The Effect of Changes in Segmental Lordosis on Global Lumbar and Adjacent Segment Lordosis After L5-S1 Anterior Lumbar Interbody Fusion.

Study Design: Retrospective Cohort Study.

Objective: Restoration of lordosis in lumbar fusion reduces low back pain, decreases adjacent segment degeneration, and improves postoperative outcomes. However, the potential effects of changes in segmental lordosis on adjacent-level and global lordosis remain less understood.

Increased cage angle effects on radiographic outcomes after stand-alone anterior lumbar interbody fusion.

Objective: Anterior lumbar interbody fusion (ALIF) is a well-accepted surgical technique used to treat various lumbar degenerative pathologies. Recently, hyperlordotic cages have been introduced to create higher degrees of lordosis to the lumbar spine. There are little data currently available to define the radiographic benefits that these cages provide with stand-alone ALIF.

Rates of Postoperative Complications and Approach-related Neurological Symptoms After L4-L5 Lateral Transpsoas Lumbar Interbody Fusion Compared With Upper Lumbar Levels.

Study Design: This was a retrospective comparative study.

Objective: To compare the likelihood of approach-related complications for patients undergoing single-level lateral lumbar interbody fusion (LLIF) at L4-L5 to those undergoing the procedure at upper lumbar levels.

Summary Of Background Data: LLIF has been associated with a number of advantages when compared with traditional interbody fusion techniques.

High-Frequency Impulse Therapy for Treatment of Chronic Back Pain: A Multicenter Randomized Controlled Pilot Study.

Purpose: This study aims to examine high-frequency impulse therapy (HFIT) impact on pain and function among patients undergoing care for chronic low back pain (CLBP).

Methods: A pilot randomized-controlled trial of HFIT system versus sham was conducted across 5 orthopedic and pain center sites in California, USA. Thirty-six patients seeking clinical care for CLBP were randomized.

Patients Undergoing 3-Level-or-Greater Decompression-Only Surgery for Lumbar Spinal Stenosis Have Similar Outcomes to Those Undergoing Single-Level Surgery at 2 Years.

Background: Stability following multilevel decompressive laminectomy without fusion has been debated using in vitro biomechanical and radiographic models. However, there is a lack of information regarding clinical outcomes for these patients. The aim of the present study was to determine the association between clinical outcomes and number of levels decompressed via laminectomy for treatment of lumbar spinal stenosis.

An Investigation of a Novel Dural Repair Device for Intraoperative Incidental Durotomy Repair.

Incidental durotomies, or dural tears, can be very difficult and time consuming to repair properly when they are encountered in confined spaces. A novel dural repair device was developed to address these situations. In this paper, the novel device was assessed against the use of traditional tools and techniques for dural repairs in two independent studies using an intricate clinical simulation model.

Feasibility and outcomes of ERAS protocol in elective cT4 colorectal cancer patients: results from a single-center retrospective cohort study.

Background: Programs of Enhanced Recovery After Surgery reduces morbidity and shorten recovery in patients undergoing colorectal resections for cancer. Patients presenting with more advanced disease such as T4 cancers are frequently excluded from undergoing ERAS programs due to the difficulty in applying established protocols. The primary aim of this investigation was to evaluate the possibility of applying a validated ERAS protocol in patients undergoing colorectal resection for T4 colon and rectal cancer and to evaluate the short-term outcome.

Reasons for revision following stand-alone anterior lumbar interbody fusion and lateral lumbar interbody fusion.

Objective: Anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) are alternative and less invasive techniques to stabilize the spine and indirectly decompress the neural elements compared with open posterior approaches. While reoperation rates have been described for open posterior lumbar surgery, there are sparse data on reoperation rates following these less invasive procedures without direct posterior decompression. This study aimed to evaluate the overall rate, cause, and timing of reoperation procedures following anterior or lateral lumbar interbody fusions without direct posterior decompression.

High-Intensity Zones on MRI of the Cervical Spine in Patients: Epidemiology and Association With Pain and Disability.

Study Design: Retrospective cohort study.

Objectives: This study aimed to address the prevalence, distribution, and clinical significance of cervical high-intensity zones (HIZs) on magnetic resonance imaging (MRI) with respect to pain and other patient-reported outcomes in the setting of patients that will undergo an anterior cervical discectomy and fusion (ACDF) procedure.

Methods: A retrospective cohort study of ACDF patients surgically treated at a single center from 2008 to 2015.

Screening policies, preventive measures and in-hospital infection of COVID-19 in global surgical practices.

Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide.

Revision Strategies for Harrington Rod Instrumentation: Radiographic Outcomes and Complications.

Study Design: Retrospective case series.

Objective: The purpose of this study is to evaluate the clinical and radiographic outcomes following revision surgery following Harrington rod instrumentation.

Methods: Patients who underwent revision surgery with a minimum of 1-year follow-up for flatback syndrome following Harrington rod instrumentation for adolescent idiopathic scoliosis were identified from a multicenter dataset.

Factors Affecting the Decision to Initiate Anticoagulation After Spine Surgery: Findings From the AOSpine Anticoagulation Global Initiative.

Study Design: Cross-sectional, international survey.

Objectives: To identify factors influencing pharmacologic anticoagulation initiation after spine surgery based on the AOSpine Anticoagulation Global Survey.

Methods: This survey was distributed to the international membership of AOSpine (n = 3805).

A Goal-directed Quality Improvement Initiative to Reduce Opioid Prescriptions After Orthopaedic Procedures.

Unlabelled: Orthopaedic surgeons are increasingly aware of deleterious effects of the opioid epidemic and the association between overprescription and diversion toward nonmedical opioid use or substance abuse. Opiate prescriptions at the time of hospital discharge have been identified as target for intervention. This study describes the successful outcome of a goal-directed intervention aimed at decreasing opioid overprescription by providing routine feedback to providers regarding their prescribing patterns.

A Review of Inpatient Opioid Consumption and Discharge Prescription Patterns After Orthopaedic Procedures.

Introduction: Tailoring opioid prescriptions to inpatient use after orthopaedic procedures may effectively control pain while limiting overprescription but may not be common in the current orthopaedic practice.

Methods: A retrospective review identified opioid-naïve patients admitted after any orthopaedic procedure. Daily and total prescription quantities as well as patient-specific factors were collected.

Idiopathic stroke after syndromic and neuromuscular scoliosis surgery: a case report and literature review.

Children with syndromic and neuromuscular scoliosis undergoing corrective surgery experience higher complication rates than those with idiopathic scoliosis. A rare but devastating complication is stroke, which occurs in 0.57% of operations for neuromuscular scoliosis but accounts for 7.

Local Application of Vancomycin in Spine Surgery Does Not Result in Increased Vancomycin-Resistant Bacteria-10-Year Data.

Study Design: Case-control study.

Objectives: To analyze the microbial flora in surgical spine infections and their antibiotic resistance patterns across time and determine the correlation between vancomycin application in the wound and vancomycin-resistant microbes.

Summary Of Background Data: Prior studies show a reduction in surgical site infections with intrawound vancomycin placement.

Spinal tuberculosis: a comprehensive review for the modern spine surgeon.

Nearly one-third of the human population is infected with tuberculosis. Of those with active disease, approximately 10% are impacted by skeletal tuberculosis. Though, traditionally a disease of the developing world and susceptible populations, with the rise of immigration, patients may present in developed countries.

An Analysis of Implant Retention and Antibiotic Suppression in Instrumented Spine Infections: A Preliminary Data Set of 67 Patients.

Background: It is unclear whether patients can be taken off suppressive antibiotics with infected retained instrumentation. This study aimed to retrospectively analyze the perioperative course and antibiotic regimen that led to the clinical intervention of patients with infected spinal instrumentation.

Methods: Consecutive adult patients with spine instrumentation who suffered surgical site infections (SSI) requiring debridement were retrospectively analyzed.

Use of Posterior Hamstring Harvest During Anterior Cruciate Ligament Reconstruction in the Pediatric and Adolescent Population.

Background: Posterior hamstring harvest has been described in the adult population in a limited fashion, but no study is available describing the use of posterior hamstring harvest in an active pediatric and adolescent cohort. At times, surgeons may be faced with a challenging anterior harvest due to patient anatomic characteristics, particularly the anatomic features and size of the pes tendons. Clinicians need to have multiple harvest approaches at their disposal.

Proximal Humerus Fracture 3-D Modeling.

The objective of this study is to determine the reproducibility and feasibility of using 3-dimensional (3-D) computer simulation of proximal humerus fracture computed tomography (CT) scans for fracture reduction. We hypothesized that anatomic reconstruction with 3-D models would be anatomically accurate and reproducible. Preoperative CT scans of 28 patients with 3- and 4-part (AO classification 11-B1, 11-B2, 11-C1, 11-C2) proximal humerus fractures who were treated by hemiarthroplasty were converted into 3-D computer models.

The influence of preoperative opioid use on inpatient opioid requirements and discharge prescriptions after primary shoulder arthroplasty.

Background: Active opioid users experience more pain and require more opioids after primary shoulder arthroplasty than non-opioid users. However, it is unknown whether discharge prescription regimens are tailored to these different postoperative opioid requirements.

Methods: We performed a retrospective analysis of a prospectively collected cohort of patients who underwent primary shoulder replacement over a 15-month period.

Autonomic dysreflexia caused by cervical stenosis.

Introduction: Autonomic dysreflexia (AD) is a well-known sequela of high spinal cord injuries (SCI). The characteristic episodic presentation is one of increased sympathetic tone: diaphoresis, hypertension, tachycardia, or reflex bradycardia. The episodes are triggered by visceral sensations and can last days to weeks.

Hypoalbuminemia Is Associated With Septic Revisions After Primary Surgery and Postoperative Infection After Revision Surgery.

Study Design: Retrospective database review.

Objective: To determine (1) the relationship between hypoalbuminemia and body mass index (BMI); (2) the association between malnutrition and revision spine surgery for septic reasons; and (3) the association between malnutrition and infection after aseptic revision spine surgery.

Summary Of Background Data: Although malnutrition has been suggested to increase the risk of infection after spine surgery, evidence supporting this hypothesis is conflicting.