Deformity Considerations in Cervical Laminoplasty: A Narrative Review.

Objectives: We discuss the incidence of postoperative kyphosis following laminoplasty and its impact on outcomes, as well as critical radiographic parameters, intraoperative technical factors, and postoperative protocols that can be used to improve results.

Summary Of Background Data: When appropriately selected, cervical laminoplasty is a motion-sparing treatment option for cervical myelopathy and is a valid alternative to laminectomy and fusion procedures. However, like other posterior-based cervical decompression techniques, laminoplasty can cause postoperative kyphosis.

Analyzing Pelvic Asymmetry by Sex and Ancestry: Insights From an Osteological Collection.

Introduction: Pelvic asymmetry has been noted in pelvic imaging, and might influence the development of various spinal pathologies, most notably scoliosis. There is a limited understanding of the relationship between pelvic asymmetry and sex and ancestry, and limited use of 3D modeling. The purpose of this study was to identify pelvic asymmetry and morphology differences between sex and ancestry utilizing 3D modeling on young adults in an osteological collection.

Protocol-driven early tracheal extubation in patients with flaccid neuromuscular scoliosis and pre-existing lung disease.

Purpose: To review the results of a postoperative respiratory pathway for patients with muscular dystrophy (MD) and spinal muscular atrophy (SMA) undergoing spinal surgery.

Methods: With IRB approval, a retrospective review was done on all patients with SMA and MD undergoing spinal surgery on a neuromuscular protocol. Baseline demographics, perioperative results, and long-term outcomes were collected.

Robotic-Assisted Versus Conventional Posterior Lumbar Fusion-An Analysis of 90-Day Complications and Readmissions.

Objective: To evaluate medical and surgical complication rates between robotic-assisted versus conventional elective posterior lumbar fusions.

Methods: The Symphony Integrated DataVerse was queried using International Classification of Diseases, 10th Edition, Clinical Modification procedure codes to identify patients undergoing elective posterior lumbar fusions for degenerative spine pathologies between 2015 and 2018. International Classification of Diseases, 10th Edition, Clinical Modification procedure codes (8E0W4CZ, 8E0W0CZ, 8E0W3CZ) were used to identify patients undergoing a robotic-assisted spinal fusion.

Evolving Surgical Management for Early-Onset Scoliosis in Spinal Muscular Atrophy Type 1 Given Improvements in Survival.

Case: We present a case of an 18-month-old child with early-onset scoliosis in the setting of spinal muscular atrophy (SMA) type 1 whose rapidly progressive scoliosis is successfully managed with magnetic growing rods, the youngest age of implantation in a patient with SMA we are currently aware of. Technical challenges, complications, and outcome are described in this case presentation.

Conclusion: Patients with SMA type 1 and early-onset scoliosis can be managed with growing-rod constructs given dramatic improvements in medical care that have expanded life expectancy.

What Is the Value of Undergoing Surgery for Spinal Metastases at Dedicated Cancer Centers?

Background: The Alliance of Dedicated Cancer Centers is an organization of 11 leading cancer institutions and affiliated hospitals that are exempt from the Medicare prospective system hospital reimbursement policies. Because of their focus on cancer care and participation in innovative cancer treatment methods and protocols, these hospitals are reimbursed based on their actual billings. The perceived lack of incentive to meet a predetermined target price and reduce costs has spurred criticism of the value of cancer care at these institutions.

The Association of "U.S. News & World Report" Hospital Rankings and Outcomes Following Anterior Cervical Fusions: Do Rankings Even Matter?

Study Design: Retrospective observational study.

Objective: The aim of this study was to evaluate whether there are any differences in outcomes and costs for elective one- to three-level anterior cervical fusions (ACFs) performed at US News and World Report (USNWR) ranked and unranked hospitals.

Summary Of Background Data: Although the USNWR rankings are advertised by media and are routinely used by patients as a guide in seeking care, evidence regarding whether these rankings are reflective of actual clinical outcome remains limited.

Hospital network participation and outcomes following elective posterior lumbar fusions - are mergers effective?

Background Context: Due to financial pressures associated with healthcare reforms, an increasing number of hospitals are now merging (or consolidating) into networks (or systems). However, it remains unclear how these mergers or network participations affect quality of care and/or costs.

Purpose: The current study aims to evaluate the impact of hospital network participation on 90-day complications, charges, and costs following elective posterior lumbar fusions (PLFs).

Does prehospital spinal immobilization influence in hospital decision to obtain imaging after trauma?

Importance: This study highlights the unnecessarily high suspicion for cervical spine injury among study providers and shows that cervical CT scans were more likely in patients who arrived to the emergency department wearing a cervical collar, even when clinically cleared for suspicion of cervical spine injury by the emergency department provider.

Objective: To determine if patients with a cervical collar were more likely to undergo cervical spine imaging than those who arrived to the emergency department without a collar.

Design: Adult trauma patients at a level 1 trauma center over 4 months (n = 1,438) were stratified by acuity (1,2, or 3), mechanism, and known injury cephalad to clavicles, defined as pain, wounds, or hematomas.

An Analysis of Hamate Morphology Relevant to Hemi-Hamate Arthroplasty.

Purpose: Dorsal fracture-dislocations of the proximal interphalangeal (PIP) joint can lead to joint incongruity from loss of the buttress function of the middle phalanx volar base. Hemi-hamate arthroplasty can reconstruct the volar articular surface of the middle phalangeal base where repair is not possible. We compared the anatomy of the hamate graft with the middle phalanx base.

Dropped Head Syndrome: A Systematic Review.

Study Design: This study was a systematic review.

Objectives: To reveal demographic factors, etiologies, response to treatment, and to propose a novel treatment algorithm for dropped head syndrome (DHS).

Summary Of Background Data: DHS is a rare condition defined by weakness of the cervical paraspinal muscles resulting in passively correctable flexion of the cervical spine.

Indications for CT-Angiography of the Vertebral Arteries After Trauma.

Study Design: Retrospective.

Objective: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk.