The Cervical Intervertebral Foramen: Microanatomy, Pathology, and Clinical Implications.

Study Design: This is an evidence-based narrative review article.

Objective: We hope to provide a primer on cervical intervertebral foramen (cIVF) anatomy for spine surgeons, interventionalists, and physiatrists who regularly treat cervical spine pathology, and encourage further exploration of this topic.

Background: This corridor for exiting cervical nerve roots is characterized by its intricate microanatomy involving ligamentous, nervous, and vascular structures.

Twenty-Year Radiographic Outcomes Following Single-Level Cervical Disc Arthroplasty: Results From a Prospective Randomized Controlled Trial.

Study Design: Prospective randomized controlled trial.

Objective: Compare range of motion (ROM) and adjacent segment degeneration (ASD) following cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) at 20-year follow-up.

Summary Of Background Data: Anterior cervical discectomy and fusion is the standard of treatment for single-level cervical disc degeneration causing radiculopathy.

Technique Pearls for Successful Cervical Disc Arthroplasty From More Than 20 Years of Surgical Experience.

Study Design: Surgical technique paper.

Objective: To describe tips and pearls for cervical disc arthroplasty (CDA).

Background: CDA has proven to be an effective means of treatment for degenerative cervical disc disease and cervical radiculopathy in properly selected patients who have previously failed non-operative treatment.

The Relationship Between Patient Demographic and Clinical Characteristics and Successful Treatment Outcomes After Basivertebral Nerve Radiofrequency Ablation: A Pooled Cohort Study of Three Prospective Clinical Trials.

Objective: Multiple studies have demonstrated the safety and effectiveness of basivertebral nerve radiofrequency ablation (BVN RFA) for improving low back pain related to the vertebral endplate. However, the influence of patient demographic and clinical characteristics on treatment outcome is unknown.

Design: Pooled cohort study of three clinical trials of patients with vertebral endplate pain identified by Type 1 and/or Type 2 Modic changes and a correlating presentation of anterior spinal element pain.

Comparison of a right versus left sided anterior approach to the thoracic and thoracolumbar spine: A case series.

Aims & Objectives: Traditionally, a left sided anterior approach has been considered the safest way to access the thoracic and thoracolumbar spine due to avoidance of the inferior vena cava (IVC). We challenge this 'go from the left' dogma by presenting a series of patients who underwent a right sided approach to the thoracic and thoracolumbar spine.

Materials & Methods: 71 anterior thoracic fusion procedures treated with either a left or right sided approach were identified and retrospectively studied.

Comparison of Lumbar Fusion With and Without Interbody Fusion for Lumbar Stenosis Using Patient-Reported Outcomes Measurement Information System (PROMIS) Computer Adaptive Testing (CAT).

Study design This was a retrospective analysis of patient-reported outcomes across a two-year period. Summary of background data Patients suffering from lumbar stenosis may experience low back pain, neurogenic claudication, and weakness. Patients can benefit from surgical intervention, including decompression with or without fusion.

Safe Spine Surgery During the COVID-19 Pandemic.

Safe spine surgery is possible during the COVID-19 pandemic. Certain urgent procedures must still be performed during this challenging time to prevent permanent long-term disability or death for patients. Precautions must be taken in the operating room to optimize safety, including the use of personal protective equipment and appropriate room setup and anesthesia and equipment optimization.

Two-Level Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty-Long-Term Evidence Update.

Background: Multiple studies have highlighted the motion-sparing benefits of single-level cervical disc arthroplasty (CDA) compared with anterior cervical discectomy and fusion (ACDF). However, few studies have reviewed multilevel ACDF versus CDA. Several recent studies have midterm and even long-term data available comparing 2-level ACDF versus CDA.

Long-Term Radiographic and Functional Outcomes of Patients With Absence of Radiographic Union at 2 Years After Single-Level Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective radiographic investigation.

Objective: To evaluate the long-term radiographic and functional outcomes of patients in whom there is absence of radiographic union at 2 years after single-level anterior cervical discectomy and fusion (ACDF).

Methods: Thirty-one patients were evaluated at standard postoperative time intervals per index trial protocol.

Far Lateral/Extraforaminal Approaches for Microdiscectomy and Foraminal Decompression in the Lumbar Spine.

Far lateral approaches to the lumbar spine are uncommon procedures but are essential techniques for spine surgeons to understand and master for the treatment of extraforaminal disk herniations and foraminal stenosis. We present our preferred approaches for open and minimally invasive techniques to perform extraforaminal decompressions and/or discectomies in the lumbar spine.

Intra-Articular Sacroiliac Joint Injection: Technical Guide.

Sacroiliac (SI) joint pathology has been an increasingly discussed pathology as a potential etiology for significant low back and lower extremity pain. While patient history and examination maneuvers can assist with identifying the SI joint as a potential cause of pain, an intra-articular SI joint injection is critical to properly diagnose the SI joint as a clinically relevant pain generator. In addition to the diagnostic information from the injection, SI joint intra-articular injections can be performed for therapeutic benefit as part of a multi-modal, conservative treatment approach for SI joint pathology.

Evaluation of DIAM™ Spinal Stabilization System for lower lumbar disc degenerative disease: A randomized, prospective, single-site study.

Objective: To determine the efficacy of DIAM Spinal Stabilization System compared with nonoperative treatment for patients with low back pain and lower lumbar disc degenerative disease.

Methods: A single center collected prospective outcomes data on 38 patients randomized to an interspinous device or non-operative treatment for symptomatic lumbar degenerative disc disease with treatment crossover allowed at 6 months.

Results: At all postoperative timepoints out to 2-years, statistically significant improvements in ODI and back pain scores were observed with the interspinous device.

Update on Spinal Cord Injury Management.

The management of acute spinal cord injury requires a multidisciplinary approach to maximize patient outcomes and potential. Treatment of this injury involves both surgical and medical intervention. Medical intervention in acute spinal cord injury is aimed at decreasing the neurotoxic environment that occurs as part of the secondary injury.

Functional Outcomes Associated With Adjacent-level Ossification Disease 10 Years After Cervical Disc Arthroplasty or ACDF.

Study Design: A retrospective review of a prospective, randomized control Food and Drug Administration (FDA) investigational device exemption trial comparing anterior cervical discectomy and fusion (ACDF) with Bryan cervical disc arthroplasty.

Objective: Determine the clinical significance of adjacent-level ossification disease (ALOD) on long-term functional outcomes after ACDF or arthroplasty.

Summary Of Background Data: ALOD occurs when the anterior longitudinal ligament and annulus adjacent to the index surgical level calcifies.

The perceived efficacy and utility of spine bioskills curricula for resident and fellow education.

The purpose of this study is to assess the role of bioskills in orthopaedic and neurosurgical resident education. A survey of the utilization and perceived efficacy of bioskills was submitted to Lumbar Spine Research Society (LSRS) members. 36/104 surgeons responded, including 25 orthopaedic, 7 neurosurgical, and 4 integrated respondents.

Role of Imaging, Tissue Sampling, and Biomarkers for Diagnosis of SSI in Spine Surgery.

In July 2018, the Second International Consensus Meeting on Musculoskeletal Infection convened in Philadelphia, PA to discuss issues regarding infection in orthopedic patients and to provide consensus recommendations on these issues to practicing orthopedic surgeons. During this meeting, attending delegates divided into subspecialty groups to discuss topics specifics to their respective fields, which included the spine. At the spine subspecialty group meeting, delegates discussed and voted upon the recommendations for 63 questions regarding the prevention, diagnosis, and treatment of infection in spinal surgery.

Consensus on Risk Factors and Prevention in SSI in Spine Surgery.

In July of 2018, the Second International Consensus Meeting (ICM) on Musculoskeletal Infection convened in Philadelphia, PA to discuss issues regarding infection in orthopedic patients and to provide consensus recommendations on these issues to practicing orthopedic surgeons. During this meeting, attending delegates divided into subspecialty groups to discuss topics specifics to their respective fields, which included the spine. At the spine subspecialty group meeting, delegates discussed and voted upon the recommendations for 63 questions regarding the prevention, diagnosis, and treatment of infection in spinal surgery.

Consensus on Implants in Infections After Spine Surgery.

In July of 2018, the Second International Consensus Meeting (ICM) on Musculoskeletal Infection convened in Philadelphia, PA was held to discuss issues regarding infection in orthopedic patients and to provide consensus recommendations on these issues to practicing orthopedic surgeons. During this meeting, attending delegates divided into subspecialty groups to discuss topics specifics to their respective fields, which included the spine. At the spine subspecialty group meeting, delegates discussed and voted upon the recommendations for 63 questions regarding the prevention, diagnosis, and treatment of infection in spinal surgery.

Consensus on the Role of Antibiotic Use in SSI Following Spinal Surgery.

In July of 2018, the Second International Consensus Meeting (ICM) on Musculoskeletal Infection convened in Philadelphia, PA was held to discuss issues regarding infection in orthopedic patients and to provide consensus recommendations on these issues to practicing orthopedic surgeons. During this meeting, attending delegates divided into subspecialty groups to discuss topics specifics to their respective fields, which included the spine. At the spine subspecialty group meeting, delegates discussed and voted upon the recommendations for 63 questions regarding the prevention, diagnosis, and treatment of infection in spinal surgery.

General Principles in the Consensus of SSI Management After Spine Surgery.

In July of 2018, the Second International Consensus Meeting (ICM) on Musculoskeletal Infection convened in Philadelphia, PA was held to discuss issues regarding infection in orthopedic patients and to provide consensus recommendations on these issues to practicing orthopedic surgeons. During this meeting, attending delegates divided into subspecialty groups to discuss topics specifics to their respective fields, which included the spine. At the spine subspecialty group meeting, delegates discussed and voted upon the recommendations for 63 questions regarding the prevention, diagnosis, and treatment of infection in spinal surgery.