Single-Level Unilateral Biportal Endoscopic versus Tubular Microdiscectomy: Comparing Surgical Outcomes and Opioid Consumption.

Background: Unilateral biportal endoscopic (UBE) microdiscectomy is an emerging minimally invasive surgery technique for treating symptomatic lumbar disc herniation. There is limited literature regarding outcomes. Here, we assess surgical outcomes and pain medication consumption for UBE vs.

Subsidence in Nonexpandable, Single-Plane Expandable, and Dual-Plane Expandable TLIFs A Propensity-Matched Cohort Study.

Background: Transforaminal lumbar interbody fusion (TLIF) has become a common tool to achieve interbody fusion in lumbar spine surgery while avoiding the time, expense, and morbidity associated with an anterior approach. Nonexpandable (NE) devices have excellent fusion results but are limited to implant size by spinal anatomy; conversely, expandable implants have been associated with increased intraoperative subsidence. Dual-plane expandable (DPE) devices are theorized to have reduced subsidence risk, but DPE cages have not been directly compared to NE and single plane expandable (SPE) implants in vivo.

Postoperative Opioid Medication Consumption Following Single-Level Lumbar Microdiscectomy Before and After Implementation of a Multimodal Opioid-Sparing Pathway.

In response to the national opioid crisis, there have been increasing efforts to decrease opioid usage in favor of nonopioid alternatives. We compared post-discharge opioid and nonopioid pain medication prescriptions in lumbar microdiscectomy (MLD) patients before and after implementation of an opioid-sparing pathway for outpatient spine surgery. Patients were grouped into pre-implementation (pre) and post-implementation (post) cohorts based on date of surgery relative to pathway implementation on September 1, 2018.

What is the impact of DEI on spine care? Does it matter if my doctor looks like me?

Though the United States population has rapidly diversified in recent decades, the American physician workforce has been slow to follow. Orthopedic surgery and neurosurgery are 2 specialties which remain particularly homogenous, and the subset of orthopedic surgeons and neurosurgeons who pursue spine surgery is even less diverse, along many different demographic axes. To provide effective, innovative, and accessible care to the changing population, greater diversity in spine surgery is essential.

Complications of Venous Thromboembolism Chemoprophylaxis in Lumbar Laminectomy With and Without Fusion.

Background: The benefit of chemoprophylaxis (CPX) agents in preventing venous thromboembolism must be weighed against potential risks. Current literature regarding the efficacy of CPX after laminectomies with or without fusion is limited, with no clear consensus to inform guidelines.

Objective: This study evaluated the association between CPX and surgical complications after lumbar laminectomy with and without fusion.

Does Bone Morphogenetic Protein Use Reduce Pseudarthrosis Rates in Single-Level Transforaminal Lumbar Interbody Fusion Surgeries?

Background: Recombinant human bone morphogenetic protein 2 (rhBMP-2, or BMP for short) is a popular biological product used in spine surgeries to promote fusion and avoid the morbidity associated with iliac crest autograft. BMP's effect on pseudarthrosis in transforaminal lumbar interbody fusion (TLIF) remains unknown.

Objective: To assess the rates of pseudarthrosis in single-level TLIF with and without concurrent use of BMP.

The Impact of Social Determinants of Health on Discharge Disposition Following One- and Two-Level Posterior Interbody Fusion.

Background Current research is limited in exploring the impact of social determinants of health (SDOH) on the discharge location within elective spine surgery. Further understanding of the influence of SDOH on disposition is necessary to improve outcomes. This study explores how SDOH influence discharge disposition for patients undergoing one- or two-level posterior interbody fusion (TLIF/PLIF).

Resolution of Radiculopathy Following Indirect Versus Direct Decompression in Single Level Lumbar Fusion.

Study Design: Retrospective analysis.

Objectives: To evaluate resolution of radiculopathy in one-level lumbar fusion with indirect or direct decompression techniques.

Methods: Patients ≥18 years of age with preoperative radiculopathy undergoing single-level lumbar fusion with up to 2-year follow-up were grouped by indirect and direct decompression.

Post-Operative Physical Therapy Following Cervical Spine Surgery: Analysis of Patient-Reported Outcomes.

Introduction Post-operative physical therapy (PT) following anterior cervical discectomy and fusion (ACDF) surgery is often performed to improve a patient's functional ability and reduce neck pain. However, current literature evaluating the benefits of post-operative PT using patient-reported outcomes (PROs) is limited and remains inconclusive. Here we compare post-operative improvement between patients who did and did not undergo formal PT after ACDF using Patient-Reported Outcomes Measurement Information System (PROMIS) scores.

Reoperation Rates Due to Adjacent Segment Disease Following Primary 1 to 2-Level Minimally Invasive Versus Open Transforaminal Lumbar Interbody Fusion.

Study Design: Retrospective analysis of prospectively collected data.

Objective: To investigate the effect of the approach of the transforaminal lumbar interbody fusion [TLIF; open vs . minimally invasive (MIS)] on reoperation rates due to ASD at 2 to 4-year follow-up.

Biologics in Spine Fusion.

Achieving fusion in spine surgery can be challenging because of patient factors such as smoking and diabetes. The consequences of pseudarthrosis can be severe, including pain, instability, and additional surgery. Autologous iliac crest bone graft is the historical standard for augmenting spine fusion, providing high rates of fusion throughout the cervical, thoracic, and lumbar spine.

The Temporality of Deep Surgical Site Infection Rates Following Spinal Laminectomy and Fusion.

Background: Deep surgical site infections (dSSI) following spinal laminectomy and fusion are serious complications associated with poor patient outcomes. The objective of this study is to investigate the monthly and seasonal variability of dSSI rates following common spinal surgeries to investigate the "July effect," which refers to the alleged increase in adverse health outcomes due to new hospital trainees at the beginning of the academic year.

Methods: We performed a retrospective analysis of patients who had a dSSI following laminectomy (without fusion) or spinal fusion (with or without laminectomy) at a single large urban academic medical center between January 2009 and August 2018.

Evaluation of Health-related Quality of Life Improvement in Patients Undergoing Cervical Versus Shoulder Surgery.

Study Design: Retrospective analysis of outcomes in cervical spine and shoulder arthroscopy patients.

Objective: The objective of this study is to assess differential improvements in health-related quality of life for cervical spine surgery compared with shoulder surgery.

Summary Of Background Data: An understanding of outcome differences between different types of orthopedic surgeries is helpful in counseling patients about expected postoperative recovery.

Comparative Analysis of Inpatient Opioid Consumption Between Different Surgical Approaches Following Single Level Lumbar Spinal Fusion Surgery.

Study Design: Single-center retrospective cohort study.

Objectives: To evaluate inpatient MME administration associated with different lumbar spinal fusion surgeries.

Methods: Patients ≥18 years of age with a diagnosis of Grade I or II spondylolisthesis, stenosis, degenerative disc disease or pars defect who underwent one-level Transforaminal Lumbar Interbody Fusion (TLIF) or one-level Anterior Lumbar Interbody Fusion (ALIF) or Lateral Lumbar Interbody Fusion (LLIF) through traditional MIS, anterior-posterior position or single position approaches between L2-S1.

Incidence of dysphagia following posterior cervical spine surgery.

Abundant literature exists describing the incidence of dysphagia following anterior cervical surgery; however, there is a paucity of literature detailing the incidence of dysphagia following posterior cervical procedures. Further characterization of this complication is important for guiding clinical prevention and management. Patients ≥ 18 years of age underwent posterior cervical fusion with laminectomy or laminoplasty between C1-T1.

Characterizing the Effect of Perioperative Narcotic Consumption and Narcotic Prescription Dosing at Discharge on Satisfaction With Pain Control for Patients Undergoing Single-level Anterior Cervical Discectomy and Fusion.

Study Design: A single-center, retrospective review of prospectively collected data on patients who underwent single-level anterior cervical discectomy and fusions (ACDFs) between October 2014 and October 2019.

Objective: To investigate the effect of perioperative narcotic consumption and amount of narcotic prescribed at discharge on patient satisfaction with pain control after single-level ACDF.

Summary Of Background Data: Prior research has demonstrated that opioid prescription habits may be related to physician desire to produce superior patient satisfaction with pain control.

Comparison of Plastic Surgeon and Spine Surgeon Closure in Revision Short Segment Thoracolumbar Spinal Fusions.

Study Design: Retrospective cohort analysis.

Objective: To compare outcomes of plastic versus spine surgeon wound closure in revision 1 to 4 level thoracolumbar fusions.

Summary Of Background Data: Plastic surgeons perform layered musculocutaneous flap closures in high-risk spine patients such as revision posterior spinal fusion and complex deformity correction surgeries.

COVID-19 pandemic and elective spinal surgery cancelations - what happens to the patients?

Background Context: The COVID-19 pandemic caused nationwide suspensions of elective surgeries due to reallocation of resources to the care of COVID-19 patients. Following resumption of elective cases, a significant proportion of patients continued to delay surgery, with many yet to reschedule, potentially prolonging their pain and impairment of function and causing detrimental long-term effects.

Purpose: The aim of this study was to examine differences between patients who have and have not rescheduled their spine surgery procedures originally cancelled due to the COVID-19 pandemic, and to evaluate the reasons for continued deferment of spine surgeries even after the lifting of the mandated suspension of elective surgeries.

Reducing Postoperative Opioid-prescribing Following Posterior Lumbar Fusion Does Not Significantly Change Patient Satisfaction.

Study Design: Retrospective comparative; LOE-3.

Objective: The purpose of this study was to investigate what effect, if any, an institutional opioid reduction prescribing policy following one- or two-level lumbar fusion has on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results.

Summary Of Background Data: Previous research has demonstrated that high levels of opioid-prescribing may be related, in part, to a desire to produce superior patient satisfaction.

Clinical photographs in the assessment of adult spinal deformity: a comparison to radiographic parameters.

Objective: The goal of this study was to reliably predict sagittal and coronal spinal alignment with clinical photographs by using markers placed at easily localized anatomical landmarks.

Methods: A consecutive series of patients with adult spinal deformity were enrolled from a single center. Full-length standing radiographs were obtained at the baseline visit.

Trends in Pain Medication Prescriptions and Satisfaction Scores in Spine Surgery Patients at a Single Institution.

Background: As the opioid crisis has gained national attention, there have been increasing efforts to decrease opioid usage. Simultaneously, patient satisfaction has been a crucial metric in the American health care system and has been closely linked to effective pain management in surgical patients. The purpose of this study was to examine rates of pain medication prescription and concurrent patient satisfaction in spine surgery patients.

Biologics and Minimally Invasive Approach to TLIFs: What Is the Risk of Radiculitis?

Background: Bone morphogenetic protein (BMP) and allograft containing mesenchymal stem cells (live cell) are popular biologic substitutes for iliac crest autograft used in transforaminal lumbar interbody fusion (TLIF). Use of these agents in the pathogenesis of postoperative radiculitis remains controversial. Recent studies have independently linked minimally invasive (MIS) TLIF with increased radiculitis risk compared to open TLIF.

Age and Gender Confound PROMIS Scores in Spine Patients With Back and Neck Pain.

Study Design: This was a single-center retrospective review.

Objectives: To explore how age and gender affect PROMIS scores compared with traditional health-related quality of life (HRQL) in spine patients.

Methods: Patients presenting with a primary complaint of back pain (BP) or neck pain (NP) were included.

Complication Risk in Primary and Revision Minimally Invasive Lumbar Interbody Fusion: A Comparable Alternative to Conventional Open Techniques?

Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution.

Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures.

Methods: Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open.