A systematic review and meta-analysis of radiation exposure in spinal surgeries: Comparing C-Arm, CT navigation, and O-Arm techniques.

Introduction: Advanced imaging techniques, such as C-arm fluoroscopy, O-arm, and CT navigation, are integral to achieving precision in orthopedic surgeries. However, these technologies also expose patients, surgeons, and operating room staff to varying levels of radiation. This systematic review and meta-analysis evaluate the radiation exposure (RE) associated with these imaging modalities and their impact on surgical outcomes.

Risk factors for mortality after 3-column osteotomy.

Purpose: Three-column osteotomies (3COs), such as pedicle subtraction osteotomy (PSO) and vertebral column resection (VCR), are used to surgically correct rigid adult spinal deformity (ASD). While extensive research exists about complications associated with 3COs, there remains a paucity of studies analyzing risk factors for mortality following 3CO. We believe the mortality rate after 3-column osteotomy will be low with specific identifiable demographic or medical risk factors.

Invasive devices to monitor the intraspinal perfusion pressure in the hemodynamic management of acute spinal cord injury: A systematic scoping review.

Background: Various methods for measuring intrathecal pressure (ITP) after spinal cord injury (SCI) to guide hemodynamic management have been investigated. To synthesize the current literature, this current study conducted a scoping review of the use of intrathecal devices to monitor ITP during acute management of SCI with the aim of understanding the association between ITP monitoring with physiological and clinical outcomes.

Methods: A systematic review of literature following the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement.

Positive Intervertebral Discs Are Not Associated with Subsidence Following Anterior Cervical Discectomy and Fusion at 3 or 6 Months.

(), formerly known as (), is an anaerobic, low-virulent bacterium that has been associated with postoperative infections of the shoulder, knee, and cervical spine. Recent studies have highlighted an association between and the development of degenerative disc disease (DDD). The aim of this study is to ascertain whether increases the risk of subsidence following anterior cervical discectomy and fusion (ACDF).

Pedicle screw placement in the cervical vertebrae using augmented reality-head mounted displays: a cadaveric proof-of-concept study.

Background: The accurate and safe positioning of cervical pedicle screws is crucial. While augmented reality (AR) use in spine surgery has previously demonstrated clinical utility in the thoracolumbar spine, its technical feasibility in the cervical spine remains less explored.

Purpose: The objective of this study was to assess the precision and safety of AR-assisted pedicle screw placement in the cervical spine.

Pelvic Incidence-Lumbar Lordosis Mismatch Is Not Associated with Early Reoperation for Adjacent Segment Disease After Lumbar Fusion.

Objective: To compare the 2-year reoperation rates for adjacent segment disease between patients with pelvic incidence-lumbar lordosis (PI-LL) mismatch postoperatively and patients with normal PI-LL measurements.

Methods: Patients undergoing elective 1- to 2-level lumbar fusion for degenerative conditions between 2016 and 2018 were retrospectively reviewed. Spinopelvic radiographic parameters immediately postoperation were measured, and PI-LL mismatch was determined using the age-adjusted thresholds defined in Lafage et al.

Superinfections of the Spine: A Single-Institution Experience.

A superinfection occurs when a new, secondary organism colonizes an existing infection. Spine infections are associated with high patient morbidity and sometimes require multiple irrigations and debridements (I&Ds). When multiple I&Ds are required, the risk of complications increases.

Diagnosis and Management of Thoracic Myelopathy.

Thoracic myelopathy can be a challenging condition to diagnose and treat. Successful outcomes depend on early recondition of the pathology and appropriate surgical referral in cases of progressive neurologic deterioration. The thoracic cord is tethered in kyphosis by the dentate ligaments and contains a tenuous blood supply.

Utilization of Augmented Reality Head-Mounted Display for the Surgical Management of Thoracolumbar Spinal Trauma.

: Augmented reality head-mounted display (AR-HMD) is a novel technology that provides surgeons with a real-time CT-guided 3-dimensional recapitulation of a patient's spinal anatomy. In this case series, we explore the use of AR-HMD alongside more traditional robotic assistance in surgical spine trauma cases to determine their effect on operative costs and perioperative outcomes. : We retrospectively reviewed trauma patients who underwent pedicle screw placement surgery guided by AR-HMD or robotic-assisted platforms at an academic tertiary care center between 1 January 2021 and 31 December 2022.

The Utility of the Validated Intraoperative Bleeding Scale in Thoracolumbar Spine Surgery: A Single-Center Prospective Study.

Study Design: Prospective, single-center study.

Objective: To evaluate the clinical relevance of the validated intraoperative bleeding severity scale (VIBe) in thoracolumbar spine surgery.

Methods: Adult patients aged 18 through 88 undergoing elective decompression, instrumentation, and fusion of the thoracolumbar spine were prospectively enrolled after informed consent was provided and written consent was obtained.

Lower Extremity Somatosensory Evoked Potentials Predict Functional Outcomes in Complete Traumatic Cervical Spinal Cord Injury.

Background: Traumatic cervical spinal cord injury (tCSCI) is often a debilitating injury, making early prognosis important for medical and surgical planning. Currently, the best early predictors of prognosis are physical examination, imaging studies, and patient demographics. Despite these factors, patient outcomes continue to vary significantly.

Rapid Implementation of a 3-Dimensional-Printed Patient-Specific Titanium Sacrum Implant for Severe Neuropathic Spinal Arthropathy and Guide to Compassionate US Regulatory Approval.

Background And Objective: Rapid design and production of patient-specific 3-dimensional-printed implants (3DPIs) present a novel opportunity to restore the biomechanically demanding integrity of the lumbopelvic junction. We present a unique case of a 61-year-old patient with severe neuropathic spinal arthropathy (Charcot spine) who initially underwent a T4-to-sacrum spinal fusion. Massive bone destruction led to dissociation of his upper body from his pelvis and legs.

FLOSEAL Versus SURGIFLO in Lumbar Surgery: Similar Outcomes, Different Costs in a Matched Cohort Analysis.

Objective: Flowable gelatin-based matrices with thrombin for hemostatic control are commercially available as Floseal (Baxter International Inc.) and Surgiflo (Ethicon Inc.).

Secondary Bony Defects after Soft Tissue Reconstruction in Limb-Threatening Lower Extremity Injuries: Does the Approach to Flap Elevation Matter?

Background:  Limb-threatening lower extremity injuries often require secondary bone grafting after soft tissue reconstruction. We hypothesized that there would be fewer wound complications when performing secondary bone grafting via a remote surgical approach rather than direct flap elevation.

Methods:  A retrospective cohort study was performed at a single Level 1 trauma center comparing complications after secondary bone grafting in patients who had undergone previous soft tissue reconstruction after open tibia fractures between 2006 and 2020.

Mechanical complications and patient-reported outcome measures associated with high pelvic incidence and persistent pelvic retroversion: the Roussouly "false type 2" profile.

Objective: The objective of this paper was to report mechanical complications and patient-reported outcome measures (PROMs) for adult spinal deformity (ASD) patients with a Roussouly "false type 2" (FT2) profile.

Methods: ASD patients treated from 2004 to 2014 at a single center were identified. Inclusion criteria were pelvic incidence ≥ 60° and a minimum 2-year follow-up.

Biomechanical Comparison of Four- versus Six-Strand Transosseous Suture Repair for Patellar Tendon Rupture.

Background:  Surgical repair is indicated for patellar tendon ruptures that result in loss of knee extensor mechanism function. However, biomechanical studies report conflicting results when comparing transosseous suture versus suture anchor repair techniques. This discrepancy may be due to inconsistencies in experimental design as these studies use various numbers of suture strands.

Multiplier Method for Predicting the Sitting Height Growth at Maturity: A Database Analysis.

This study aims to develop multipliers for the spine and sitting height to predict sitting height at maturity. With the aid of longitudinal and cross-sectional clinical databases, we divided the total sitting height, cervical, thoracic, and lumbar lengths at skeletal maturity by these same four factors at each age for each percentile given. A series of comparisons were then carried out between the multipliers as well as the percentiles and the varied racial and ethnic groups within them.

Risk of Avascular Necrosis with The Modified Dunn Procedure in SCFE Patients: A Meta-Analysis.

In situ stabilization is a widely accepted treatment for slipped capital femoral epiphysis (SCFE) despite risks of avascular necrosis (AVN) and femoroacetabular impingement (FAI). The modified Dunn procedure with surgical hip dislocation attempts to maintain epiphyseal perfusion and allows anatomic epiphyseal repositioning, theoretically reducing AVN and FAI risks. We systematically evaluated the literature, elucidating overall and stability-stratified rates of AVN following the modified Dunn procedure, and revision rates in non-AVN patients.

Similar Accuracy of Surgical Plans After Initial In-Person and Telemedicine Evaluation of Spine Patients.

Objective: The aim of this study was to compare accuracy of surgical plans generated from in-person and telemedicine evaluations and assess the reasons for surgical plan changes between initial evaluation and surgery. The secondary objective was to assess the effect of changes in surgical planning on postoperative outcomes.

Methods: In this retrospective cohort study, consecutive patients who were evaluated as new patients by orthopaedic spine faculty between 2019 and 2021 were divided by appointment type: telemedicine (n = 39) and in-person (n = 92).

Telemedicine Improves Access to Care for Spine Patients With Low Socioeconomic Status.

Study Design: Retrospective cohort study.

Objectives: The objective of this study is to compare the likelihood of missing a scheduled telemedicine and in-person appointments for spine patients. The secondary objective is to assess the impact of socioeconomic status on missed telemedicine and in-person appointments.

Postoperative outcomes of minimally invasive pedicle screw fixation for treatment of unstable pathologic neoplastic fractures.

Study Design: Retrospective Case Series.

Objectives: Minimally invasive techniques have emerged as a useful tool in the treatment of neoplastic spine pathology due to decrease in surgical morbidity and earlier adjuvant treatment. The objective of this study was to analyze outcomes and complications in a cohort of unstable, symptomatic pathologic fractures treated with percutaneous pedicle screw fixation (PPSF).

Comparison of Outcomes in Percutaneous Fixation of Traumatic Fractures between Ankylosing Spondylitis and Diffuse Idiopathic Skeletal Hyperostosis.

Study Design: Retrospective cohort study.

Objectives: This study aims to analyze outcomes and complications of patients with thoracic and lumbar fractures in the setting of ankylosing spinal disorders (ASD) treated with minimally invasive surgery (MIS).

Methods: The operative logs from 2012 to 2019 from one academic, Level I trauma center were reviewed for cases of thoracic and lumbar spinal fractures in patients with ASD treated with a MIS approach.