Publications by authors named "Maximilian Korsun"
Purpose: This study investigates the relationship between surgical levels and coronal deformity to identify risk factors for failing to achieve a minimal clinically important difference (MCID) in the Oswestry Disability Index (ODI) following short-segment isolated decompression or fusion surgery in patients with degenerative scoliosis (DS) and concurrent lumbar canal stenosis (LCS), without severe sagittal deformity malalignment.
Methods: Patients with degenerative scoliosis who underwent 1- or 2-level lumbar isolated decompression or fusion surgery were included. Surgical level was labeled as "Cobb-related" when decompression or surgical levels spanned or were between end vertebrae, and "outside" when the operative levels did not include the end vertebrae.
Study Design: Retrospective cohort study.
Summary Of Background Data: The optimal surgical approach for multilevel cervical stenosis in elderly patients is controversial because of the risk of life-threatening complication.
Objective: To compare life-threatening early complication rates between ≥3 levels anterior and posterior cervical surgery in elderly patients.
Article Synopsis
- The study was a retrospective cohort review comparing single level (SLD) and dual level (DLD) minimally invasive decompression surgeries for lumbar spinal stenosis (LSS) in patients with adjacent level disease.
- Findings indicated that patients undergoing single level decompression experienced similar clinical outcomes to those with dual level decompression over a 2-year period, despite longer operative times for DLD procedures.
- The conclusion suggests that for patients with single level symptoms and adjacent stenosis, treating only the symptomatic level is equally effective, potentially reducing unnecessary risks and surgery time associated with dual level procedures.
Background: Although a few recent studies showed good outcomes in back pain-predominant patients following decompression alone, none of the studies had a comparative fusion group.
Purpose: We sought to compare outcomes of minimally invasive decompression alone versus fusion in patients with predominant back pain.
Methods: This retrospective cohort study included patients who underwent minimally invasive decompression alone or fusion and had preoperative back pain > leg pain.
Objective: Prior studies investigating the use of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) for treatment of degenerative lumbar conditions and concomitant sagittal deformity have not stratified patients by preoperative pelvic incidence (PI)-lumbar lordosis (LL) mismatch, which is the earliest parameter to deteriorate in mild sagittal deformity. Thus, the aim of the present study was to determine the impact of preoperative PI-LL mismatch on clinical outcomes and sagittal balance restoration among patients undergoing MI-TLIF for degenerative spondylolisthesis (DS).
Methods: Consecutive adult patients undergoing primary 1-level MI-TLIF between April 2017 and April 2022 for DS with ≥ 6 months radiographic follow-up were included.
Objective: The aim of this study was to assess the correlation between patient-perceived changes in health and commonly utilized patient-reported outcome measures (PROMs) in lumbar spine surgery.
Methods: This was a retrospective review of prospectively collected data on consecutive patients who underwent lumbar microdiscectomy, lumbar decompression, or lumbar fusion at a single academic institution from 2017 to 2023. Correlation between the global rating of change (GRC) questionnaire, a 5-item Likert scale (much better, slightly better, about the same, slightly worse, and much worse), and PROMs (Oswestry Disability Index, visual analog scale for back and leg pain, 12-Item Short Form Health Survey Physical Component Summary and Mental Component Summary, and PROMIS physical function) was assessed using Spearman's rank correlation coefficients.
Purpose: To compare the outcomes of decompression alone and fusion for L4-5 DLS in different age cohorts (< 70 years, ≥ 70 years).
Methods: This retrospective cohort study included patients who underwent minimally invasive decompression or fusion for L4-5 DLS and had a minimum of 1-year follow-up. Outcome measures were: (1) patient-reported outcome measures (PROMs) (Oswestry Disability Index, ODI; Visual Analog Scale back and leg, VAS; 12-Item Short Form Survey Physical Component Score, SF-12 PCS), (2) minimal clinically important difference (MCID), (3) patient acceptable symptom state (PASS), (4) response on the global rating change (GRC) scale, and (5) complication rates.
Background Context: Robotic spine surgery, utilizing 3D imaging and robotic arms, has been shown to improve the accuracy of pedicle screw placement compared to conventional methods, although its superiority remains under debate. There are few studies evaluating the accuracy of 3D navigated versus robotic-guided screw placement across lumbar levels, addressing anatomical challenges to refine surgical strategies and patient safety.
Purpose: This study aims to investigate the pedicle screw placement accuracy between 3D navigation and robotic arm-guided systems across distinct lumbar levels.
Study Design: Retrospective cohort.
Objective: To study the impact of class 2/3 obesity (body mass index, BMI >35) on outcomes following minimally invasive decompression.
Summary Of Background Data: No previous study has analyzed the impact of class 2/3 obesity on outcomes following minimally invasive decompression.
Study Design: Retrospective review of prospectively collected data.
Objective: To analyze temporal trends in improvement after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).
Summary Of Background Data: Although several studies have shown that patients improve significantly after MIS TLIF, evidence regarding the temporal trends in improvement is still largely lacking.
Study Design: Retrospective cohort study.
Objective: To determine the impact of psoas muscle health [cross-sectional area (CSA)] on achieving minimal clinically important differences (MCID) in patient-reported outcome measures (PROMs) following laminectomy for patients with predominant back pain (PBP) and leg pain (PLP).
Summary Of Background Data: Psoas muscle health is linked to postoperative outcomes in decompression patients, with MRI-based grading of psoas CSA correlating with these outcomes.
Article Synopsis
- The study used a retrospective cohort design to find factors that predict slower or no improvement after surgery for L4-5 degenerative lumbar spondylolisthesis (DLS).
- It focused on various clinical and radiological measures, assessing a range of predictor variables including patient demographics, comorbidities, and specific surgical outcomes over a minimum of 1 year.
- Key findings showed that certain factors like pelvic tilt, depression, VAS leg scores, and facet orientation impacted improvement outcomes both in the short and long term after surgery.
Article Synopsis
- The study analyzes how the length of time patients experience symptoms before cervical disc replacement (CDR) affects their recovery outcomes.* -
- Researchers found that patients with shorter preoperative symptom durations (<6 months) showed significantly better improvements in pain and function compared to those with longer durations (≥6 months) during early and late recovery.* -
- Prolonged symptoms before surgery were linked to a higher likelihood of not achieving meaningful improvement in outcomes like neck and arm pain, indicating that timing of surgery may impact overall effectiveness.*
Study Design: Cross-sectional survey and retrospective review of prospectively collected data.
Objective: To explore how patients perceive their decision to pursue spine surgery for degenerative conditions and evaluate factors correlated with decisional regret.
Summary Of Background Data: Prior research shows that one-in-five older adults regret their decision to undergo spinal deformity surgery.
Article Synopsis
- - The study reviewed data from patients who underwent minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and received erector spinae plane (ESP) blocks, aiming to find why some patients did not experience pain relief post-surgery.
- - Out of 134 patients, nearly 37% failed to benefit from the ESP block, with factors such as being female, using opioids before surgery, having anxiety, and hyperlipidemia linked to this lack of response.
- - The findings highlight the need for further analysis on how specific patient characteristics influence the effectiveness of ESP blocks in pain management after surgeries like MI-TLIF.
Study Design: Retrospective review of a prospectively collected multisurgeon registry.
Objective: To evaluate the outcomes of minimally invasive (MI) decompression in patients with severe degenerative scoliosis (DS) and identify factors associated with poorer outcomes.
Summary Of Background Context: MI decompression has gained widespread acceptance as a treatment option for patients with lumbar canal stenosis and DS.
Study Design: Retrospective cohort study.
Objective: (1) To develop a reliable grading system to assess the severity of posterior intervertebral osteophytes and (2) to investigate the impact of posterior intervertebral osteophytes on clinical outcomes after L5-S1 decompression and fusion through anterior lumbar interbody fusion (ALIF) and minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF).
Background: There is limited evidence regarding the clinical implications of posterior lumbar vertebral body osteophytes for ALIF and MIS-TLIF surgeries and there are no established grading systems that define the severity of these posterior lumbar intervertebral osteophytes.
Study Design: Retrospective cohort.
Objective: To compare the characteristics of the minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) metrics when interpreting Neck Disability Index (NDI) following cervical spine surgery.
Methods: Patients who underwent primary cervical fusion, discectomy, or laminectomy were included.
Bone morphogenetic protein (BMP) gene delivery to Lewis rat lumbar intervertebral discs (IVDs) drives bone formation anterior and external to the IVD, suggesting the IVD is inhospitable to osteogenesis. This study was designed to determine if IVD destruction with a proteoglycanase, and/or generating an IVD blood supply by gene delivery of an angiogenic growth factor, could render the IVD permissive to intra-discal BMP-driven osteogenesis and fusion. Surgical intra-discal delivery of naïve or gene-programmed cells (BMP2/BMP7 co-expressing or VEGF expressing) +/- purified chondroitinase-ABC (chABC) in all permutations was performed between lumbar 4/5 and L5/6 vertebrae, and radiographic, histology, and biomechanics endpoints were collected.
View Article and Find Full Text PDFStudy Design: Retrospective review of a prospectively maintained multisurgeon registry.
Objective: To study recovery kinetics and associated factors after cervical spine surgery.
Summary Of Background Data: Few studies have described return to activities cervical spine surgery.
Study Design: Retrospective review of a prospectively collected registry.
Objective: The purpose of the present study was to investigate the impact of frailty and radiographical parameters on postoperative dysphagia after anterior cervical spine surgery (ACSS).
Summary Of Background Data: There is a growing body of literature indicating an association between frailty and increased postoperative complications following various surgeries.
Background Context: While cervical disc replacement (CDR) has been emerging as a reliable and efficacious treatment option for degenerative cervical spine pathology, not all patients undergoing CDR will achieve minimal clinically important difference (MCID) in patient-reported outcome measures (PROMs) postoperatively-risk factors for failure to achieve MCID in PROMs following CDR have not been established.
Purpose: To identify risk factors for failure to achieve MCID in Neck Disability Index (NDI, Visual Analog Scale (VAS) neck and arm following primary 1- or 2-level CDRs in the early and late postoperative periods.
Study Design: Retrospective review of prospectively collected data.
Study Design: Retrospective cohort.
Summary Of Background Data: Although minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) are utilized to interpret Oswestry Disability Index (ODI), it is unclear whether there is a clearly better metric between the two and if not, which metric should be utilized when.
Objective: To compare the characteristics of MCID and PASS when interpreting ODI after lumbar spine surgery.
Objective: The objective of this study was to assess the outcomes of patients with predominant back pain (pBP) undergoing minimally invasive decompression surgery compared with patients with nonpredominant back pain (npBP).
Methods: This was a retrospective cohort study. Patients were divided into two groups based on the presenting complaint: 1) pBP, defined as visual analog scale (VAS) back pain score > VAS leg pain score; and 2) npBP.
Article Synopsis
- The study is a retrospective review examining the learning curves of three spine surgeons performing robotic minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) using prospectively collected patient data.
- Results showed varying learning curves: Surgeon 1 demonstrated significant improvement and mastery by the 31st case, while Surgeons 2 and 3 did not show clear learning curves, though there were hints of improvement in surgeon 3’s later cases.
- The study highlights that more experienced surgeons may not experience the same steep learning curves as less experienced ones, suggesting that proficiency in robotic MI-TLIF can develop differently based on surgical experience.