The Impact of Unilateral Transfemoral Amputation on Lumbar Bone and Muscle Quality.

Objective: To examine the long-term perioperative changes in lumbar bone density, muscle size and fatty atrophy, and facet degeneration after transfemoral amputation (TFA).

Design: All patients who underwent TFA at an academic center between 2002-2022 were retrospectively identified. Patients were required to have preoperative and postoperative CT (>1 year) and regularly utilize a prosthesis.

Culture-Negative Native Vertebral Osteomyelitis: A Narrative Review of an Underdescribed Condition.

The incidence of culture-negative NVO (CN-NVO) cases is increasing, presenting significant diagnostic and therapeutic challenges due to the inability to isolate causative organisms with conventional microbiological methods. Factors influencing the diagnosis of CN-NVO include prior antimicrobial therapy, low pathogen burden, fastidious or intracellular organisms, technical issues, and non-infectious mimickers. Diagnosis often relies on imaging modalities like magnetic resonance imaging (MRI) and computed tomography (CT)-guided biopsy, though these methods can sometimes fail to yield positive microbiological results.

Contemporary Practice Patterns in the Treatment of Cervical Stenosis and Central Cord Syndrome: A Survey of the Cervical Spine Research Society.

Study Design: Cross-sectional study.

Objective: To evaluate for areas of consensus and divergence of opinion within the spine community regarding the management of cervical spondylotic conditions and acute traumatic central cord syndrome (ATCCS) and the influence of the patient's age, disease severity, and myelomalacia.

Summary Of Background Data: There is ongoing disagreement regarding the indications for, and urgency of, operative intervention in patients with mild degenerative myelopathy, moderate to severe radiculopathy, isolated axial symptomatology with evidence of spinal cord compression, and ATCCS without myelomalacia.

Unilateral versus bilateral pedicle screw fixation with anterior lumbar interbody fusion: a comparison of postoperative outcomes.

Purpose: To determine of the impact of ALIF with minimally invasive unilateral pedicle screw fixation (UPSF) versus bilateral pedicle screw fixation (BPSF) on perioperative outcomes, radiographic outcomes, and the rates of fusion, subsidence, and adjacent segment stenosis.

Methods: All adult patients who underwent one-level ALIF with UPSF or BPSF at an academic institution between 2015 and 2022 were retrospectively identified. Postoperative outcomes including length of hospital stay (LOS), wound complications, readmissions, and revisions were determined.

Factors Related to Clinical Performance in Spine Surgery Fellowship: Can We Predict Success.

Introduction: The factors most important in the spine fellowship match may not ultimately correlate with quality of performance during fellowship. This study examined the spine fellow applicant metrics correlated with high application rank compared with the metrics associated with the strongest clinical performance during fellowship.

Methods: Spine fellow applications at three academic institutions were retrieved from the San Francisco Match database (first available to 2021) and deidentified for application review.

MRI Vertebral Bone Quality Correlates With Interbody Cage Subsidence After Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective observational study of consecutive patients.

Objective: The purpose of the study was to evaluate VBQ as a predictor of interbody subsidence and to determine threshold values that portend increased risk of subsidence.

Summary Of Background Data: Many risk factors have been reported for the subsidence of interbody cages in anterior cervical discectomy and fusion (ACDF).

The Effect of C2 Muscular Exposure Technique on Radiographic and Clinical Outcomes After C2-T2 Posterior Cervical Fusion.

Study Design: Retrospective cohort analysis.

Objective: To determine whether the C2 exposure technique was a predictor of change in cervical alignment and patient-reported outcomes measures (PROMs) after posterior cervical decompression and fusion (PCDF) for degenerative indications.

Background: In PCDF handling of the C2 posterior paraspinal musculature during the operative approach varies by surgeon technique.

Significant Reduction in Bone Density as Measured by Hounsfield Units in Patients with Ankylosing Spondylitis or Diffuse Idiopathic Skeletal Hyperostosis.

Multisegmental pathologic autofusion occurs in patients with ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH). It may lead to reduced vertebral bone density due to stress shielding. This study aimed to determine the effects of autofusion on bone density by measuring Hounsfield units (HU) in the mobile and immobile spinal segments of patients with AS and DISH treated at a tertiary care center.

Bone Quality as Measured by Hounsfield Units More Accurately Predicts Proximal Junctional Kyphosis than Vertebral Bone Quality Following Long-Segment Thoracolumbar Fusion.

Objective: To compare the prognostic power of Hounsfield units (HU) and Vertebral Bone Quality (VBQ) score for predicting proximal junctional kyphosis (PJK) following long-segment thoracolumbar fusion to the upper thoracic spine (T1-T6).

Methods: Vertebral bone quality around the upper instrumented vertebrae (UIV) was measured using HU on preoperative CT and VBQ on preoperative MRI. Spinopelvic parameters were also categorized according to the Scoliosis Research Society-Schwab classification.

The effect of C2 screw type on perioperative outcomes and long-term stability after C2-T2 posterior cervical decompression and fusion.

Purpose: To determine if C2 pedicle versus pars screw type predicts change in fusion status, C2 screw loosening, cervical alignment, and patient-reported outcomes measures (PROMs) after C2-T2 posterior cervical decompression and fusion (PDCF).

Methods: All adult patients who underwent C2-T2 PCDF for myelopathy or myeloradiculopathy between 2013-2020 were retrospectively identified. Patients were dichotomized by C2 screw type into bilateral C2 pedicle and bilateral C2 pars screw groups.

Reduced Bone Density Based on Hounsfield Units After Long-Segment Spinal Fusion with Harrington Rods.

Background: Long-segment instrumentation, such as Harrington rods, offloads vertebrae within the construct, which may result in significant stress shielding of the fused segments. The present study aimed to determine the effects of spinal fusion on bone density by measuring Hounsfield units (HUs) throughout the spine in patients with a history of Harrington rod fusion.

Methods: Patients with a history of Harrington rod fusion treated at a single academic institution were identified.

A Standardized Curriculum Improves Trainee Rod Bending Proficiency in Spinal Deformity Surgery. Results of a Prospective Randomized Controlled Educational Study.

Introduction: Surgical simulation is increasingly being accepted as a training platform to promote skill development and a safe surgical technique. Preliminary investigations in spine surgery show that simulation paired with educational intervention can markedly improve trainee performance. This study used a newly developed thoracolumbar fusion rod bending model to assess the effect of a novel educational curriculum and simulator training on surgical trainee rod bending speed and proficiency.

Paraspinal Sarcopenia is Associated With Worse Patient-Reported Outcomes Following Laminoplasty for Degenerative Cervical Myelopathy.

Study Design: Retrospective cohort study.

Objective: The present study is the first to assess the impact of paraspinal sarcopenia on patient-reported outcome measures (PROMs) following cervical laminoplasty.

Background: While the impact of sarcopenia on PROMs following lumbar spine surgery is well-established, the impact of sarcopenia on PROMs following laminoplasty has not been investigated.

En bloc resection of a high cervical chordoma followed by reconstruction with a free vascularized fibular graft: illustrative case.

Background: Wide excision of chordoma provides better local control than intralesional resection or definitive radiotherapy. The en bloc excision of high cervical chordomas is a challenging endeavor because of the complex anatomy of this region and limited reconstructive options.

Observations: This is the first case report to describe reconstruction with a free vascularized fibular graft following the en bloc excision of a chordoma involving C1-3.

Semispinalis Cervicis Sarcopenia is Associated With Worsening Cervical Sagittal Balance and Junctional Alignment Following Posterior Cervical Fusion for Myelopathy.

Study Design: This was a retrospective cohort study.

Objective: The present study is the first to investigate whether cervical paraspinal sarcopenia is associated with cervicothoracic sagittal alignment parameters after posterior cervical fusion (PCF).

Summary Of Background Data: Few studies have investigated the association between sarcopenia and postoperative outcomes after cervical spine surgery.

Multifidus Sarcopenia Is Associated With Worse Patient-reported Outcomes Following Posterior Cervical Decompression and Fusion.

Study Design: Retrospective cohort study.

Objective: The present study is the first to assess the impact of paraspinal sarcopenia on patient-reported outcome measures (PROMs) following posterior cervical decompression and fusion (PCDF).

Summary Of Background Data: While the impact of sarcopenia on PROMs following lumbar spine surgery is well-established, the impact of sarcopenia on PROMs following PCDF has not been investigated.

Does Preoperative Bone Mineral Density Impact Fusion Success in Anterior Cervical Spine Surgery? A Prospective Cohort Study.

Objective: The purpose of this study was to identify risk factors for pseudarthrosis in patients undergoing anterior cervical discectomy and fusion (ACDF) with a focus on the role of bone mineral density (BMD) on arthrodesis.

Methods: We retrospectively reviewed a prospectively collected database of patients undergoing 1- to 4-level ACDF for degenerative indications between 2012 and 2018 at a single institution. All patients were required to have undergone a preoperative dual-energy x-ray absorptiometry (DEXA) scan.

Postoperative and Intraoperative Cement Augmentation for Spinal Fusion.

Objective: To review outcomes of patients undergoing spinal fusion with prophylactic cement augmentation (CA) of pedicle screws and adjacent levels.

Methods: In a retrospective case-control study, 59 patients underwent CA of pedicle screws for spinal fusion between 2003 and 2018. Most patients (83%) underwent postoperative CA, while 17% underwent intraoperative CA.

C1 and C2 Fractures Above a Previous Fusion Treated with Internal Fixation without Fusion: A Case Report.

Case: A 71-year-old woman sustained C1 lateral mass and type 2 odontoid fractures 3 years after C2-T2 anterior-posterior fusion. She was treated with C1-C4 instrumentation without fusion for 9 months followed by instrumentation removal to restore atlantoaxial motion. After instrumentation removal, she maintained clinically relevant cervical lateral bending, rotation, and flexion and extension.

The Value of Cement Augmentation in Patients With Diminished Bone Quality Undergoing Thoracolumbar Fusion Surgery: A Review.

Study Design: Systematic review.

Objectives: Osteoporosis predisposes patients undergoing thoracolumbar (TL) fusion to complications and revision surgery. Cement augmentation (CA) improves fixation of pedicle screws to reduce these complications.

Nonsurgical Management of Combined Occipitocervical and Atlantoaxial Distraction Injuries: A Case Report.

Case: A 41-year-old man sustained occipitocervical dislocation (OCD) and atlantoaxial dislocation (AAD) injuries in a motor vehicle collision. These injuries were treated nonoperatively with a hard cervical collar and activity restrictions with an excellent result at 4-year follow-up.

Conclusion: OCD and AAD injuries require prompt diagnosis and immobilization.

Prospective Evaluation of Radiculitis following Bone Morphogenetic Protein-2 Use for Transforaminal Interbody Arthrodesis in Spine Surgery.

Study Design: Prospective observational cohort study.

Purpose: This study aims to evaluate the safety and efficacy of bone morphogenetic protein-2 (BMP-2) in transforaminal lumbar interbody fusion (TLIF) with regard to postoperative radiculitis.

Overview Of Literature: Bone morphogenetic protein (BMP) is being used increasingly as an alternative to iliac crest autograft in spinal arthrodesis.