Long-segment posterior cervical decompression and fusion: does caudal level affect revision rate?

Objective: Posterior cervical decompression and fusion (PCDF) is a commonly performed procedure to address cervical myelopathy. A significant number of these patients require revision surgery for adjacent-segment disease (ASD) or pseudarthrosis. Currently, there is no consensus among spine surgeons on the inclusion of proximal thoracic spine instrumentation.

Variation in global treatment for subaxial cervical spine isolated unilateral facet fractures.

Purpose: To determine the variation in the global treatment practices for subaxial unilateral cervical spine facet fractures based on surgeon experience, practice setting, and surgical subspecialty.

Methods: A survey was sent to 272 members of the AO Spine Subaxial Injury Classification System Validation Group worldwide. Questions surveyed surgeon preferences with regard to diagnostic work-up and treatment of fracture types F1-F3, according to the AO Spine Subaxial Cervical Spine Injury Classification System, with various associated neurologic injuries.

Overview of Traumatic Brain Injury in American Football Athletes.

Objective: The aim of this review is to provide a summary of the epidemiology, clinical presentation, pathophysiology, and treatment of traumatic brain injury in collision athletes, particularly those participating in American football.

Data Sources: A literature search was conducted using the PubMed/MEDLINE and Google Scholar databases for publications between 1990 and 2019. The following search phrases were used: "concussion," "professional athletes," "collision athletes," "mild traumatic brain injury," "severe traumatic brain injury," "management of concussion," "management of severe traumatic brain injury," and "chronic traumatic encephalopathy.

Does Facet Distraction Affect Patient Outcomes After ACDF?

Study Design: Retrospective cohort study.

Objective: The aim of this study is to determine if there is a correlation between the amount of facet distraction and postoperative patient-reported outcomes after ACDF.

Methods: A retrospective cohort analysis of patients undergoing 1 to 3 level ACDF for degenerative pathologies at a single academic center was performed.

Patient Outcomes Following Short-segment Lumbar Fusion Are Not Affected by PI-LL Mismatch.

Study Design: This is a retrospective cohort study.

Objective: The objective of this study was to further elucidate the relationship between pelvic incidence-lumbar lordosis (PI-LL) mismatch and surgical outcomes in patients undergoing short segment lumbar fusions for degenerative lumbar disease.

Summary Of Background Data: There are few studies examining the relationship between spinopelvic parameters and patient reported outcome measurements (PROMs) in short segment lumbar degenerative disease.

Establishing the Injury Severity of Subaxial Cervical Spine Trauma: Validating the Hierarchical Nature of the AO Spine Subaxial Cervical Spine Injury Classification System.

Study Design: Global cross-sectional survey.

Objective: The aim of this study was to validate the AO Spine Subaxial Cervical Spine Injury Classification by examining the perceived injury severity by surgeon across AO geographical regions and practice experience.

Summary Of Background Data: Previous subaxial cervical spine injury classifications have been limited by subpar interobserver reliability and clinical applicability.

Are Patient Outcomes Affected by the Presence of a Fellow or Resident in Lumbar Decompression Surgery?

Study Design: Retrospective cohort study.

Objective: The aim of this study was to determine whether the presence of a fellow or resident (F/R) compared to a physician assistant (PA) affected surgical variables or short-term patient outcomes.

Summary Of Background Data: Although orthopedic spine fellows and residents must participate in minimum number of decompression surgeries to gain competency, the impact of trainee presence on patient outcomes has not been assessed.

The Subaxial Cervical AO Spine Injury Score.

Study Design: Global cross-sectional survey.

Objective: To develop an injury score for the AO Spine Subaxial Cervical Spine Injury Classification System.

Methods: Respondents numerically graded each variable within the classification system for severity.

The Current Status of Spinal Posttraumatic Deformity: A Systematic Review.

Study Design: Systematic Review.

Objective: To systematically analyze the definitions and descriptions in literature of "Spinal Posttraumatic Deformity" (SPTD) in order to support the development of a uniform and comprehensive definition of clinically relevant SPTD.

Methods: A literature search in 11 international databases was performed using "deformity" AND "posttraumatic" and its synonyms.

How do C2 tilt and C2 slope correlate with patient reported outcomes in patients after anterior cervical discectomy and fusion?

Background/context: C2 tilt and C2 slope are quick and easy measurements to obtain on lateral radiographs and may be used to determine overall cervical sagittal alignment; however, the influence of these measurements on patient outcomes has not been well established in literature.

Purpose: To determine if C2 tilt and/or C2 slope predict patient outcomes better compared with conventional radiographic measures after an anterior cervical discectomy and fusion (ACDF).

Study Design/setting: Retrospective cohort study.

Spine Patient Satisfaction With Telemedicine During the COVID-19 Pandemic: A Cross-Sectional Study.

Study Design: Original research, cross-sectional study.

Objectives: Evaluate patient satisfaction with spine care delivered via telemedicine. Identify patient- and visit-based factors associated with increased satisfaction and visit preference.

Do Preoperative Epidural Steroid Injections Increase the Risk of Infection After Lumbar Spine Surgery?

Study Design: Retrospective study.

Objective: To elucidate an association between preoperative lumbar epidural corticosteroid injections (ESI) and infection after lumbar spine surgery.

Summary Of Background Data: ESI may provide diagnostic and therapeutic benefit; however, concern exists regarding whether preoperative ESI may increase risk of postoperative infection.

The Management of Acute Lumbar Stress Reactions of the Pedicle and Pars in Professional Athletes Playing Collision Sports.

Acute stress reactions in the lumbar spine most commonly occur in athletes at the pars interarticularis followed by the pedicle. These reactions occur as a result of repetitive microtrauma from supraphysiological loads applied to the lumbar spine. Characteristic motions such as trunk extension and twisting are also thought to play a role and may be sport-specific.

Artificial Intelligence in Spine Care.

Artificial intelligence is an exciting and growing field in medicine to assist in the proper diagnosis of patients. Although the use of artificial intelligence in orthopedics is currently limited, its utility in other fields has been extremely valuable and could be useful in orthopedics, especially spine care. Automated systems have the ability to analyze complex patterns and images, which will allow for enhanced analysis of imaging.

Development of a Telemedicine Neurological Examination for Spine Surgery: A Pilot Trial.

Study Design: This was a prospective cohort study.

Objective: The objective of this study was to design and test a novel spine neurological examination adapted for telemedicine.

Summary Of Background Data: Telemedicine is a rapidly evolving technology associated with numerous potential benefits for health care, especially in the modern era of value-based care.

Does the Size or Location of Lumbar Disc Herniation Predict the Need for Operative Treatment?

Study Design: Retrospective cohort study.

Objective: The goal of this study was to determine whether the absolute size (mm), relative size (% canal compromise), or location of a single-level, lumbar disc herniation (LDH) on axial and sagittal cuts of magnetic resonance imaging (MRI) were predictive of eventual surgical intervention.

Methods: MRIs of 89 patients were reviewed, and patients were split into groups based on type of management received (34 nonoperative vs 55 microdiscectomy).

Depression Identified on the Mental Component Score of the Short Form-12 Affects Health Related Quality of Life After Lumbar Decompression Surgery.

Study Design: This was a retrospective comparative study.

Objective: The goal of this study was to further elucidate the relationship between preoperative depression and patient-reported outcome measurements (PROMs) following lumbar decompression surgery.

Summary Of Background Data: The impact of preoperative depression on PROMs after lumbar decompression surgery is not well established.

Does Smoking Affect Short-Term Patient-Reported Outcomes After Lumbar Decompression?

Study Design: Retrospective cohort study.

Objective: The goal of this study was to determine how smoking status influences patient-reported outcome measurements (PROMs) in patients undergoing lumbar decompression surgery.

Methods: Patients undergoing lumbar decompression between 1 to 3 levels at a single-center, academic hospital were retrospectively identified.

Does Smoking Status Influence Health-Related Quality of Life Outcome Measures in Patients Undergoing ACDF?

Study Design: Retrospective comparative study.

Objective: Whereas smoking has been shown to affect the fusion rates for patients undergoing an anterior cervical discectomy and fusion (ACDF), the relationship between smoking and health-related quality of life outcome measurements after an ACDF is less clear. The purpose of this study was to evaluate whether smoking negatively affects patient outcomes after an ACDF for cervical degenerative pathology.

Is Open Surgery for Metastatic Spinal Cord Compression Secondary to Lung Cancer Really Beneficial? A Systematic Review.

Objective: Spinal cord compression secondary to metastatic epidural lung cancer generally has a worse prognosis when compared with other metastatic tumors. The purpose of this study was to determine the impact of open surgery on the survival time, ambulation status, and associated prognostic variables of these patients over the past 2 decades.

Methods: We searched the PubMed, MEDLINE, and CENTRAL databases to identify patients with spinal cord compression secondary to metastatic lung cancer.

Description and Reliability of the AOSpine Sacral Classification System.

Background: Several classification systems exist for sacral fractures; however, these systems are primarily descriptive, are not uniformly used, have not been validated, and have not been associated with a treatment algorithm or prognosis. The goal of the present study was to demonstrate the reliability of the AOSpine Sacral Classification System among a group of international spine and trauma surgeons.

Methods: A total of 38 sacral fractures were reviewed independently by 18 surgeons selected from an expert panel of AOSpine and AOTrauma members.

The Outcomes of Patients With Neck Pain Following ACDF: A Comparison of Patients With Radiculopathy, Myelopathy, or Mixed Symptomatology.

Study Design: Retrospective cohort study.

Objective: The goal of the present study was to determine whether neck pain responds differently to anterior cervical discectomy and fusion (ACDF) between patients with cervical radiculopathy and/or cervical myelopathy.

Summary Of Background Data: Many patients who undergo ACDF because of radiculopathy/myelopathy also complain of neck pain.

Updated Return-to-Play Recommendations for Collision Athletes After Cervical Spine Injury: A Modified Delphi Consensus Study With the Cervical Spine Research Society.

Background: Previous studies have attempted to establish return-to-play (RTP) guidelines in collision sport athletes after cervical spine injury; however, recommendations have been limited by scant high-quality evidence and basic consensus survey methodologies.

Objective: To create relevant clinical statements regarding management in collision sport athletes after cervical spine injury, and establish consensus RTP recommendations.

Methods: Following the modified Delphi methodology, a 3 round survey study was conducted with spine surgeons from the Cervical Spine Research Society and National Football League team physicians in order to establish consensus guidelines and develop recommendations for cervical spine injury management in collision sport athletes.