Airway Management for Emergency Spinal Epidural Hematoma Evacuation With Awake Spine Surgery: Case Report and Literature Review.

Background: Postoperative spinal epidural hematomas (pSEHs) are a rare complication of microdiscectomy surgery. The hematoma may be unnoticed intraoperatively, but timely treatment may prevent permanent neurologic impairment. Airway management in patients with a full stomach is generally performed with rapid sequence intubation and general anesthesia.

Predictors of Survival After Emergent Surgical Decompression for Acutely Presenting Spinal Metastasis.

Background: Metastatic spinal tumors represent 90% of spinal masses and present variably with slow progression and/or rapid symptomatic worsening. Several prognostic scoring systems have been proposed. However, patients presenting acutely and requiring emergent surgery represent a unique subset of patients with different prognostic indicators.

The Adjustable Cranial Plate: A Novel Implant Designed to Eliminate the Need for Cranioplasty Surgery Following a Hemicraniectomy Operation.

Background: Decompressive hemicraniectomy (DHC) is performed to relieve life-threatening intracranial pressure elevations. After swelling abates, a cranioplasty is performed for mechanical integrity and cosmesis. Cranioplasty is costly with high complication rates.

Postoperative Use of the Muscle Relaxants Baclofen and/or Cyclobenzaprine Associated With an Increased Risk of Delirium Following Lumbar Fusion.

Study Design: Retrospective, single-center, cohort study.

Objective: Investigate whether the incidence of postoperative delirium in older adults undergoing spinal fusion surgery is associated with postoperative muscle relaxant administration.

Summary Of Background Data: Baclofen and cyclobenzaprine are muscle relaxants frequently used for pain management following spine surgery.

Surgeon-Specific Treatment Selection Bias and Heterogeneous Perioperative Practices in an Observational Spine Surgery Study. A Statistical Tutorial with Implications for Analysis of Observational Studies of Perioperative Interventions.

Background: It is essential that treatment effects reported from retrospective observational studies are as reliable as possible. In a retrospective analysis of spine surgery patients, we obtained a spurious result: tranexamic acid (TXA) had no effect on intraoperative blood loss. This statistical tutorial explains how this result occurred and why statistical analyses of observational studies must consider the effects of individual surgeons.

Biomechanical assessment of the effect of sublaminar band tensioning on lumbar motion.

Objective: Adjacent-segment disease (ASD) proximal to lumbosacral fusion is assumed to result from increased stress and motion that extends above or below the fusion construct. Sublaminar bands (SBs) have been shown to potentially mitigate stresses in deformity constructs. A similar application of SBs in lumbar fusions is not well described yet may potentially mitigate against ASD.

Risk factors for delirium in elderly patients after lumbar spinal fusion.

Objective: To identify perioperative risk factors for postoperative delirium (POD) in patients aged 65 or older undergoing lumbar spinal fusion procedures.

Patients And Methods: A retrospective cohort analysis was performed on patients undergoing lumbar spinal fusion over an approximately three-year period at a single institution. Demographic and perioperative data were obtained from electronic medical records.

Spinal Meningioma in Adults: Imaging Characteristics, Surgical Outcomes, and Risk Factors for Recurrence.

Objective: Although spinal meningiomas (SMs) are associated with overall long tumor-free survival, SMs can recur. This study analyzed factors associated with complications, misdiagnosis, and recurrence of SMs.

Methods: We reviewed patient demographics; radiographic characteristics of patients with SMs, including level, location within the canal, and size; surgical resection; pathology; and recurrence.

Use of a Smartphone Leveling Application to Optimize Cervical Thoracic Alignment Before Posterior Instrumentation.

Objective: Posterior cervical decompression and instrumentation (PCDI) often is associated with increase in sagittal balance and loss of lordosis. Here, we propose a simple method of surgical positioning using a readily available smartphone application to optimize cervical thoracic alignment in PCDI. The intent of this optimization is to minimize losses in lordosis and increases in sagittal balance.

Cervical alignment in the obese population following posterior cervical fusion for cervical myelopathy.

Study Design: Retrospective cohort study OBJECTIVE: The aim of this study was to investigate the effect of body mass index (BMI) on the reoperation rate and cervical sagittal alignment of patients who underwent posterior cervical decompression and fusion for cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Cervical sagittal balance has been correlated with postoperative clinical outcomes. Previous studies have shown worse postoperative sagittal alignment and higher reoperation rates in patients with high BMI undergoing anterior decompression and fusion.

What is the most accurate substitute for an invisible T1 slope in cervical radiographs? A comparative study of a novel method with previously reported substitutes.

Objective: The ability to utilize the T1 slope is often limited by poor visibility on cervical radiographs. The C7 slope has been proposed as a reliable substitute but may have similar limitations of visibility. Herein, the authors propose a novel method that takes advantage of the superior visibility on CT to accurately substitute for the radiographic T1 slope and compare the accuracy of this method with previously reported substitutes.

Bone flap management strategies for postcraniotomy surgical site infection.

Background: Surgical site infection (SSI) after a craniotomy is traditionally treated with wound debridement and disposal of the bone flap, followed by intravenous antibiotics. The goal of this study is to evaluate the safety of replacing the bone flap or performing immediate titanium cranioplasty.

Methods: All craniotomies at single center between 2008 and 2020 were examined to identify 35 patients with postoperative SSI.

Outcomes and complications of surgical treatment of anterior osteophytes causing dysphagia: Single center experience.

Study Design: Retrospective case series.

Objective: To better understand the functional swallow outcomes, cervical balance, and surgical complications, we examined patients with anterior osteophytes and dysphagia who were treated operatively.

Summary Of Background Data: Anterior osteophytes from diffuse idiopathic skeletal hyperostosis (DISH) or degenerative etiology of the cervical spine can cause dysphagia from mechanical compression of the esophagus.

Relationship between odontoid fracture angle and cervical sagittal balance.

Background: Fractures can occur in various locations within the odontoid process with differing orientations. However, little is known about what factors contribute to the anterior versus posterior angles/orientation of these fractures.

Methods: We evaluated 74 patients with odontoid fractures (2013-2018) from a single-institution.