Biomechanical Comparison of Multilevel Stand-Alone Lumbar Lateral Interbody Fusion With Posterior Pedicle Screws: An In Vitro Study.

Objective: Lumbar lateral interbody fusion (LLIF) allows placement of large interbody cages while preserving ligamentous structures important for stability. Multiple clinical and biomechanical studies have demonstrated the feasibility of stand-alone LLIF in single-level fusion. We sought to compare the stability of 4-level stand-alone LLIF utilizing wide (26 mm) cages with bilateral pedicle screw and rod fixation.

Characterization of ion release from a novel biomaterial, Molybdenum-47.5Rhenium, in physiologic environments.

Background Context: Metals from spinal implants are released into surrounding tissues by various mechanisms. Metal ion release has been associated with clinical implant failure, osteolysis, and remote site accumulation with adverse events. Significant corrosion and associated metal ion release has been described with currently used spinal implant alloys.

Delayed prosthetic seroma: a localized inflammatory response to COVID vaccination and infection?

We present a patient whom we believe developed a late abdominal mesh collection in response to COVID-19 mRNA vaccination booster and COVID-19 infection. A polypropylene mesh was placed during her right breast reconstruction operation 2 years ago where she underwent a right transverse abdominis rectus muscle (TRAM) free flap. She recovered uneventfully from this operation.

Biomechanical Comparison of Unilateral and Bilateral Pedicle Screw Fixation after Multilevel Lumbar Lateral Interbody Fusion.

Study Design: Human Cadaveric Biomechanical Study.

Objectives: Lumbar Lateral Interbody Fusion (LLIF) utilizing a wide cage has been reported as having favorable biomechanical characteristics. We examine the biomechanical stability of unilateral pedicle screw and rod fixation after multilevel LLIF utilizing 26 mm wide cages compared to bilateral fixation.

Late Seroma in Breast Implants: A Coronavirus Disease 2019 Phenomenon?

The coronavirus disease 2019 (COVID-19) pandemic has been challenging in all aspects of the medical field with new clinical presentations constantly arising. Plastic surgeons are not immune to this and need to be aware of their implications. There has been a recent report of late periprosthetic seroma (breast implant) as a clinical manifestation of COVID-19 infection.

Different definition of sarcopenia and mortality in cancer: A meta-analysis.

Objectives: Sarcopenia has been an emerging theme in clinical oncology. Various definitions of sarcopenia have been proposed, but their prognostic performance have yet to be evaluated and compared. The aim of this meta-analysis is to comprehensively evaluate the performance of different cutoff definitions of sarcopenia in cancer mortality prognostication.

Sarcopenia and mortality in cancer: A meta-analysis.

Objectives: The aim of this meta-analysis is to comprehensively evaluate the effects of lean mass on all-cause mortality across different cancer types.

Methods: This is a meta-analysis. Cohort studies on lean mass and mortality published before December 20, 2017 were obtained by systematic search on PubMed, Cochrane Library, and Embase.

Sarcopenia and mortality in different clinical conditions: A meta-analysis.

Objectives: Sarcopenia is recognized to be a health problem which is as serious as obesity, but its relevance to mortality is unclear. We conducted a meta-analysis of cohort studies on lean mass and mortality in populations with different health conditions.

Methods: In this study, a systematic search of PubMed, Cochrane Library and Embase was performed for cohort studies published before Dec 20, 2017 which examined the relationship between lean mass and mortality.

The effect of different measurement modalities in the association of lean mass with mortality: A systematic review and meta-analysis.

Objectives: Lean mass is commonly measured by 3 modalities, dual energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and computerized tomography (CT). CT is considered the most accurate, while lean mass measured by DXA and BIA often consists of non-muscle compartment, and hence considered less accurate when compared with CT. It remains unclear if the association of lean mass with mortality would differ using different measurement modalities.

Systematic review and meta-analysis of lean mass and mortality: Rationale and study description.

Objectives: Muscle mass is one of the key components in defining sarcopenia and is known to be important for locomotion and body homeostasis. Lean mass is commonly used as a surrogate of muscle mass and has been shown to be associated with increased mortality. However, the relationship of lean mass with mortality may be affected by different clinical conditions, modalities used, cut-off point to define low or normal lean mass, and even types of cancer among cancer patients.

Sacroiliac joint injections with the guidance of three-dimensional cone beam computed tomography (3D-CBCT) and fluoroscopy fusion.

Background: We describe our diagnostic sacroiliac joint (SIJ) injection technique under the guidance of three-dimensional cone beam computed tomography (3D-CBCT) fused with real-time fluoroscopy.

Methods: A retrospective review of 17 patients (mean age 55.4 (range 40-74) years) who received a total of 23 diagnostic SIJ injections between March 2016 and November 2017 were performed.

Gracilis pull-through flap for the repair of a recalcitrant recto-vaginal fistula.

Recto-vaginal fistulas are difficult to treat due to their high recurrence rate. Currently, no single surgical intervention is universally regarded as the best treatment option for rectovaginal fistulas. We present a case of recurrent recto-vaginal fistula surgically treated with a gracilis pull-through flap.

The landscape of selection in 551 esophageal adenocarcinomas defines genomic biomarkers for the clinic.

Esophageal adenocarcinoma (EAC) is a poor-prognosis cancer type with rapidly rising incidence. Understanding of the genetic events driving EAC development is limited, and there are few molecular biomarkers for prognostication or therapeutics. Using a cohort of 551 genomically characterized EACs with matched RNA sequencing data, we discovered 77 EAC driver genes and 21 noncoding driver elements.

The impact of mental health on patient-reported outcomes in cervical radiculopathy or myelopathy surgery.

Optimizing functional outcomes and disability status are essential for effective surgical treatment of cervical spine disorders. Mental impairment is common among patients with cervical spine complaints; yet little is known about the impact of baseline mental status with respect to overall patient-reported outcomes. This was a retrospective analysis of patients with cervical spondylosis with myelopathy(CM) or radiculopathy(CR: cervical disc herniation, stenosis, or spondylosis without myelopathy) at 2-year follow-ups.

Transforaminal Lumbar Interbody Fusion: Traditional Open Versus Minimally Invasive Techniques.

Recently, minimally invasive spine arthrodesis has gained popularity among spine surgeons. Minimally invasive techniques have advantages and disadvantages compared with traditional open techniques. Comparisons between short-term outcomes of minimally invasive transforaminal interbody fusion and open transforaminal interbody fusion in terms of estimated blood loss, postoperative pain, and hospital length of stay have been well documented and generally favor the minimally invasive technique.

Direct Measurement of Tissue Oxygenation as a Method of Diagnosis of Acute Compartment Syndrome.

Objective: The aim of this study was to investigate the utility of direct measurement of tissue oxygenation during compartment syndrome (CS) and tourniquet-induced ischemia in a large animal model. We hypothesize that as compartment pressure (CP) rises, circulation within the compartment will decrease resulting in a decreased level of oxygen in the muscle.

Methods: This study used a dog model of both CS- and tourniquet-based ischemia.

Impact of a Bundled Payment System on Resource Utilization During Spine Surgery.

Background: In a bundled payment system, a single payment covers all costs associated with a single episode of care. Spine surgery may be well suited for bundled payments because of clearly defined episodes of care, but the impact on current practice has not been studied. We sought to examine how a theoretical bundled payment strategy with financial disincentives to resource utilization would impact practice patterns.

How Effective is Physical Therapy for Common Low Back Pain Diagnoses?: A Multivariate Analysis of 4597 Patients.

Study Design: A retrospective review.

Objective: The aim of this study is to evaluate whether the treatment of low back pain with physical therapy results in clinically significant improvements in patient-reported pain and functional outcomes.

Summary Of Background Data: Low back pain is a major cause of morbidity and disability in health care.

Is the lateral jack-knife position responsible for cases of transient neurapraxia?

Objective: The lateral jack-knife position is often used during transpsoas surgery to improve access to the spine. Postoperative neurological signs and symptoms are very common after such procedures, and the mechanism is not adequately understood. The objective of this study is to assess if the lateral jack-knife position alone can cause neurapraxia.

The versatile functions of Sox9 in development, stem cells, and human diseases.

The transcription factor Sox9 was first discovered in patients with campomelic dysplasia, a haploinsufficiency disorder with skeletal deformities caused by dysregulation of expression during chondrogenesis. Since then, its role as a cell fate determiner during embryonic development has been well characterized; expression differentiates cells derived from all three germ layers into a large variety of specialized tissues and organs. However, recent data has shown that ectoderm- and endoderm-derived tissues continue to express in mature organs and stem cell pools, suggesting its role in cell maintenance and specification during adult life.

Bone Morphogenetic Protein (BMP) signaling in development and human diseases.

Bone Morphogenetic Proteins (BMPs) are a group of signaling molecules that belongs to the Transforming Growth Factor-β (TGF-β) superfamily of proteins. Initially discovered for their ability to induce bone formation, BMPs are now known to play crucial roles in all organ systems. BMPs are important in embryogenesis and development, and also in maintenance of adult tissue homeostasis.

Evaluation of immediate postoperative complications and outcomes among military personnel treated for spinal trauma in Afghanistan: a cohort-control study of 50 cases.

Study Design: Retrospective case-control study.

Objective: The objective of the study was to compare neurological outcomes and complication rates between a series of combat-injured patients treated in Afghanistan (AFG) and those treated at Landstuhl Regional Medical Center (LRMC).

Summary Of Background Data: At present, no studies have addressed the ideal timing and setting for surgical stabilization in combat-injured soldiers who sustain spinal trauma.

Characterization of scaffold carriers for BMP9-transduced osteoblastic progenitor cells in bone regeneration.

Successful bone tissue engineering at least requires sufficient osteoblast progenitors, efficient osteoinductive factors, and biocompatible scaffolding materials. We have demonstrated that BMP9 is one of the most potent factors in inducing osteogenic differentiation of mesenchymal progenitors. To facilitate the potential use of cell-based BMP9 gene therapy for bone regeneration, we characterize the in vivo osteoconductive activities and bone regeneration potential of three clinically used scaffold materials, type I collagen sponge, hydroxyapatite-tricalcium phosphate (HA-TCP), and demineralized bone matrix (DBM), using BMP9-expressing C2C12 osteoblastic progenitor cells.

Psychological distress in the active duty military spine patient.

Disorders of the spine are a substantial burden to the military health care system that degrades readiness in the overall force. Because treatment outcomes are affected by psychosocial factors, assessment of psychological distress is important for patients with spine complaints. The incidence of psychological distress in the unique military population is not well described.

Effect of vacuum spine board immobilization on incidence of pressure ulcers during evacuation of military casualties from theater.

Background Context: In the summer of 2009, the vacuum spine board (VSB) was designated by the US Air Force as the preferred method of external spinal immobilization during aeromedical transport of patients with suspected unstable thoracolumbar spine fractures. One purported advantage of the VSB is that, by distributing weight over a larger surface area, it decreases the risk of skin pressure ulceration.

Purpose: To examine whether the rate of pressure ulcers has changed since the introduction of the VSB.