High incidence of dural tears with 3-column osteotomies: a systematic review of adult spinal deformity surgery literature for the past decade.

Purpose: Dural tear (DT) is a well-known complication of spinal surgery. We aimed to systematically review the literature from the past decade and determine the incidence and risk factors for DT in the adult spinal deformity (ASD) population to improve both the surgical strategy and counseling of patients undergoing ASD correction.

Methods: A systematic review from 2013 to 2023 utilizing PRISMA guidelines was performed.

Thermal Damage in Orthopaedics.

There are numerous potential sources of thermal damage encountered in orthopaedic surgery. An understanding of the preclinical mechanisms of thermal damage in tissues is necessary to minimize iatrogenic injuries and use these mechanisms therapeutically. Heat generation is a phenomenon that can be used to a surgeon's benefit, most commonly for hemostasis and local control of tumors.

Moderate sagittal plane deformity patients have similar radiographic and functional outcomes with either anterior or posterior surgery.

Purpose: This study aimed to compare the functional and radiographic outcomes of two surgical interventions for adult spinal deformity (ASD): anterior lumbar interbody fusion with anterior column realignment (ALIF-ACR) and posterior approach using Smith-Peterson osteotomy with transforaminal lumbar interbody fusion and pedicle screw fixation (TLIF-Schwab2).

Methods: A retrospective cohort study included 61 ASD patients treated surgically between 2019 and 2020 at a single tertiary orthopedic specialty hospital. Patients were divided into two groups: Group 1 (ALIF-ACR, 29 patients) and Group 2 (TLIF-Schwab2, 32 patients).

Laminoplasty in Motion: Evolving Techniques and Complications.

Cervical laminoplasty is an increasingly popular surgical option for the treatment of cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL). Over the past few decades, there have been substantial developments in both surgical technique and hardware options. As the field of cervical surgery rapidly evolves, there is a timely need to reassess the evolving complications associated with newer techniques.

Cross-cultural adaptation, reliability, and validity of the Russian version of the Spine Oncology Study Group Outcomes Questionnaire (SOSGOQ2.0).

Objective: The most validated health-related quality-of-life (HRQOL) questionnaire specific to the metastatic spine cancer population is the Spine Oncology Study Group Outcomes Questionnaire version 2 (SOSGOQ2.0). The purpose of this study was to translate and validate a Russian version of the SOSGOQ2.

Spinolaminar locking plates improve fixation strength compared to pedicle screws: a biomechanical analysis.

Introduction: Pedicle screw loosening is a significant complication of posterior spinal fixation, particularly among osteoporotic patients and in deformity constructs. In orthopedic trauma surgery, locking plates and screws have revolutionized the fixation of osteoporotic fractures. We have combined the traumatology principle of fixed-angle locking plate fixation with the spine principles of segmental instrumentation.

Are all Cages Created Equal? Analysis of Cervical Cage Malfunctions Using FDA MAUDE Database.

Study Design: Retrospective case series.

Objective: To characterize failure rates of cervical cages based on manufacturer and design characteristics using the nationwide database of reported malfunctions.

Background: The Food and Drug Administration (FDA) aims to ensure the safety and efficacy of cervical interbody implants postimplantation; however, intraoperative malfunctions may be overlooked.

Does the Bone Mineral Density of the Lumbar Spine Correlate With Dual-Energy X-ray Absorptiometry Score? A Cadaveric-Based Analysis of Computed Tomography Densitometry.

Background: Pedicle screw loosening is a complication of spinal instrumentation in osteoporotic patients. Dual-energy x-ray absorptiometry scans are not able to detect variations in bone mineral density (BMD) within specific regions of vertebrae. The purpose of this study was to investigate whether spine scores correlate with cortical and cancellous BMD of pedicles and other 6 anatomical regions of lumbar spine.

An Analysis of a Decade of Lumbar Interbody Cage Failures in the United States: A MAUDE Database Study.

Study Design: A retrospective case series.

Objective: This study aims to assess the rates of lumbar interbody cage failures based on their material and manufacturer.

Summary Of Background Data: Perioperative lumbar interbody cage malfunctions are underreported events in the spine literature and may result in complications.

Conditional survival after surgery for metastatic tumors of the spine: does prognosis change over time?

Purpose: Conditional survival (CS) provides a dynamic prediction of patient survival by incorporating the time an individual has already survived given their disease specific characteristics. The objective of the current study was to estimate CS among patients after surgery for spinal cord compression or spinal instability, as well as stratify CS according to relevant patient- and disease-related characteristics.

Methods: The clinical outcomes of 361 patients undergoing surgical management of metastatic spinal tumors were retrospectively analyzed.

Pyogenic spinal infections warrant a total spine MRI.

: retrospective case series. : the presenting clinical symptoms of spinal infections are often nonspecific and a delay in diagnosis can lead to adverse patient outcomes. The morbidity and mortality of patients with multifocal spinal infections is significantly higher compared to unifocal infections.

C1-C2 Facet Joint Penetration by C2 Pedicle Screws: Influence of Local Anatomy, Bone Mineral Density, and Screw Length.

Background: A challenge of C2 pedicle screw placement is to avoid penetration into the C1-C2 facet joint, as this may alter normal biomechanics and accelerate joint degeneration. Our objective was to clarify how local anatomy and surgical technique may relate to C2 pedicle screw penetration into the C1-C2 facet joint.

Methods: C2 pedicle screws were inserted using a fluoroscopically assisted freehand technique.

Fusion Mass Screws in Revision Spinal Deformity Surgery: A Simple and Safe Alternative Fixation.

Background: Revision spinal deformity surgery has a high rate of complications. Fixation may be challenging due to altered anatomy. Screws through a fusion mass are an alternative to pedicle screw fixation.

Hardware Failure in Spinal Tumor Surgery: A Hallmark of Longer Survival?

Objective: Instrumentation failure in spine tumor surgery is a common reason for revision operation. Increases in patient survival demand a better understanding of the hardware longevity. The study objective was to investigate risk factors for instrumentation failure requiring revision surgery in patients with spinal tumors.

Alternatives to Traditional Pedicle Screws for Posterior Fixation of the Degenerative Lumbar Spine.

Background: Traditional pedicle screws are currently the gold standard to achieve stable 3-column fixation of the degenerative lumbar spine. However, there are cases in which pedicle screw fixation may not be ideal. Due to their starting point lateral to the pars interarticularis, pedicle screws require a relatively wide dissection along with a medialized trajectory directed toward the centrally located neural elements and prevertebral vasculature.

Whole-Spine Magnetic Resonance Imaging: A Review of Suggested Indications.

»: The spinal column has a propensity for lesions to manifest in a multifocal manner, and identification of the lesions can be difficult.

»: When used to image the spine, magnetic resonance imaging (MRI) most accurately identifies the presence and location of lesions, guiding the treatment plan and preventing potentially devastating complications that are known to be associated with unidentified lesions.

»: Certain conditions clearly warrant evaluation with whole-spine MRI, whereas the use of whole-spine MRI with other conditions is more controversial.

In-vitro 3D Analysis of Sacroiliac Joint Kinematics: Primary and Coupled Motions.

Study Design: An in-vitro biomechanical study of human cadaver sacroiliac joints.

Objective: Our study aimed to develop a more comprehensive understanding of the native motion of the SIJ within the context of spinal kinematics and spinal implant evaluation.

Summary Of Background Data: Increasing attention has been given to the sacroiliac joint (SIJ) as a source of low back pain, despite its limited range of motion.

Pedicle Screws Challenged: Lumbar Cortical Density and Thickness Are Greater in the Posterior Elements Than in the Pedicles.

Study Design: Controlled laboratory study.

Objective: To measure the total bone mineral density (BMD), cortical volume, and cortical thickness in seven different anatomical regions of the lumbar spine.

Methods: Using computed tomography (CT) images, 3 cadaveric spines were digitally isolated by applying filters for cortical and cancellous bone.

Non-Pedicular Fixation Techniques for the Treatment of Spinal Deformity: A Systematic Review.

Background: In recent years, the use of pedicle screws has become the gold standard for achieving stable, 3-column fixation of the spine. However, pedicle screw placement may not always be ideal, such as in adolescent idiopathic scoliosis, because of pedicle morphology. An understanding of the alternatives to pedicle screw fixation is therefore important in the treatment of patients with spinal deformity.

Motion Preservation at All Costs? Multilevel Hinge Nonunion, Plate Breakage, and Intradural Plate Migration After Cervical Laminoplasty: A Case Report and Literature Review.

Background: Cervical laminoplasty is a motion-preserving procedure that addresses spinal cord compression and avoids postlaminectomy kyphosis associated with cervical laminectomy. The most common complications include C5 nerve palsy, axial neck pain, hinge nonunion, and premature closure. Plating is a relatively newer method of laminoplasty fixation that may provide greater stabilization postoperatively and reduce the risk of laminoplasty closure compared with less rigid (e.

Anterior Lumbar Interbody Fusion May Provide Superior Decompression of the Foraminal Space Compared with Direct Foraminotomy: Biomechanical Cadaveric Study.

Objective: The objective of this cadaveric biomechanical study was to compare the area of the foraminal space during motion in the intact condition, after direct decompression via foraminotomy, and after indirect decompression via anterior lumbar interbody spacer insertion.

Methods: Eight (8) L5-S1 cadaver specimens were used for testing. Each specimen was tested in the intact state, after posterior foraminotomy, and after standalone anterior lumbar interbody fusion (ALIF).

High Prevalence of Multifocal Spine Infections Involving the Cervical and Thoracic Regions: A Case for Imaging the Entire Spine.

Objective: Pyogenic spinal infections account for 2%-4% of orthopaedic infections. They are often difficult to diagnose, resulting in a delay in diagnosis. Risk factors for orthopaedic and spinal infection are well-documented in the literature, yet there is a paucity of studies examining risk factors specifically for multifocal spinal infections.

Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation.

OBJECTIVE Bilateral symptoms have been reported in 8%-35% of patients with sacroiliac (SI) joint dysfunction. Stabilization of a single SI joint may significantly alter the stresses on the contralateral SI joint. If the contralateral SI joint stresses are significantly increased, degeneration may occur; alternatively, if the stresses are significantly reduced, bilateral stabilization may be unnecessary for patients with bilateral symptoms.

Changes in foraminal area with anterior decompression versus keyhole foraminotomy in the cervical spine: a biomechanical investigation.

OBJECTIVE Anterior cervical discectomy and fusion (ACDF) with or without partial uncovertebral joint resection (UVR) and posterior keyhole foraminotomy are established operative procedures to treat cervical disc degeneration and radiculopathy. Studies have demonstrated reliable results with each procedure, but none have compared the change in neuroforaminal area between indirect and direct decompression techniques. The purpose of this study was to determine which cervical decompression method most consistently increases neuroforaminal area and how that area is affected by neck position.