Optimal Duration of Antibiotic Therapy for Primary Osteomyelitis Discitis: A Systematic Review and Network Meta-Analysis.

Study Design: Systematic Review and Network-Meta-analysis.

Purpose: This study aimed to systematically review the literature on management of primary osteomyelitis discitis and perform a network meta-analysis comparing the efficacy of different antibiotic treatment durations.

Background: Primary osteomyelitis discitis is a challenging condition with varying management strategies.

Comparative Analysis of Large Language Models and Spine Surgeons in Surgical Decision-Making and Radiological Assessment for Spine Pathologies.

Objective: This study aimed to investigate the accuracy of large language models (LLMs), specifically ChatGPT and Claude, in surgical decision-making and radiological assessment for spine pathologies compared to experienced spine surgeons.

Methods: The study employed a comparative analysis between the LLMs and a panel of attending spine surgeons. Five written clinical scenarios encompassing various spine pathologies were presented to the LLMs and surgeons, who provided recommended surgical treatment plans.

Neurologic Quality of Life Outcomes in Patients with Normal Pressure Hydrocephalus After Ventriculoperitoneal Shunt Placement: A Prospective Assessment of Cognition, Mobility, and Social Participation.

Background: Idiopathic normal pressure hydrocephalus (iNPH) typically presents with gait disturbances, cognitive decline, and urinary incontinence. Symptomatic improvement generally occurs following shunt placement, but limited evidence exists on the quality of life (QOL) metrics in iNPH. Therefore, we conducted a prospective study of the effect of shunt placement on QOL in iNPH patients, using Quality of Life in Neurologic Disorders (Neuro-QOL) metrics.

Predictors of syrinx presentation and outcomes in pediatric Chiari malformation type I: a single institution experience of 218 consecutive syrinx patients.

Purpose: Chiari I malformation (CM-I) in pediatric patients can impose substantial neurologic and functional impairment. Additionally, the presence of syrinx is often a harbinger of clinical compromise, but little attention has been devoted to identifying features associated with syrinx development and the clinical impact of syrinx resolution. Therefore, this study aims to identify clinical and radiographic variables associated with preoperative syrinx presence and postoperative syrinx reduction in pediatric patients with CM-I and determine the relationship between postoperative syrinx reduction and clinical symptom improvement.

Basilar Impression: A Systematic Review and Meta-Analysis of Clinical Features, Operative Strategies, and Outcomes.

Objective: Basilar impression (BI) is a rare yet debilitating abnormality of the craniovertebral junction, known to cause life-threatening medullary brainstem compression. Our study analyzes surgical approaches for BI and related outcomes.

Methods: A systematic review was conducted using PubMed, Google Scholar, and Web of Science electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to critically assess primary articles examining BI.

Age is Associated with Level of First-Time Anterior Cervical Discectomy and Fusion: An Ordinal Analysis of Factors Influencing Timing of Cervical Degeneration.

Background: Symptomatic cervical spondylosis is often treated with anterior cervical discectomy and fusion (ACDF). However, few factors can predict which cervical level will degenerate and require intervention. This analysis evaluates preprocedural factors associated with level of first-time single-level ACDF.

3D-Printed Spine Models for Planning Staged Minimally Invasive Transverse Process Resections for Bertolotti Syndrome: Technical Note.

Background: Three-dimensional (3D) printing has enabled numerous advances in spine surgery execution and education. However, few examples exist to outline how this technology can aid the performance of complex spine surgery using minimally invasive surgery (MIS) techniques. Therefore, we present a case that illustrates the benefits of 3D-printed spine model production before and after correction of a congenital lumbosacral anomaly using an MIS approach.

Metastatic Infiltration of Nervous Tissue and Periosteal Nerve Sprouting in Multiple Myeloma-Induced Bone Pain in Mice and Human.

Multiple myeloma (MM) is a neoplasia of B plasma cells that often induces bone pain. However, the mechanisms underlying myeloma-induced bone pain (MIBP) are mostly unknown. Using a syngeneic MM mouse model, we show that periosteal nerve sprouting of calcitonin gene-related peptide (CGRP) and growth associated protein 43 (GAP43) fibers occurs concurrent to the onset of nociception and its blockade provides transient pain relief.

Image-Guided Percutaneous Multilevel Pediculosynthesis for Treatment of Contiguous Pedicle Stress Fractures: Technical Case Report.

Background: Nontraumatic pedicle fracture is uncommon, with sparsely described cases of conservative management versus surgical treatment by open fusion or percutaneous fixation.

Methods: We report the case of a 60-year-old woman with nontraumatic L4 and L5 pedicle fracture who developed additional pedicle fractures at L3 while undergoing conservative management in a brace. The patient underwent percutaneous pediculosynthesis with screw fixation without fusion at L3-5 bilaterally.

Single Nucleotide Polymorphisms and Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis of the Literature.

Study Design: Meta-analysis.

Objective: To determine the single nucleotide polymorphisms (SNPs) that are related to adult idiopathic scoliosis.

Summary And Background Data: Adolescent idiopathic scoliosis (AIS) is considered one of the most prevalent spinal diseases.

Transfusion Guidelines in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of the Currently Available Evidence.

Our study aims to provide a synthesis of the best available evidence on the hemoglobin (hgb) red blood cell (RBC) transfusion thresholds in adult traumatic brain injury (TBI) patients, as well as describing the risk factors and outcomes associated with RBC transfusion in this population. A systematic review and meta-analysis was conducted using PubMed, Google Scholar, and Web of Science electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to assess articles discussing RBC transfusion thresholds and describe complications secondary to transfusion in adult TBI patients in the perioperative period. Fifteen articles met search criteria and were reviewed for analysis.

Applying 3-Dimensional Printing and Modeling for Preoperative Reconstruction and Instrumentation Placement Planning in Complex Deformity Surgery.

Background: Advances in three-dimensional (3D) printing technology have enabled the development of customized instrumentation and surgical training platforms. However, no existing studies have assessed how patient-specific 3D-printed spine models can facilitate patient education and operative planning in complex spinal deformity correction.

Objective: To present a cost-effective technique for constructing personalized 3D-printed spine models for patients with severe spinal deformities and to outline how these models can promote informed consent, trainee education, and planning for instrumentation placement and alignment correction.

RNA profiling of human dorsal root ganglia reveals sex differences in mechanisms promoting neuropathic pain.

Neuropathic pain is a leading cause of high-impact pain, is often disabling and is poorly managed by current therapeutics. Here we focused on a unique group of neuropathic pain patients undergoing thoracic vertebrectomy where the dorsal root ganglia is removed as part of the surgery allowing for molecular characterization and identification of mechanistic drivers of neuropathic pain independently of preclinical models. Our goal was to quantify whole transcriptome RNA abundances using RNA-seq in pain-associated human dorsal root ganglia from these patients, allowing comprehensive identification of molecular changes in these samples by contrasting them with non-pain-associated dorsal root ganglia.

Trends in Racial and Ethnic Representation Among Neurosurgery Applicants and Residents: A Comparative Analysis of Procedural Specialties.

Background: Diversity, equity, and inclusion within the healthcare workforce are conducive to providing culturally competent care. However, few existing studies have assessed the level of racial and ethnic diversity among resident physicians and residency applicants. Our objective was to provide a comparative analysis of the trends in racial and ethnic representation within different subspecialties in medicine.

Standard of Care During a Crisis: What Should a Surgeon Know (and Do)?

Numerous catastrophic events in the 21st century have motivated renewed discussion regarding whether the traditional definition of standard of care appropriately applies to clinical decision-making in crisis scenarios. Some authorities have proposed the adoption of a crisis standard of care, which refines physician responsibilities during a crisis event in accordance with population health principles. However, this proposal is fraught with controversy, and current medical and legal scholarship on this topic remains complex and conflicted.

Development and Internal Validation of the Postoperative Analgesic Intake Needs Score: A Predictive Model for Post-Operative Narcotic Requirement after Spine Surgery.

Study Design: Retrospective Cohort.

Objective: The aim of this study was to develop a clinical tool to pre-operatively risk-stratify patients undergoing spine surgery based on their likelihood to have high postoperative analgesic requirements.

Methods: A total of 1199 consecutive patients undergoing elective spine surgery over a 2-year period at a single center were included.

The natural history of non-functioning pituitary adenomas: A meta-analysis of conservatively managed tumors.

Background: Non-functioning pituitary adenomas (NFPA) are often discovered incidentally. The natural history of NFPA is not well understood, obfuscating evidence-based management decisions. Meta-data of radiographically followed NFPA may help guide conservative versus operative treatment of these tumors.

Decisional Regret Among Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity: A Single Institutional Study.

Study Design: Retrospective.

Objective: To investigate the prevalence of decisional regret among older adults undergoing surgery for adult spinal deformity (ASD).

Summary Of Background Data: Among older adults (≥65 years old), ASD is a leading cause of disability, with a population prevalence of 60% to 70%.