Degenerative Cervical Myelopathy: History, Physical Examination, and Diagnosis.

: Degenerative cervical myelopathy is a progressive neurological disorder that is commonly encountered in clinical practice and its incidence is expected to increase alongside the aging population. Given the importance of early and accurate diagnosis in this patient population, this narrative review aims to provide a repository of up-to-date information regarding pertinent patient history, physical exam findings, and potential alternate diagnoses. : The PubMed database was queried for publications from 1 January 2019 to 19 March 2024.

Metastasis of WHO Grade II Meningioma With Subsequent Pathological T12 Fracture: A Case Report.

Case: A 64-year-old woman with a history of World Health Organization Grade II (Ki-67 20%) atypical meningioma presented with T12 vertebral body burst fracture as a complication of metastatic meningioma (SSTR2+). Following disease progression, decompression surgery and stabilization through T10-L2 posterior thoracolumbar instrumented fusion was performed.

Conclusion: This is one of few documented cases of spinal metastatic meningioma causing pathological fracture and the first to detail surgical management and longitudinal follow-up.

Cervical disc arthroplasty is safe across various obesity levels.

Background Context: As surgical indications for cervical disc arthroplasty (CDA) continue to expand, a growing patient population is now becoming indicated for this procedure. Little is known about whether CDA is safe in the overweight and obese populations, and how this procedure compares to anterior cervical discectomy and fusion (ACDF) in this particular demographic.

Purpose: To evaluate the outcomes of CDA across varying levels of body mass indices and to compare these to ACDF.

Anticoagulation in patients with atrial fibrillation undergoing inpatient total knee arthroplasty: A matched analysis.

Background: Patients with atrial fibrillation (AF) often require lifetime anticoagulation using drugs such as Warfarin and Direct-acting Oral Anticoagulants (DOAC). It is important to assess the impact that prior anticoagulant use has on the post-operative complications in patients with AF undergoing TKA.

Methods: This is a retrospective analysis of the PearlDiver database querying all patients who underwent an inpatient TKA.

Defining modern iatrogenic flatback syndrome: examination of segmental lordosis in short lumbar fusion patients undergoing thoracolumbar deformity correction.

Purpose: Understanding the mechanism and extent of preoperative deformity in revision procedures may provide data to prevent future failures in lumbar spinal fusion patients.

Methods: ASD patients without prior spine surgery (PRIMARY) and with prior short (SHORT) and long (LONG) fusions were included. SHORT patients were stratified into modes of failure: implant, junctional, malalignment, and neurologic.

The Importance of Alignment in the Management of Thoracolumbar Trauma.

Spinal injuries occur in 3% of all patients with trauma, most commonly in males, and often as a result of high-velocity impact followed by abrupt deceleration. The most affected region after spinal trauma is the thoracolumbar junction because of the anterior center of gravity at the T12-L1 vertebral level and the relatively stiff thoracic spine uniting with the mobile lumbar spine. Many classifications exist to guide the choice of operative versus nonoperative management of traumatic injuries at this site.

Patient-reported Physical and Mental Health Outcomes Following Lumbar Spinal Fusion versus Total Hip and Total Knee Replacement.

Background: Total hip and knee arthroplasty (THA/TKA) are reliable surgical procedures for alleviating pain and optimizing function. Spinal fusion has also been shown to be beneficial, however the comparative benefit of THA/TKA to lumbar spinal fusion is incompletely understood.

Methods: This study analyzed a single-center database of patients who underwent primary lumbar spinal fusion, elective primary TKA, or THA.

Impact of Prior Cervical Fusion on Patients Undergoing Thoracolumbar Deformity Correction.

Study Design: Retrospective analysis of prospectively collected data.

Objective: Evaluate the impact of prior cervical constructs on upper instrumented vertebrae (UIV) selection and postoperative outcomes among patients undergoing thoracolumbar deformity correction.

Background: Surgical planning for adult spinal deformity (ASD) patients involves consideration of spinal alignment and existing fusion constructs.

Lumbar Spondylolisthesis Grading: Current Standards and Important Factors to Consider for Management.

Spondylolisthesis is a common condition with a prevalence of 4-6% in childhood and 5-10% in adulthood. The Meyerding Classification, developed in 1932, assigns grades (I to V) based on the degree of slippage observed on standing, neutral lateral lumbar radiographs. Despite its historical significance and reliability, more factors should be evaluated to predict spondylolisthesis progression, especially in low-grade cases.

Hip Osteoarthritis in Patients Undergoing Surgery for Severe Adult Spinal Deformity: Prevalence and Impact on Spine Surgery Outcomes.

Background: Hip osteoarthritis (OA) is common in patients with adult spinal deformity (ASD). Limited data exist on the prevalence of hip OA in patients with ASD, or on its impact on baseline and postoperative alignment and patient-reported outcome measures (PROMs). Therefore, this paper will assess the prevalence and impact of hip OA on alignment and PROMs.

Adolescent idiopathic scoliosis in adulthood.

Adolescent idiopathic scoliosis (AIS) is an abnormal coronal curvature of the spine that most commonly presents in adolescence. While it may be asymptomatic, AIS can cause pain, cosmetic deformity, and physical and psychological disability with curve progression. As adolescents with AIS enter adulthood, condition outcomes vary with some experiencing curve stabilization and others noting further curve progression, chronic pain, osteoporosis/fractures, declines in pulmonary and functional capacity, among others.

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.

Restoring L4-S1 Lordosis Shape in Severe Sagittal Deformity: Impact of Correction Techniques on Alignment and Complication Profile.

Background: Severe sagittal plane deformity with loss of L4-S1 lordosis is disabling and can be improved through various surgical techniques. However, data are limited on the differing ability of anterior lumbar interbody fusion (ALIF), pedicle subtraction osteotomy (PSO), and transforaminal lumbar interbody fusion (TLIF) to achieve alignment goals in severely malaligned patients.

Methods: Severe adult spinal deformity patients with preoperative PI-LL >20°, L4-S1 lordosis <30°, and full body radiographs and PROMs at baseline and 6-week postoperative visit were included.

Hyperlipidemia, Obesity, and Diabetes, and Risk of Ossification of the Posterior Longitudinal Ligament.

Background: Several risk factors of ossification of the posterior longitudinal ligament (OPLL) have been established, including diabetes and obesity. However, the relationship between hyperlipidemia (HLD) and OPLL is incompletely understood.

Methods: PearlDiver was queried to identify adults with (+) and without (-) HLD, diabetes, and obesity.

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.