Isolated thoracic and lumbar transverse process fractures: Do they need spine surgeon evaluation? a high volume level I trauma center experience with cost analysis.

Background: Transverse process fractures (TPF) of the thoracic and lumbar spine have become increasingly identified due to CT imaging. Spine service consultation is common for further evaluation and management. There are several studies that demonstrate no difference in clinical outcome with or without spine service intervention.

Assessing Treatment of Floating Lateral Mass (FLM) Fractures of the Subaxial Cervical Spine.

Study Design: Retrospective cohort.

Objective: The purpose of the study was to evaluate differences across surgical approaches (anterior, posterior, or combined anterior-posterior) in terms of outcomes following treatment for floating lateral mass (FLM) fractures. Furthermore, we sought to determine whether operative approach to FLM fracture treatment remains superior to nonoperative treatment in terms of clinical outcomes.

Transpedicular Screw Placement Accuracy Using the O-Arm Versus Freehand Technique at a Single Institution.

Study Design: Retrospective cohort.

Objective: The objective of this study was to assess the effectiveness of the O-arm as an intraoperative imaging tool by comparing accuracy of pedicle screw placement to freehand technique.

Methods: The study comprised a total of 1161 screws placed within the cervical (n = 187) thoracic (n = 657), or lumbar (n = 317) spinal level.

Disparities in Access to Musculoskeletal Care: Narrowing the Gap: AOA Critical Issues Symposium.

The current health-care system in the United States has numerous barriers to quality, accessible, and affordable musculoskeletal care for multiple subgroups of our population. These hurdles include complex cultural, educational, and socioeconomic factors. Tertiary referral centers provide a disproportionately large amount of the care for the uninsured and underinsured members of our society.

Inter/Intraobserver Reliability of T1 Pelvic Angle (TPA), a Novel Radiographic Measure for Global Sagittal Deformity.

Study Design: Reliability analysis.

Objective: To assess intra- and interobserver agreement of the T1 pelvic angle (T1PA), a novel radiographic measure of spinal sagittal alignment. Orthopedic surgeons of various levels of experience measured the T1PA in a series of healthy adult volunteers.

The effect of pelvic motion on spinopelvic parameters.

Background Context: To date, many studies have examined how pelvic position affects the spinal curvature and spinopelvic parameters. However, these studies focus on a static relationship, comparing pelvis and spine in a relaxed or baseline position only. Indeed, the spinopelvic connection is dynamic, as subjects can easily be taught to rotate their pelvis anteriorly or posteriorly on the femoral head, all while maintaining an erect posture.

Pelvic incidence: a fixed value or can you change it?

Background Context: There has been renewed interest in the pelvic vertebrae by spinal surgeons recently. Those involved in working with patients with adult spinal deformity focus on the position of the fused spine as it relates to the pelvis, and determine success or failure by specific numbers for given pelvic parameters. The pelvic parameters that are commonly measured for these patients are pelvic tilt, sacral slope, and pelvic incidence (PI).

Analysis of Cervical Angiograms in Cervical Spine Trauma Patients, Does it Make a Difference?

Study Design: Retrospective review.

Objective: To evaluate computed tomography angiogram (CTA) use for diagnosing blunt vertebral artery injury (BVAI) at a single institution, to assess the incidence of BVAI in the studied population, and determine if diagnosis affected care. We also wanted to evaluate if testing and treatment resulted in complications.

Results of the Scoliosis Research Society Morbidity and Mortality Database 2009-2012: A Report From the Morbidity and Mortality Committee.

Introduction: Members of the Scoliosis Research Society are required to annually submit complication data regarding deaths, visual acuity loss, neurological deficit and infection (2012-1st year for this measure) for all deformity operations performed. The purpose of this study is to report the 2012 results and the differences in these complications from the years 2009-2012.

Methods: The SRS M&M database is a self-reported complications registry of deformity operations performed by the members.

Diagnosis, Treatment, and Outcome of Stenotrophomonas maltophilia Discitis and Cervical Osteomyelitis: A Case Report and Review of the Literature.

Case: A fifty-six-year-old man presented with a three-month history of worsening neck pain and weakness of the right arm. Magnetic resonance imaging revealed C5-C6 osteomyelitis and discitis and a prevertebral abscess from C3 to C7. He underwent staged instrumented anterior and posterior spinal fusion from C5 to C7, with an anterior C5-C6 cervical discectomy and a C6 corpectomy.

A Comparison of Early Clinical and Radiographic Complications of Iliac Screw Fixation Versus S2 Alar Iliac (S2AI) Fixation in the Adult and Pediatric Populations.

Study Design: Retrospective chart review.

Objective: To compare short-term clinical and radiographic complications between iliac screw (IS) and S2 alar-iliac (S2AI) screw fixation techniques in the adult and pediatric populations.

Summary Of Background Data: Pelvic fixation with lumbosacral implants is in widespread practice with numerous indications.

Acute Complications After Adult Spinal Deformity Surgery in Patients Aged 70 Years and Older.

Study Design/setting: This report is a retrospective case series that examined the acute complications of patients aged 70 years and older undergoing spinal deformity surgery that required fusion of at least 6 levels.

Objective: To determine the acute complications that patients in the eighth decade of their life experience after spinal reconstructive surgery, and how these complication rates compare with other patient populations undergoing similar procedures.

Summary Of Background Data: As the mean age of the United States population rises, more older patients with painful spinal deformities can be expected.

Evaluation of a new spine classification system, does it accurately predict treatment?

Study Design: The Thoracolumbar Injury Severity Score (TLISS) was introduced as a novel classifications system. Its aim was to simplify classification of thoracolumbar fractures, grade their severity in an ordinal manner as a guide to management. This study attempted to validate the TLISS as a guide to management.

Teachability and reliability of a new classification system for lower cervical spinal injuries.

Study Design: Reliability and validation study.

Objective: The objective of this study is to evaluate a new lower cervical spine injury classification system and assess its reliability, teachability, and clinical applications.

Summary Of Background Data: The recently proposed Cervical Spine Injury Severity Score (CSISS) morphologically describes lower cervical spine injuries and grades them on a score of 1 to 20 depending on the integrity of the 4 columns that make up the cervical spine.

Comparative reliability of 3 thoracolumbar fracture classification systems.

Study Design: Prospective study of 3 spine surgeons, 3 spine fellows, 3 nonspine orthopedists, and 12 orthopedic residents classifying 97 thoracolumbar fractures using the Denis, Association for Osteosynthesis (AO), and Thoracolumbar Injury Severity Score (TLISS) systems and reclassifying them 3 months later.

Objective: To compare the reliability of the Denis, AO, and TLISS classification systems and evaluate the skills necessary for their use.

Summary Of Background Data: The Denis and AO systems are the traditional methods of classification of thoracolumbar fractures.

Face tissue pressure in prone positioning: a comparison of three face pillows while in the prone position for spinal surgery.

Study Design: This is a prospective, randomized study.

Objective: The purpose was to compare the tissue-pillow interface pressures at the forehead and chin in patients positioned in the prone fashion for spinal surgery on each of 3 facial positioners.

Summary Of Background Data: Facial pressure ulcers have been infrequently observed after spinal surgery requiring prone positioning.

Face tissue pressures in prone positioning: a comparison of 3 pillows.

Study Design: Pilot Study.

Objective: The objective of this study was to compare face tissue pressures for 3 different prone head positioners in healthy, conscious individuals in the prone position.

Summary Of Background Data: The incidence of intraoperatively acquired pressure ulcers has been reported to range from 12% to 66%; healthcare literature lacks information about lesions specific to the face.

Vacuum-assisted wound closure in postoperative spinal wound infection.

Combined with antibiotic therapy, vacuum-assisted wound closure may help reduce the need for serial irrigation and debridement surgery, contributing to a decrease in overall hospital stay.

Cervical degenerative cyst located within the body of C2: a case report and review of the literature.

Study Design: A case report and review of the literature are presented.

Objectives: To describe the clinical course and treatment of a patient with an unusual intraosseous degenerative cyst within the body of the axis, as well as review the literature regarding these lesions.

Summary Of Background Data: Intraosseous degenerative cysts of the cervical spine are extremely rare.

The role of debridement and antibiotics in gunshot wounds to the spine.

Background: The number of spinal cord injuries due to gunshot wounds continues to rise each year, and they currently rank third behind motor vehicle collisions and falls. Spine and wound infections pose difficult problems for transgastrointestinal gunshot wounds to the spine.

Methods: A retrospective review of 114 patients with low-velocity gunshot wounds to the spine was performed.