Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Evaluation and Treatment of Pyogenic Spondylodiscitis of the Spine: AO Spine Knowledge Forum Trauma and Infection.

Study Design: Literature Review with clinical recommendations.

Objective: To highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.

Methods: Five influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed.

Inpatient Multimodal Pain Regimens Do Not Impact Hospital Length of Stay or Long-term Postoperative Opioid Use Following 1 and 2-Level Lumbar Fusion.

Study Design: Retrospective cohort study.

Objective: To determine hospital length of stay (LOS) and long-term opioid consumption among patients who received inpatient multimodal analgesia following lumbar spine surgery, as opposed to those who received opioids alone.

Summary Of Background Data: Opioids have long been the historical choice for managing postoperative pain.

Role of Altmetric Attention Scores in Evaluating the Influence of Spine Surgery Research.

Study Design: Retrospective cohort.

Objective: To analyze the annual trends in the most prevalent topics, journals, and geographic regions of the top 100 spine surgery articles, as determined by altmetric attention scores (AASs). We also describe the relationship between AAS and traditional article metrics.

How Reliable is the Assessment of Fusion Status Following ACDF Using Dynamic Flexion-Extension Radiographs?

Study Design: Reliability study.

Objectives: The radiographic diagnosis of non-union is not standardized. Prior authors have suggested using a cutoff of <1 mm interspinous process motion (ISPM) on flexion-extension radiographs, but the ability of practicing surgeons to make these measurements reliably is not clear.

A Comprehensive Exploration of Digital Twinning in Spine Surgery.

One recent innovation in the health care landscape is the integration of Digital Twin (DT) in the field of spine surgery. DT, first used in 2002 is defined as the replication of physical entities in a virtual environment. It has emerged as a transformative tool for optimizing complex systems.

Perioperative Antidepressant Use is Associated with Symptomatic Pseudarthrosis after Lumbar Fusion.

Study Design: Retrospective cohort.

Objective: To explore the relationship between symptomatic pseudoarthrosis requiring revision after lumbar fusion and antidepressant use.

Summary Of Background Data: Approximately 25% of patients undergoing spine surgery are taking antidepressants.

Higher socioeconomic status is associated with greater rates of surgical resource utilization prior to spine fusion surgery.

Background Context: Previous research has demonstrated an association between socioeconomic status (SES) and patient health, specifically noting that patients of lower SES have poor health outcomes. Understanding how social factors, including socioeconomic status (SES), relate to disparities in health outcomes is critical to closing gaps in equitable care to patients. While several studies have examined the effect of SES on postoperative spine outcomes, there is limited spine literature evaluating SES in the context of barriers to spine care.

Impact of Antidepressant Use on Intraoperative Blood Loss and Transfusion Rates in Lumbar Fusion Surgery.

Objective: A quarter of spine surgery patients take antidepressants. Basic science research has suggested serotonergic antidepressants impair platelet function. This has been supported by only a small number of works in the setting of spine surgery.

Postoperative Ketamine May be Associated with Venous Thromboembolism in Chronic Opioid Users After Spine Surgery.

Objective: Venous thromboembolism (VTE) is a serious postoperative adverse event after spine surgery. In patients with pain refractory to typical multimodal analgesia regimens after spine surgery, whom are often chronic opioid users, perioperative ketamine is an alternative analgesic that has grown in popularity. The aim of this study is to assess the risk of VTE in chronic opioid users undergoing spine surgery.

The Effect of Community-Level Socioeconomic Status on Surgical Outcomes Following Revision Lumbar Fusion.

Background: The purpose of this study is to determine the impact of community-level socioeconomic status (SES) on surgical outcomes and patient-reported outcome measures (PROMs) following revision lumbar fusion.

Methods: Adult patients who underwent revision lumbar fusion surgery from 2011-2021 were grouped by Distressed Community Index (DCI) into Prosperous, Comfortable, Mid-tier, and At-Risk/Distressed cohorts. Demographics, surgical information, and PROMs were compared based on DCI community status.

Lumbar Fusion Surgical Prophylaxis Using Cefazolin vs. Vancomycin in the Penicillin-Allergic Patient.

Study Design: Retrospective cohort study.

Objective: To compare peri- and postoperative infection rates among patients with mild to moderate penicillin allergies who receive cefazolin vs vancomycin as prophylaxis for lumbar fusion. Additionally, we sought to determine if patients receiving cefazolin exhibited any clinical symptoms suggestive of drug-induced hypersensitivity reactions, and to compare those rates to patients who received vancomycin.

Race, Ethnicity, and Gender Representation Among US Academic Spine Surgeons.

Background: Although diversity has improved across certain orthopaedic subspecialties, enhancing diversity within spine surgery has remained a challenge. We aimed to investigate the current state of sex, racial, and ethnic diversity among academic orthopaedic spine surgeons in the United States.

Methods: In January 2024, a cross-sectional analysis of orthopaedic spine surgery faculty in the United States was conducted using the Doximity database to identify eligible surgeons.

One-year patient reported outcomes after single-level lumbar fusion at orthopedic specialty hospital compared to tertiary referral center.

Background Context: Lumbar spinal fusion is an increasingly common operation to treat symptoms related to degenerative disorders of the spine including radiculopathy and pain. As the volume of spine surgeries grows, it is becoming increasingly common for procedures to take place in nontertiary care centers, including orthopaedic specialty hospitals (OSH). While previous research demonstrates that surgical outcomes at an OSH are noninferior to those at a tertiary referral center (TRC), the implications of this difference on patient-reported outcome measures (PROMs) have not been sufficiently assessed.

Historical Perspectives on the Evolution of Spino-Pelvic Fixation and its Implications on Clinical Care A Narrative Review.

Study Design: Broad narrative review.

Objectives: To review and summarize the evolution of spinopelvic fixation (SPF) and its implications on clinical care.

Methods: A thorough review of peer-reviewed literature was performed on the historical evolution of sacropelvic fixation techniques and their respective advantages and disadvantages.

Opioid Prescription Trends Among Orthopaedic, Primary Care, and Pain Management Providers in Spine Surgery Patients.

Objective: To determine prescription trends across specialties in the perioperative care of patients undergoing spine surgery from 2018 to 2021.

Summary Of Background Data: A range of measures, including implementation of state prescription drug monitoring programs, have been instituted to combat the opioid epidemic. Considering the continued presence of opioids for spine-related pain management, a better understanding of the patterns of opioid prescription practices may be important for future intervention.

Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Optimizing Management and Minimizing Risk of Osteoporotic Vertebral Fractures - Perspectives of the AO Spine KF Trauma and Infection Group Key Opinion Leaders.

Study Design: Literature review with clinical recommendations.

Objective: To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders.

Methods: 4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice.

Socioeconomic Status Impacts Length of Stay and Nonhome Discharge Disposition After Posterior Cervical Decompression and Fusion.

Study Design: Retrospective cohort study.

Objective: To examine how community-level economic disadvantage impacts short-term outcomes following posterior cervical decompression and fusion (PCDF) for cervical spondylotic myelopathy.

Summary Of Background Data: The effects of socioeconomic factors, measured by the Distress Community Index (DCI), on postoperative outcomes after PCDF are underexplored.

An evaluation of fusion status following lumbar fusion surgery utilizing multi-planar computed tomography.

Purpose: To report the rate of fusion in a sample of patients undergoing lumbar fusion surgery and assess interrater reliability of computed tomography (CT)-based parameters for the assessment of fusion.

Methods: All adult patients who underwent lumbar fusion surgery from 2017 to 2021 were retrospectively identified. Patient demographics and surgical characteristics were collected through chart review of the electronic medical records.

Preoperative Radiographic Predictors of Subsequent Fusion After Lumbar Decompression Surgery.

Study Design: Retrospective cohort study.

Objective: The purpose of this study is to determine which demographic, surgical, and radiographic preoperative characteristics are most associated with the need for subsequent fusion after decompression lumbar spinal surgery.

Summary Of Background Data: There is a relatively high rate of the need for repeat decompression or fusion after an index decompression procedure for degenerative spine disease.

Which North American spine society disc herniation morphology descriptors are most associated with improvements in clinical outcomes after microdiscectomy?

Background: The North American Spine Society (NASS) assembled the first ever comprehensive naming system for describing lumbar disc disease, including lumbar disc herniation. The objectives of this study were (1) to determine which NASS descriptors are most predictive of independent patient-reported outcomes after microdiscectomy and (2) to identify the inter-rater reliability of each NASS descriptor.

Methods: Adult patients (≥18 years) who underwent a lumbar microdiscectomy from 2014-2021 were retrospectively identified.