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A Cadaver Feasibility Study of Extradural Contralateral C7 Ventral Root Transfer Technique for Treating Upper Extremity Paralysis
Study Design. A total of 6 formalin-fixed cadavers were included in the cadaver feasibility study. Objective. The aim was to ascertain the anatomical feasibility of extradural contralateral C7 ventral root transfer technique by cervical posterior. Summary of Background Data. Upper limb spastic hemiplegia is a common sequela after stroke. In our previous study, the authors established a method by transferring contralateral C7 dorsal and ventral roots to the corresponding C7 dorsal and ventral roots on the affected side in the cervical posterior. Methods. In the present study, six formalin-fixed cada...
Source: Spine - August 18, 2022 Category: Orthopaedics Tags: Anatomy Source Type: research

Trends in Comorbidities and Complications Among Patients Undergoing Inpatient Spine Surgery
Study Design. Retrospective database study. Objective. We sought to identify trends in demographics, comorbidities, and postoperative complications among patients undergoing ACDF and PLF. Summary of Background Data. As demand for anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF) surgery continues to increase, it is important to understand changes in the healthcare system and patient populations undergoing these procedures. Methods. We identified 220,520 ACDF and 151,547 PLF surgeries (2006–2016; Premier Healthcare database). Annual proportions or medians were calculated for patie...
Source: Spine - August 28, 2020 Category: Orthopaedics Tags: SURGERY Source Type: research

Intraoperative Ischemic Stroke in Elective Spine Surgery: A Retrospective Study of Incidence and Risk
Conclusion. . With the increase of spinal procedures, it is important to identify patients at risk for having an ischemic stroke and to optimize their comorbidities preoperatively. Patients with intraoperative ischemic stroke carry a higher risk for morbidity and mortality during the index hospitalization. Level of Evidence: 4
Source: Spine - January 8, 2020 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Quantification of Risk Factors for Cervical Ossification of the Posterior Longitudinal Ligament in Korean Populations: A Nationwide Population-based Case-control Study
Conclusion. OPLL was significantly associated with comorbidities such as hypertension, ischemic stroke diabetes mellitus, hypothyroidism, and osteoporosis. Our findings can provide helpful information for OPLL prediction and offer important health benefits. Level of Evidence: 3
Source: Spine - August 3, 2019 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

Can Elective Spine Surgery Be Performed Safely Among Nonagenarians?: Analysis of a National Inpatient Database in Japan
Study Design. Retrospective cohort study. Objective. To compare morbidity and mortality between nonagenarians and other older adult patients who underwent elective spine surgery. Summary of Background Data. There is a lack of information of the perioperative risks of nonagenarians undergoing spine surgery. Methods. Data of patients aged ≥65 years who underwent elective spine surgery from July 2010 to March 2013 were extracted from the Diagnosis Procedure Combination database, a nationwide administrative inpatient database in Japan. Clinical outcomes included mortality, occurrence of major complications (cardia...
Source: Spine - February 14, 2019 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Coagulation Profile as a Risk Factor for 30-Day Morbidity and Mortality Following Posterior Lumbar Fusion
Study Design. A retrospective cohort study. Objective. The aim of this study was to identify associations between abnormal coagulation profile and postoperative morbidity and mortality in patients undergoing posterior lumbar fusion (PLF). Summary of Background Data. The literature suggests that abnormal coagulation profile is associated with postoperative complications, notably the need for blood transfusion. However, there is little research that directly addresses the influence of coagulation profile on postoperative complications following PLF. Methods. The American College of Surgeons National Surgical Quality Impro...
Source: Spine - June 15, 2017 Category: Orthopaedics Tags: Surgery Source Type: research

Perioperative Neurologic Complications in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 564 Patients
Conclusion. The overall incidence of neurologic complications in ASD surgery was 17.6%. The incidence of surgical neurologic complications was 13.7%. There was a higher risk of neurologic complications in revision cases and in cases in which interbody fusion was required. Level of Evidence: 3
Source: Spine - March 15, 2017 Category: Orthopaedics Tags: Deformity Source Type: research

Medical Complications After Adult Spinal Deformity Surgery: Incidence, Risk Factors, and Clinical Impact
Conclusion. Risk factors for the development of postoperative medical complications after correction of ASD include smoking, hypertension, and duration of symptoms. Patients who have one or more of these risk factors should be identified and informed during informed consent of their increased risks. They should be optimized preoperatively, and followed closely during the postoperative period. Level of Evidence: 3
Source: Spine - November 12, 2016 Category: Orthopaedics Tags: Deformity Source Type: research

Risk Factors for 30-Day Unplanned Readmission and Major Perioperative Complications After Spine Fusion Surgery in Adults: A Review of the National Surgical Quality Improvement Program Database
Conclusion. This study provides benchmark rates of 30-day readmission based on diagnosis and procedure codes from a high-quality database for adult spinal fusion patients and showed increased rates of 30-day unplanned readmission and major perioperative complications for patients with specific risk factors. Targeted preoperative planning on modifiable risk factors with proportional reimbursement may promote higher-quality healthcare. Level of Evidence: 3
Source: Spine - October 1, 2016 Category: Orthopaedics Tags: Health Services Research Source Type: research

Goal-Directed Fluid Therapy Based on Stroke Volume Variation in Patients Undergoing Major Spine Surgery in the Prone Position: A Cohort Study
Conclusion. Our study shows that application of a GDFT based on SVV in major spine surgery is feasible and can lead to reduced blood losses and transfusions, better postoperative respiratory performance, shorter ICU stay, and faster return of bowel function. Level of Evidence: 3
Source: Spine - September 10, 2016 Category: Orthopaedics Tags: Surgery Source Type: research

Effect of Antifibrinolytic Therapy on Complications, Thromboembolic Events, Blood Product Utilization, and Fusion in Adult Spinal Deformity Surgery
Conclusion. TXA or EACA use was associated with increased minor intraoperative complications. TXA was associated with decreased major perioperative complications. AF was associated with decreased utilization of blood products without an increased rate of thromboembolic events. Given the nature of this study, transfusion threshold was not standardized. Future studies with rigid criteria for transfusion should be prospectively performed to better evaluate the impact of AF during ASD surgery. Level of Evidence: 3
Source: Spine - July 9, 2016 Category: Orthopaedics Tags: Deformity Source Type: research

Worsening Cervical Epidural Hematoma After Tissue Plasminogen Activator Administration for Stroke Like Symptoms
Conclusion. To our knowledge, only three cases of cervical SEH with hemiparesis erroneously treated with tPA resulting in neurological decline because of the enlargement of an existing hematoma, including the current case, have been reported in the English literature. It is important for physicians, especially those who administer tPA treatment, to include cervical SEH in the differential diagnosis of stroke in patients presenting with sudden back pain followed by the onset of neurological deficits including hemiparesis. Level of Evidence: 5
Source: Spine - March 26, 2016 Category: Orthopaedics Tags: Case Report Source Type: research

Duplex Ultrasonography-Detected Positional Vertebral Artery Occlusion in Upper Cervical Rheumatoid Arthritis
Study Design. Prospective imaging study. Objective. To clarify the frequency of positional vertebral artery (VA) occlusion using duplex ultrasonography in patients with rheumatoid arthritis (RA). Summary of Background Data. Some patients with upper cervical RA develop thromboembolic stroke related to positional and transient VA occlusions; however, whether RA patients have positional VA occlusion without neurological symptoms is unclear. Methods. Outpatients with RA were enrolled. Clinical data were collected, and radiograph examinations were performed to measure the anterior atlantodental interval (AADI), the posterior at...
Source: Spine - December 21, 2015 Category: Orthopaedics Tags: Cervical Spine Source Type: research

Rheumatoid Arthritis–Induced Lateral Atlantoaxial Subluxation With Multiple Vertebrobasilar Infarctions
Conclusion. In patients with RA, the potential risk of AAS should be recognized. Lateral AAS in particular may induce cerebral ischemia by positional VA occlusion in advanced stages of the disease. Level of Evidence: N/A
Source: Spine - January 31, 2015 Category: Orthopaedics Tags: Case Report Source Type: research