Laminectomy and fusion better maintains horizontal gaze than laminoplasty in cervical spondylotic myelopathy.

Background: Laminectomy and fusion (LF) and laminoplasty (LP) are common treatments for cervical spondylotic myelopathy and myeloradiculopathy. While both procedures show similar clinical improvement, LF requires bony fusion while LP offers motion preservation. Cervical sagittal alignment and horizontal gaze maintenance are key outcome measures, but their comparative effects between LF and LP remain unclear.

Glycemic laboratory values are associated with increased length of stay and 90-day revision risk following surgical management of adult spinal deformity.

Background Context: Diabetes mellitus (DM) is a common comorbidity among patients undergoing spinal fusion for adult spinal deformity (ASD) surgery. An elevated Hemoglobin A1c (HbA1c) and elevated postoperative glucose have been shown to increase the risk of complications following spine and other orthopedic surgeries; however, data is limited for ASD.

Purpose: To investigate glycemic control and ASD surgery to inform surgical decision making, medical optimization, and patient education.

TMS-evoked potentials unveil occipital network involvement in patients diagnosed with Parkinson's disease within 5 years of inclusion.

Distinguishing Parkinson's disease (PD) subgroups may be achieved by observing network responses to external stimuli. We compared TMS-evoked potential (TEP) measures from stimulation of bilateral motor cortex (M1), dorsolateral prefrontal cortex (DLPFC), and visual cortex (V1) between 62 PD patients (age: 69.9 ± 7.

Cervical Laminoplasty Versus Laminectomy and Fusion: A Comprehensive Time-driven Activity-based Cost Analysis.

Study Design: Retrospective study.

Objective: To compare the true cost between posterior cervical laminectomy and fusion and cervical laminoplasty using time driven activity-based costing methodology.

Summary Of Background Data: Cervical laminoplasty (LP) and posterior cervical laminectomy with fusion (LF) are effective procedures for treating cervical myelopathy.

What Is the Risk of Irrigation and Debridement Following Foot and Ankle Surgery? Development of a Risk Severity Scoring System.

Background: Surgical site infection (SSI) after foot and ankle surgery has serious negative effects on patient health and quality of life. While previous studies have looked at predisposing factors for SSI, to our knowledge, no study has proposed a risk severity score.

Questions/purposes: Can a risk severity score, based on patient demographic characteristics and surgical variables, be developed for preoperative use in patients undergoing foot and ankle surgery that will calculate the risk of an irrigation and debridement (I&D) procedure within 90 days of surgery utilizing data from previous surgeries?

Methods: A retrospective chart study was performed on patients undergoing foot and ankle surgery.

The effect of cannabinoids on single-level lumbar arthrodesis outcomes in a rat model.

Background Context: The opioid epidemic is a public health crisis affecting spine care and pain management. Medical marijuana is a potential nonopioid analgesic yet to be studied in the surgical setting since its effects on bone healing are not fully understood. Studies have demonstrated analgesic and potentially osteoinductive properties of cannabinoids with endocannabinoid receptor expression in bone tissue.

Assessing the variation and drivers of cost in 1-level lumbar fusion: a time-driven activity-based costing analysis.

Background Context: As value-based health care arrangements gain traction in spine care, understanding the true cost of care becomes critical. Historically, inaccurate cost proxies have been used, including negotiated reimbursement rates or list prices. However, time-driven activity-based costing (TDABC) allows for a more accurate cost assessment, including a better understanding of the primary drivers of cost in 1-level lumbar fusion.

Postoperative Patient Portal Messaging Is Associated With Return to the Emergency Department After Lumbar Spine Surgery.

Study Design: Retrospective study.

Objective: To explore the association between patients undergoing lumbar spine surgery who message their care team via an electronic patient portal (EPP) postoperatively and emergency department (ED) visits within 90 days of surgery.

Summary Of Background Data: Secure patient messaging through electronic patient portals has grown over recent years.

Inpatient opioid use varies by construct length among laminoplasty versus laminectomy and fusion patients.

Background: Laminoplasty (LP) and laminectomy and fusion (LF) are utilized to achieve decompression in patients with symptomatic degenerative cervical myelopathy (DCM). Comparative analyses aimed at determining outcomes and clarifying indications between these procedures represent an area of active research. Accordingly, we sought to compare inpatient opioid use between LP and LF patients and to determine if opioid use correlated with length of stay.

Generation of Prior Information in a Dual-Mode Microwave-Ultrasound Breast Imaging System.

A new breast imaging system capable of obtaining ultrasound and microwave scattered-field measurements with minimal or no movement of the breast between measurements has recently been reported. In this work, we describe the methodology that has been developed to generate prior information about the internal structures of the breast based on ultrasound data measured with the dual-mode system. This prior information, estimating both the geometry and complex-valued permittivity of tissues within the breast, is incorporated into the microwave inversion algorithm as a means of enhancing image quality.

What's New in Peripheral Nerve Stimulation.

Peripheral nerve stimulation (PNS) is a powerful interventional option for the management of otherwise intractable pain. This technique involves the implantation of electrodes to apply electrical stimulation to named peripheral nerves, thereby alleviating pain in the territory of the target nerves. Recent advancements, largely driven by physician-industry relationships, have transformed the therapy into one that is minimally invasive, safe, evidence-based, and effective.

Does Nasal Screening for Methicillin-Resistant Staphylococcus aureus (MRSA) Prevent Deep Surgical Site Infections for Elective Cervical Spinal Fusion?

Study Design: Retrospective cohort study.

Objective: The objective of this study was to determine the relationship between nasal methicillin-resistant Staphylococcus aureus (MRSA) testing and surgical site infection (SSI) rates in the setting of primary posterior cervical instrumented spine surgery.

Summary Of Background Data: Preoperative MRSA screening and decolonization has demonstrated success for some orthopedic subspecialties in prevention of SSIs.

Vector Angle Analysis of Multimodal Neuromonitoring Data for Continuous Prediction of Delayed Cerebral Ischemia.

Background: Dysfunctional cerebral autoregulation often precedes delayed cerebral ischemia (DCI). Currently, there are no data-driven techniques that leverage this information to predict DCI in real time. Our hypothesis is that information using continuous updated analyses of multimodal neuromonitoring and cerebral autoregulation can be deployed to predict DCI.

Brain Network Integrity Changes in Subjective Cognitive Decline: A Possible Physiological Biomarker of Dementia.

The current study seeks to illustrate potential early and objective neurophysiological biomarkers of neurodegenerative cognitive decline by evaluating features of brain network physiological performance and structure utilizing different modalities. This study included 17 clinically healthy individuals with self-reported cognitive decline (Subjective Cognitive Decline group, SCD, no objective finding of cognitive decline), 12 individuals diagnosed with amnestic Mild Cognitive Impairment (aMCI), 11 individuals diagnosed with Dementia, and 15 healthy subjects. All subjects underwent computerized cognitive performance testing, MRI scans including T1 for gray matter (GM) volume quantification, DTI for quantification of white matter (WM) microstructure fractional anisotropy (FA) and mean diffusivity (MD), and brain network function evaluation using DELPHI (TMS-EEG) measures of connectivity, excitability, and plasticity.

Clinicians' perceptions around discectomy surgery for lumbar disc herniation: a survey of orthopaedic and neuro-surgeons in Australia and New Zealand.

Introduction: Understanding practice-based differences in treatment of lumbar disc herniations (LDHs) is vital for reducing unwarranted variation in the delivery of spine surgical health care. Identifying factors that influence surgeons' decision-making will offer useful insights for developing the most cost-effective and safest surgical strategy as well as developing surgeon education materials for common lumbar pathologies. This study was to capture any variation in techniques used by surgeons in Australia and New Zealand (ANZ) region, and perceived complications of different surgical procedures for primary and recurrent LDH (rLDH).

Open epidural blood patch to augment durotomy repair in lumbar spine surgery: surgical technique and cohort study.

Background Context: Incidental durotomy during elective spine surgery is relatively common. While usually benign and self-limited, it can be associated with morbidity, increased cost, and medicolegal ramifications. Dural repair typically involves performing a primary closure using a suture or dural staple; repairs are then frequently augmented with a sealant, patch, or fat/fascial graft.

Osteoporosis is under recognized and undertreated in adult spinal deformity patients.

Background: Adult spinal deformity (ASD) patients may have osteoporosis, predisposing them to an increased risk for surgical complications. Prior studies have demonstrated that treating osteoporosis improves surgical outcomes. In this study we determine the prevalence of osteoporosis in ASD patients undergoing long spinal fusions and the rate at which osteoporosis is treated.

Evaluation of White Matter Integrity Utilizing the DELPHI (TMS-EEG) System.

Objective: The aim of this study was to evaluate brain white matter (WM) fibers connectivity damage in stroke and traumatic brain injury (TBI) subjects by direct electrophysiological imaging (DELPHI) that analyzes transcranial magnetic stimulation (TMS)-evoked potentials (TEPs).

Methods: The study included 123 participants, out of which 53 subjects with WM-related pathologies (39 stroke, 14 TBI) and 70 healthy age-related controls. All subjects underwent DELPHI brain network evaluations of TMS-electroencephalogram (EEG)-evoked potentials and diffusion tensor imaging (DTI) scans for quantification of WM microstructure fractional anisotropy (FA).

Vancomycin-impregnated calcium sulfate beads compared with vancomycin powder in adult spinal deformity patients undergoing thoracolumbar fusion.

Introduction: Adult spinal deformity (ASD) surgery patients are at higher risk for surgical site infections (SSIs) due to large incisions, high blood loss, long surgical duration, and extensive instrumentation. The use of vancomycin powder has demonstrated inconsistent results in ASD surgery. Antibiotic-impregnated calcium sulfate beads have been used in arthroplasty and foot and ankle surgery with promising results.