Does Robotic Spine Surgery Add Value to Surgical Practice over Navigation-Based Systems? A Study on Operating Room Efficiency.

Spine surgery has undergone significant advancements, particularly with regard to robotic systems that enhance surgical techniques and improve patient outcomes. As these technologies become increasingly integrated into surgical practice, it is essential to evaluate their added value and cost savings. Hence, this study compared robot-assisted and navigation-based spine surgery, focusing on surgical efficiency.

Genetic regulation of injury-induced heterotopic ossification in adult zebrafish.

Heterotopic ossification is the inappropriate formation of bone in soft tissues of the body. It can manifest spontaneously in rare genetic conditions or as a response to injury, known as acquired heterotopic ossification. There are several experimental models for studying acquired heterotopic ossification from different sources of damage.

The Evolution of Lateral Lumbar Interbody Fusion: A Journey from Past to Present.

Lumbar interbody fusion procedures have seen a significant evolution over the years, with various approaches being developed to address spinal pathologies and instability, including posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), and lateral lumbar interbody fusion (LLIF). LLIF, a pivotal technique in the field, initially emerged as extreme/direct lateral interbody fusion (XLIF/DLIF) before the development of oblique lumbar interbody fusion (OLIF). To ensure comprehensive circumferential stability, LLIF procedures are often combined with posterior stabilization (PS) using pedicle screws.

Frequency and predictors of implant-related complications after posterior cervical fusion.

Study Design: Retrospective, observational study.

Purpose: To determine the frequency and predictors of implant-related complications in adults after posterior cervical fusion.

Overview Of Literature: Published literature on lumbosacral fusion suggest that implant-related complications are not uncommon.

Living with Fibrodysplasia Ossificans Progressiva: Radiological Images of a Patient with Extensive Heterotopic Ossification.

Fibrodysplasia ossificans progressiva (FOP) is an exceptionally rare genetic disorder characterized by the progressive formation of heterotopic bone in soft tissues. Here, we present the radiological findings of an 18-year-old female diagnosed with FOP who had severe spinal and right-upper-limb abnormalities. Her SF-36 scores suggested significant impairment in physical function, affecting work and other regular daily activities.

Multiple Clay Shoveler's Fractures of the Thoracic Spine.

Typically, a clay shoveler's fracture is a stress-type avulsion fracture involving the spinous processes of the lower cervical or upper thoracic vertebrae. Even though C7 and T1 are the most commonly involved spinal levels, these avulsion fractures can occur at any lower cervical or upper thoracic level, either as solitary or multiple fractures. This fracture used to be common in workers who shovel heavy loads of clay for long periods, hence its name.

Correction of degenerative lumbar coronal deformity using asymmetrical interbody cages: Surgical technique and case report.

In adult degenerative spondylosis, much emphasis has been placed upon recognizing the sagittal plane deformity and techniques to restore this alignment. However, the coronal plane deformity has not received much attention and, if left uncorrected, may lead to poorer outcomes. Here, we present a case of degenerative lumbar scoliosis with a rigid coronal malalignment secondary to a dysplastic sacrum.

Postoperative Urinary Retention Following Thoracolumbosacral Spinal Fusion: Prevalence, Risk Factors, and Outcomes.

Objective Postoperative urinary retention (POUR) is an often-underestimated common complication following spine surgery, and it is essential to avoid its untoward long-term consequences. Besides, a dilemma exists regarding the appropriate timing for the postoperative removal of indwelling catheter (IDC). Hence, we aim to describe the prevalence, risk factors, and outcomes of POUR and also come up with recommendations for the removal of IDC.

Early Postoperative Loss of Disc Height Following Transforaminal and Lateral Lumbar Interbody Fusion: A Radiographic Analysis.

Study Design: Retrospective comparative radiological study.

Purpose: To analyze the difference in early disc height loss following transforaminal and lateral lumbar interbody fusion (TLIF and LLIF).

Overview Of Literature: Minimal disc height loss facilitated by the polyaxial screw heads can occur naturally due to mechanical loading following lumbar fusion procedures.

Musculoskeletal regeneration: A zebrafish perspective.

Musculoskeletal injuries are common in humans. The cascade of cellular and molecular events following such injuries results either in healing with functional recovery or scar formation. While fibrotic scar tissue serves to bridge between injured planes, it undermines functional integrity.

Incidence of pedicle breach following open and minimally invasive spinal instrumentation: A postoperative CT analysis of 513 pedicle screws applied under fluoroscopic guidance.

Background: Even though pedicle screw application is a common procedure, and in-spite of spine surgeons being proficient with the technique, mal-positioning of pedicle screws can still occur. We intend to determine by postoperative CT analysis, the incidence of pedicle screw breach in the thoracolumbar spine despite satisfactory intraoperative placement confirmed by fluoroscopy.

Materials And Methods: Consecutive patients diagnosed with thoracolumbar fractures who underwent open or minimally invasive posterior stabilization under fluoroscopic guidance were retrospectively reviewed.

Transverse myelitis masquerading as cauda equina syndrome, stroke and cervical myelopathy.

Transverse myelitis is an uncommon but well-defined neurological syndrome. However, a high index of suspicion is needed to diagnose this condition, especially when it occurs in concomitance with preexisting spinal canal stenosis. We report our patient, a 48 year old male, who initially presented to our spine clinic with acute onset unilateral lower limb weakness associated with urinary retention, which was suspected to be cauda equina syndrome due to a prolapsed intervertebral disc.

Degenerative cervical myelopathy presenting as subjective lower limb weakness could be a trap towards misdiagnosis.

When patients presenting with subjective lower limb weakness (SLLW) are encountered, it is natural to suspect a lumbar pathology and proceed with related clinical examination, investigations and management. However, SLLW could be a sign of degenerative cervical myelopathy (DCM) due to an evolving cord compression. In such circumstances, if symptoms are not correlated to myelopathy at the earliest, there could be potential complications over time.

Neuromonitoring in Cervical Spine Surgery: When Is a Signal Drop Clinically Significant?

Study Design: Retrospective cohort study.

Purpose: To identify the clinical significance of different patterns of intraoperative neuromonitoring (IONM) signal alerts.

Overview Of Literature: IONM is a long-established valuable adjunct to complex spine surgeries.

Fibrodysplasia ossificans progressiva: current concepts from bench to bedside.

Heterotopic ossification (HO) is a disorder characterised by the formation of ectopic bone in soft tissue. Acquired HO typically occurs in response to trauma and is relatively common, yet its aetiology remains poorly understood. Genetic forms, by contrast, are very rare, but provide insights into the mechanisms of HO pathobiology.

Spinal Navigation for Cervical Pedicle Screws: Surgical Pearls and Pitfalls.

Study Design: Retrospective cohort study.

Objective: We intend to evaluate the accuracy and safety of cervical pedicle screw (CPS) insertion under O-arm-based 3-dimensional (3D) navigation guidance.

Methods: This is a retrospective study of patients who underwent CPS insertion under intraoperative O-arm-based 3D navigation during the years 2009 to 2018.

Morphological Parameters of the Thoracic Pedicle in an Asian Population: A Magnetic Resonance Imaging-Based Study of 3324 Pedicles.

Study Design: A cross-sectional magnetic resonance imaging (MRI)-based anatomical study.

Objectives: Instrumentation of the thoracic spine may be challenging due to the unique pedicle morphology and the proximity of vital structures. As prior morphological studies have mostly been done in Caucasians, our study aims to determine the optimal pedicle screw size for transpedicular fixation in an Asian population.

Prospective Evaluation of the Time Required for Insertion of 380 Lumbar and Sacral Pedicle Screws Using Navigation with an Intraoperative 3-Dimensional Imaging System.

Background: The aim of this study was to evaluate the time required for various parts of the procedure to insert lumbar and sacral pedicle screws using navigation with an intraoperative, 3-dimensional imaging system. Comparison of these timings was carried out for different surgical indications.

Methods: This was a single-surgeon prospective cohort study of 69 consecutive patients (between August 2013 and June 2018) who underwent insertion of 380 pedicle screws into the lumbar and sacral vertebrae.

Orthostatic Hypotension Following Cervical Spine Surgery: Prevalence and Risk Factors.

Study Design: Retrospective case series.

Objectives: This study aims to determine the prevalence and risk factors for orthostatic hypotension (OH) in patients undergoing cervical spine surgery.

Methods: Data was collected from records of 190 consecutive patients who underwent cervical spine procedures at our center over 24 months.

Reliability of the new modified Moro's classification and oblique corridor grading to assess the feasibility of oblique lumbar interbody fusion.

Introduction: The modified Moro's classification (MMC) of psoas morphology and oblique corridor (OC) grading were recently proposed. Their reliability needs to be tested.

Methods: T2 weighted lumbar disc level axial-cut MRI images of patients with degenerative spondylosis were distributed to five spine surgeons.

Factors Influencing Early Disc Height Loss Following Lateral Lumbar Interbody Fusion.

Study Design: Retrospective radiological analysis.

Purpose: To analyze the factors influencing early disc height loss following lateral lumbar interbody fusion (LLIF).

Overview Of Literature: Postoperative disc height loss can occur naturally as a result of mechanical loading.