Publications by authors named "Jeremy Fogelson"
Objective: The purpose of this study was to evaluate the risk factors for loss of intraoperative correction, as measured by lumbar lordosis (LL), with an emphasis on rod characteristics.
Methods: A retrospective study identified patients at least 50 years of age who underwent instrumented fusion with an upper instrumented vertebrae (UIV) in the upper thoracic spine (T1-T6) or thoracolumbar junction (T10-L2) to the pelvis. Inclusion criteria included intraoperative x-rays that allowed for LL measurement, postop standing x-rays, and a minimum follow up of 24 months with the original rods still in place.
Objective: Hounsfield units (HUs) may better predict biomechanical complications of instrumented fusion than conventional bone quality measures. Typically, noncontrast axial slices are used. This study aims to address the influence of reconstruction plane and contrast administration on measured HUs in patients undergoing lumbar spine imaging.
View Article and Find Full Text PDFVentral Thoracic Cerebrospinal Fluid Leak Repair in Spontaneous Intracranial Hypotension Complicated by Superficial Siderosis: 2-Dimensional Operative Video.
Oper Neurosurg (Hagerstown)
October 2024
Paraspinal Sarcopenia and Lower Hounsfield Units are Independent Predictors of Increased Risk for Proximal Junctional Complications Following Thoracolumbar Fusions Terminating in the Upper Thoracic Spine.
Global Spine J
August 2024
Article Synopsis
- * Researchers compared two groups of patients: those who did not develop PJK or PJF and those who did, finding that patients with PJK/PJF had significantly lower muscle density and higher rates of severe sarcopenia.
- * The findings indicate that having severe sarcopenia and lower bone density increases the risk of these complications following thoracolumbar spinal fusion surgeries.
Purpose: To determine of the impact of ALIF with minimally invasive unilateral pedicle screw fixation (UPSF) versus bilateral pedicle screw fixation (BPSF) on perioperative outcomes, radiographic outcomes, and the rates of fusion, subsidence, and adjacent segment stenosis.
Methods: All adult patients who underwent one-level ALIF with UPSF or BPSF at an academic institution between 2015 and 2022 were retrospectively identified. Postoperative outcomes including length of hospital stay (LOS), wound complications, readmissions, and revisions were determined.
Article Synopsis
- The study aimed to investigate the incidence of interbody subsidence in patients who underwent transforaminal lumbar interbody fusion (TLIF), along with identifying risk factors and evaluating the consequences of subsidence on complications and fusion rates.
- A retrospective analysis was conducted on adult patients who had one- or two-level TLIF from 2017-2019, excluding those with certain conditions or incomplete follow-ups, and used CT scans to measure subsidence after surgery.
- Results indicated that 28% of fusion levels encountered moderate subsidence, while 35% faced severe subsidence, with factors such as cage surface area and material type linked to higher subsidence rates.
Change in spinal bone mineral density as estimated by Hounsfield units following osteoporosis treatment with romosozumab, teriparatide, denosumab, and alendronate: an analysis of 318 patients.
J Neurosurg Spine
September 2024
Article Synopsis
- This study aimed to assess how different osteoporosis medications affect bone density, measured in Hounsfield units (HU), among spine and nonspine surgery patients.
- A total of 318 patients participated, with significant improvements in HU observed in those treated with romosozumab for about 10.5 months and teriparatide for more than 23 months.
- The findings suggest that romosozumab is a strong option for enhancing bone density efficiently before elective spine fusion surgery, compared to other treatments.
Study Design: Retrospective cohort analysis.
Objective: To determine whether the C2 exposure technique was a predictor of change in cervical alignment and patient-reported outcomes measures (PROMs) after posterior cervical decompression and fusion (PCDF) for degenerative indications.
Background: In PCDF handling of the C2 posterior paraspinal musculature during the operative approach varies by surgeon technique.
Multisegmental pathologic autofusion occurs in patients with ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH). It may lead to reduced vertebral bone density due to stress shielding. This study aimed to determine the effects of autofusion on bone density by measuring Hounsfield units (HU) in the mobile and immobile spinal segments of patients with AS and DISH treated at a tertiary care center.
View Article and Find Full Text PDFObjective: To compare the prognostic power of Hounsfield units (HU) and Vertebral Bone Quality (VBQ) score for predicting proximal junctional kyphosis (PJK) following long-segment thoracolumbar fusion to the upper thoracic spine (T1-T6).
Methods: Vertebral bone quality around the upper instrumented vertebrae (UIV) was measured using HU on preoperative CT and VBQ on preoperative MRI. Spinopelvic parameters were also categorized according to the Scoliosis Research Society-Schwab classification.
Purpose: To determine if C2 pedicle versus pars screw type predicts change in fusion status, C2 screw loosening, cervical alignment, and patient-reported outcomes measures (PROMs) after C2-T2 posterior cervical decompression and fusion (PDCF).
Methods: All adult patients who underwent C2-T2 PCDF for myelopathy or myeloradiculopathy between 2013-2020 were retrospectively identified. Patients were dichotomized by C2 screw type into bilateral C2 pedicle and bilateral C2 pars screw groups.
Introduction: Interspinous devices (ISDs) and interlaminar devices (ILDs) are marketed as alternatives to conventional surgery for degenerative lumbar conditions; comparisons with decompression alone are limited. The present study reviews the extant literature comparing the cost and effectiveness of ISDs/ILDs with decompression alone.
Methods: Articles comparing decompression alone with ISD/ILD were identified; outcomes of interest included general and disease-specific patient-reported outcomes, perioperative complications, and total treatment costs.
Background: Long-segment instrumentation, such as Harrington rods, offloads vertebrae within the construct, which may result in significant stress shielding of the fused segments. The present study aimed to determine the effects of spinal fusion on bone density by measuring Hounsfield units (HUs) throughout the spine in patients with a history of Harrington rod fusion.
Methods: Patients with a history of Harrington rod fusion treated at a single academic institution were identified.
Article Synopsis
- * A study of 116 patients undergoing PSO found that 44% experienced durotomy, with prior surgical history being a notable predictor, particularly previous decompression at the PSO site.
- * Patient factors like comorbidities, weight, and BMI didn't significantly differentiate those with and without durotomy, nor did surgeon training or surgical techniques; however, outcomes like hospitalization and reoperation rates were similar for both groups.
Article Synopsis
- * Researchers examined data from 100 patients treated for mobile spine metastases, finding that lower average HUs were linked to a higher risk of fractures, while VBQ did not show a significant correlation.
- * The study concluded that using HUs could be a more reliable predictor for pathologic fractures post-radiotherapy compared to VBQ, with specific thresholds providing insight into fracture risk.
Study Design: Retrospective observational study of consecutive patients.
Objective: The purpose of the study is to determine if a surgeon's qualitative assessment of bone intraoperatively correlates with radiologic parameters of bone strength.
Summary Of Background Data: Preoperative radiologic assessment of bone can include modalities such as computed tomography (CT) Hounsfield units (HUs), dual-energy x-ray absorptiometry (DXA) bone mineral density with trabecular bone score (TBS) and magnetic resonance imaging vertebral bone quality (VBQ).
Systemic sclerosis affects 14-21 per million persons annually and can present with calcinosis-deposition in the skin and subcutaneous tissues. In rare circumstances, paraspinal depositions are also seen, which can cause neural element compression requiring surgical intervention. Here we present the case of a 61-year-old woman with systemic sclerosis on goal-directed therapy who presented with neurogenic pseudoclaudication and imaging suggesting severe joint hypertrophy.
View Article and Find Full Text PDFArticle Synopsis
- This study analyzed the relationship between Hounsfield units (HUs) and bone health measurements using biomechanical computed tomography (BCT) and dual-energy x-ray absorptiometry (DXA) in patients who underwent BCT for spine-related issues.
- It found a strong correlation between HUs and BCT measures of vertebral strength and trabecular bone mineral density (BMD), while DXA showed weak correlation with HUs.
- HUs effectively predicted osteoporosis and low BMD, with specific HU thresholds identified for diagnosis, suggesting their potential use as a reliable tool in assessing bone health.
Introduction: Surgical simulation is increasingly being accepted as a training platform to promote skill development and a safe surgical technique. Preliminary investigations in spine surgery show that simulation paired with educational intervention can markedly improve trainee performance. This study used a newly developed thoracolumbar fusion rod bending model to assess the effect of a novel educational curriculum and simulator training on surgical trainee rod bending speed and proficiency.
View Article and Find Full Text PDFObjective: The purpose of this study was to analyze risk factors for sacral fracture following noninstrumented partial sacral amputation for en bloc chordoma resection.
Methods: A multicenter retrospective chart review identified patients who underwent noninstrumented partial sacral amputation for en bloc chordoma resection with pre- and postoperative imaging. Hounsfield units (HU) were measured in the S1 level.
Study Design: Retrospective cohort study.
Objective: The present study is the first to assess the impact of paraspinal sarcopenia on patient-reported outcome measures (PROMs) following cervical laminoplasty.
Background: While the impact of sarcopenia on PROMs following lumbar spine surgery is well-established, the impact of sarcopenia on PROMs following laminoplasty has not been investigated.
Article Synopsis
- The study aimed to assess spinopelvic parameters and spinal deformities in patients with idiopathic normal pressure hydrocephalus (iNPH) who underwent shunting.
- Seventeen patients were analyzed, showing a notable prevalence of sagittal plane deformities, with many exhibiting significant pelvic and lumbar discrepancies.
- The findings suggest that negative spinal alignment is common in these patients, potentially causing postural instability, and indicate a need for further evaluation and future studies to monitor changes post-surgery.
Article Synopsis
- The study aimed to evaluate surgical outcomes for patients suffering from severe neck pain who underwent laminoplasty for cervical spondylotic myelopathy (CSM).
- A total of 91 patients were analyzed retrospectively, with significant improvements in neck pain reported at 6 months and 1 year post-surgery, regardless of their preoperative pain severity.
- The findings suggest that patients with moderate to severe neck pain can achieve similar levels of pain relief and disability improvements as those with mild pain after the surgical procedure.