MRI Radiological Predictors of Requiring Microscopic Lumbar Discectomy After Lumbar Disc Herniation.

Study Design: Retrospective cohort study.

Objective: To investigate radiological differences in lumbar disc herniations (herniated nucleus pulposus [HNP]) between patients receiving microscopic lumbar discectomy (MLD) and nonoperative patients.

Methods: Patients with primary treatment for an HNP at a single academic institution between November 2012 to March 2017 were divided into MLD and nonoperative treatment groups.

Preoperative MRI predictors of health-related quality of life improvement after microscopic lumbar discectomy.

Background: Lumbar herniated nucleus pulposus (HNP) is a common spinal pathology often treated by microscopic lumbar discectomy (MLD), though prior reports have not demonstrated which preoperative MRI factors may contribute to significant clinical improvement after MLD.

Purpose: To analyze the MRI characteristics in patients with HNP that predict meaningful clinical improvement in health-related quality of life scores (HRQoL) after MLD.

Study Design/setting: Retrospective clinical and radiological study of patients undergoing MLD for HNP at a single institution over a 2-year period.

Implantation of a bone-anchored annular closure device in conjunction with tubular minimally invasive discectomy for lumbar disc herniation: a retrospective study.

Background: Minimally invasive techniques for lumbar discectomy have been recommended as superior to open techniques due to lower blood loss, lower rates of infection and shorter recovery. There are, however, concerns that this approach does not sufficiently remove the herniated nuclear material, thus leaving the patient susceptible to reherniation requiring reoperation. The purpose of this study was to examine the safety and viability of an annular closure device in limiting reherniation and reoperation in a cohort of patients undergoing minimally invasive lumbar discectomy with the assistance of an annular closure device.

The facet joint loading profile of a cervical intervertebral disc replacement incorporating a novel saddle-shaped articulation.

Study Design: Biomechanical study.

Objective: To evaluate the cervical facet loading profile of an intervertebral cervical disc prosthesis incorporating a unique saddle-shaped articulation and to determine the effect of implantation of the prosthesis on both the loading curve and area distribution of facet loading, when compared with that of an intact specimen.

Summary Of Background Data: This is the first study that examines the effect of implantation of a cervical disc replacement on the loading of the facet joints.

The manubrium as an external guide for centralizing anterior cervical plates: technique tips and initial experience.

Study Design: Technique tips and retrospective review of prospectively collected data.

Objective: To describe a technique for centralizing cervical plates using the center of the manubrium as a primary external guide and its alignment with the mandible as a secondary guide.

Summary Of Background Data: Proper alignment of cervical plates is desirable to avoid improper placement of screws and possibly altered biomechanical performance.

Intradiscal pressure monitoring in the cervical spine.

Background: Discography has been widely used in the lumbar and cervical spine as a diagnostic tool to identify sources of discogenic pain that may be amenable to surgical treatment. Discography in the cervical spine is currently performed without the benefit of pressure monitoring, and corresponding pressure parameters have not been determined.

Objective: The purpose of this study was to develop the framework for intradiscal pressure monitoring in the cervical spine and the basis for a pressure curve that will reflect clinically significant cervical internal disc disruption.

Early failure of lumbar disc replacement: case report and review of the literature.

We report a case of a patient who underwent two-level lumbar total disc replacement at L4-L5 and L5-S1 with the ProDisc II prosthesis, who was diagnosed with early anterior migration of the caudally placed device with partial occlusion of the left common iliac vein. The device was explanted and revised to an anterior lumbar interbody fusion with posterior instrumented fusion. Despite the substantial experience with lumbar disc arthroplasty in Europe and the United States, there exist few reports of device explantation or revision.

Anterior cervical decompression and fusion with plate fixation as an outpatient procedure.

Background Context: Outpatient cervical spine surgery has previously been described for posterior laminoforaminotomy and anterior microdiscectomy with allograft fusion. Anterior cervical discectomy and fusion (ACDF) with plate fixation has not, to our knowledge, been described as an outpatient procedure.

Purpose: The objective of this study was to evaluate the safety and feasibility of ACDF with instrumentation when performed as an outpatient in a free-standing ambulatory surgical center.

Manifestations of hereditary multiple exostoses.

The solitary osteochondroma, a common pediatric bone tumor, is a cartilage-capped exostosis. Hereditary multiple exostosis is an autosomal dominant disorder manifested by the presence of multiple osteochondromas. Linkage analysis has implicated mutations in the EXT gene family, resulting in an error in the regulation of normal chondrocyte proliferation and maturation that leads to abnormal bone growth.