The Incidence of Adjacent Segment Pathology After Cervical Disc Arthroplasty Compared with Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Objective: The aim of this study was to assess rates of adjacent segment degeneration (ASDeg), adjacent segment disease (ASDis), and reoperation rates as a result of adjacent segment pathology in patients who have undergone anterior cervical discectomy and fusion (ACDF) versus cervical disc arthroplasty (CDA).

Methods: A comprehensive search of randomized controlled trials was performed in PubMed from 2012 to 2019. Relevant studies included were assessed for quality using the Cochrane Beck Review Group guidelines.

Symptomatic Postoperative Epidural Hematoma in the Lumbar Spine.

A symptomatic postoperative epidural hematoma (SPEH) in the lumbar spine is a complication with variable presentation and the potential to rapidly cause an irrecoverable neurological injury. Significant heterogeneity exists among current case series reporting SPEH in the literature. This review attempts to clarify the known incidence, risk factors, and management pearls.

Predictors of Readmission and Prolonged Length of Stay After Cervical Disc Arthroplasty.

Study Design: Retrospective cohort study.

Objective: The aim of the study was to assess which factors increase risk of readmission within 30 days of surgery or prolonged length of stay (LOS) (≥2 days) after cervical disc arthroplasty (CDA).

Summary Of Background Data: Several studies have shown noninferiority at mid- and long-term outcomes after cervical disc arthroplasty (CDA) compared to anterior cervical discectomy and fusion ACDF, but few have evaluated short-term outcomes regarding risk of readmission or prolonged LOS after surgery.

Hepatitis C Virus Infection as a Predictor of Complications and Increased Costs Following Primary Lumbar Fusion Surgery.

Study Design: Retrospective cohort study.

Objective: The aim of this study was to identify whether hepatitis C virus (HCV) diagnosis influences in-hospital lengths of stay (LOS), postoperative complications, readmission rates, or costs following primary posterior lumbar fusions in an elective setting.

Summary Of Background Data: Although joint arthroplasty literature has shown increased complication rates and costs for patients seropositive with HCV without liver disease compared to those without HCV, this comorbidity has not been explored in the spine literature.

Current incidence of adjacent segment pathology following lumbar fusion versus motion-preserving procedures: a systematic review and meta-analysis of recent projections.

Background Context: Lumbar fusion has shown to be an effective surgical management option when indicated, improving patient outcomes and functional status. However, concerns of adjacent segment pathology (ASP) due to reduced mobility at the operated segment have fostered the emergence of motion-preserving procedures (MPP).

Purpose: To assess rates of radiographic adjacent segment degeneration (ASDeg) and symptomatic adjacent segment disease (ASDis) as well as reoperation rates due to ASP in patients who have undergone lumbar fusion compared to motion-preservation for degenerative disorders.

Potential Selection Bias in Observational Studies Comparing Cervical Disc Arthroplasty to Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective study using a national administrative database.

Objective: To define the cohort differences in patient characteristics between patients undergoing cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) in a large national sample, and to describe the impact of those baseline patient characteristics on analyses of costs and complications.

Summary Of Background Data: CDA was initially studied in high quality, randomized trials with strict inclusion criteria.

Trends in Leadership at Spine Surgery Fellowships.

Study Design: Cross-sectional study.

Objective: To illustrate demographic trends among spine fellowship leaders (FLs).

Summary Of Background Data: No previous study in the orthopedic literature has analyzed the demographic characteristics or past surgical training of FL in an orthopedic sub-specialty.

Mobile messaging and smartphone apps for patient communication and engagement in spine surgery.

Mobile health (mHealth) applications are rapidly becoming increasingly available to patients. These interventions utilize simple mobile messaging (SMS) and software applications on mobile devices for a variety of purposes. In the surgical population mHealth applications have shown promise in increasing medication and protocol adherence, monitoring patients after surgery, and helping modify behaviors associated with poor surgical outcomes.

Complications and Risk Factors Using Structural Allograft Versus Synthetic Cage: Analysis 17 783 Anterior Cervical Discectomy and Fusions Using a National Registry.

Study Design: Retrospective cohort study.

Objective: To determine the rates of perioperative complications in patients undergoing anterior cervical discectomy and fusion (ACDF) with allograft versus synthetic cage.

Methods: A large national administrative health care database was queried for ACDF procedures performed between 2007 and 2014 using ICD-9 (International Statistical Classification of Diseases, 9th revision) and CPT (Current Procedural Terminology) codes.

Preoperative Risk Stratification in Spine Tumor Surgery: A Comparison of the Modified Charlson Index, Frailty Index, and ASA Score.

Study Design: A retrospective review of prospectively collected data.

Objective: The purpose of this study is to compare and validate several preoperative scores for predicting outcomes following spine tumor resection.

Summary Of Background Data: Preoperative risk assessment for patients undergoing spinal tumor resection remains challenging.

Coagulation Laboratory Testing Is Predictive of Wound Complications Following Microdiscectomy.

Study Design: Retrospective review.

Objective: To determine whether abnormal preoperative testing is associated with postoperative complications in patients undergoing a microdiscectomy.

Methods: Patients undergoing a microdiscectomy between 2006 and 2013 were identified in the National Surgical Quality Improvement Program database based on appropriate current procedural terminology coding.

Lumbar Interbody Fusions for Degenerative Spondylolisthesis: Review of Techniques, Indications, and Outcomes.

Study Design: Broad narrative review.

Objectives: To review and summarize the current literature on the outcomes, techniques, and indications of lumbar interbody fusion in degenerative spondylolisthesis.

Methods: A thorough review of peer-reviewed literature was performed on the outcomes, techniques, and indications of lumbar interbody fusions in degenerative spondylolisthesis.

Software-Based Postoperative Communication With Patients Undergoing Spine Surgery.

Study Design: Observational study.

Objectives: Perioperative patient anxiety is a major concern in orthopedic surgery. Mobile messaging applications have been used in a number of healthcare settings.

Fibromyalgia as a Predictor of Increased Postoperative Complications, Readmission Rates, and Hospital Costs in Patients Undergoing Posterior Lumbar Spine Fusion.

Study Design: Retrospective review.

Objective: The aim of this study was to identify whether a concomitant diagnosis of fibromyalgia (FM) influences postoperative complications, readmission rates or cost following primary 1 to 2 level lumbar fusions in an elective setting.

Summary Of Background Data: Patients with FM often are limited by chronic lower back pain, many of whom will seek operative treatment.

Evidence of an Inherited Predisposition for Spinal Cord Tumors.

Study Design: Retrospective study.

Objectives: To determine familial clustering of primary spinal cord tumors using a statewide genealogy database.

Methods: The Utah Population Database (UPDB) was queried using ICD-Oncology (International Classification of Diseases for Oncology) codes for primary spinal cord tumors.

The utility of preoperative laboratories in predicting postoperative complications following posterolateral lumbar fusion.

Background Context: Several studies have suggested that laboratory results have minimal impact on clinical decision making in surgery. Despite the widespread use of preoperative testing in spine surgery and the large volume of posterolateral lumbar fusions (PLFs) being performed each year, no study has assessed the ability of preoperative laboratories to predict adverse events following PLF.

Purpose: The purpose of this study was to explore the relationship between commonly obtained preoperative laboratory results and postoperative complications following one- to two-level PLF.

Higher Modified Charlson Index Scores Are Associated With Increased Incidence of Complications, Transfusion Events, and Length of Stay Following Revision Hip Arthroplasty.

Background: Revision total hip arthroplasty (RHA) has been associated with greater morbidity and length of stay (LOS) compared to primary total hip arthroplasty. Despite this, few validated metrics exist for risk stratification in RHA cohorts. The Charlson Comorbidity Index (CCI) has been associated with complications in total hip arthroplasty, but its utility in revision surgery remains unexplored.

An Operative Complexity Index Shows Higher Volume Hospitals and Surgeons Perform More Complex Adult Spine Deformity Operations.

Background: Though previous studies have shown improved outcomes associated with higher volume surgeons and hospitals, this may not be replicated in ASDS due to case complexity variation. We hypothesized that high-volume surgeons perform more complex surgeries. Therefore, we defined an Operative Complexity Index (OCI), specifically for the National Inpatient Samples (NIS) data, which provides information on in-hospital postoperative complications, to assess rates of adult spine deformity surgery (ASDS) cases as they relate to surgeon and hospital operative volume.

PROMIS PF CAT Outperforms the ODI and SF-36 Physical Function Domain in Spine Patients.

Study Design: The Oswestry Disability Index v2.0 (ODI), SF36 Physical Function Domain (SF-36 PFD), and PROMIS Physical Function CAT v1.2 (PF CAT) questionnaires were prospectively collected from 1607 patients complaining of back or leg pain, visiting a university-based spine clinic.

Oswestry Disability Index: a psychometric analysis with 1,610 patients.

Background: One-fourth of the adult US population has or will experience back pain and has undergone one of a myriad of treatments. Understanding the outcomes of these many treatments from pharmacologic to surgical, from manipulation to modality, allows for a better understanding and value-driven decision making. Patient-reported outcome measures are the current standard and include general and disease-specific measures.

Autologous Tumor Cell Lysate-Loaded Dendritic Cell Vaccine Inhibited Tumor Progression in an Orthotopic Murine Model for Hepatocellular Carcinoma.

The immune status of the tumor microenvironment influences tumor progression, and hepatocellular carcinoma (HCC) with an immunosuppressive signature often is associated with a poor prognosis. This study examined the impact of a bone marrow-derived dendritic cell (DC) vaccine loaded with autologous tumor cell lysate on tumor progression and the tumor microenvironment using an orthotopic murine HCC model. An orthotopic murine HCC was established by implantation of Hepa1-6 cells in the liver.