Surgical Management of Adult Spinal Deformity Patients with Osteoporosis.

Adult spinal deformity (ASD) commonly affects older adults, with up to 68% prevalence in those over 60, and is often complicated by osteoporosis, which reduces bone mineral density (BMD) and increases surgical risks. Osteoporotic patients undergoing ASD surgery face higher risks of complications like hardware failure, pseudoarthrosis, and proximal junctional kyphosis (PJK). Medical management with antiresorptive medications (e.

The Impact of Symptom Duration on Postoperative Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.

Background And Context: The optimal timing at which patients should undergo Anterior Cervical Discectomy and Fusion (ACDF) surgery to achieve the best outcomes has not been determined. Given that patients may experience delays in care and that insurance companies often require a minimum of six weeks of conservative treatment before surgery, it is essential to determine the impact of symptom duration on outcomes following ACDF.

Purpose: To evaluate the impact of symptom duration on outcomes following ACDF surgery.

Postoperative delirium following total joint arthroplasty: epidemiology, risk factors, and associated complications.

Introduction: Postoperative delirium (POD) is a feared complication following major surgery in elderly patients. Further investigation of the risk factors and consequences of POD following total joint arthroplasty is warranted.

Methods: Patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) were identified using PearlDiver.

The $12 Billion Board Certification Process: Examination Characteristics, Revenues, and Expenditures.

Background: Over 90% of U.S. physicians are currently board certified.

Physical Therapy for Patients with Thoracolumbar Vertebral Fractures.

Vertebral fractures are a common cause of back pain and pain-related functional impairments in elderly patients. Despite their widespread occurrence, vertebral fractures frequently remain underdiagnosed, often leading to suboptimal management and poor clinical outcomes. This review specifically examines the role of physical therapy (PT) in managing vertebral fractures, describing current literature and evidence-based guidelines from the American Physical Therapy Association and the American Academy of Orthopaedic Surgeons.

Alignment considerations in degenerative spinal conditions: A narrative review.

Background: With an aging population, degenerative spinal diseases are contributing significantly to the healthcare's burden. Spinal alignment in the context of adult spinal deformities has become an important domain of research.

Methods: We conducted a narrative review of the latest considerations in spinal alignment within the context of degenerative spinal conditions, discussed current strategies for morphological assessment and finally identified potential areas for future research.

Strategies for Preventing Tunnel Convergence in Multiligament Knee Injury Reconstructions.

Background: Multiligament knee injuries (MLKIs) are complex and heterogeneous, often associated with concomitant injuries, and necessitates precise treatment strategies.

Preoperative Management: Effective preoperative management in MLKIs requires comprehensive evaluation, starting with a detailed patient history to identify the mechanisms of injury and prior treatments. Physical examination assesses for knee stability, while imaging techniques including magnetic resonance imaging (MRI) and radiographs detail ligament, cartilage, and meniscal injuries to identify all injured structures.

Autologous chondrocyte implantation, matrix-induced autologous chondrocyte implantation, osteochondral autograft transplantation and osteochondral allograft improve knee function and pain with considerations for patient and cartilage defects characteristics: A systematic review and meta-analysis.

Purpose: Previous studies have reported on the outcomes of autologous chondrocyte implantation (ACI) versus matrix-induced ACI (MACI) and microfracture. Specific clinical outcomes of ACI, MACI, osteochondral autograft transplantation (OAT) and osteochondral allograft (OCA) have not been well studied. The purpose of this systematic review and meta-analysis was to analyze the outcomes of these regenerative surgical techniques with an emphasis on comparing their effectiveness using the International Knee Documentation Committee (IKDC) subjective score, the Lysholm Knee Scoring Scale, the Tegner Activity Scale and the Visual Analogue Scale (VAS) score for the surgical treatment of tibiofemoral joint cartilage defects.

Liposomal bupivacaine reduces postoperative pain and opioids consumption in spine surgery: a meta-analysis of 1,269 patients.

Background Context: Postoperative pain management in spine surgery remains a challenge. Liposomal bupivacaine (LB) has emerged as an alternative or adjunct to opioid-based analgesia. However, existing studies evaluating LB efficacy in spine surgery yield conflicting results and a meta-analysis compiling the literature is lacking.

Postoperative Delirium Following Posterior Lumbar Spinal Fusion: Epidemiology, Risk Factors, and Associated Complications.

Background: Postoperative delirium (POD) is frequently reported in the elderly after major surgery. Several risk factors have been identified, including age, surgical complexity, and comorbidities.

Methods: Posterior lumbar fusion patients were identified using PearlDiver and filtered into two cohorts based on the presence or absence of POD within 7 days of surgery.

One-Level versus Two-Level Anterior Lumbar Interbody Fusion (ALIF) from L4-S1: Comparison of Complications, Alignment, and Patient Outcomes.

Study Design: Retrospective cohort study.

Objective: Compare outcomes in patients undergoing one-level or two-level anterior lumbar interbody fusion (ALIF) at L4-S1.

Background: Although ALIF may deliver restoration of lumbar lordosis and improvement in clinical outcomes, it also carries risk of complications including major vascular injury.

Does the Application of Topical Vancomycin Reduce Surgical Site Infections in Spine Surgery? A Meta-analysis of Randomized Controlled Trials.

Background: Surgical site infections (SSIs) represent a major challenge in spine surgery, leading to severe morbidity, mortality, and increased costs. The local application of antibiotics, particularly vancomycin, has emerged as a potential strategy. Individual randomized controlled trials (RCTs) have disagreed about the efficacy of topical vancomycin in preventing SSIs after spine surgery, and so a meta-analysis that pools data from those RCTs might be helpful to inform clinicians' decisions on the topic.

Cortical Trajectory versus Traditional Pedicle Screw Trajectory in Open Transforaminal Lumbar Interbody Fusion: Meta-Analysis of Complications and Clinical Outcomes.

Background: Lumbar degenerative disease imposes a substantial burden on global health care expenditures. Transforaminal lumbar interbody fusion (TLIF) using either traditional trajectory (TT) pedicle screws or cortical bone trajectory (CBT) pedicle screws has become increasingly common. This meta-analysis evaluated outcomes and safety of open TLIF with TT compared with CBT.

Isolated lateral radial head dislocation in a child: A case report and literature review.

Introduction: Radial head dislocations in children can result from congenital anomalies, traumatic events, or as part of more complex injuries like Monteggia fractures. These dislocations are rare and may be overlooked unless considered in differential diagnoses.

Case Presentation: We describe a unique instance of a post-traumatic isolated lateral radial head dislocation in a 5-year-old boy with no previous medical concerns.

Laminoplasty Versus Laminectomy and Posterior Fusion for Cervical Myelopathy : A Meta-Analysis of Radiographic and Clinical Outcomes.

Study Design: Meta-analysis.

Objective: This meta-analysis investigates the outcomes of laminoplasty (LP) and laminectomy with fusion (LF) to guide effective patient selection for these 2 procedures.

Background: Although LF traditionally offers the ability for excellent posterior decompression, it may alter cervical spine biomechanics and increase the risk of adjacent segment degeneration.

Lumbar Disc Replacement Versus Interbody Fusion: Meta-analysis of Complications and Clinical Outcomes.

Background: Lumbar spinal fusion is a commonly performed operation with relatively high complication and revision surgery rates. Lumbar disc replacement is less commonly performed but may have some benefits over spinal fusion. This meta-analysis aims to compare the outcomes of lumbar disc replacement (LDR) versus interbody fusion (IBF), assessing their comparative safety and effectiveness in treating lumbar DDD.

Same-Day Versus Staged Spinal Fusion: A Meta-analysis of Clinical Outcomes.

Study Design: Meta-analysis.

Objective: This meta-analysis aims to compare same-day versus staged spine surgery, assessing their effects on patient care and health care system efficiency.

Background: In spinal surgery, the debate between whether same-day and staged surgeries are better for patients continues, as the decision may impact patient-related outcomes, health care resources, and overall costs.

ChatGPT Earns American Board Certification in Hand Surgery.

Purpose: Artificial Intelligence (AI), and specifically ChatGPT, has shown potential in healthcare, yet its performance in specialized medical examinations such as the Orthopaedic Surgery In-Training Examination and European Board Hand Surgery diploma has been inconsistent. This study aims to evaluate the capability of ChatGPT-4 to pass the American Hand Surgery Certifying Examination.

Methods: ChatGPT-4 was tested on the 2019 American Society for Surgery of the Hand (ASSH) Self-Assessment Exam.