Impact of nutritional status in patients with metastatic spinal tumors who underwent palliative surgery.

Background: Preoperative nutritional status significantly affects postoperative outcomes in patients with metastatic spinal tumors. Understanding the relationship between nutritional status and survival rates can help optimize treatment strategies and improve patient outcomes.

Methods: This retrospective study was performed on 57 patients who underwent palliative surgery between May 2009 and April 2023.

Accuracy of Cup Placement Angle, Leg Lengthening, and Offset Measurement Using an AR-Based Portable Navigation System: Validation in Supine and Lateral Decubitus Positions for Total Hip Arthroplasty.

: Total hip arthroplasty (THA) requires accurate implant placement to ensure optimal outcomes. In this study, the AR Hip navigation system, an imageless portable navigation tool using augmented reality (AR), was evaluated for measuring radiographic inclination (RI), anteversion (RA), leg lengthening (LL), and offset (OS) changes in supine and lateral decubitus THA. Notably, this is the first report to assess the accuracy of LL and OS measurements using AR technology.

Dynamic Balance and Muscle Activity in Lifesavers: A Study on Intrinsic and Extrinsic Foot Muscles.

Activities on sandy soil are known to contribute to improved leg strength and balance. Lifesavers (LSs) have shown that sandy soil activity promotes intrinsic foot muscle development and improves balance. LS improves leg strength and balance through activities on sandy soil.

Continuous local antibiotic perfusion technique for surgical site infections after shoulder surgery.

Background: Continuous local antibiotic perfusion (CLAP) is a method for preserving tissue and function against surgical site infections (SSIs) after shoulder surgery.

Methods: To describe the application of the novel CLAP technique to 10 patients with SSIs after shoulder surgery that were not controlled with repeated surgical débridement or elderly patients who are insufficient physical resilience for further surgeries.

Results: CLAP, consisting of gentamicin, was performed for 2 weeks, after which the infection was well-controlled.

"As long as you have a dream and as long as you work hard, your dream will come true".

Background: Some young physicians decide their ultimate life goals early in life. The purpose of this article is to convey the message with feeling that because everyone lives only once, I want them to try many various things.

Method: The author introduces several unpredictable episodes that became watershed moments for him, and describes how he each behaved.

Posterior Dislocation of the Sternoclavicular Joint in a Patient With Hemophilia: A Case Report.

Posterior sternoclavicular joint (SCJ) dislocations are rare but serious injuries. We report our experience with a patient with hemophilia who experienced posterior dislocation of the SCJ and was treated with an open repair technique.  A 17-year-old man with hemophilia had a posterior dislocation of the SCJ and the proximal clavicle was an approximation to the brachiocephalic artery.

Subchondral insufficiency fractures of the medial tibial condyle are associated with medial meniscus extrusion: A retrospective observational study.

Background: To the best of our knowledge, no prior studies have identified any risk factors for subchondral insufficiency fractures of the medial tibial condyle. This study aimed to explain relationships between subchondral insufficiency fractures of the medial tibial condyle and the meniscus status, lower extremity alignment, or osteoporosis.

Methods: This retrospective study included 325 consecutive patients whose chief complaint is knee joint pain and who had visited one institution between April 2016 and March 2021, of which 70 patients (8 men and 62 women) who had suspected subchondral insufficiency fractures of the medial tibial condyle had undergone magnetic resonance imaging and radiographic examination.

Utility of a Navigated High-Speed Drill in Robotic-Assisted Screw Placement for Spine Surgery.

Purpose To elucidate the utility of a navigated high-speed drill used after the version upgrade in surgeries assisted by a spinal robotics system. Methods The subjects were 166 patients who underwent screw placement using a spinal robotics system between April 2021 to July 2023. A significant change during the study was the introduction of a navigated high-speed drill in 80 post-upgrade cases, aimed at improving drilling accuracy.

Comparison of Radiographic and Patient-Reported Outcomes After Surgery in Adolescent Idiopathic Scoliosis Between Robotics and Navigation: An Analysis Using Propensity Score Matching.

Purpose This study aimed to compare the radiographic and patient-reported outcomes after surgery in adolescent idiopathic scoliosis (AIS) between robotics and navigation using propensity score matching. Methods This retrospective study involved 50 patients undergoing posterior spinal fusion for AIS between October 2016 and August 2022, utilizing navigation or robotic systems, analyzing them using propensity score matching. The evaluations included assessments using X-ray, Scoliosis Research Society 22-Item (SRS-22) Questionnaire, and CT, considering variables such as age, gender, BMI, and Lenke type.

Long-term changes in bone mineral density following adolescent idiopathic scoliosis surgery: a minimum 34-year follow-up.

Purpose: To investigate longitudinal changes in bone mineral density (BMD) in middle-aged female patients who underwent spinal fusion for adolescent idiopathic scoliosis (AIS).

Methods: The study subjects were 229 female patients who were diagnosed with AIS and underwent spinal fusion between 1968 and 1988. A two-step survey study was conducted on 19 female AIS patients.

Nutritional Status Is Associated With Survival Following Spinal Surgery in Patients With Metastatic Spinal Tumors.

Background Preoperative and postoperative nutritional statuses are reported to influence the outcomes and complications of multidisciplinary treatment, including patient survival. However, a causal relationship between nutritional status and survival following spinal surgery has not been demonstrated in patients with metastatic spinal tumors. The present study was, therefore, designed to evaluate the correlation between the nutritional status and survival following spinal surgery in patients with metastatic spinal tumors.

Learning curves for robotic-assisted spine surgery: an analysis of the time taken for screw insertion, robot setting, registration, and fluoroscopy.

Purpose: The purpose of this study was to clarify the learning curve for robotic-assisted spine surgery. We analyzed the workflow in robotic-assisted spine surgery and investigated how much experience is required to become proficient in robotic-assisted spine surgery.

Methods: The data were obtained from consecutive 125 patients who underwent robotic-assisted screw placement soon after introducing a spine robotic system at a single center from April 2021 to January 2023.

Safety of robotic-assisted screw placement for spine surgery: Experience from the initial 125 cases.

Background: The present study aimed to evaluate the safety of robot-assisted screw placement in 125 cases after introducing a spinal robotics system and to identify the situations where deviation was likely to occur.

Methods: The subjects were 125 consecutive patients who underwent robotic-assisted screw placement using a spinal robotics system (Mazor X Stealth Edition, Medtronic) from April 2021 to January 2023. The 1048 screws placed with robotic assistance were evaluated.

Balloon kyphoplasty combined with percutaneous pedicle screw (PPS) for the treatment of osteoporotic thoracolumbar fractures has minimum correction loss 2 years after surgery: compared to vertebroplasty using hydroxyapatite block combined with PPS.

Background: Balloon kyphoplasty (BKP) is a useful treatment performed in patients with painful osteoporotic vertebral body fracture (OVF). However, in cases with large intra-vertebral clefts and cases with posterior spinal tissue damage, adjacent vertebral body fractures (AVFs), and cement migration may occur early after BKP, which may be a factor for poor results. In such cases, percutaneous vertebroplasty (PVP) combined with percutaneous pedicle screw (PPS) is useful treatment.

Impact of the COVID-19 Pandemic on Middle-Aged and Older Patients With Adolescent Idiopathic Scoliosis Who Underwent Spinal Fusion: A Questionnaire-Based Survey.

Purpose To investigate the impact of the COVID-19 pandemic on middle-aged and older patients with adolescent idiopathic scoliosis (AIS) who underwent spinal fusion. Methods The subjects were 252 AIS patients who underwent spinal fusion between 1968 and 1988. The surveys were performed before the COVID-19 pandemic (a primary survey in 2014) and during the pandemic (a secondary survey in 2022).

Health-Related Quality of Life of Patients With Adolescent Idiopathic Scoliosis at Least 40 Years After Surgery.

Study Design: Retrospective study.

Objective: The aim was to clarify the health-related quality of life (QOL) of patients who had adolescent idiopathic scoliosis (AIS) at a minimum of 40 years after surgery.

Summary Of Background Data: The postoperative health-related QOL of middle-aged patients with AIS has been reported to be good, but that of middle-aged and older patients with AIS has yet to be completely explored.

Accuracy and Screw Insertion Time of Robotic-Assisted Cortical Bone Trajectory Screw Placement for Posterior Lumbar Interbody Fusion: A Comparison of Early, Middle, and Late Phases.

Introduction The purpose of this study was to evaluate robotic-assisted cortical bone trajectory (CBT) screw placement. Early, middle, and late phases of robotic-assisted CBT screw placement were compared for accuracy and screw insertion time by comparing time and accuracy in every phase.  Methods A retrospective review was conducted on the initial 40 patients who underwent spinal fusion using CBT screws in one institution from September 2021 to September 2022 utilizing a spine surgery robot system (Mazor X Stealth Edition, Medtronic Inc.

Accuracy of computer-assisted pedicle screw placement for adolescent idiopathic scoliosis: a comparison between robotics and navigation.

Purpose: To compare the accuracy of pedicle screw placement in adolescent idiopathic scoliosis (AIS) between robotics and navigation and clarify the factors that cause screw deviation when robotics is used.

Methods: Fifty consecutive patients who underwent posterior spinal fusions with computer-assisted pedicle screw placement including robotics and navigation for AIS were included. A total of 741 pedicle screws (250: Robot group, 491: Navi group) were evaluated on postoperative CT images.

The Learning Curve of Robotic-Assisted Pedicle Screw Placements Using the Cumulative Sum Analysis: A Study of the First 50 Cases at a Single Center.

Introduction: The purpose of this study was to clarify how many cases surgeons need to experience to pass the learning phase of robotic-assisted spine surgery using the cumulative sum (CUSUM) analysis.

Methods: A retrospective review was conducted on the initial 50 consecutive patients who underwent robotic-assisted pedicle screw placements with open procedures using a spine robotic system (Mazor X Stealth Edition) at a single center from April 2021 to January 2022. There were 19 male and 31 female patients with a mean age of 58.

Diagnosis of Spinal Infection with Alpha-defensin Lateral Flow Test: A Preliminary Report.

Introduction: The alpha-defensin lateral flow test has been used in periprosthetic joint infection as a diagnostic support tool because of its simplicity and speed. However, the test has not been used to diagnose spinal infections. The purpose of this study was to investigate the efficacy of the alpha-defensin lateral flow test for diagnosing spinal infections.

Robotics is useful for less-experienced surgeons in spinal deformity surgery.

Purpose: To verify whether robotics was useful for surgeons who had less experience with spinal deformity surgery.

Methods: A retrospective review was conducted of 70 consecutive patients who underwent robotic-assisted pedicle screw placements with open procedures using a spine robotic system (Mazor X Stealth Edition) at a single institution from April 2021 to April 2022. Gertzbein-Robbins grades were used to assess the deviation of the 599 pedicle screws in the postoperative CT images.

Accuracy of robotic-assisted pedicle screw placement comparing junior surgeons with expert surgeons: Can junior surgeons place pedicle screws as accurately as expert surgeons?

Background: The purpose of this study was to verify whether a spine robotic system was useful for junior surgeons.

Methods: Twenty-seven patients underwent posterior spinal fusion with open surgery using a spine robotic system (Mazor X Stealth Edition, Medtronic Inc., Dublin, Ireland) from April to August 2021.

Screw Insertion Time, Fluoroscopy Time, and Operation Time for Robotic-Assisted Lumbar Pedicle Screw Placement Compared With Freehand Technique.

Introduction The purpose of this study was to clarify the superiority of robotic-assisted lumbar pedicle screw placement in terms of screw insertion time, fluoroscopy time, and operation time. Methods The subjects were 46 patients who underwent a posterior lumbar interbody fusion with an open procedure for lumbar degenerative disease from April 2021 to February 2022. The robot group contained 29 cases of screw insertion using a spine robotic system (Mazor X Stealth Edition, Medtronic Inc.

Supramalleolar Lateral Opening-Wedge Osteotomy in Conjunction With Progressive Collapsing Foot Deformity Reconstruction for PCFD With Ankle Instability.

Background: Reconstruction of progressive collapsing foot deformity (PCFD) with ankle instability (PCFD class E) remains a substantial challenge to orthopaedic surgeons. We report the outcomes of PCFD class E treated by means of a relatively standard PCFD foot reconstruction approach with the addition of a supramalleolar lateral opening-wedge osteotomy.

Methods: We conducted a retrospective study of 13 patients (15 ankles) who underwent this procedure for PCFD class E between 2010 and 2021.