Severe (>100 Degrees) Thoracic Adolescent Idiopathic Scoliosis - A Comparison of Surgical Approaches.

Study Design: Retrospective.

Objective: Severe curves >100° in adolescent idiopathic scoliosis (AIS) are rare and require careful operative planning. The aim of this study was to assess baseline, perioperative, and 2-year differences between anterior release with posterior instrumentation (AP), posterior instrumentation with posterior column osteotomies (P), and posterior instrumentation with 3-column vertebral osteotomies (VCR).

Self-image in spinal deformity: a state-of-the-art review.

Purpose: To review the current literature surrounding the assessment of self-image in pediatric and adult spinal deformity.

Methods: The literature were reviewed for studies examining patient-reported outcome measurements (PROM) and self-image in pediatric and adult spinal deformity. PROM performance metrics were collected and described.

Preoperative Robotics Planning Facilitates Complex Construct Design in Robot-Assisted Minimally Invasive Adult Spinal Deformity Surgery-A Preliminary Experience.

(1) The correction of adult spinal deformity (ASD) can require long, complex constructs with multiple rods which traverse important biomechanical levels to achieve multi-pelvic fixation. Minimally invasive (MIS) placement of these constructs has historically been difficult. Advanced technologies such as spinal robotics platforms can facilitate the design and placement of these constructs and further enable these surgical approaches in MIS deformity surgery.

Scoliosis Research Society-22r and Ceiling Effects: Limited Capabilities for Precision Medicine With Adolescent Idiopathic Scoliosis.

Study Design: Retrospective registry analysis.

Objective: To examine predictions of individual Scoliosis Research Society-22r (SRS-22r) questions one year after surgery for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: A precision-medicine approach to AIS surgery will inform patients of the likelihood of achieving particular results from surgery, specifically individual responses to the SRS-22r questionnaire.

A systematic review of pseudarthrosis and reoperation rates in minimally invasive adult spinal deformity correction.

Background/objective: The recent development of minimally invasive surgical techniques (MIS) has made possible the correction of adult spinal deformity (ASD) with less blood loss and shorter hospital stays. However, minimally invasive placement of pedicle screws at the proximal level of the construct can increase pseudarthrosis risk, leading to implant failure, kyphosis, and reoperations. We aggregate existing literature to describe pseudarthrosis rates at the proximal thoracic or thoracolumbar junction in MIS and subsequent reoperation rates.

Frequency and predictors of complication clustering within 30 days of spinal fusion surgery: a study of children with neuromuscular scoliosis.

Purpose: There is limited information on the clustering or co-occurrence of complications after spinal fusion surgery for neuromuscular disease in children. We aimed to identify the frequency and predictive factors of co-occurring perioperative complications in these children.

Methods: In this retrospective database cohort study, we identified children (ages 10-18 years) with neuromuscular scoliosis who underwent elective spinal fusion in 2012-2020 from the National Surgical Quality Improvement Program-Pediatric database.

Patient-specific rods in adult spinal deformity: a systematic review.

Purpose: The purpose of this review was to evaluate the effectiveness of patient-specific rods for adult spinal deformity.

Methods: A systematic review of the literature was performed through an electronic search of the PubMed, Scopus, and Web of Science databases. Human studies between 2012 and 2023 were included.

De novo cerebral pseudoaneurysm formation: a rare delayed complication of stereotactic electroencephalography in children.

Objective: To describe the rare complication of cerebral pseudoaneurysm formation following stereotactic electroencephalography (sEEG) lead implantation in children.

Methods: A retrospective chart review of all pediatric patients undergoing sEEG procedures between 2015 and 2020 was performed. Cases of pseudoaneurysm were identified and reviewed.

Microsurgical resection of a ruptured intraventricular arteriovenous malformation in a neonate: considerations in management. Illustrative case.

Background: Arteriovenous malformations (AVMs) are the most common cause of intracranial hemorrhage in children, although they are rarer in neonates. Age, location, lesion architecture, and rupture status define treatment options. Sparse literature exists to guide the management of clinically symptomatic intraventricular AVM rupture in neonates.

The Cost of Operating: Analysis of Single-Use Instrument Costs for Craniotomies.

Introduction All-cause craniotomies comprise a significant portion of neurosurgical practice as well as hospital costs. While some instruments are reusable with a fixed cost, price variability for similar single-use instruments exists. A better understanding of these cost variations within cranial procedures can better inform operating physicians to be cost-sensitive stewards.

Navigated Radiofrequency Ablation Peripheral Rhizotomy for Lumbosacral Hypertonia in a Nonambulatory Patient With Spinal Fusion: Indications, Surgical Techniques, and Lessons Learned.

Background And Objectives: Radiofrequency ablation (RFA) is a destructive therapy which causes target tissue destruction by application of a thermal dose. Neurosurgical applications of RFA are well-described for myriad chronic pain and movement disorder diagnoses. In fact, RFA pallidotomy and thalamotomy are the initial procedures from which the field of neurosurgical management for movement disorders emerged.

Integrating navigation assistance for redirecting freehanded spinal instrumentation: experience and technique.

Retrospective review of all spinal fusions > 3 levels involving the thoracolumbar and/or sacroiliac at a single institution, by a single surgeon between 3/12/2020 and 8/13/2021 were reviewed. All screws that were secondarily navigated after identified as misdirected on intraoperative CT scan were included. Neuromonitoring reports were culled for mA threshold to triggered EMG response for all redirected screws.

Rett Syndrome-Associated Scoliosis: Analysis of National Trends and Treatment Patterns of a Rare Indication for Posterior Instrumented Fusion.

Study Design: Retrospective database cohort study.

Objective: To evaluate U.S.

Single position robot-assisted pedicle screw placement with S2-alar-iliac fixation in lateral decubitus: cadaveric feasibility study and early clinical experience.

Objectives: Single position lateral fusion with robotic assistance eliminates the need for surgical staging while harnessing the precision of robotic adjuncts. We expand on this technique by demonstrating the technical feasibility of placing bilateral pedicle screws with S2-alar-iliac (S2AI) fixation while in the lateral position.

Methods: A cadaveric study was performed using 12 human specimens.

Impaired angiogenesis in diabetic critical limb ischemia is mediated by a miR-130b/INHBA signaling axis.

Patients with peripheral artery disease (PAD) and diabetes compose a high-risk population for development of critical limb ischemia (CLI) and amputation, although the underlying mechanisms remain poorly understood. Comparison of dysregulated microRNAs from diabetic patients with PAD and diabetic mice with limb ischemia revealed the conserved microRNA, miR-130b-3p. In vitro angiogenic assays demonstrated that miR-130b rapidly promoted proliferation, migration, and sprouting in endothelial cells (ECs), whereas miR-130b inhibition exerted antiangiogenic effects.

SRS-22r Self-Image After Surgery for Adolescent Idiopathic Scoliosis at 10-year Follow-up.

Study Design: Retrospective cohort.

Objective: To examine SRS-Self Image scores at up to 10 years after surgery for adolescent idiopathic scoliosis (AIS).

Summary Of Background Data: Self-image is complex with implications for surgical and patient-reported outcomes after AIS surgery.

Radiographic alignment outcomes after the single-position prone transpsoas approach: a multi-institutional retrospective review of 363 cases.

Objective: The aim of this paper was to evaluate the changes in radiographic spinopelvic parameters in a large cohort of patients undergoing the prone transpsoas approach to the lumbar spine.

Methods: A multicenter retrospective observational cohort study was performed for all patients who underwent lateral lumber interbody fusion via the single-position prone transpsoas (PTP) approach. Spinopelvic parameters from preoperative and first upright postoperative radiographs were collected, including lumbar lordosis (LL), pelvic incidence (PI), and pelvic tilt (PT).

Barriers to Identifying Learning Disabilities: A Qualitative Study of Clinicians and Educators.

Objective: The estimated prevalence of learning disabilities (LDs) is nearly 8% of all children. Fewer than 5% of all children are diagnosed in public schools, jeopardizing remediation. We aimed to identify barriers affecting front-line child-facing professionals in detecting LDs in school-aged children.

Spine Deformity Associated with Chiari I Malformation and Syringomyelia.

The management of scoliosis in patients with Chiari I malformation and syringomyelia is a complex decision-making process, which is changing due to evolving evidence. Headache and scoliosis are common presenting symptoms of an underlying Chiari. History, physical examination, and screening with MRI are cornerstones of diagnosis.

Prone-lateral access to the lumbar spine: single-level corpectomy with approach discussion.

The lateral lumbar interbody fusion has evolved as newly envisioned access corridors become feasible with technological advances. Prone lateral access has evolved as a single-access approach to combine the benefits of minimally invasive surgery with direct and indirect decompression of the neural elements with synergistic anterior and posterior column correction. In this video, the authors discuss the pearls, pitfalls, and adjuvant technologies they use in a high-volume prone lateral center via case demonstration of a prone lateral corpectomy.

Traumatic rupture of thoracic epidural capillary hemangioma resulting in acute neurologic deficit: illustrative case.

Background: Thoracic epidural capillary hemangioma is exceedingly rare, with only a few reported cases. The typical presentation usually includes chronic, progressive symptoms of spinal cord compression in middle-aged adults. To the authors' knowledge, this case is the first report in the literature of acute traumatic capillary hemangioma rupture.

Neurocheck Frequency: Determining Perceptions and Barriers to Implementation of Evidence-Based Practice.

Background: Following acute brain injury, patients in the intensive care unit often undergo hourly or every-other-hour exams ("neurochecks") to monitor for neurodeterioration. We assessed health care provider attitudes towards neurocheck frequency and evaluated providers' ideal neurocheck frequency.

Methods: This was a cross-sectional, online survey distributed in Spring 2021 at a tertiary care academic medical center.