[Packaging waste in the operating room].

Background: Climate change is a central issue for our future. The increase in the amount of greenhouse gases in the atmosphere promotes the so-called greenhouse effect, resulting in climate change. Worldwide, the amount of plastic waste amounts to approximately 8 billion tons.

Lower-limb internal loading and potential consequences for fracture healing.

Mechanical loading is known to determine the course of bone fracture healing. We hypothesise that lower limb long bone loading differs with knee flexion angle during walking and frontal knee alignment, which affects fracture healing success. Using our musculoskeletal modelling constrained against data from patients with instrumented knee implants allowed us to assess internal loads in femur and tibia.

NOS inhibition reverses TLR2-induced chondrocyte dysfunction and attenuates age-related osteoarthritis.

Osteoarthritis (OA) is a joint disease featuring cartilage breakdown and chronic pain. Although age and joint trauma are prominently associated with OA occurrence, the trigger and signaling pathways propagating their pathogenic aspects are ill defined. Following long-term catabolic activity and traumatic cartilage breakdown, debris accumulates and can trigger Toll-like receptors (TLRs).

Bone collagen quality in lumbar fusion patients: the association between volumetric bone mineral density and advanced glycation endproducts.

Purpose: The sole determination of volumetric bone mineral density (vBMD) is insufficient to evaluate overall bone integrity. The accumulation of advanced glycation endproducts (AGEs) stiffens and embrittles collagen fibers. Despite the important role of AGEs in bone aging, the relationship between AGEs and vBMD is poorly understood.

Optimization of chondrocyte isolation from human articular cartilage to preserve the chondrocyte transcriptome.

The isolation of chondrocytes from human articular cartilage for single-cell RNA sequencing requires extensive and prolonged tissue digestion at 37 C. Modulations of the transcriptional activity likely take place during this period such that the transcriptomes of isolated human chondrocytes no longer match their original status . Here, we optimized the human chondrocyte isolation procedure to maximally preserve the transcriptome.

The predictive value of a novel site-specific MRI-based bone quality assessment, endplate bone quality (EBQ), for severe cage subsidence among patients undergoing standalone lateral lumbar interbody fusion.

Background Context: Studies have shown that site-specific bone density measurements had more predictive value for complications than standard whole-region measurements. Recently, MRI-based assessments of vertebral bone quality (VBQ) were introduced. However, there have been few studies that investigate the association between site-specific MRI bone assessment and osteoporosis-related complications in patients undergoing lumbar interbody fusion.

Preoperative MRI-based vertebral bone quality (VBQ) score assessment in patients undergoing lumbar spinal fusion.

Background Context: The importance of bone status assessment in spine surgery is well recognized. The current gold standard for assessing bone mineral density is dual-energy X-ray absorptiometry (DEXA). However, DEXA has been shown to overestimate BMD in patients with spinal degenerative disease and obesity.

Effects of an opioid stewardship program on opioid consumption and related outcomes after multilevel lumbar spine fusion: a pre- and postimplementation analysis of 268 patients.

Objective: Opioid stewardship programs combine clinical, regulatory, and educational interventions to minimize inappropriate opioid use and prescribing for orthopedic and spine surgery. Most evaluations of stewardship programs quantify effects on prescriber behavior, whereas patient-relevant outcomes have been relatively neglected. The authors evaluated the impact of an opioid stewardship program on perioperative opioid consumption, prescribing, and related clinical outcomes after multilevel lumbar fusion.

Future Perspectives in Spinal Cord Repair: Brain as Saviour? TSCI with Concurrent TBI: Pathophysiological Interaction and Impact on MSC Treatment.

Traumatic spinal cord injury (TSCI), commonly caused by high energy trauma in young active patients, is frequently accompanied by traumatic brain injury (TBI). Although combined trauma results in inferior clinical outcomes and a higher mortality rate, the understanding of the pathophysiological interaction of co-occurring TSCI and TBI remains limited. This review provides a detailed overview of the local and systemic alterations due to TSCI and TBI, which severely affect the autonomic and sensory nervous system, immune response, the blood-brain and spinal cord barrier, local perfusion, endocrine homeostasis, posttraumatic metabolism, and circadian rhythm.

Mapping of Venous Sinus Anatomy and Occipital Bone Thickness for Safe Screw Placement in 100 Patients with 46,200 Standardized Measurements Using Computed Tomography Angiography.

Study Design: Retrospective descriptive study.

Objective: The aim of this study was to create topographical maps of occipital bone thickness and venous sinus (VS) presence to assess the risks of screw insertion in four commercially available occipital plates.

Summary Of Background Data: Craniocervical junction instability and deformity are serious pathological conditions that require posterior fixation of the occipital bone to the cervical vertebrae.

Workers' Compensation Status in Association with a High NDI Score Negatively Impacts Post-Operative Dysphagia and Dysphonia Following Anterior Cervical Fusion.

Background: Anterior cervical discectomy and fusion (ACDF) is a safe and effective procedure but has approach-related complications like postoperative dysphagia and dysphonia (PDD). Patient-reported outcome measures including the Hospital for Special Surgery Dysphagia and Dysphonia Inventory (HSS-DDI) have been used for the assessment of PDD. Various factors have been described that affect ACDF outcomes, and our aim was to investigate the effect of workers' compensation (WC) status.

Spinal Cord Medial Safe Zone for C2 Pedicle Instrumentation: An MRI Measurement Analysis.

Study Design: Retrospective observational study.

Objective: The aim of this study was to investigate the spinal cord safety margins for C2 instrumentation.

Summary Of Background Data: Intraoperative spinal cord injury during C2 spine surgery is a rare, but potentially life-threatening complication.

Coronavirus Disease 2019 Exposure in Surgeons and Anesthesiologists at a New York City Specialty Hospital: A Cross-Sectional Study of Symptoms and SARS-CoV-2 Antibody Status.

Objective: We measured the seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) immunoglobulin G (IgG) antibodies among surgeons and anesthesiologists and associated antibody status with coronavirus disease 2019 (COVID-19) clinical illness.

Methods: A cross-sectional study of SARS-CoV-2 IgG seroprevalence with a survey assessing demographics, SARS-CoV-2 exposure risk, and COVID-19 illness. The primary outcome was the period prevalence of SARS-CoV-2 IgG antibodies associated with COVID-19 illness.

Thoracic bone mineral density measured by quantitative computed tomography in patients undergoing spine surgery.

Background Context: The thoracic spine is a common location for vertebral fractures as well as instrumentation failure after long spinal fusion procedures. The association between those complications and bone mineral density (BMD) are well recognized. Due to the overlying sternum and ribs in the thoracic spine, projectional BMD assessment tools such as dual energy x-ray absorptiometry (DXA) are limited to the lumbar spine.

The association of transversus abdominis plane block with length of stay, pain and opioid consumption after anterior or lateral lumbar fusion: a retrospective study.

Purpose: Anterior (ALIF) and lateral (LLIF) lumbar interbody fusion is associated with significant postoperative pain, opioid consumption and length of stay. Transversus abdominis plane (TAP) blocks improve these outcomes in other surgical subtypes but have not been applied to spine surgery. A retrospective study of 250 patients was performed to describe associations between TAP block and outcomes after ALIF/LLIF.

The cervical spine demonstrates less postoperative bone loss than the lumbar spine.

The objective of this study is to determine the bone mineral density (BMD) changes in adjacent vertebra following anterior cervical discectomy and fusion (ACDF). Consecutive patients undergoing ACDF with available preoperative and postoperative computed tomography (CT) imaging were included. Quantitative CT measurements of screw-free cervical and first thoracic vertebra were performed.

Endplate volumetric bone mineral density is a predictor for cage subsidence following lateral lumbar interbody fusion: a risk factor analysis.

Background Context: It has been reported in previous studies that a decreased bone mineral density (BMD) as measured by dual X-ray absorptiometry (DXA) is associated with subsidence. However, there is limited research on the role of volumetric BMD (vBMD) as measured by quantitative computed tomography (QCT). Further, metabolic conditions such as obesity and type 2 diabetes have been associated with poor bone quality, but the impact of these metabolic conditions on on subsidence rates following lateral lumbar interbody fusion (LLIF) remains unclear.

C2 Pedicle Sclerosis Grading, More Than Diameter, Predicts Surgeons' Preoperative Assessment of Safe Screw Placement: A Novel Classification System.

Background: The preoperative assessment of C2 morphology is important for safe instrumentation. Sclerotic changes are often seen in C2 pedicles. Evaluating the diameter measurements solely might not accurately assess the safety of screw insertion.

Trends in lumbar spinal fusion-a literature review.

Over the past several decades, there has been an upward trend in the total number of spinal fusion procedures worldwide. Advanced spinal fusion techniques with or without internal fixation, additional innovations in surgical approaches, innovative implants including a wide variety of interbody devices, and new alternatives in bone grafting materials are some reasons for the increasing number of spine fusion procedures. Moreover, the indications for spinal fusion have broadened over time.

The effect of obesity, diabetes, and epidural steroid injection on regional volumetric bone mineral density measured by quantitative computed tomography in the lumbosacral spine.

Purpose: High body mass index (BMI) is positively correlated with bone mineral density (BMD) in healthy adults; however, the effect of BMI on regional segmental BMDs in the axial skeleton is unclear. In addition, obese patients often have glucose intolerance and patients with lumbar spine pathology commonly have a history of epidural steroid injections (ESIs). The purpose of this study is to evaluate the effect of these patient factors on regional differences in BMD measured by quantitative computed tomography (QCT) in a lumbar fusion patient cohort.

Determinants of Postoperative Spinal Height Change among Adult Spinal Deformity Patients with Long Construct Circumferential Fusion.

Study Design: Retrospective clinical study.

Purpose: To describe postoperative height changes and identify the predictive factors of spinal height (SH) changes among patients with adult spinal deformity (ASD) who underwent circumferential lumbar fusion with instrumentation.

Overview Of Literature: Postoperative height changes remain an important issue after spinal fusion surgery that affects the overall satisfaction with surgery.

The Association Between Endplate Changes and Risk for Early Severe Cage Subsidence Among Standalone Lateral Lumbar Interbody Fusion Patients.

Study Design: Retrospective case series.

Objective: The aim of this study was to investigate the association of Modic type endplate changes with the risk of severe subsidence after standalone lateral lumbar interbody fusion (SA-LLIF).

Summary Of Background Data: It has been reported that certain endplate radiolographic features are associated with higher regional bone mineral density (BMD) in the adjacent vertebrae in the lumbar spine.

Expectations of Lumbar Surgery Outcomes among Opioid Users Compared with Non-Users.

Study Design: Matched cohort study.

Purpose: To compare and describe the effect of opioid usage on the expectations of lumbar surgery outcomes among patients taking opioids and patients not taking opioids.

Overview Of Literature: Chronic opioid use is common among lumbar-spine surgery patients.

Prevalence of osteoporosis and osteopenia diagnosed using quantitative CT in 296 consecutive lumbar fusion patients.

Objective: Osteoporosis is a metabolic bone disease that increases the risk for fragility fractures. Screening and diagnosis can be achieved by measuring bone mineral density (BMD) using quantitative CT tomography (QCT) in the lumbar spine. QCT-derived BMD measurements can be used to diagnose osteopenia or osteoporosis based on American College of Radiology (ACR) thresholds.