Editorial to Advances in Minimally Invasive Spine Surgery.

Degenerative spinal pathology is a leading cause of morbidity in the United States with a predicted increase in prevalence as the population ages [...

Safety and efficacy of minimally invasive posterior cervical fusion: a single center, single surgeon retrospective review.

Standard posterior cervical fusion is a common surgical technique that utilizes lateral mass screws and rods for fixation. A relatively new, minimally invasive technique involving interfacet decortication and placement of spacers has shown promise in terms of outcomes. We sought to determine fusion rates and complications of this new technique at our institution to bolster current literature.

Decompression and Interlaminar Stabilization for Lumbar Spinal Stenosis: A Cohort Study and Two-Dimensional Operative Video.

Background and Objectives: Lumbar spinal stenosis is one of the most common causes of disability in the elderly and often necessitates surgical intervention in patients over the age of 65. Our study aimed to evaluate the clinical efficacy of interlaminar stabilization following decompressive laminectomy in patients with lumbar stenosis without instability. Materials and Methods: Twenty patients with lumbar stenosis underwent decompressive laminectomy and interlaminar stabilization at our academic institution.

A Retrospective Review of the Timing of Glasgow Coma Scale Documentation in a Trauma Database: Implications for Patient Care, Research, and Performance Metrics.

Background: The Glasgow Coma Scale (GCS) is intended to be an objective, reliable measure of a patient's mental status. It is included as a metric for trauma registries, having implications for performance metrics and research. Our study compared the GCS recorded in the trauma registry (GCS-1) with that recorded in the neurosurgery consultation (GCS-2).

Minimally invasive lateral corpectomy for thoracolumbar traumatic burst fractures.

Objective: The need for anterior column reconstruction after thoracolumbar burst fractures remains controversial. Here, the authors present their experience with minimally invasive lateral thoracolumbar corpectomies for traumatic fractures.

Methods: Between 2012 and 2019, 59 patients with 65 thoracolumbar fractures underwent 65 minimally invasive lateral corpectomies (MIS group).

Minimally Invasive Management of Civilian Gunshot Wounds to the Lumbar Spine: A Case Series and Technical Report.

Background: Treatment of penetrating gunshot wounds (GSW) to the spine remains controversial. The decision to operate is often based on surgeon preference and experience. We present a case series of 7 patients who underwent minimally invasive thoracolumbar/sacral decompression and bullet removal at a level 1 trauma center.

The Impact of Drug and Alcohol Intoxication on Glasgow Coma Scale Assessment in Patients with Traumatic Brain Injury.

Background: The effect of intoxicating substances on assessment of Glasgow Coma Scale (GCS) in the trauma setting has not been completely elucidated.

Methods: A trauma registry was queried for patients with blunt head trauma in 2013-2017. Initial GCS score and toxicology screening from the database were reviewed.

Traumatic cervical spine injury during sexual activity.

Sexual activity is unlikely to result in spinal injuries. We present the first case of a cervical fracture-subluxation and spinal cord injury following sexual activity. This 31-year-old female presented to the emergency room with neck pain and quadriparesis, following sexual activity in an extreme position.

Outcomes of posterior cervical fusion and decompression: a systematic review and meta-analysis.

Background Context: Posterior cervical fusion (PCF) with decompression is a treatment option for patients with conditions such as spondylosis, spinal stenosis, and degenerative disc disorders that result in myelopathy or radiculopathy. The annual rate, number, and cost of PCF in the United States has increased. Far fewer studies have been published on PCF outcomes than on anterior cervical fusion (ACF) outcomes, most likely because far fewer PCFs than ACFs are performed.

Change in Policy Allowing Overlapping Surgery Decreases Length of Stay in an Academic, Safety-Net Hospital.

Background: The practice of surgeons running overlapping operating rooms has recently come under scrutiny.

Objective: To examine the impact of hospital policy allowing overlapping rooms in the case of patients admitted to a tertiary care, safety-net hospital for urgent neurosurgical procedures.

Methods: The neurosurgery service at the hospital being studied transitioned from routinely allowing 1 room per day (period 1) to overlapping rooms (period 2), with the second room being staffed by the same attending surgeon.

A case series of penetrating spinal trauma: comparisons to blunt trauma, surgical indications, and outcomes.

OBJECTIVEWhile blunt spinal trauma accounts for the majority of spine trauma, penetrating injuries affect a substantial number of patients. The goal of this study was to examine the epidemiology of penetrating spine injuries compared with blunt injuries and review the operative interventions and outcomes in the penetrating spine injury group.METHODSThe prospectively maintained trauma database was queried for spinal fractures from 2012 to 2018.

The increasing frequency of intravenous drug abuse-associated spinal epidural abscesses: a case series.

OBJECTIVEFew studies have been published specifically examining intravenous drug abuse (IVDA)-associated spinal epidural abscesses (SEAs), an unfortunate sequela of the opioid crisis in the United States. Here, the authors examined a series of patients with IVDA-associated SEAs in order to shed light on this challenging disease entity.METHODSThis study is a retrospective chart review of patients presenting with IVDA-associated SEAs at the authors' institution from 2013 to 2018, spanning the statewide implementation of opioid-prescribing restrictions.

Peroneal Nerve Repair of a 9 Year Old: Return of Motor Function after 2 Years.

Major factors that influence functional nerve recovery, postrepair, are length of the nerve defect, type of injury, operative technique, time until treatment, and age of the patient. We present a severe motor nerve defect in a complicated peroneal nerve injury in a 9-year-old that showed functional return after a delayed period of 23 months with sural nerve cable grafting. This case revealed the increased resiliency and regenerative capacity of motor end plates in young patients.

The Effects of Agrin Isoforms on Diabetic Neuropathic Pain in a Rat Streptozotocin Model.

Background: Diabetes mellitus affects 9.3% of the US population and increases risks of surgery and complications. Diabetic neuropathic pain (DNP), one of the main consequences of diabetes mellitus, is extremely difficult to treat.

A modified, less invasive posterior subscapular approach to the brachial plexus: case report and technical note.

The traditional posterior subscapular approach offers excellent exposure of the lower brachial plexus and has been successfully used in patients with recurrent thoracic outlet syndrome after an anterior operation, brachial plexus tumors involving the proximal roots, and postirradiation brachial plexopathy, among others. However, this approach also carries some morbidity, mostly related to the extensive muscle dissection of the trapezius, rhomboids, and levator scapulae. In this article, the authors present the surgical technique and video illustration of a modified, less invasive posterior subscapular approach, using a small, self-retaining retractor and only a partial trapezius and rhomboid minor muscle dissection.

Caudal vertebral body fractures following lateral interbody fusion in nonosteoporotic patients.

Background: The minimally invasive lateral transpsoas approach for lumbar fusions has become increasingly popular. However, vertebral body fractures have been reported after this procedure, particularly in patients with osteoporosis and patients undergoing multilevel fusions. We evaluated the risk factors for caudal vertebral body fractures in 2 nonosteoporotic patients with single-level disease.

The effects of lumbar facet dowels on joint stiffness: a biomechanical study.

Background: Facet joint arthrosis may play a significant role in low back pain generation. The placement of facet dowels is a percutaneous treatment that aims to fuse the facets and increase joint stiffness. In this cadaveric study, we evaluated spine stiffness after facet dowel insertion in combination with several surgical procedures and determined which motions promote dowel migration.

Primary cervical spine carcinoid tumor in a woman with arm paresthesias and weakness: a case report.

Introduction: Carcinoid tumors are neuroendocrine neoplasms derived from the enterochromaffin cells. Central nervous system involvement is rare and has been reported either as metastases to the brain and spine or primary tumors involving the sacrococcygeal spine. We report the first case of a primary carcinoid tumor of the cervical spine.

Gunshot wounds to the spine in post-Katrina New Orleans.

Background: Gunshot wounds (GSW) to the spine represent a major health concern within today's society. Our study assessed the epidemiologic characteristics of patients with GSW to the spine treated in New Orleans.

Patients And Methods: A retrospective chart review was performed from January 2007 through November 2011 on all the patients who were seen in the emergency room and diagnosed with a gunshot wound to the spine.

Genitofemoral nerve protection during the lateral retroperitoneal transpsoas approach.

Background: The minimally invasive lateral retroperitoneal approach for lumbar fusions is a novel technique with good results, but also with significant sensory and motor complications.

Objective: To present the early results of a modified surgical technique, in which the psoas muscle is dissected under direct visualization.

Methods: Thirteen consecutive patients with L4-5 or L3-4 pathology were prospectively followed after being treated using a minimally invasive lateral approach with direct exposure of the psoas muscle before dissection.

The role of nerve growth factor in neuropathic pain inhibition produced by resiniferatoxin treatment in the dorsal root ganglia.

Background: Resiniferatoxin (RTX), an excitotoxic agonist for vanilloid receptor 1, is a promising candidate for intractable pain treatment.

Objective: We evaluated the effects of RTX, applied to dorsal root ganglia (DRG) at high doses (1200 ng), in sensory-motor function and nerve growth factor (NGF) alterations in a photochemical sciatic nerve injury rat model.

Methods: Following RTX injection into the L3-6 DRG at high doses and behavioral evaluation, the rats were sacrificed and the DRG were tested by immunohistochemistry and mRNA analysis for NGF and its' receptors, tyrosine kinase A (TrkA) and p75.

Traumatic spinal fracture treated by vertebroplasty: a case report.

Introduction: Surgical treatment for lumbar burst fractures is complex and typically involves either a retroperitoneal corpectomy and/or a posterior pedicle screw fixation. We describe the case of a patient with a lumbar burst fracture who was cured via a less invasive approach that has not been previously reported as standalone treatment.

Case Presentation: This 25-year-old Caucasian man presented with excruciating axial low back pain exacerbated by any attempt to elevate the head of the bed after a motor vehicle accident.