian Wang, Shaeffer Bannigan, Frank Vizesi Tags: Letters to the editor Source Type: research

Editorial Board
(Source: The Spine Journal)
Source: The Spine Journal - January 26, 2021 Category: Orthopaedics Source Type: research

Table of Contents
(Source: The Spine Journal)
Source: The Spine Journal - January 26, 2021 Category: Orthopaedics Source Type: research

Meetings Calendar
(Source: The Spine Journal)
Source: The Spine Journal - January 26, 2021 Category: Orthopaedics Source Type: research

Biomechanical comparison of semirigid junctional fixation techniques to prevent proximal junctional failure after thoracolumbar adult spinal deformity correction
Adult spinal deformity patients treated operatively by long-segment instrumented spinal fusion are prone to develop proximal junctional kyphosis (PJK) and failure (PJF). A gradual transition in range of motion (ROM) at the proximal end of spinal instrumentation may reduce the incidence of PJK and PJF, however, previously evaluated techniques have not directly been compared. (Source: The Spine Journal)
Source: The Spine Journal - January 22, 2021 Category: Orthopaedics Authors: Remco J.P. Doodkorte, Alex K. Roth, Jacobus J. Arts, L.M. Arno Lataster, Lodewijk W. van Rhijn, Paul C. Willems Tags: Basic Science Source Type: research

Biomechanical comparison of semi-rigid junctional fixation techniques to prevent proximal junctional failure after thoracolumbar adult spinal deformity correction
Adult spinal deformity patients treated operatively by long-segment instrumented spinal fusion are prone to develop proximal junctional kyphosis (PJK) and failure (PJF). A gradual transition in range of motion (ROM) at the proximal end of spinal instrumentation may reduce the incidence of PJK and PJF, however previously evaluated techniques have not directly been compared. (Source: The Spine Journal)
Source: The Spine Journal - January 22, 2021 Category: Orthopaedics Authors: Remco J.P. Doodkorte, Alex K. Roth, Jacobus J. Arts, L.M. Arno Lataster, Lodewijk W. van Rhijn, Paul C. Willems Tags: Basic Science Source Type: research

Cost-effectiveness of Open Transforaminal Lumbar Interbody Fusion (OTLIF) versus Minimally Invasive Transforaminal Lumbar Interbody Fusion (MITLIF): A Systematic Review and Meta-Analysis
The number of performed instrumented lumbar spine surgeries and associated healthcare-related costs have increased over the last decades, and will increase further in the future. With the consistent growth of healthcare-related costs, cost-effectiveness of surgical techniques is of major relevance. Common indications for instrumented lumbar spine surgery are spondylolisthesis and degenerative disease. A commonly used technique is the open transforaminal lumbar interbody fusion (OTLIF). Nowadays, there is an increasing interest in the minimally invasive variation of this technique (MITLIF). (Source: The Spine Journal)
Source: The Spine Journal - January 22, 2021 Category: Orthopaedics Authors: Ruud Droeghaag, Sem M.M. Hermans, Inge J.M.H. Caelers, Silvia M.A.A. Evers, Wouter L.W. van Hemert, Henk van Santbrink Source Type: research

A novel nano-hydroxyapatite/synthetic polymer/bone morphogenetic protein-2 composite for efficient bone regeneration
Efficient bone regeneration using recombinant human bone morphogenetic protein-2 (BMP-2) is needed to reduce side effects caused by high-dose BMP-2 use. The composite material of polylactic acid –polyethene glycol (PLA-PEG) for sustained release and an osteogenic nano-hydroxyapatite (nHAp) can contribute to efficient bone regeneration by BMP-2. (Source: The Spine Journal)
Source: The Spine Journal - January 22, 2021 Category: Orthopaedics Authors: Zeynep Bal, Feza Korkusuz, Hiroyuki Ishiguro, Rintaro Okada, Junichi Kushioka, Ryota Chijimatsu, Joe Kodama, Daisuke Tateiwa, Yuichiro Ukon, Shinichi Nakagawa, Eda Çiftci Dede, Merve Gizer, Petek Korkusuz, Hideki Yoshikawa, Takashi Kaito Source Type: research

Instrumentation techniques to prevent proximal junctional kyphosis and proximal junctional failure in adult spinal deformity correction - a systematic review of biomechanical studies
Correction of adult spinal deformity (ASD) by long segment instrumented spinal fusion is an increasingly common surgical intervention. However, it is associated with high rates of complications and revision surgery, especially in the elderly patient population. The high construct stiffness of instrumented thoracolumbar spinal fusion has been postulated to lead to a higher incidence of proximal junctional kyphosis (PJK) and failure (PJF). Several cadaveric biomechanical studies have reported on surgical techniques to reduce the incidence of PJF/PJK. (Source: The Spine Journal)
Source: The Spine Journal - January 19, 2021 Category: Orthopaedics Authors: Remco J.P. Doodkorte, Timon F.G. Vercoulen, Alex K. Roth, Rob A. de Bie, Paul C. Willems Source Type: research

Effect of low-dose amitriptyline on low back pain with a neuropathic component: a post hoc analysis
Low back pain (LBP) is a major, global health problem, with limited effective treatments [1,2]. We recently conducted a clinical trial to examine the efficacy of a low-dose tricyclic antidepressant (TCA; amitriptyline) in those with chronic, nonspecific LBP [3]. Although we found no statistically superior effect favoring low-dose amitriptyline for our primary outcome, there was a significant improvement in disability and consistent evidence across multiple outcomes to suggest a beneficial effect. (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Donna M. Urquhart, Anita E. Wluka, Stephane Heritier, Chris Fong, Yuanyuan Wang, Flavia M. Cicuttini Tags: Research Letter Source Type: research

Cage-screw and anterior plating combination reduces the risk of micromotion and subsidence in multilevel anterior cervical discectomy and fusion —a finite element study
Anterior cervical discectomy and fusion (ACDF) is widely used to treat patients with spinal disorders, where the cage is a critical component to achieve satisfactory fusion results. However, it is still not clear whether a cage with screws or without screws will be the best choice for long-term fusion as the micromotion (sliding distance) and subsidence (penetration) of the cage still take place repeatedly. (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Maohua Lin, Stephen Z. Shapiro, James Doulgeris, Erik D. Engeberg, Chi-Tay Tsai, Frank D. Vrionis Tags: Basic Science Source Type: research

IL-1 β promotes disk degeneration and inflammation through direct injection of intervertebral disk in a rat lumbar disk herniation model
Lumbar intervertebral disk herniation (LDH) is a common disease that causes low back pain, radiating leg pain, and sensory impairment. Preclinical studies rely heavily upon standardized animal models of human diseases to predict clinical treatment efficacy and to identify and investigate potential adverse events in human subjects. The current method for making the LDH model involves harvesting the nucleus pulposus (NP) from autologous coccygeal disks and applying to the lumbar nerve roots just proximal to the corresponding dorsal root ganglion. (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Hyunseong Kim, Jin Young Hong, Junseon Lee, Wan-Jin Jeon, In-Hyuk Ha Tags: Basic Science Source Type: research

What is the Predictive Value of Intraoperative Somatosensory Evoked Potential Monitoring for Postoperative Neurological Deficit in Cervical Spine Surgery? – A Meta-analysis
Cervical decompression and fusion surgery has been shown to effectively relieve neural impingement [1 –4]. During cervical surgery, the spinal cord and nerve roots are at risk for potential injury, which may result in a postoperative neurological deficit [5,6,7]. Studies evaluating neurological deficits after spine surgery for cervical myelopathy have reported new motor deficits at rates of 0.2-0. 9% [7,8] and radicular symptoms at rates of 0.2-3.2% [8,9]. Although the numerical frequency of new neurological complications is low, the consequences of these injuries can be devasting. (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Rajiv P. Reddy, Robert Chang, Brian P. Rosario, Shreya Sudadi, Katherine M. Anetakis, Jeffrey R. Balzer, Donald J. Crammond, Jeremy D. Shaw, Parthasarathy D. Thirumala Tags: Review Article Source Type: research

Cage-screw and anterior plating combination reduces the risk of micromotion and subsidence in multi-level anterior cervical discectomy and fusion - A finite element study
Anterior cervical discectomy and fusion (ACDF) is widely used to treat patients with spinal disorders, where the cage is a critical component to achieve satisfactory fusion results. However, it is still not clear whether a cage with screws or without screws will be the best choice for long-term fusion as the micromotion (sliding distance) and subsidence (penetration) of the cage still take place repeatedly. (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Maohua Lin, Stephen Z. Shapiro, James Doulgeris, Erik D. Engeberg, Chi-Tay Tsai, Frank D. Vrionis Tags: Basic Science Source Type: research

Relationship Between Initial Opioid Prescription Size and Likelihood of Refill after Spine Surgery
Best practices in opioid prescribing after elective surgery have been developed for most surgical subspecialties, including spine. However, some percentage of patients will become chronic users. (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Lara Massie, Vidhya Gunaseelan, Jennifer Waljee, Chad Brummett, Jason M. Schwalb Tags: Clinical Study Source Type: research

Effect of low-dose amitriptyline on low back pain with a neuropathic component: A post-hoc analysis
Low back pain(LBP) is a major, global health problem, with limited effective treatments [1, 2]. We recently conducted a clinical trial to examine the efficacy of a low-dose tricyclic antidepressant (TCA; amitriptyline) in those with chronic, non-specific LBP [3]. Although we found no statistically superior effect favoring low-dose amitriptyline for our primary outcome, there was a significant improvement in disability and consistent evidence across multiple outcomes to suggest a beneficial effect. (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Donna M Urquhart, Anita E Wluka, Stephane Heritier, Chris Fong, Yuanyuan Wang, Flavia M Cicuttini Tags: Research Letter Source Type: research

IL-1 β promotes disc degeneration and inflammation through direct injection of intervertebral disc in a rat lumbar disc herniation model
Lumbar intervertebral disc herniation (LDH) is a common disease that causes low back pain, radiating leg pain, and sensory impairment. Preclinical studies rely heavily upon standardized animal models of human diseases to predict clinical treatment efficacy and to identify and investigate potential adverse events in human subjects. The current method for making the LDH model involves harvesting the nucleus pulposus (NP) from autologous coccygeal discs and applying to the lumbar nerve roots just proximal to the corresponding dorsal root ganglion (DRG). (Source: The Spine Journal)
Source: The Spine Journal - January 15, 2021 Category: Orthopaedics Authors: Hyunseong Kim, Jin Young Hong, Junseon Lee, Wan-Jin Jeon, In-Hyuk Ha Tags: Basic Science Source Type: research

Incidence and Degrees of Neurologic Decline Following Thoracic Costotransversectomy
Thoracic costotransversectomies (TCT) are amongst the most invasive spine procedures performed. Of greatest concern to the patient and surgeon is the risk of iatrogenic neurologic injury associated with these procedures. Most available studies limit their assessment of neurologic function to nonspecific scales such as the broader ASIA scoring system of A to E and have not comprehensively described the rates of iatrogenic injury following these procedures by looking more precisely with ASIA motor scoring (0-100) which allows for more in-depth analysis. (Source: The Spine Journal)
Source: The Spine Journal - January 12, 2021 Category: Orthopaedics Authors: Ashraf N. El Naga, Celeste Tavolaro, Julie Agel, Haitao Zhou, Carlo Bellabarba, Richard J. Bransford Tags: Clinical Study Source Type: research

Pathomechanism and prevention of further surgery after posterior decompression for lumbar spinal canal stenosis in patients with diffuse idiopathic skeletal hyperostosis
Lumbar spinal canal stenosis (LSS) is a common degenerative disease that has increased proportionately with increased aging of the population. In a cross-sectional study in Japan, the prevalence of symptomatic LSS was 9.3% [1]. In another population-based study in Japan, the LSS prevalence increased with age and was particularly high at age 70-79  years, irrespective of gender [2]. Posterior lumbar decompression surgery for patients with LSS with neurological complications is a common spine surgery. (Source: The Spine Journal)
Source: The Spine Journal - January 12, 2021 Category: Orthopaedics Authors: Hideaki Nakajima, Shuji Watanabe, Kazuya Honjoh, Arisa Kubota, Akihiko Matsumine Tags: Clinical Study Source Type: research