Delayed Screw Migration Following Anterior Cervical Discectomy and Fusion.

Objective: To identify the clinical and surgical characteristics and treatment options of patients suffering delayed (>1 month) screw back-out after anterior cervical discectomy and fusion (ACDF).

Methods: A systematic review was performed searching Embase, Medline, and Scopus for relevant case studies and case series of delayed screw back-out after ACDF.

Results: A total of 25 studies encompassing 31 patients were identified and included.

Traumatic Central Cord Syndrome.

Central cord syndrome (CCS) is the most common form of incomplete spinal cord injury, with an increasing incidence with the aging population. This is a clinical diagnosis defined by weakness greater in the upper than lower extremities and often prominent sensory complaints in the hands. CCS is typically seen in individuals with underlying cervical canal stenosis from spondylosis who experience sudden forceful movement of the neck, especially hyperextension, resulting in contusion of the spinal cord.

Surgical Management of Thoracic Dorsal Arachnoid Webs: A 10-Year Single-Institution Experience.

Objective: Thoracic dorsal arachnoid webs are intradural membranes that may cause obstruction of cerebrospinal fluid flow and spinal cord compression. Although well recognized, they are rare and there is a paucity of long-term data on their natural history and prognosis. We reviewed radiographic features, surgical indications, and pathologic specimens of patients diagnosed with focal thoracic dorsal arachnoid webs.

Traumatic durotomy and entrapment of neural elements in a lumbar burst and laminar fracture diagnosed on preoperative imaging: illustrative case.

Background: Traumatic dural lacerations can be caused by thoracolumbar burst fractures and, infrequently, can be associated with the entrapment of neural elements within a laminar fracture. The diagnosis of both is difficult to make on preoperative imaging, as the conditions are typically appreciated during surgical exploration. The authors present a case of traumatic durotomy with entrapment of neural elements in a laminar fracture that they believed could be appreciated on preoperative magnetic resonance imaging (MRI).

Prediction of primary admission total charges following cervical disc arthroplasty utilizing machine learning.

Background Context: Cervical disc arthroplasty (CDA) has become an increasingly popular alternative to anterior cervical discectomy and fusion, offering benefits such as motion preservation and reduced risk of adjacent segment disease. Despite its advantages, understanding the economic implications associated with varying patient and hospital factors remains critical.

Purpose: To evaluate how hospital size, geographic region, and patient-specific variables influence charges associated with the primary admission period following CDA.

Operative Time Associated With Increased Length of Stay After Single-level Cervical Disk Arthroplasty: An Analysis of 3681 Surgeries.

Study Design: Level III evidence-retrospective cohort.

Objective: The purpose of this study was to (1) determine whether longer CDA operative time increases the risk of 30-day postoperative complications, (2) analyze the association between operative time and subsequent health care utilization, and (3) discharge disposition.

Background: Cervical disk arthroplasty (CDA) most commonly serves as an alternative to anterior cervical discectomy and fusion (ACDF) to treat cervical spine disease, however, with only 1600 CDAs performed annually relative to 132,000 ACDFs, it is a relatively novel procedure.

Risk Factors for Undergoing Surgical Intervention for Vertebral Compression Fractures: An Analysis of 703,499 Patients.

Background: Vertebral compression fractures (VCFs) are typically treated nonoperatively but can be treated with either kyphoplasty or vertebroplasty when indicated. The decision to treat patients with/without surgical intervention is dependent on the severity of deformity and patient risk profile. The aims of this study were to: 1) compare baseline patient demographics, 2) identify risk factors of patients undergoing operative vs.

Modern Internet Search Analytics: Is There a Difference in What Patients are Searching Regarding the Operative and Nonoperative Management of Scoliosis?

Study Design: Observational Study.

Objectives: This study aimed to investigate the most searched types of questions and online resources implicated in the operative and nonoperative management of scoliosis.

Methods: Six terms related to operative and nonoperative scoliosis treatment were searched on Google's People Also Ask section on October 12, 2023.

GPT-4 as a Source of Patient Information for Anterior Cervical Discectomy and Fusion: A Comparative Analysis Against Google Web Search.

Study Design: Comparative study.

Objectives: This study aims to compare Google and GPT-4 in terms of (1) question types, (2) response readability, (3) source quality, and (4) numerical response accuracy for the top 10 most frequently asked questions (FAQs) about anterior cervical discectomy and fusion (ACDF).

Methods: "Anterior cervical discectomy and fusion" was searched on Google and GPT-4 on December 18, 2023.

Risk Factors for Readmission Following Surgical Decompression for Spinal Epidural Abscesses: An Analysis of 4595 Patients.

Study Design: Retrospective cohort study.

Objectives: The study aimed to (1) compare baseline demographics of patients undergoing surgery for SEA who were/were not readmitted; (2) identify risk factors for 90-day readmissions; and (3) quantify 90-day episode-of-care health care costs.

Background: Spinal epidural abscess (SEA), while rare, occurring ~2.

Intraspinal cervicothoracic junction chondrosarcoma: illustrative case.

Background: Chondrosarcoma is an uncommon spinal tumor that can present as an extraskeletal mass. Rarely, these tumors present as dumbbell tumors through the neural foramina, mimicking schwannomas or neurofibromas.

Observations: A 46-year-old female presented with 2 years of worsening right-arm radiculopathy.

ChatGPT as a Source of Patient Information for Lumbar Spinal Fusion and Laminectomy: A Comparative Analysis Against Google Web Search.

Study Design: Retrospective Observational Study.

Objective: The objective of this study was to assess the utility of ChatGPT, an artificial intelligence chatbot, in providing patient information for lumbar spinal fusion and lumbar laminectomy in comparison with the Google search engine.

Summary Of Background Data: ChatGPT, an artificial intelligence chatbot with seemingly unlimited functionality, may present an alternative to a Google web search for patients seeking information about medical questions.

Intramedullary Spinal Hemorrhage in Behcet's Syndrome: A Case Report and Systematic Review.

Acute neurological manifestations in patients with Behcet's syndrome are rare yet may lead to devastating outcomes. Distinguishing primary neurological deficits from spontaneous hemorrhagic insults is of particular importance for the prognosis of patients with Behcet's syndrome. Here, we investigate the clinical characteristics, management, and outcomes of nontraumatic hemorrhagic injury in patients with Bechet's syndrome.

Thecal sac ligation in the setting of thoracic spondyloptosis with complete cord transection.

Background: Traumatic spondyloptosis (TS) with complete spinal cord transection and unrepairable durotomy is particularly rare and can lead to a difficult-to-manage cerebrospinal fluid (CSF) leak.

Methods: We performed a systematic review of the literature on TS and discuss the management strategies and outcomes of TS with cord transection and significant dural tear. We also report a novel case of a 26-year-old female who presented with thoracic TS with complete spinal cord transection and unrepairable durotomy with high-flow CSF leak.

Distinctive Characteristics of Thoracolumbar Junction Region Stenosis.

Study Design: Retrospective case series and systemic literature meta-analysis.

Background: Thoracolumbar junction region stenosis produces spinal cord compression just above the conus and may manifest with symptoms that are not typical of either thoracic myelopathy or neurogenic claudication from lumbar stenosis.

Objective: As few studies describe its specific pattern of presenting symptoms and neurological deficits, this investigation was designed to improve understanding of this pathology.

Is Cervical Disk Arthroplasty a Suitable Alternative to Treat Degenerative Cervical Myelopathy?

Study Design: Systemic review.

Objective: To understand the role of cervical disk arthroplasty in the treatment of cervical myelopathy.

Summary Of Background Data: The surgical management of degenerative cervical myelopathy (DCM) most frequently involves decompression and fusion, but stiffness introduced by the fusion and adjacent segment degeneration remain problems that can result in significant morbidity.

The Natural History of Degenerative Cervical Myelopathy.

Degenerative cervical myelopathy (DCM) is the most frequent cause of spinal cord dysfunction and injury in the adult population and leads to significant loss of quality of life and economic impact from its associated medical care expenditures and loss of work. Surgical intervention is recommended for patients manifesting progressing neurological signs and symptoms of myelopathy, but the optimal management in individuals who have mild and clinically stable disease manifestations is controversial. Understanding the natural history of DCM is, thus, important in assessing patients and identifying those most appropriately indicated for surgical management.

Primary and Revision Cervical Disc Arthroplasty from 2010-2020: Patient Demographics, Utilization Trends, and Health Care Reimbursements.

Objectives: Despite lack of nationwide Medicare coverage by the Centers for Medicare and Medicaid Services, the utilization of cervical disc arthroplasty (CDA) has risen in popularity. The purpose was to compare primary and revision CDA from 2010 to 2020 with respect to: (1) utilization trends, (2) patient demographics, and (3) health care reimbursements.

Methods: Using the PearlDiver database, we studied patients undergoing primary and revision CDA for degenerative cervical spine pathology from 2010 to 2020.

Multi-Level Posterior Cervical Foraminotomy Associated With Increased Post-operative Infection Rates and Overall Re-Operation Relative to Anterior Cervical Discectomy With Fusion or Cervical Disc Arthroplasty.

Study Design: Retrospective Cohort Study.

Objective: Cervical radiculopathy meeting operative criteria has traditionally been managed using anterior cervical discectomy and fusion (ACDF). However, cervical disc arthroplasty (CDA) and posterior cervical foraminotomy (PCF) are also reasonable options.

Adult Trauma Patients With Thoracolumbar Injury Classification and Severity Score of 4: A Systematic Review.

Study Design: Systematic review.

Objective: Evaluate characteristics of patients with thoracolumbar injury classification and severity (TLICS) score of 4 (To4) severity traumatic thoracolumbar injury.

Summary Of Background Data: The TLICS score is used to predict the need for operative versus nonoperative management in adult patients with traumatic thoracolumbar injury.

Cervical fusion for adult patients with atlantoaxial rotatory subluxation.

Background: Atlantoaxial rotatory subluxation (AARS) is a rare injury of the C1/C2 junction. It is often associated with trauma in adults. Treatment may depend on the duration of symptoms and clinical presentation, but there is no consensus regarding the ideal management of these injuries.

Management and outcomes of adult traumatic cervical spondyloptosis: A case report and systematic review.

Study Design: Systematic Review.

Objective: To elucidate treatment modalities and outcomes of patients with traumatic cervical spondyloptosis (TCS).

Summary: Traumatic cervical spondyloptosis (TCS) is rare and typically leads to devastating neurological injury.

Classifications and level of evidence trends from the most influential literature on thoracolumbar burst fractures: A bibliometric analysis.

Background: There are known classifications that describe thoracolumbar (TL) burst type injury but it is unclear which have the most influence on management. Our objective is to investigate the association of classification publications with the quantity and type of the most influential articles on TL burst fractures.

Methods: Web of Science was searched, and exclusion and inclusion criteria were used to extract the top 100 cited articles on TL burst fractures.