Patient-specific implants and spinal alignment outcomes.

Background: Patient specific (PS) technology has become popular in the field of spine surgery, as it gives surgeons control over the manufacturing of implants based on a patient's anatomy. Patient specific surgical guides, preoperative planning software, and patient specific implants - such as rods and cages, have demonstrated promising results in the literature for helping surgeons achieve spinal alignment goals.

Methods: A review of the literature regarding PS technology in spine surgery for the correction of spinal deformity was performed and is compiled here.

Intraoperative fat embolism syndrome associated with implantation of titanium sacroiliac joint fusion implants: a report of two cases.

Background: For patients undergoing long-construct fusion surgeries, simultaneous sacroiliac joint (SIJ) fusion is a growing trend in spine surgery. Some options for posterior SIJ fusion include 3D-printed triangular titanium implants or self-harvesting SIJ screws. Both implants require fixation within the sacrum and ileum.

Atypical Mycobacterial Infections of the Spine: Evaluation and Management.

Background: Atypical mycobacterial infections of the spine can be difficult to treat and represent a subset of the vertebral osteomyelitis and diskitis spectrum often requiring early and aggressive surgical intervention. The purpose of this review is to improve the understanding of and approach to disease management from the perspective of the spine surgeon.

Materials And Methods: Debridement or excision of the affected levels may be necessary to decrease mycobacterial loads and restore biomechanics.

Genetics of Intervertebral Disc Degeneration.

Purpose Of Review: Intervertebral disc degeneration is a contributor to chronic back pain. While a part of the natural aging process, early or rapid intervertebral disc degeneration is highly heritable. In this review, we summarize recent progress towards unraveling the genetics associated with this degenerative process.

Multidisciplinary Treatment of Persistent Nontuberculous Mycobacterial Spinal Hardware Infection with a Pedicled Superior Gluteal Artery Perforator Flap.

Nontuberculous mycobacterial hardware infections are extremely challenging to treat. Multidisciplinary care involving removal of infected hardware, thorough debridement, and durable soft tissue coverage in conjunction with antibiotic therapy is essential for successful management. This case report presents a patient with chronic mycobacterial spinal hardware infection that underwent successful treatment with aggressive serial debridements and reconstruction with a large pedicled superior gluteal artery perforator flap coverage.

Catastrophic acute failure of pelvic fixation in adult spinal deformity requiring revision surgery: a multicenter review of incidence, failure mechanisms, and risk factors.

Objective: There are few prior reports of acute pelvic instrumentation failure in spinal deformity surgery. The objective of this study was to determine if a previously identified mechanism and rate of pelvic fixation failure were present across multiple institutions, and to determine risk factors for these types of failures.

Methods: Thirteen academic medical centers performed a retrospective review of 18 months of consecutive adult spinal fusions extending 3 or more levels, which included new pelvic screws at the time of surgery.

Alternative Uses of O-Arm and Stealth Navigation Technology Over 10 Years: The University of Colorado Experience.

Intraoperative computed tomography scanning with O-arm and use of Stealth navigation can improve surgical outcomes in a variety of orthopedic subspecialties. In spine surgery, the accuracy, precision, and safety of pedicle screw and interbody implant placement has improved. This technology is now routinely used in percutaneous pedicle screw placement and minimally invasive sacroiliac joint fusion.

Blockade of Osteoclast-Mediated Bone Resorption With a RANKL-Inhibitor Enhances Bone Formation in a Rat Spinal Fusion Model.

Study Design: Rat spine fusion model.

Objective: The present study aimed to determine whether administration of osteoprotegerin (OPG) in a rat model of spinal fusion increases bone volume, bone density, and decreases osteoclasts in the fusion mass.

Summary Of Background Data: OPG is a soluble RANK-ligand inhibitor that blocks osteoclast differentiation and activation.

Pre-Operative Planning in Complex Deformities and Use of Patient-Specific UNiD Instrumentation.

Study Design: Review of current literature and authors experience.

Objective: Pre-operative planning is an integral part of complex spine surgery. With the advent of computer-assisted planning, multiple surgical plans can be evaluated utilizing alignment parameters, and the best plan for individual patients selected.

Navigation Options for Spinal Surgeons: State of the Art 2021.

The use of navigation in spinal surgery has been increasing over the past decade. There are three primary types of navigation in spinal surgery: three-dimensional image-based computer-assisted navigation, robot-assisted navigation, and three-dimensional printed patient-specific drill guides for navigation. All three have demonstrated increased accuracy in placement of spinal instrumentation versus freehand or fluoroscopic-assisted techniques.

Estrogen receptor Alpha in human knee articular cartilage of healthy and osteoarthritic females.

Objective: Estrogen and osteoarthritis association has previously been proposed. This study evaluates the presence of estrogen receptors (ER)-α in articular cartilage, and its association.

Methods: A prospective cohort study of women undergoing anterior cruciate ligament reconstruction (controls) or total knee arthroplasty (cases) was performed.

Expectoration of anterior cervical discectomy and fusion cage: a case report.

Anterior cervical implant failure can lead to catastrophic sequalae and requires prompt evaluation and management to reduce significant morbidity. This case report describes a 51-year-old female who underwent a C2-3 and C3-4 anterior cervical discectomy and fusion (ACDF) with stand-alone, integrated plate-cage interbody devices for cervical spondylotic myelopathy (CSM). Initial procedure was performed at an outside institution.

Postoperative pelvic incidence (PI) change may impact sagittal spinopelvic alignment (SSA) after instrumented surgical correction of adult spine deformity (ASD).

Objectives: To study factors causing postoperative change of PI after surgical correction of ASD and to assess the effect of this variability on postoperative PI-LL mismatch.

Background: PI is used as an individual constant to define lumbar lordosis (LL) correction goal (PI-LL < 10). Postoperative changes of PI were shown but with opposite vectors.

Radius of Curvature in Patient-Specific Short Rod Constructs Versus Standard Pre-Bent Rods.

Background: Recent studies support the need for sagittal alignment restoration when performing lumbar degenerative spinal fusions. The development of patient-specific spine rods (PSSRs) may help maintain or improve sagittal alignment in these surgeries.

Methods: A retrospective review was conducted for patients who underwent posterior spinal surgeries involving 4 or less levels.

Toxicology Screening Testing in Patients Undergoing Spine Surgery: A Prospective Observational Pilot Study.

Background: Chronic opioid use and polypharmacy are commonly seen in chronic pain patients presenting for spine procedures. Substance abuse and misuse have also been reported in this patient population. Negative perioperative effects have been found in patients exposed to chronic opioid, alcohol, and recreational substances.

Vertebral Osteomyelitis.

Unlabelled: A report of an instance of vertebral osteomyelitis secondary to an uncommon pathogen, .

Summary: is a rapidly growing nontuberculous osteomyelitis which is typically nonpathogenic with only four reported cases of human infection. Diagnosing infections related to nontuberculous mycobacteria (NTM) is difficult and can often be delayed as conventional microbiologic tests are inadequate.

Strap stabilization for proximal junctional kyphosis prevention in instrumented posterior spinal fusion.

Study Design: This is a retrospective, single-institution, cohort study.

Objectives: To evaluate the association of Mersilene tape use and risk of proximal junctional kyphosis (PJK), after surgical correction of adult spinal deformity (ASD) by posterior instrumented fusion (PIF). PJK, following long spinal PIF, is a complication which often requires reoperation.

Transpedicular-Transdiscal Cement Augmentation Treatment of Thoracolumbar Fusion Proximal Junctional Failure.

Background: Long instrumented fusions for adult deformity have a proximal junction kyphosis rate between 20% and 40%. When symptomatic, proximal junctional failure (PJF) often requires revision surgery and is associated with significant morbidity. Vertebral cement augmentation (VCA) has been used for prophylaxis against PJF but has not been previously described as treatment after onset of PJF has occurred.

Long-Term Treatment Effect and Predictability of Spinopelvic Alignment After Surgical Correction of Adult Spine Deformity With Patient-Specific Spine Rods.

Study Design: Retrospective case series.

Objective: To evaluate the short- and long-term treatment effect (TE) of spinopelvic parameters after surgical correction of adult spine deformity (ASD) utilizing preoperative planning and patient-specific spine rods (PSSRs), and to assess the correspondence between planned and real outcomes.

Summary Of Background Data: PSSR have been used in ASD correction for the last decade.

Mini-open sacroiliac joint fusion with direct bone grafting and minimally invasive fixation using intraoperative navigation.

Background: Describe a novel technique for sacroiliac arthrodesis using intraoperative navigation, direct bone grafting, and minimally invasive implants. Report on the outcomes of the first cohort of these patients.

Methods: Institutional review board (IRB) approved, single center, two surgeon, retrospective study.

Patient-specific Rods for Surgical Correction of Sagittal Imbalance in Adults: Technical Aspects and Preliminary Results.

Study Design: This was an innovative concept and a preliminary prospective series.

Objective: The aim of this study was to present the concept and the technical aspects of patient-specific rods (PSR), and compare preoperative and postoperative sagittal parameters (after PSR implantation), with a special focus on the difference pelvic incidence (PI)-lumbar lordosis (LL).

Background: Despite established techniques for planning and proven correlations between quality of life and sagittal alignment, some patients do not achieve optimal radiologic outcomes after surgery and are still hypolordotic and imbalanced.

Surgical Intervention for Cauda Equina Syndrome in the Second and Third Trimesters of Pregnancy: A Report of Three Cases.

Case: Low back pain affects >50% of pregnant women. However, cauda equina syndrome (CES) during pregnancy is rare. Because a delay in treatment increases the risk of irreversible neurologic damage, acute onset is regarded as a surgical emergency.