The Ultrasonic Bone Scalpel does not Outperform the High-Speed Drill: A Single Academic Experience.

Background: Spinal decompression and osteotomies are conventionally performed using high-speed drills (HSDs) and rongeurs. The ultrasonic bone scalpel (UBS) is a tissue-specific osteotome that preferentially cuts bone while sparing the surrounding soft tissues. There is ongoing investigation into its ability to optimize peri- and postoperative outcomes in spine surgery.

Sugammadex and blood loss during cervical spine fusion surgery.

Background And Aims: Sugammadex (SUG) has been associated with changes in coagulation studies. Most reports have concluded a lack of clinical significance based on surgical blood loss with SUG use at the end of surgery. Previous reports have not measured its use intraoperatively during ongoing blood loss.

Narrow and Ultranarrow Transitions in Highly Charged Xe Ions as Probes of Fifth Forces.

Optical frequency metrology in atoms and ions can probe hypothetical fifth forces between electrons and neutrons by sensing minute perturbations of the electronic wave function induced by them. A generalized King plot has been proposed to distinguish them from possible standard model effects arising from, e.g.

Comparison of Perioperative and Long-term Outcomes Following PEEK and Autologous Cranioplasty: A Single Institution Experience and Review of the Literature.

Objective: Three-dimensionally (3D) printed polyether-ether-ketone (PEEK) implants are a relatively novel option for cranioplasty that have recently gained popularity. However, there is ongoing debate with respect to material efficacy and safety compared to autologous bone grafts. The purpose of this study was to offer our institution's experience and add to the growing body of literature.

An Unusual Case of Neurenteric Cyst in a Patient with Split Cord Malformation.

Neurenteric cyst in a split cord malformation is a rare finding. We report an adult female becoming acutely symptomatic secondary to an expanding neurenteric cyst, though previous imaging had demonstrated stability. We discuss our workup and management with surgical resection and possible etiologies of her acute decline.

Impact of extent of resection and adjuvant therapy in diffuse gliomas of the spine.

Background Content: Diffuse gliomas of the spine (DGS)-consisting of intradural intramedullary glioblastoma, astrocytoma, and oligodendroglioma-are exceedingly rare tumors that account for about 2% of primary spinal cord tumors. Much is unknown about their optimal treatment regimen due to a relative lack of clinical outcome data.

Purpose: To provide an updated analysis on treatment and outcomes in DGS.

Practical Use of Augmented Reality Modeling to Guide Revision Spine Surgery: An Illustrative Case of Hardware Failure and Overriding Spondyloptosis.

Background And Importance: Augmented reality (AR) is a novel technology with broadening applications to neurosurgery. In deformity spine surgery, it has been primarily directed to the more precise placement of pedicle screws. However, AR may also be used to generate high fidelity three-dimensional (3D) spine models for cases of advanced deformity with existing instrumentation.

Comparison of One-day Combined versus Staged Anterior and Posterior Cervical Decompression, Fixation, and Fusion.

Aim: To compare the perioperative outcomes between single-day combined or separate-day staged surgeries for cervical spinal stenosis.

Material And Methods: A retrospective cohort analysis was conducted on consecutive patients admitted at a single institution between July 2015 and April 2019, who underwent either single-day combined or separate-day staged surgeries during the same hospitalization period. Demographics, comorbidities, hospital length of stay, and perioperative complications were compared between the patient groups.

High Resolution Photoexcitation Measurements Exacerbate the Long-Standing Fe XVII Oscillator Strength Problem.

For more than 40 years, most astrophysical observations and laboratory studies of two key soft x-ray diagnostic 2p-3d transitions, 3C and 3D, in Fe XVII ions found oscillator strength ratios f(3C)/f(3D) disagreeing with theory, but uncertainties had precluded definitive statements on this much studied conundrum. Here, we resonantly excite these lines using synchrotron radiation at PETRA III, and reach, at a millionfold lower photon intensities, a 10 times higher spectral resolution, and 3 times smaller uncertainty than earlier work. Our final result of f(3C)/f(3D)=3.

Surgical management of a complex case of Charcot arthropathy of the spine: a case report.

Introduction: The authors present a case of a 55-year-old male with T10 complete paraplegia diagnosed with Charcot arthropathy of the spine (CAS).

Case Presentation: He presented to an outside institution with vomiting and productive cough with subsequent computed tomography (CT) and MRI imaging revealing L5 osteomyelitis and a paraspinal abscess. Given the patient's inability to remain in good posture in his wheelchair he underwent a multilevel vertebrectomy and thoracolumbar fusion.

Cost-effectiveness of adult spinal deformity surgery in a military healthcare system.

OBJECTIVEAdult spinal deformity surgery is an effective way of treating pain and disability, but little research has been done to evaluate the costs associated with changes in health outcome measures. This study determined the change in quality-adjusted life years (QALYs) and the cost per QALY in patients undergoing spinal deformity surgery in the unique environment of a military healthcare system (MHS).METHODSPatients were enrolled between 2011 and 2017.

Return-to-active-duty rates after anterior cervical spine surgery in military pilots.

OBJECTIVESymptomatic cervical spondylosis with or without radiculopathy can ground an active-duty military pilot if left untreated. Surgically treated cervical spondylosis may be a waiverable condition and allow return to flying status, but a waiver is based on expert opinion and not on recent published data. Previous studies on rates of return to active duty status following anterior cervical spine surgery have not differentiated these rates among military specialty occupations.

Cervical and Thoracolumbar Spine Injury Evaluation, Transport, and Surgery in the Deployed Setting.

This Cervical and Thoracolumbar Spine Injury Evaluation, Transport, and Surgery Clinical Practice Guideline (CPG) is designed to provide guidance to the deployed provider when they are treating a combat casualty who has sustained a spine or spinal cord injury. The CPG objective for the treatment and the movement of these patients is to maintain spinal stability through transport, perform decompression when urgently needed, achieve definitive stabilization when appropriate, avoid secondary injury, and prevent deterioration of the patient's neurological condition. Thorough and accurate documentation of the patient's neurological examination is crucial to ensure appropriate management decisions are made as the patient transits through the evacuation system.

Spine Injuries Sustained by U.S. Military Personnel in Combat are Different From Non-Combat Spine Injuries.

Spine injuries are more prevalent among Iraq and Afghanistan veterans than among veterans of previous conflicts. The purpose of this investigation was to characterize the context, mode, and clinical outcomes of spine injuries sustained by U.S.

Performance of Cervical Arthroplasty at a Pseudarthrosed Level of a MultiLevel Anterior Cervical Discectomy and Fusion: Case Report.

Objective: To present a conversion from an anterior cervical discectomy and fusion (ACDF) to cervical arthroplasty in a 40-year-old, active duty member and perform a review of the literature.

Methods: A helicopter pilot in the U.S.

Integrin Alpha-9 Mediates Lymphatic Valve Formation in Corneal Lymphangiogenesis.

Purpose: We recently reported that corneal lymphatic vessels develop integrin alpha-9 (Itga-9)-positive valves during inflammatory lymphangiogenesis. The purpose of this study was to further investigate the role of Itga-9 in corneal lymphatic valve formation in vivo and lymphatic endothelial cell (LEC) functions in vitro.

Methods: Standard murine suture placement model was used to study the effect of Itga-9 blockade on lymphatic valve formation in vivo using Itga-9 neutralizing antibody.

Results of the AANS membership survey of adult spinal deformity knowledge: impact of training, practice experience, and assessment of potential areas for improved education: Clinical article.

Object: Adult spinal deformity (ASD) surgery is increasing in the spinal neurosurgeon's practice.

Methods: A survey of neurosurgeon AANS membership assessed the deformity knowledge base and impact of current training, education, and practice experience to identify opportunities for improved education. Eleven questions developed and agreed upon by experienced spinal deformity surgeons tested ASD knowledge and were subgrouped into 5 categories: (1) radiology/spinopelvic alignment, (2) health-related quality of life, (3) surgical indications, (4) operative technique, and (5) clinical evaluation.

Outcomes following cervical disc arthroplasty: a retrospective review.

Cervical disc arthroplasty has emerged as a viable technique for the treatment of cervical radiculopathy and myelopathy, with the proposed benefit of maintenance of segmental range of motion. There are relatively few, non-industry sponsored studies examining the outcomes and complications of cervical disc arthroplasty. Therefore, we set out to perform a single center evaluation of the outcomes and complications of cervical disc arthroplasty.

Outcomes of single-level cervical disc arthroplasty versus anterior cervical discectomy and fusion.

Several studies have established the short-term safety and efficacy of cervical disc arthroplasty (CDA) as compared to anterior cervical discectomy and fusion (ACDF). However, few single-center comparative trials have been performed, and current studies do not contain large numbers of patients. We retrospectively reviewed all patients from a single military tertiary medical center between August 2008 to August 2012 who underwent single-level CDA or single-level ACDF and compared their clinical outcomes and complications.