Should the pelvis be included? An analysis of distal junctional failure risk factors in correcting adult spinal deformity in women with fusion to L5.

Purpose: To identify the risk factors for distal junctional failure (DJF) in women treated for adult spine deformity with fusion to L5 and to highlight the significance of preoperative assessment, surgical decision-making, and postoperative care.

Methods: This is a retrospective study of data collected prospectively on the local institutional spine surgery registry (2016-2021). All patients, women older than 18 years, with a diagnosis of adult spine deformity who underwent long posterior instrumentation to L5 and had a minimum of 2-years follow-up were included in the study (two groups: with or without DJF).

The Positive Side Effect of Anterior Cervical Decompression and Fusion on Axial Neck Pain.

Study Design: Observational Cohort Study.

Objectives: This study aims to comprehensively assess the outcomes of anterior cervical spine surgery in patients who have undergone surgical intervention for radiculopathy or myelopathy, with a specific focus on the surgery's impact on axial neck pain.

Methods: Data from an institutional spine surgery registry were analyzed for patients who underwent anterior cervical spine surgery between January 2016 and March 2022.

Diagnostic Approach and Differences between Spinal Infections and Tumors.

Study Design: A systematic review of the literature about differential diagnosis between spine infection and bone tumors of the spine.

Background And Purpose: The differential diagnosis between spine infection and bone tumors of the spine can be misled by the prevalence of one of the conditions over the other in different areas of the world. A review of the existing literature on suggestive or even pathognomonic imaging aspects of both can be very useful for correctly orientating the diagnosis and deciding the most appropriate area for biopsy.

The Diagnostic Process of Spinal Post-traumatic Deformity: An Expert Survey of 7 Cases, Consensus on Clinical Relevance Does Exist.

Study Design: Survey of cases.

Objective: To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD).

Summary Of Background Data: SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment.

Quality Control for Spine Registries: Development and Application of a New Protocol.

Registries are gaining importance both in clinical practice and for research purposes. However, quality control is paramount to ensure that data are consistent and reliable. Quality control protocols have been proposed for arthroplasty registries, but these are not directly applicable to the spine setting.

The burden of preoperative fear-avoidance beliefs in workers after thoracic and lumbar spine surgery: a 2-year follow-up study.

Spinal disorders are the main reasons for sick leave and early retirement among the working population in industrialized countries. When "red flags" are present, spine surgery is the treatment of choice. However, the role of psychosocial factors such as fear-avoidance beliefs in spine surgery outcomes is still debated.

Long spine fusions to the sacrum-pelvis are associated with greater post-operative proximal junctional kyphosis angle in sitting position.

Study Design: A single-centre retrospective study.

Background And Purpose: Although adult patients spend most of their time in sitting positions, the assessment of spinopelvic parameters in adult deformity surgery is commonly performed in standing X-rays. Our study compares the standing and sitting sagittal alignment parameters in subjects who underwent thoracolumbar fusion.

Need of vascular surgeon and comparison of value for anterior lumbar interbody fusion (ALIF) in lateral decubitus: Delphi consensus.

Background And Purpose: Anterior lumbar approaches are recommended for clinical conditions that require interbody stability, spinal deformity corrections or a large fusion area. Anterior lumbar interbody fusion in lateral decubitus position (LatALIF) has gained progressive interest in the last years. The study aims to describe the current habit, the perception of safety and the perceptions of need of vascular surgeons according to experienced spine surgeons by comparing LatALIF to the standard L5-S1 supine ALIF (SupALIF).

Post-operative L5 radiculopathy after L5-S1 hyperlordotic anterior lumbar interbody fusion (HL-ALIF) is related to a greater increase of lordosis and smaller post-operative posterior disc height: results from a cohort study.

Study Design: A single-centre retrospective study.

Background And Purpose: This study aims to investigate the rate of L5 radiculopathy, to identify imaging features associated with the complication and to evaluate the clinical outcomes in adult spine deformity patients undergoing L5-S1 ALIF with hyperlordotic cages.

Methods: Design: retrospective cohort study.

Setting for single position surgery: survey from expert spinal surgeons.

Purpose: To describe a comprehensive setting of the different alternatives for performing a single position fusion surgery based on the opinion of leading surgeons in the field.

Methods: Between April and May of 2021, a specifically designed two round survey was distributed by mail to a group of leaders in the field of Single Position Surgery (SPS). The questionnaire included a variety of domains which were focused on highlighting tips and recommendations regarding improving the efficiency of the performance of SPS.

The sitting vs standing spine.

Background: Planning of surgical procedures for spinal fusion is performed on standing radiographs, neglecting the fact that patients are mostly in the sitting position during daily life. The awareness about the differences in the standing and sitting configuration of the spine has increased during the last years. The purpose was to provide an overview of studies related to seated imaging for spinal fusion surgery, identify knowledge gaps and evaluate future research questions.

Perioperative Predictive Factors for Positive Outcomes in Spine Fusion for Adult Deformity Correction.

Purpose: Identifying perioperative factors that may influence the outcomes of long spine fusion for the treatment of adult deformity is key for tailored surgical planning and targeted informed consent. The aim of this study was to analyze the association between demographic or perioperative factors and clinical outcomes 2 years after long spine fusion for the treatment of adult deformity.

Methods: This study is a multivariate analysis of retrospectively collected data.

The Influence of Baseline Clinical Status and Surgical Strategy on Early Good to Excellent Result in Spinal Lumbar Arthrodesis: A Machine Learning Approach.

The study aims to create a preoperative model from baseline demographic and health-related quality of life scores (HRQOL) to predict a good to excellent early clinical outcome using a machine learning (ML) approach. A single spine surgery center retrospective review of prospectively collected data from January 2016 to December 2020 from the institutional registry (SpineREG) was performed. The inclusion criteria were age ≥ 18 years, both sexes, lumbar arthrodesis procedure, a complete follow up assessment (Oswestry Disability Index-ODI, SF-36 and COMI back) and the capability to read and understand the Italian language.

Peri-Surgical Inflammatory Profile Associated with Mini-Invasive or Standard Open Lumbar Interbody Fusion Approaches.

Background: Different surgical approaches are available for lumbar interbody fusion (LIF) to treat disc degeneration. However, a quantification of their invasiveness is lacking, and the definition of minimally invasive surgery (MIS) has not been biochemically detailed. We aimed at characterizing the inflammatory, hematological, and clinical peri-surgical responses to different LIF techniques.

The aging spine: the effect of vertebral fragility fracture on sagittal alignment.

Unlabelled: Our study investigates the relationship, in the aging population, between vertebral fractures, spinal alignment, and quality of life. Kyphotic fractures were related to more significant disability and impaired spinopelvic alignment. The spinal malalignment was strongly associated with fractures in the thoracolumbar junction vertebrae and the absence of powerful compensatory mechanisms as thoracic hypokyphosis and lower lumbar hyperlordosis.

Correlation between age, coronal and sagittal parameters and spine flexibility in patients with adolescent idiopathic scoliosis.

Purpose: To investigate the correlation between spine flexibility and age, skeletal maturity, coronal and sagittal parameters for adolescent idiopathic scoliosis (AIS).

Methods: All AIS patients evaluated for surgery were included. Following parameters were obtained: age, gender, skeletal maturity (Risser and Sanders), Cobb angle at high thoracic (HT), mean thoracic (MT) and thoracolumbar/lumbar (TL/L) level, flexibility of HT, MT and TL/L curves, coronal and sagittal parameters.

Anterior Lumbar Interbody Fusion (ALIF) L5-S1 with overpowering of posterior lumbosacral instrumentation and fusion mass: a reliable solution in revision spine surgery.

Background And Purpose: In cases of spine surgical revisions of patients affected by sagittal malalignment, the restoration of the ideal lumbar lordosis (LL) is mandatory. ALIF procedures represent a powerful and effective approach to improve the LL in case of hypolordosis. This study evaluates the feasibility of ALIF to overpower posterior lumbar instrumentation and fusion mass in revision spine surgery and secondarily to estimate complications, clinical and radiological outcomes.

The use of electronic PROMs provides same outcomes as paper version in a spine surgery registry. Results from a prospective cohort study.

Background And Purpose: Patient-Reported Measured Outcomes (PROMs) are essential to gain a full understanding of a patient's condition, and in spine surgery, these questionnaires are of help when tailoring a surgical strategy. Electronic registries allow for a systematic collection and storage of PROMs, making them readily available for clinical and research purposes. This study aimed to investigate the reliability between the electronic and paper form of ODI (Oswestry Disability Index), SF-36 (Short Form Health Survey 36) and COMI-back (Core Outcome Measures Index for the back) questionnaires.

A Novel Technique for Spondylolysis Repair With Pedicle Screws, Rod and Polyester Band: Case Report With Technical Note and Systematic Literature Review.

Study Design: Systematic review and case report.

Objective: Our study aims to present a new technique using three components to repair the pars defect: pedicle screws, rod and polyester band. Furthermore, we perform a systematic literature review of the previously described techniques.

Assessment and prediction of spine surgery invasiveness with machine learning techniques.

Background: The interest in Minimally Invasive Surgery (MIS) techniques has greatly increased in the recent years due to their significant advantages, both in terms of outcome improvement and cost reduction. Also in spine surgery, MIS is now applicable to several conditions and, above all, in low back pain (LBP) treatment. However, reliable and objective measures of invasiveness, necessary to compare different procedures, are still lacking.