Postoperative Ketamine May be Associated with Venous Thromboembolism in Chronic Opioid Users After Spine Surgery.

Objective: Venous thromboembolism (VTE) is a serious postoperative adverse event after spine surgery. In patients with pain refractory to typical multimodal analgesia regimens after spine surgery, whom are often chronic opioid users, perioperative ketamine is an alternative analgesic that has grown in popularity. The aim of this study is to assess the risk of VTE in chronic opioid users undergoing spine surgery.

Opioid Prescription Trends Among Orthopaedic, Primary Care, and Pain Management Providers in Spine Surgery Patients.

Objective: To determine prescription trends across specialties in the perioperative care of patients undergoing spine surgery from 2018 to 2021.

Summary Of Background Data: A range of measures, including implementation of state prescription drug monitoring programs, have been instituted to combat the opioid epidemic. Considering the continued presence of opioids for spine-related pain management, a better understanding of the patterns of opioid prescription practices may be important for future intervention.

An evaluation of fusion status following lumbar fusion surgery utilizing multi-planar computed tomography.

Purpose: To report the rate of fusion in a sample of patients undergoing lumbar fusion surgery and assess interrater reliability of computed tomography (CT)-based parameters for the assessment of fusion.

Methods: All adult patients who underwent lumbar fusion surgery from 2017 to 2021 were retrospectively identified. Patient demographics and surgical characteristics were collected through chart review of the electronic medical records.

Impact of Preoperative Intervertebral Disc Degeneration on Patient-Reported Outcome Measures After Lumbar Fusion.

Objective: The Pfirrmann scoring system classifies lumbosacral disc degeneration based on magnetic resonance imaging signal intensity. The relationship between pre-existing disc degeneration and patient-reported outcome measures (PROMs) after one-level lumbar fusion is not well documented. The purpose of this study was to investigate the relationship between the severity of preoperative intervertebral disc degeneration and preoperative and postoperative PROMs in patients undergoing one-level lumbar fusion.

Construct length analysis of type B and C cervical and thoracolumbar fractures.

Objectives: The purpose of this study is to identify if construct length affects the rate of surgical complications and instrumentation revision following surgical fixation of subaxial and thoracolumbar Type B and C fractures. This study evaluates the effect of ankylosing spondylitis/diffuse idiopathic skeletal hyperostosis (AS/DISH) within this population on outcomes.

Methods: Retrospective review of 91 cervical and 89 thoracolumbar Type B and C fractures.

A Comparison of Clinical Outcomes Between Anterior Cervical Discectomy and Fusion Versus Posterior Cervical Laminoplasty for Multilevel Cervical Myelopathy.

Study Design: Retrospective Cohort.

Objective: To compare patient-reported outcomes and surgical outcomes after anterior cervical discectomy and fusion (ACDF) versus cervical laminoplasty for multilevel cervical spondylotic myelopathy.

Background: Treatment options for multilevel cervical spondylotic myelopathy include ACDF and cervical laminoplasty.

The Relationship Between Disc Herniation Morphology and Patient-Reported Outcomes after Microdiscectomy.

Objective: Determine if herniation morphology based on the Michigan State University Classification is associated with differences in (1) patient-reported outcome measures (or (2) surgical outcomes after a microdiscectomy.

Methods: Adult patients undergoing single-level microdiscectomy between 2014 and 2021 were identified. Demographics and surgical characteristics were collected through a query search and manual chart review.

Relating preoperative MCS-12 to microdiscectomy outcomes.

Purpose: To determine the impact of poor mental health on patient-reported and surgical outcomes after microdiscectomy.

Methods: Patients ≥ 18 years who underwent a single-level lumbar microdiscectomy from 2014 to 2021 at a single academic institution were retrospectively identified. Patient-reported outcomes (PROMs) were collected at preoperative, three-month, and one-year postoperative time points.

Preoperative Hounsfield Units Predict Pedicle Screw Loosening in Osteoporotic Patients Following Short Segment Lumbar Fusion.

Study Design: Retrospective Cohort.

Objective: (1) To determine if vertebral HU values obtained from preoperative CT predict postoperative outcomes following 1-3 level lumbar fusion and (2) to investigate whether decreased BMD values determined by HU predict cage subsidence and screw loosening.

Summary Of Background Data: In light of suboptimal screening for osteoporosis, vertebral computerized tomography(CT) Hounsfield Units(HU), have been investigated as a surrogate for bone mineral density(BMD).

Significance of Facet Fluid Index in Anterior Cervical Degenerative Spondylolisthesis.

Study Design: Retrospective cohort study.

Purpose: To correlate cervical facet fluid characteristics to radiographic spondylolisthesis, determine if facet fluid is associated with instability in cervical degenerative spondylolisthesis, and examine whether vertebral levels with certain facet fluid characteristics and spondylolisthesis are more likely to be operated on.

Overview Of Literature: The relationship between facet fluid and lumbar spondylolisthesis is well-documented; however, there is a paucity of literature investigating facet fluid in degenerative cervical spondylolisthesis.

How Does the Severity of Neuroforaminal Compression in Cervical Radiculopathy Affect Outcomes of Anterior Cervical Discectomy and Fusion.

Study Design: This study is a retrospective cohort study.

Purpose: This study aims to determine whether preoperative neuroforaminal stenosis (FS) severity is associated with motor function patient-reported outcome measures (PROMs) following anterior cervical discectomy and fusion (ACDF).

Overview Of Literature: Cervical FS can significantly contribute to patient symptoms.

Lateral approach to the lumbar spine: The utility of an access surgeon.

Background: Lateral lumbar interbody fusions (LLIFs) utilize a retroperitoneal approach that avoids the intraperitoneal organs and manipulation of the anterior vasculature encountered in anterior approaches to the lumbar spine. The approach was championed by spinal surgeons; however, general/vasculature surgeons may be more comfortable with the approach.

Objective: The objective of this study was to compare short-term outcomes following LLIF procedures based on whether a spine surgeon or access surgeon performed the approach.

The Impact of Unexpected Billing in Spine Surgery and How the Price Calculator Can Improve Patient Care.

Study Design: Survey study.

Objective: The objective of this study was to determine the impact of unexpected in-network billing on the patient experience after spinal surgery.

Summary Of Background Data: The average American household faces difficulty paying unexpected medical bills.

The Impact of Physical Therapy After Lumbar Fusion Surgery.

Study Design: Retrospective Cohort.

Objective: To determine if outcomes varied between patients based on physical therapy (PT) attendance after lumbar fusion surgery.

Summary Of Background Data: The literature has been mixed regarding the efficacy of postoperative PT to improve disability and back pain, as measured by patient-reported outcome measures.

Reasons for transfer and subsequent outcomes among patients undergoing elective spine surgery at an orthopedic specialty hospital.

Objective: To evaluate the reasons for transfer as well as the 90-day outcomes of patients who were transferred from a high-volume orthopedic specialty hospital (OSH) following elective spine surgery.

Materials And Methods: All patients admitted to a single OSH for elective spine surgery from 2014 to 2021 were retrospectively identified. Ninety-day complications, readmissions, revisions, and mortality events were collected and a 3:1 propensity match was conducted.

The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion.

Objectives: The objectives of our study were to compare the fusion rates and surgical outcomes of lumbar fusion surgery based on the (1) type of demineralized bone matrix (DBM) carrier allograft, (2) the presence/absence of a carrier, and (3) the presence of bone fibers in DBM.

Methods: Patients >18 years of age who underwent single-level posterolateral decompression and fusion (PLDF) between L3 and L5 between 2014 and 2021 were retrospectively identified. We assessed bone grafts based on carrier type (no carrier, sodium hyaluronate carrier, and glycerol carrier) and the presence of bone fibers.

Perioperative Dexamethasone Does Not Reduce Postoperative Opioid Use Following Anterior Cervical Discectomy and Fusion.

Objective: To determine if dexamethasone administration reduced narcotic consumption during hospitalization and to evaluate if patients who received dexamethasone refilled fewer opioid prescriptions postoperatively.

Methods: All adult patients who underwent primary elective 1- to 4-level anterior cervical discectomy and fusion at a single center were retrospectively identified. Prescription opioid use was collected from governmental online prescription drug monitoring programs, and in-hospital opioid use was collected from each patient's medication administration record and recorded as morphine milligram equivalents (MMEs).

The Implication of Preoperative Central Stenosis on Patient-Reported Outcomes After Lumbar Decompression Surgery.

Objective: To assess the impact of central stenosis severity on patient-reported outcomes after lumbar decompression.

Methods: Patient diagnosis, demographics, and surgical characteristics were collected via query search and manual chart review of electronic medical records. The inclusion criteria were posterior lumbar decompressions from 2014-2020, with accessible magnetic resonance imaging reports.

Predictors of Blood Transfusion in Patients Undergoing Lumbar Spinal Fusion.

Objective: To determine risk factors for perioperative blood transfusion after lumbar fusion surgery.

Methods: After institutional review board approval, a retrospective cohort study of adult patients who underwent lumbar fusion at a single, urban tertiary academic center was retrospectively retrieved. Our primary outcome, blood transfusion, was collected via chart query.

Comparison of Postoperative Opioid Use After Anterior Cervical Diskectomy and Fusion or Posterior Cervical Fusion.

Introduction: Posterior cervical fusion (PCF) and anterior cervical diskectomy and fusion (ACDF) are two main surgical management options for the treatment of cervical spondylotic myelopathy. Although ACDF is less invasive than PCF which should theoretically reduce postoperative pain, it is still unknown whether this leads to reduced opioid use. Our objective was to evaluate whether PCF increases postoperative opioid use compared with ACDF.