Decompression without Fusion in Patients with Low-Grade Degenerative Spondylolisthesis and Stenosis: Long-Term Patient-Reported Outcome.

Background: One-third of patients with neurogenic claudication caused by lumbar spinal stenosis have low-grade degenerative spondylolisthesis. Decompression in these patients is considered a risk factor for instability, and it remains unclear whether instrumented fusion should be added. This study aims to assess the long-term clinical outcomes of decompressive surgery without instrumented fusion in patients with symptomatic spinal stenosis regardless of low-grade degenerative spondylolisthesis.

A systematic review evaluating the association of atherosclerosis and lumbar degenerative disc disease.

Introduction: Lumbar disc herniation (LDH) and disc degeneration (DD) are associated with low back pain (LBP) and sciatica, which are common health problems. Emerging evidence suggests a link between vascular health, specifically abdominal aortic calcification (AAC) and systemic lipid profiles, and these spinal conditions.

Research Question: This study investigates the associations between AAC, systemic lipid profiles, lumbar Modic Changes (MC), DD/LDH, and the occurrence of LBP or sciatica.

Surgical versus conservative treatment for odontoid fractures in older people: an international prospective comparative study.

Background: The optimal treatment for odontoid fractures in older people remains debated. Odontoid fractures are increasingly relevant to clinical practice due to ageing of the population.

Methods: An international prospective comparative study was conducted in fifteen European centres, involving patients aged ≥55 years with type II/III odontoid fractures.

Assessing accuracy of measurement methods for bony fusion assessment after anterior cervical discectomy.

Background Context: Currently, there is no universally accepted method for assessing radiological fusion shortly after anterior cervical discectomy. Five-year follow-up radiological X-rays demonstrating solid fusion or absence of fusion provided a gold standard for comparison with various assessment methods.

Purpose: Establishing the most accurate diagnostic test for earlier bony fusion assessment by comparing different cut-off values for the difference in interspinous distance and the change in Cobb angle on dynamic radiological images against the established gold standard.

Association Between Radiological Severity of Lumbar Spinal Stenosis and Spinopelvic Parameters in Adult Patients With Achondroplasia.

Background And Objectives: Adults with achondroplasia are more vulnerable to suffer from neurogenic claudication because of a congenital narrow spinal canal, which makes them susceptible to lumbar spinal stenosis (LSS). The study aims to investigate the correlations between sagittal alignment parameters and the degree of LSS in patients with achondroplasia with LSS.

Methods: The radiological data of adult achondroplasts presented to the neurosurgical clinic of our medical center from 2019 to 2022 were collected.

Modic Changes in the Lumbar Spine: Exploring Their Association with Abdominal Aortic Calcification as a Potential Indicator of Systemic Atherosclerosis.

Background: This was a cross-sectional study on the correlation between abdominal aortic calcification (AAC) and Modic changes (MC). Little is known regarding the etiology of MC in the lumbar spine. Currently, insufficient vascularization of the endplate has been proposed to contribute to the appearance of MC.

Thromboembolic prophylaxis in neurosurgical practice: a systematic review.

Background: In neurosurgical patients, the risk of developing venous thromboembolism (VTE) is high due to the relatively long duration of surgical interventions, usually long immobilization time after surgery, and possible neurological deficits which can negatively influence mobility. In neurosurgical clinical practice, there is lack of consensus on optimal prophylaxis against VTE, mechanical or pharmacological.

Objective: To systematically review available literature on the incidence of VTE in neurosurgical interventions and to establish an optimum prevention strategy.

Low-Threshold-For-Surgery Versus Primarily-Conservative Treatment for Odontoid Fractures in the Elderly: Evaluating Practice Variation in The Netherlands.

Study Design: Retrospective cohort study.

Objectives: Odontoid fractures are the most common cervical spine fractures in the elderly. The optimal treatment remains controversial.

The optimal treatment of type II and III odontoid fractures in the elderly: an updated meta-analysis.

Purpose: Odontoid fractures are the most common cervical spine fractures in the elderly, with a controversial optimal treatment. The objective of this review was to compare the outcome of surgical and conservative treatments in elderly (≥ 65 years), by updating a systematic review published by the authors in 2013.

Methods: A comprehensive search was conducted in seven databases.

Symptomatic lumbar stenosis due to low-grade degenerative spondylolisthesis can effectively be treated with mere decompression.

Purpose: Adding instrumented spondylodesis to decompression in symptomatic spinal stenosis with degenerative spondylolisthesis is subject of debate. The presence of spondylolisthesis due to degeneration is an indicator of severe facet joint and intervertebral disc degeneration, and this may fit increased instability of the spine. We aim to establish the incidence of degenerative spondylolisthesis in spinal stenosis surgical candidates and to evaluate the incidence of failure of decompressive surgery without concomitant spondylodesis as initial treatment.

Association between clinical findings and the presence of lumbar spine osteoarthritis imaging features: A systematic review.

Objective: Spinal osteoarthritis is difficult to study and diagnose, partly due to the lack of agreed diagnostic criteria. This systematic review aims to give an overview of the associations between clinical and imaging findings suggestive of spinal osteoarthritis in patients with low back pain to make a step towards agreed diagnostic criteria.

Design: We searched MEDLINE, Embase, Web of Science, and CINAHL from inception to April 29, 2021 to identify observational studies in adults that assessed the association between selected clinical and imaging findings suggestive of spinal osteoarthritis.

Cost effectiveness of implanting a prosthesis after anterior cervical discectomy for radiculopathy: results of the NECK randomized controlled trial.

Background Context: In the treatment of cervical radiculopathy due to a herniated disc, potential surgical treatments include: anterior cervical discectomy (ACD), ACD and fusion using a cage (ACDF), and anterior cervical disc arthroplasty (ACDA). Previous publications yielded comparable clinical and radiological outcome data for the various implants, but research on their comparative costutility has been inconclusive.

Purpose: To evaluate the cost utility of ACD, ACDF, and ACDA.

Clinical outcome in decompression alone versus decompression and instrumented fusion in patients with isthmic spondylolisthesis: a prospective cohort study.

Objective: In the surgical treatment of isthmic spondylolisthesis, it is debatable whether instrumented fusion is mandatory in addition to decompression. The objective of this prospective cohort study was to assess the long-term effect of decompression alone compared with decompression and instrumented fusion in patients who underwent the intervention of their own preference. The results were compared with those in patients who underwent randomly assigned treatment.

The association between Disease Activity Score and rheumatoid arthritis-associated cervical deformity: radiological evaluation of the BeSt trial.

Objective: The authors' objective was to evaluate the association of the Disease Activity Score (DAS) with cervical spine deformity in rheumatoid arthritis (RA) patients during 10-year optimal treatment of systemic disease.

Methods: The authors evaluated radiological and 10-year follow-up (FU) data of the BeSt (BehandelStrategien) trial. In 272 RA patients, atlantoaxial subluxation (AAS), presence of vertical translocation (VT), and subaxial subluxation (SAS) were evaluated.

Long-term results of the NECK trial-implanting a disc prosthesis after cervical anterior discectomy cannot prevent adjacent segment disease: five-year clinical follow-up of a double-blinded randomised controlled trial.

Background Context: Motion preserving anterior cervical disc arthroplasty (ACDA) in patients with cervical radiculopathy was introduced to prevent symptomatic adjacent segment disease as compared to anterior cervical discectomy and fusion (ACDF).

Purpose: To evaluate the long-term outcome in patients with cervical radiculopathy due to a herniated disc undergoing ACDA, ACDF or ACD (no cage, no plate) in terms of clinical outcome measured by the Neck Disability Index (NDI). Likewise, clinically relevant adjacent segment disease is assessed as a long-term result.

The type of cervical disc herniation on MRI does not correlate to clinical outcomes.

Aims: The aim of this study was to investigate whether the type of cervical disc herniation influences the severity of symptoms at the time of presentation, and the outcome after surgical treatment.

Methods: The type and extent of disc herniation at the time of presentation in 108 patients who underwent anterior discectomy for cervical radiculopathy were analyzed on MRI, using a four-point scale. These were dichotomized into disc bulge and disc herniation groups.

The impact of mental health on outcome after anterior cervical discectomy: cohort study assessing the influence of mental health using predictive modelling.

Background: Depression and anxiety are common mental disorders among patients with chronic pain. It is hypothesised that patients suffering from these disorders benefit less from cervical spine surgery than mentally healthy patients. Therefore, this study aimed to quantify the effect of mental health status on functional outcome after anterior cervical discectomy in a post hoc analysis on RCT data.

The Influence of Reducing Disease Activity Score on Cervical Spine Deformity in Rheumatoid Arthritis: A Systematic Review.

Background: Rheumatoid arthritis (RA) can cause deformity in particularly the craniocervical but also in the lower cervical region.

Objectives: The aim of this study is to give an overview of current literature on the association of disease activity score (DAS) and the prevalence and progression of rheumatoid arthritis-associated cervical spine deformities.

Methods: A literature search was done in PubMed, Embase, and Web of Science using a sensitive search string combination (Supplemental File).

Interspinous process device versus conventional decompression for lumbar spinal stenosis: 5-year results of a randomized controlled trial.

Objective: Interspinous process distraction devices (IPDs) can be implanted to treat patients with intermittent neurogenic claudication (INC) due to lumbar spinal stenosis. Short-term results provided evidence that the outcomes of IPD implantation were comparable to those of decompressive surgery, although the reoperation rate was higher in patients who received an IPD. This study focuses on the long-term results.

Study protocol: effect of infection, Modic and inflammation on clinical outcomes in surgery for radiculopathy (EIMICOR).

Background: Evidence indicates that inflammatory processes are involved in radicular pain as well as in resorption of herniated disc tissue. Furthermore there are indications that the presence of vertebral end plate pathology (Modic changes; MC) is associated with a negative effect on inflammation. It is hypothesized that in patients with MC, the (possibly bacterial induced) inflammation will be accompanied by pro inflammatory cytokines that worsen the outcome, and that in patients without MC, the inflammation is accompanied by cytokines that induce a resorption process to accelerate recovery.

Deep Learning for Adjacent Segment Disease at Preoperative MRI for Cervical Radiculopathy.

Background Patients who undergo surgery for cervical radiculopathy are at risk for developing adjacent segment disease (ASD). Identifying patients who will develop ASD remains challenging for clinicians. Purpose To develop and validate a deep learning algorithm capable of predicting ASD by using only preoperative cervical MRI in patients undergoing single-level anterior cervical diskectomy and fusion (ACDF).