Influence of Body Mass Index on Surgical and Patient Outcomes for Cervical Spine Surgery.

Study Design: Secondary analysis of prospectively collected registry.

Objective: We aim to investigate the effects of body mass index (BMI) on postsurgical cervical spine surgery outcomes and identify a potential substratification of obesity with worse outcomes.

Summary Of Background Data: The impact of BMI on cervical spine surgery is unknown, with controversial outcomes for patients high and low BMI.

Understanding Geospatial Trends in Lumbar Fusion Incidence and Technique in Medicare Populations.

Study Design: Retrospective study with epidemiologic analysis of public Medicare data.

Objective: This study seeks to utilize geospatial analysis to identify distinct trends in lumbar fusion incidence and techniques in Medicare populations.

Summary Of Background Data: With an aging population and new technologies, lumbar fusion is an increasingly common procedure.

Noniatrogenic spinal cord ischemia: A patient level meta-analysis of 125 case reports and series.

Background: Guidelines are needed to manage spinal cord infarctions. Here, we evaluated the incidence of noniatrogenic spinal ischemia, focusing on the spinal levels involved, and the relative efficacy of different management strategies.

Methods: We performed a meta-analysis of 147 patients who sustained noniatrogenic spinal cord ischemia within the past 10 years.

Short-Segment Pedicle Fixation of Traumatic Low Lumbar Fractures (L3-L5): Report of 36 Cases.

Study Design: Prospective review.

Objective: The aim was to assess the efficacy and safety of short-segment pedicle fixation of low lumbar fractures (L3-L5).

Background: Low lumbar fractures are relatively uncommon, and limited data exists regarding the management of these injuries.

Iatrogenic spinal cord ischemia: A patient level meta-analysis of 74 case reports and series.

Background: We seek to characterize the features of iatrogenic spinal ischemia, determine which spinal levels are affected, and evaluate the efficacy of management strategies.

Methods: We performed a meta-analysis of case reports and series of spinal ischemia in the past 10 years. 343 full-length case reports and case series were screened against predefined inclusion/exclusion criteria.

Evaluating robotic pedicle screw placement against conventional modalities: a systematic review and network meta-analysis.

Objective: Several approaches have been studied for internal fixation of the spine using pedicle screws (PSs), including CT navigation, 2D and 3D fluoroscopy, freehand, and robotic assistance. Robot-assisted PS placement has been controversial because training requirements, cost, and previously unclear benefits. This meta-analysis compares screw placement accuracy, operative time, intraoperative blood loss, and overall complications of PS insertion using traditional freehand, navigated, and robot-assisted methods.

The evolving neurosurgical perspective on Enhanced Recovery After Surgery (ERAS): a systematic review.

Introduction: Enhanced recovery after surgery (ERAS) programs may be implemented to minimize the body's stress response to surgery and enable a safe and timely discharge. Successful implementation involves a multifaceted approach from surgeons, anesthesiologists, nurses, nutritionists, and nonclinical staff.

Evidence Acquisition: National databases (MEDLINE (PubMed), Cochrane Central, and Google Scholar databases) were searched to identify studies on the clinical implementation of ERAS protocols in neurosurgery.

BIIB093 (intravenous glibenclamide) for the prevention of severe cerebral edema.

Background: Vasogenic edema in the setting of acute ischemic stroke can be attributed to the opening of transient receptor potential 4 channels, which are expressed in the setting of injury and regulated by sulfonylurea receptor 1 (SUR1) proteins. Glibenclamide, also known as glyburide, RP-1127, Cirara, and BIIB093, is a second-generation sulfonylurea that binds SUR1 at potassium channels and may significantly reduce cerebral edema following stroke, as evidenced by recent clinical trials. This review provides a comprehensive analysis of clinical considerations of glibenclamide use and current patient outcomes when administered in the setting of acute ischemic stroke to reduce severe edema.

Weight-Bearing Magnetic Resonance Imaging as a Diagnostic Tool That Generates Biomechanical Changes in Spine Anatomy.

Weight-bearing magnetic resonance imaging (MRI) is a unique modality in diagnostic imaging that allows for the assessment of spinal pathology in ways considered previously inaccessible or insufficient with the conventional MRI technique. Due to limitations in positioning within the MRI machine itself, difficulties would be posed in determining the underlying cause of a patient's pain or neurological symptoms, as the traditional supine position utilized can, in many cases, alleviate the severity of presented symptoms. Weight-bearing MRI addresses this concern by allowing a clinician to position a patient (to a certain degree) into flexion, extension, rotation, or side-bending with an axial load that can mimic physiologic conditions in order to replicate the conditions the patient experiences in order to give clinicians a clearer understanding of the anatomical relationship of the spine and surrounding tissues that may lead to a particular presentation of symptoms.

Enhanced Spinal Therapy: Extracorporeal Shock Wave Therapy for the Spine.

Extracorporeal shock wave therapy (ESWT) is a non-invasive therapeutic method used for pain management and muscle strength improvement through the use of shock waves. In vitro studies have demonstrated that shockwave therapy induces fluctuation in redox reaction regulation and increases in Mitogen-Activated Protein Kinase (MAPK) signal transduction pathways, stimulating increased gene expression in the nucleus. ESWT has also been shown to upregulate angiogenesis and growth factors through activation of endothelial nitric oxide synthase (eNOS) and vascular endothelial growth factor (VEGF).