Complications and Cost in Open Versus Endoscopic Lumbar Decompression: A Database Study.

Study Design: A retrospective database study.

Objective: To compare complications and costs associated with endoscopic and open lumbar decompression on a large scale.

Background: Though open lumbar decompression is considered the gold standard, endoscopic procedures are on the rise.

Geographical and Specialty-specific Variation in the Utilization of Laminoplasty for Cervical Myelopathy.

Study Design: Level IV retrospective cohort study.

Objectives: Despite the positive outcomes associated with laminoplasty, there is significant surgeon variability in the use of laminoplasty for cervical myelopathy in the United States. In this study, we explored how geographic and specialty-specific differences may influence the utilization of laminoplasty to treat cervical myelopathy.

Does Anterior Cervical Spine Surgery Increase the Likelihood of Developing Obstructive Sleep Apnea? A Pearldiver Study.

Objectives: Literature is sparse on the development of obstructive sleep apnea (OSA) after anterior cervical spine surgery and includes few case reports. Our objective is to evaluate the role of anterior cervical spine surgery as a risk factor for developing OSA.

Methods: A retrospective cohort study was performed utilizing the M157 subset of the PearlDiver national database.

Mindfulness Applications: Can They Serve as a Stress, Anxiety, and Burnout Reduction Tool in Orthopaedic Surgery Training? A Randomized Control Trial.

Unlabelled: Stress and burnout are prevalent within the orthopaedic surgery community. Mindfulness techniques have been shown to improve wellness, yet traditional courses are generally time-intensive with low surgeon utilization. We sought to determine whether the introduction of a simple mindfulness-based phone application would help decrease stress, anxiety, and burnout in orthopaedic surgery residents.

Should patients with lumbar stenosis and grade I spondylolisthesis be treated differently based on spinopelvic alignment? A retrospective, two-year, propensity matched, comparison of patient-reported outcome measures and clinical outcomes from multiple sites within a single health system.

Background: Degenerative lumbar spondylolisthesis is one of the most common pathologies addressed by surgeons. Recently, data demonstrated improved outcomes with fusion in conjunction with laminectomy compared to laminectomy alone. However, given not all degenerative spondylolistheses are clinically comparable, the best treatment option may depend on multiple parameters.

Racial Differences in Patients Undergoing Anterior Cervical Discectomy and Fusion: A Multi-Site Study.

Study Design: This was a retrospective chart review.

Objective: The objective of this study was to examine disparities within patients undergoing anterior cervical discectomy and fusion (ACDF) at a multi-site tertiary referral center with specific focus on factors related to length of stay (LOS).

Summary Of Background Data: There are previously described racial disparities in spinal surgery outcomes and quality metrics.

Predicting Reciprocal Thoracic Change, Proximal Junctional Kyphosis, and Revision Surgery in Adult Spinal Deformity.

Background: Compensatory mechanisms in patients with adult spinal deformity (ASD) that lead to poor quality of life include positive sagittal balance and pelvic retroversion. The objective of this retrospective review was to identify demographic and radiographic parameters of sagittal alignment that are correlated with thoracic kyphosis (TK), PJK, and reoperation in patients undergoing surgical correction for ASD.

Methods: A single-center database of 155 patients with ASD undergoing surgery from 2008 to 2015 was reviewed.

The Outcomes of Patients With Neck Pain Following ACDF: A Comparison of Patients With Radiculopathy, Myelopathy, or Mixed Symptomatology.

Study Design: Retrospective cohort study.

Objective: The goal of the present study was to determine whether neck pain responds differently to anterior cervical discectomy and fusion (ACDF) between patients with cervical radiculopathy and/or cervical myelopathy.

Summary Of Background Data: Many patients who undergo ACDF because of radiculopathy/myelopathy also complain of neck pain.

Preoperative Risk Stratification: Who Needs Medical Consultation?

Study Design: Spine update.

Objective: The purpose of this study is to provide a review of preoperative clearance and optimization, before elective spine surgery.

Summary Of Background Data: Patient optimization preceding elective surgery is critical to ensure the best possible outcome.

The Impact of Multiple Comorbid Mental Health Disorders on Health-related Quality of Life Following ACDF.

Study Design: Retrospective comparative study.

Objective: The goal was to determine whether comorbid depression and/or anxiety influence outcomes after anterior cervical discectomy and fusion (ACDF) for patients with degenerative cervical pathology.

Background Data: The role preoperative mental health has on patient reported outcomes after ACDF surgery is not well understood.

Proton Pump Inhibitor Use Affects Pseudarthrosis Rates and Influences Patient-Reported Outcomes.

Study Design: Retrospective cohort review.

Objectives: Cervical pseudarthrosis is a frequent cause of need for revision anterior cervical discectomy and fusion (ACDF) and may lead to worse patient-reported outcomes. The effect of proton pump inhibitors on cervical fusion rates are unknown.

Does an Uninstrumented Level Increase the Rate of Revision Surgery in a Multilevel Posterior Cervical Decompression and Fusion?

Study Design: This was a retrospective cohort study.

Objective: The goal of this study is to determine if skipping a single level affects the revision rate for patients undergoing multilevel posterior cervical decompression and fusion (PCDF).

Summary Of Background Data: A multilevel PCDF is a common procedure for patients with cervical spondylotic myelopathy.

Medicaid Reimbursement for Common Spine Procedures: Are Compensation Rates Consistent?

Study Design: Health Services Research.

Objective: The purpose of this study is to determine the variability of Medicaid (MCD) reimbursement for patients who require spine procedures, and to assess how this compares to regional Medicare (MCR) reimbursement as a marker of access to spine surgery.

Summary Of Background Data: The current health care environment includes two major forms of government reimbursement: MCD and MCR, which are regulated and funded by the state and federal government, respectively.

Unicompartmental Knee Arthroplasty Provides Significantly Greater Improvement in Function than Total Knee Arthroplasty Despite Equivalent Satisfaction for Isolated Medial Compartment Osteoarthritis.

Background: While some advocate for unicompartmental knee arthroplasty (UKA) for isolated medial compartment osteoarthritis (OA), others favor total knee arthroplasty (TKA). The purpose of this study was to compare the functional outcomes of UKA and TKA performed for patients with unicompartmental arthritis (OA).

Methods: A study was performed on 133 patients that met strict criteria for UKA, but who underwent either medial UKA or TKA for isolated medial compartment OA based upon physician equipoise.

Sarcopenia does not affect clinical outcomes following lumbar fusion.

Sarcopenia, defined as decreased skeletal muscle mass or function, has recently been found to have increased perioperative morbidity and mortality. The relationship between sarcopenia and clinical outcomes in patients undergoing lumbar fusion has not been examined. This study investigates whether sarcopenia affects fusion rates and outcomes following single-level lumbar decompression and fusion.

Dimensions of the Subaxial Lateral Mass: A Systematic Review of Anatomic (Morphometric) Measurement Studies.

Study Design: This was a systematic review.

Objective: To review and synthesize information on subaxial lateral mass dimensions in order to determine the ideal starting point, trajectory, and size of a lateral mass screw.

Summary Of Background Data: The use of lateral mass instrumentation for posterior cervical decompression and fusion has become routine as these constructs have increased rigidity and fusion rates.

Medicaid Reimbursement for Common Orthopedic Procedures Is Not Consistent.

Two major forms of physician reimbursement include Medicare (MCR; federally funded) and Medicaid (MCD; state funded). The only oversight provided to individual states for setting MCD reimbursement is that it must provide a standard payment that does not negatively affect patient care. The goals of this study were to determine the variability of MCD reimbursement for patients who require orthopedic procedures and to assess how this compares with regional MCR reimbursement.

The Total Cost to the Health Care System in Medicare and Medicaid Patients for the Treatment of Cervical Myelopathy.

Introduction: Cervical myelopathy is a common indication for spine surgery. Modern medicine demands high quality, cost-effective treatment. Most cost analyses fail to account for complication costs from nonoperative treatment.

Descriptive Analysis of Associated Factors for Urgent Versus Nonurgent Inpatient Spine Transfers to a Tertiary Care Hospital.

Patients with spine-associated symptoms are transferred regularly to higher levels of care for operative intervention. It is unclear what factors lead to the transfer of patients with spine pathology to level I care facilities, and which transfers are indicated. All patients with isolated spinal pathology who were transferred from 2011 to 2015 were reviewed.

Preinjury Patient Characteristics and Postinjury Neurological Status Are Associated With Mortality Following Spinal Cord Injury.

Study Design: Retrospective cohort study.

Objectives: This study investigates the association between spinal cord injuries (SCI) and post-injury mortality.

Summary Of Background Data: SCIs) are severe conditions treated in the acute trauma setting.

The Effect of Postoperative Spinal Infections on Patient Mortality.

Study Design: A retrospective, matched cohort study.

Objectives: This study aims to investigate the association between surgical site infection (SSI) and mortality and ascertain any factors that predict mortality in those diagnosed with SSI.

Summary Of Background Data: Despite significant efforts toward mitigation, SSI, including deep infection, remains a common complication following spine surgery, Considerable morbidity may be associated with infection, including hospital readmission, revision surgery, and delayed rehabilitation.

Routine Postoperative Laboratory Tests Are Unnecessary After Partial Knee Arthroplasty.

Background: While partial knee arthroplasty (PKA) is increasingly performed on an outpatient basis, many surgeons still admit patients overnight and obtain laboratory studies on the first postoperative day. The purpose of this study was to investigate the utility and cost effectiveness of routine postoperative laboratory studies after PKA.

Methods: This is a retrospective review of 322 consecutive unilateral or bilateral simultaneous PKAs (unicompartmental, patellofemoral, and modular bicompartmental knee arthroplasty) performed by a single surgeon.

Periprosthetic joint infection increases the risk of one-year mortality.

Background: Periprosthetic joint infection continues to potentially complicate an otherwise successful joint replacement. The treatment of this infection often requires multiple surgical procedures associated with increased complications and morbidity. This study examined the relationship between periprosthetic joint infection and mortality and aimed to determine the effect of periprosthetic joint infection on mortality and any predictors of mortality in patients with periprosthetic joint infection.