Minimally Invasive Hemilaminectomy in Baastrup Disease: A Case Report and Discussion of "Kissing Spine Disease".

Case: A patient presented with midline back pain radiating into the left lower extremity. Magnetic Resonance images revealed an abnormal midline dorsal structure described as a facet cyst. Rupture was attempted by spinal needle under fluoroscopic guidance.

Removal of Spinal Instrumentation Is Not Required to Successfully Treat Postoperative Wound Infections in Most Cases.

Introduction: Controversy exists regarding whether spinal implants need to be removed to treat postoperative deep wound infections (DWIs). This retrospective study aimed to determine whether the removal or retention of implants impacts the successful treatment of a DWI after spine surgery.

Methods: Postoperative spine surgery patients presenting with signs of infection who underwent irrigation and debridement (I&D) at Twin Cities Spine Surgeons at Abbott Northwestern Hospital, Minnesota, USA, were studied.

Minimally Invasive Decompression With Noninstrumented Facet Fusion Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion for Stenosis Associated With Grade 1 Lumbar Degenerative Spondylolisthesis.

Study Design: Retrospective matched cohort study.

Summary Of Background Data: With a growing interest in minimally invasive spine surgery (MIS), the question of which technique is the most advantageous for patients with low-grade degenerative lumbar spondylolisthesis (DLS) still remains unclear.

Objective: To compare patient-reported outcomes, perioperative morbidity, and rates of reoperation between MIS decompression with either unilateral noninstrumented facet fusion (MIS-F) or with transforaminal interbody fusion (MIS-T) for grade 1 DLS.

Choose Wisely: Surgical Selection of Candidates for Outpatient Anterior Cervical Surgery Based on Early Complications Among Inpatients.

Background: Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are attractive targets for transition to the outpatient setting. We assessed the prevalence of rapid responses and major complications in the inpatient setting following 1 or 2-level ACDFs and CDAs. We evaluated factors that may place patients at greater risk for a rapid response or a postoperative complication.

Surgical Treatment of Single Level Cervical Radiculopathy: A Comparison of Anterior Cervical Decompression and Fusion (ACDF) Versus Cervical Disk Arthroplasty (CDA) Versus Posterior Cervical Foraminotomy (PCF).

Study Design: This was a retrospective cohort study.

Objective: The objective of this study is to retrospectively compare the clinical outcomes, complication rates, and reoperation rates among the 4 treatments in patients with cervical radiculopathy.

Summary Of Background Data: Surgical options for cervical radiculopathy include anterior cervical discectomy and fusion (ACDF), open posterior cervical foraminotomy (O-PCF), minimally invasive posterior cervical foraminotomy (MI-PCF), and cervical disk arthroplasty (CDA).

Symptomatic pseudarthrosis requiring revision surgery after 1- or 2-level ACDF with plating: peek versus allograft.

Background: Polyetheretherketone (PEEK) and machined allograft interbody spacers are among devices used as fusion adjuncts in anterior cervical discectomy and fusion (ACDF). Most results are good to excellent but some patients develop pseudarthrosis. We compared the reoperation rates for pseudarthrosis following 1- or 2-level ACDF with PEEK or allograft cages.

Complications with Minimally Invasive Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis in the Obese Population.

Study Design: A level-3 retrospective cohort analysis.

Objective: The aim of this study was to describe obesity's effect on complications and outcomes in degenerative spondylolisthesis patients treated by minimally invasive transforaminal lumbar interbody fusion (MI TLIF).

Summary Of Background Data: Obesity is associated with a greater complication rate among lumbar spine surgery patients.

Posterolateral Versus Transforaminal Interbody L4/5 Fusion: Correlation With Subsequent Surgery.

Study Design: This is a retrospective cohort study.

Objective: To compare posterolateral versus transforaminal interbody fusion (PLF vs. PLF+TLIF) of the L4/5 segment regarding rates of subsequent surgery, clinical and radiographic parameters, and patient satisfaction.

Clinical and Radiologic Comparison of Minimally Invasive Surgery With Traditional Open Transforaminal Lumbar Interbody Fusion: A Review of 452 Patients From a Single Center.

Study Design: Retrospective analysis of prospective data for parallel, consecutive series of patients (Level III).

Objective: Compare clinical results and radiographic outcomes of minimally invasive surgery (MIS) versus open techniques for transforaminal lumbar interbody fusion (TLIF).

Summary Of Background Data: Minimally invasive techniques allow transforaminal exposure with decreased soft tissue disruption, but the question remains whether surgical and functional outcomes are equivalent to open techniques.

Posterior cervical lateral mass screw fixation and fusion to treat pseudarthrosis of anterior cervical fusion.

Study Design: Retrospective clinical cohort study.

Objective: To determine the efficacy of posterior lateral mass screw/rod fixation and fusion for the treatment of symptomatic pseudarthrosis of anterior cervical fusion.

Summary Of Background Data: Both anterior revision and posterior repair of cervical pseudarthrosis have been reported.

Salvage procedures for pseudarthrosis after transforaminal lumbar interbody fusion (TLIF)-anterior-only versus anterior-posterior surgery: a clinical and radiological outcome study.

A retrospective review was performed to analyze the radiographic and functional outcomes of two different surgeries to repair a pseudarthrosis following a transforaminal lumbar interbody fusion (TLIF) procedure. Although there are several published reports on the results of the TLIF procedure, there are no reports on how to salvage a failed TLIF. A total of 38 consecutive patients with failed TLIF procedures (at 50 levels) were repaired by either a direct anterior approach only (21 patients) or by a combined direct anterior approach coupled with a posterior exploration and pseudarthrosis repair (17 patients).

A concomitant posterior approach improves fusion rates but not overall reoperation rates in multilevel cervical fusion for spondylosis.

Study Design: Retrospective comparative study of 2 approaches to multilevel fusion for cervical spondylosis in consecutive patients at a single institution.

Objective: To provide justification for a concomitant posterior approach in multilevel cervical fusion for spondylosis by demonstrating decreased pseudarthrosis and reoperation rates.

Summary Of Background Data: Among the factors that affect cervical rates is the number of levels, such that increasing the number of levels leads to lower fusion rates.

The use of bone morphogenetic protein in lumbar spine surgery.

Creating a solid lumbar spinal fusion remains a challenge. Despite advances in fixation, a pseudarthrosis still may occur. Recently, attention has focused on creating a more biologically favorable environment to enhance fusion rate.

Cervical degenerative changes in idiopathic scoliosis patients who underwent long fusion to the sacrum as adults: incidence, severity, and evolution.

Background: To date, there have been no published studies of the degenerative changes in the cervical spine in adult idiopathic scoliosis patients with thoracic and lumbar curves severe enough to require major reconstructive surgery.

Materials And Methods: The primary study group was 48 adult patients who had previously undergone a fusion from T10 or higher to the sacrum as an adult for idiopathic scoliosis. These were compared to 38 adults with unfused idiopathic scoliosis of 30 degrees -50 degrees and to 42 symptomatic adults presenting with cervical pain.

Cervical degenerative index: a new quantitative radiographic scoring system for cervical spondylosis with interobserver and intraobserver reliability testing.

Background: The lack of a widely available scoring system for cervical degenerative spondylosis encouraged the authors to establish and validate a systematic quantitative radiographic index.

Materials And Methods: This study included intraobserver and interobserver reliability testing among three reviewers with different years of experience. Each observer independently scored four cervical radiographs of 48 patients at separate intervals, and statistical analysis of the grading was performed.

Perioperative complications in revision anterior lumbar spine surgery: incidence and risk factors.

Study Design: This is a retrospective review of 129 consecutive anterior lumbar revision surgeries in 108 patients. It is a single-center, multi-surgeon study.

Objective: To determine occurrence rates and risk factors for perioperative complications in revision anterior lumbar fusion surgery.

Clinical and radiological outcome of anterior-posterior fusion versus transforaminal lumbar interbody fusion for symptomatic disc degeneration: a retrospective comparative study of 133 patients.

Abundant data are available for direct anterior/posterior spine fusion (APF) and some for transforaminal lumbar interbody fusion (TLIF), but only few studies from one institution compares the two techniques. One-hundred and thirty-three patients were retrospectively analyzed, 68 having APF and 65 having TLIF. All patients had symptomatic disc degeneration of the lumbar spine.

Revision lumbar arthrodesis for the treatment of lumbar cage pseudoarthrosis: complications.

Study Design: A study documenting major complications encountered in revision procedures for lumbar cage pseudoarthrosis.

Objective: To document the perioperative complications associated with revision surgery for threaded cylindrical cage pseudoarthrosis.

Summary Of Background Data: Pseudoarthrosis after cylindrical cage placement manifests as persistent or recurrent pain and disability after surgery.

Complications in long fusions to the sacrum for adult scoliosis: minimum five-year analysis of fifty patients.

Study Design: A retrospective study of complications with minimal 5-year follow-up of 50 adults with scoliosis with fusion from T10 or higher to S1.

Objectives: To document the perioperative and long-term complications and instrumentation problems, and to attempt to determine variables which may influence these problems. It is not a study of curve correction, balance, or functional outcome.

Reliability and accuracy of fine-cut computed tomography scans to determine the status of anterior interbody fusions with metallic cages.

Background Context: Computed tomography (CT) scan has been shown to be more accurate than radiographs in evaluating anterior interbody fusion but may still over-read the extent of fusion.

Purpose: To assess the reliability and accuracy of fine-cut CT scans with reconstructions in evaluating anterior lumbar interbody fusion (ALIF) with metallic cages using surgical exploration as the reference standard.

Study Design: Accuracy of a diagnostic test referenced to the gold standard.

SF-36 PCS benefit-cost ratio of lumbar fusion comparison to other surgical interventions: a thought experiment.

Study Design: A retrospective review of prospectively collected data.

Objectives: To review systematically the SF-36 PCS outcomes of a large data set, including several randomized clinical trials for lumbar spine fusion at 1 and 2 years after surgery. We also present for comparison a review of typical changes in SF-36 PCS in other surgical interventions (total knee replacement, total hip replacement, and coronary artery bypass surgery) to define the average reimbursement costs per PCS improvement with each of these interventions.

Stepwise methodology for plain radiographic assessment of pedicle screw placement: a comparison with computed tomography.

Objective: The objective of this study is to evaluate the effectiveness of a specific methodology for plain radiographic assessment of lumbar pedicle screw position.

Purpose: To evaluate the effectiveness of using orthogonal plain radiographs and a systematic method of interpretation, developed by the senior author, in assessing the placement of lumbar and lumbosacral pedicle screws.

Study Design: This was an adult cadaver study of the accuracy of using plain radiographs or computed tomography to assess pedicle screw position.

Minimally invasive transforaminal lumbar interbody fusion: indications, technique, and complications.

The authors provide an overview of the minimally invasive transforaminal lumbar interbody fusion (TLIF) procedure including indications, technique, and complications. This novel technique is a method of achieving circumferential lumbar fusion using a unilateral dorsal approach. Minimally invasive TLIF uses a tubular retractor that is inserted via a muscle-dilating exposure, thereby minimizing the approach-related morbidity.