Association of Safety-Net hospital status and hospital outcomes following ACDF or PCDF for CSM.

Introduction: Safety net hospitals (SNH) serve a large proportion of patients with Medicaid or without insurance. However, few prior studies have addressed the impact of SNH status on outcomes following anterior cervical discectomy and fusion (ACDF) or posterior cervical decompression and fusion (PCDF) for cervical spondylotic myelopathy (CSM). The aim of this study was to assess the association between SNH status outcomes following ACDF or PCDF for CSM.

Analysis of short- and delayed unplanned readmission rates after anterior discectomy and fusion for CSM.

Introduction: Many patients with cervical spondylotic myelopathy (CSM) undergo anterior cervical discectomy and fusion (ACDF). Many of these patients are readmitted, but there is no clear understanding of drivers of readmission. The aim of this study was to assess the patient- and hospital-level factors that contribute to 7-, 30-, and 90-day readmissions after treatment of CSM.

The association between female sex and depression following traumatic brain injury: A systematic review and meta-analysis.

While women tend to experience more severe psychiatric and neurobehavioral symptoms following traumatic brain injury (TBI), the connection between sex and post-TBI depression remains poorly understood. To explore the potential association between sex and post-TBI depression, we conducted a systematic review and meta-analysis, including studies with participants who had no prior diagnosis of depression. Thirteen studies met the criteria for inclusion, collectively investigating a cohort of 449,471 individuals with TBI.

Impact of preoperative nutritional status on morbidity and mortality in elderly patients undergoing subdural hematoma evacuation: the role of the Geriatric Nutritional Risk Index.

Objective: Nutritional status has been shown to impact patient outcomes across several neurosurgical procedures. However, few prior studies have assessed associations between preoperative nutritional status and outcomes in elderly patients undergoing subdural hematoma evacuations. The aim of this study was to identify associations between preoperative nutritional status and short-term outcomes in patients aged 65 years and older undergoing subdural hematoma evacuation.

An evidence-based approach to the recovery of bladder and bowel function after pediatric spinal cord injury.

Introduction: Bladder dysfunction and associated complications of the urinary system negatively impact the quality of life in children living with spinal cord injury (SCI). Pediatric lower urinary tract deficits include bladder over-activity, inefficient emptying, decreased compliance, and incontinence. Recent evidence in adults with SCI indicates significant improvements in bladder capacity and detrusor pressure following participation in an activity-based recovery locomotor training (ABR-LT) rehabilitative program.

Polypharmacy in elective lumbar spinal surgery for degenerative conditions with 24-month follow-up.

We sought to identify long-term associations of medical complications and healthcare utilization related to polypharmacy following spinal surgery for degenerative lumbar pathology. The IBM MarketScan dataset was used to select patients who underwent spinal surgery for degenerative lumbar pathology with 2-year follow-up. Regression analysis compared two matched cohorts: those with and without polypharmacy.

Effect of cannabis use history on postoperative opioid utilization in lumbar fusion patients: an American retrospective study.

Study Design: A retrospective cohort study.

Purpose: To examine the effect of cannabis use history on postoperative opioid utilization in patients undergoing one- to three-level lumbar fusion for degenerative spine disease.

Overview Of Literature: Strategies to minimize dosing and chronic opioid use are needed for spine surgery given their widespread prescription for postsurgical pain management.

Assessing a revised-risk analysis index for morbidity and mortality after spine surgery for metastatic spinal tumors.

Background: Risk Analysis Index (RAI) has been increasingly used to assess surgical frailty in various procedures, but its effectiveness in predicting mortality or in-patient hospital outcomes for spine surgery in metastatic disease remains unclear. The aim of this study was to compare the predictive values of the revised RAI (RAI-rev), the modified frailty index-5 (mFI-5), and advanced age for extended length of stay, 30-day readmission, complications, and mortality among patients undergoing spine surgery for metastatic spinal tumors.

Methods: A retrospective cohort study was performed using the 2012-2022 ACS NSQIP database to identify adult patients who underwent spinal surgery for metastatic spinal pathologies.

The Impact of Preoperative Spinal Injection Timing on the Postoperative Complications of Lumbar Fusion.

Objective: To determine the impact of epidural spinal injections (ESIs) on postoperative surgical complications.

Methods: This retrospective all-payer database analysis identified 202,181 adult patients undergoing one- to three-level transforaminal lumbar interbody fusion (TLIF) from 2010 to 2020. A 1:1 exact matching on comorbidities and demographics was performed, creating 2 cohorts: 1) patients who received an ESI within 90 days of surgery and 2) patients who did not receive an ESI.

Impact of Depression on Postoperative Medical and Surgical Outcomes in Spine Surgeries: A Systematic Review and Meta-Analysis.

The relationship between psychiatric disorders, including depression, and invasive interventions has been a topic of debate in recent literature. While these conditions can impact the quality of life and subjective perceptions of surgical outcomes, the literature lacks consensus regarding the association between depression and objective perioperative medical and surgical complications, especially in the neurosurgical domain. MEDLINE (PubMed), EMBASE, PsycINFO, and the Cochrane Library were queried in a comprehensive manner from inception until 10 November 2023, with no language restrictions, for citations investigating the association between depression and length of hospitalization, medical and surgical complications, and objective postoperative outcomes including readmission, reoperation, and non-routine discharge in patients undergoing spine surgery.

Efficacy and utility of antifibrinolytics in pediatric spine surgery: a systematic review and network meta-analysis.

Antifibrinolytics have gained increasing attention in minimizing blood loss and mitigating the risks associated with massive transfusions, including infection and coagulopathy in pediatric patients undergoing spine surgery. Nevertheless, the selection of optimal agent is still a matter of debate. We aim to review the utility of these agents and compare the efficacy of antifibrinolytics in pediatric and adolescent spine surgeries.

Isolated unilateral alar ligamentous injury: illustrative cases.

Background: Isolated unilateral alar ligament injury (IUALI) is a rare and likely underreported occurrence after upper cervical trauma, with only 16 cases documented in the literature to date. Patients generally present with neck pain, and definitive diagnosis is typically made by magnetic resonance imaging (MRI). Unfortunately, likely due in part to its rarity, there are no formal guidelines for the treatment of an IUALI.

Reduced racial disparities among newborns with intraventricular hemorrhage.

Introduction: Intraventricular hemorrhage (IVH) can ensue permanent neurologic dysfunction, morbidity, and mortality. While previous reports have identified disparities based on patient gender or weight, no prior study has assessed how race may influence in neonatal or infantile IVH patients. The aim of this study was to investigate the impact of race on adverse event (AE) rates, length of stay (LOS), and total cost of admission among newborns with IVH.

Variations in the genomic profiles and clinical behavior of meningioma by racial and ethnic group.

Objective: The influence of socioeconomic factors on racial disparities among patients with sporadic meningiomas is well established, yet other potential causative factors warrant further exploration. The authors of this study aimed to determine whether there is significant variation in the genomic profile of meningiomas among patients of different races and ethnicities and its correlation with clinical outcomes.

Methods: The demographic, genomic, and clinical data of patients aged 18 years and older who had undergone surgery for sporadic meningioma between September 2008 and November 2021 were analyzed.

Decompression Alone Versus Interspinous/Interlaminar Device Placement for Degenerative Lumbar Pathologies: Systematic Review and Meta-Analysis.

Introduction: Interspinous devices (ISDs) and interlaminar devices (ILDs) are marketed as alternatives to conventional surgery for degenerative lumbar conditions; comparisons with decompression alone are limited. The present study reviews the extant literature comparing the cost and effectiveness of ISDs/ILDs with decompression alone.

Methods: Articles comparing decompression alone with ISD/ILD were identified; outcomes of interest included general and disease-specific patient-reported outcomes, perioperative complications, and total treatment costs.

Impact of a quality improvement initiative and monthly multidisciplinary meetings on outcomes after posterior spinal fusion for adolescent idiopathic scoliosis.

Introduction: Several studies have demonstrated the benefits of enhanced recovery after surgery (ERAS) protocols for patients with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal instrumented fusion (PSIF). However, there are relatively few studies investigating the effect of regular multidisciplinary team meetings on level selection, surgical performance parameters, and patient outcomes after PSIF for AIS. The aim of this study was to assess changes in intra- and postoperative outcomes following multidisciplinary team meeting implementation for patients undergoing PSIF for AIS.

Racial disparities in the management and outcomes of primary osseous neoplasms of the spine: a SEER analysis.

Purpose: Primary osseous neoplasms of the spine, including Ewing's sarcoma, osteosarcoma, chondrosarcoma, and chordoma, are rare tumors with significant morbidity and mortality. The present study aims to identify the prevalence and impact of racial disparities on management and outcomes of patients with these malignancies.

Methods: The 2000 to 2020 Surveillance, Epidemiology, and End Results (SEER) Registry, a cancer registry, was retrospectively reviewed to identify patients with Ewing's sarcoma, osteosarcoma, chondrosarcoma, or chordoma of the vertebral column or sacrum/pelvis.

Impact of Preoperative Frailty on Outcomes in Patients with Cervical Spondylotic Myelopathy Undergoing Anterior vs. Posterior Cervical Surgery.

: Frailty has been shown to negatively influence patient outcomes across many disease processes, including in the cervical spondylotic myelopathy (CSM) population. The aim of this study was to assess the impact that frailty has on patients with CSM who undergo anterior cervical discectomy and fusion (ACDF) or posterior cervical decompression and fusion (PCDF). : A retrospective cohort study was performed using the 2016-2019 national inpatient sample.