Surgical Management of Adult Spinal Deformity Patients with Osteoporosis.

Adult spinal deformity (ASD) commonly affects older adults, with up to 68% prevalence in those over 60, and is often complicated by osteoporosis, which reduces bone mineral density (BMD) and increases surgical risks. Osteoporotic patients undergoing ASD surgery face higher risks of complications like hardware failure, pseudoarthrosis, and proximal junctional kyphosis (PJK). Medical management with antiresorptive medications (e.

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.

The Impact of Symptom Duration on Postoperative Outcomes in Patients Undergoing Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.

Background And Context: The optimal timing at which patients should undergo Anterior Cervical Discectomy and Fusion (ACDF) surgery to achieve the best outcomes has not been determined. Given that patients may experience delays in care and that insurance companies often require a minimum of six weeks of conservative treatment before surgery, it is essential to determine the impact of symptom duration on outcomes following ACDF.

Purpose: To evaluate the impact of symptom duration on outcomes following ACDF surgery.

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.

Postoperative delirium following total joint arthroplasty: epidemiology, risk factors, and associated complications.

Introduction: Postoperative delirium (POD) is a feared complication following major surgery in elderly patients. Further investigation of the risk factors and consequences of POD following total joint arthroplasty is warranted.

Methods: Patients who underwent total knee arthroplasty (TKA) or total hip arthroplasty (THA) were identified using PearlDiver.

The predictive power of the Roussouly classification on mechanical complications after surgery for adult spinal deformity: systematic review and meta-analysis.

Background: With the increasing prevalence of adult spinal deformity (ASD) in the aging population, the need for corrective surgery has surged, highlighting the importance of preventing mechanical complications (MC) such as junctional kyphosis/failure and rod breakage. The Roussouly classification, which categorizes natural variations in spinal posture, may hold predictive value in assessing the risk of these complications, as it guides the restoration of sagittal alignment based on a patient's preoperative spinal shape.

Methods: PubMed, Cochrane, and Google Scholar (pages 1-20) were searched through August 2024 to find articles comparing the incidence of mechanical complications between patients who were matched and mismatched to their ideal Roussouly shape after surgery for ASD.

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.

Shouldering the load: A scoping review of incidence, types, and risk factors of shoulder injuries in weight-lifting athletes.

Lifestyles advocating for proper health and fitness have been trending in recent years, and as such, sports like weightlifting have become very popular worldwide. While these sports improve physical fitness and cardiovascular health, they carry an inherent risk for physical injuries, mainly to the shoulder. In this review, we aimed to explore the epidemiology of shoulder injuries in weightlifting using a systematic search of the literature.

Shoulder injury patterns and trends in the national football league: an epidemiological analysis.

Background: Athletic movements in American football render the shoulder vulnerable to injury. The aim of this study was to explore the epidemiology of shoulder injuries in the National Football League (NFL).

Methods: Injury data from the 2019-2022 seasons were extracted from official NFL website and secondary resources.

A Proposed Patient Selection Algorithm for Total Joint Arthroplasty Same-Day Discharge From an Ambulatory Surgery Center.

Background: Identifying appropriate patients for same-day discharge (SDD) total joint arthroplasty (TJA) is critical for maintaining optimal patient safety and outcomes. This study investigated patient outcomes after SDD TJA at a single ambulatory surgery center (ASC) and proposes a TJA patient-selection algorithm based on findings and existing literature.

Methods: A retrospective chart review of 660 patients was performed between July 2019 and October 2021 for all patients who underwent primary TJA in a single ASC.

Outpatient versus inpatient total shoulder arthroplasty: A meta-analysis of clinical outcomes and adverse events.

Background: In recent years, orthopaedic procedures have increasingly shifted from inpatient to outpatient settings. This trend includes total shoulder arthroplasty (TSA), which is being performed more frequently in outpatient facilities and ambulatory surgical centres. The purpose of this study was to compare the clinical outcomes and rates of adverse events between outpatient and inpatient TSA.

Multilevel En-Bloc Excision of Thoracic Spine Primary Chondrosarcoma Through an All-Posterior Approach: A Report of Two Cases.

Chondrosarcomas are malignant, cartilage-forming neoplasms. As these tumours are resistant to chemotherapy and radiotherapy, en-bloc excision of the tumour with wide margins is the only option that provides maximum disease-free survival and possible cure. We present two cases of primary chondrosarcoma of the thoracic spine treated by multilevel en-bloc excision through an all-posterior approach.

Liposomal bupivacaine reduces postoperative pain and opioids consumption in spine surgery: a meta-analysis of 1,269 patients.

Background Context: Postoperative pain management in spine surgery remains a challenge. Liposomal bupivacaine (LB) has emerged as an alternative or adjunct to opioid-based analgesia. However, existing studies evaluating LB efficacy in spine surgery yield conflicting results and a meta-analysis compiling the literature is lacking.

Outpatient Versus Inpatient Total Hip and Knee Arthroplasty in Morbidly Obese Patients.

Background: Morbidly obese patients undergoing total joint arthroplasty (TJA) face increased postoperative complications, yet studies assessing the safety of this surgery in the outpatient setting for this population are lacking. This study aimed to fill this gap by assessing the safety and benefits of outpatient TJA in morbidly obese patients.

Methods: This study is a retrospective review of a commercial claims database.

Pre-Operative Traction in Femoral Fractures for Pain Management: A Meta-Analysis of Comparative Studies.

Objectives: This meta-analysis studies and assesses the pain relief effect of different pre-operative traction systems in proximal and femoral shaft fractures as this subject is still debated and no clear guidelines are established.

Methods: PubMed, Cochrane, Embase and Google Scholar (page 1-20) were searched until January 2024. The clinical outcomes collected consisted of pain scales following traction.

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.

Traumatic spine fractures and concomitant venous thromboembolism: A systematic review.

Objective: Venous thromboembolism (VTE) associated with bony fractures have been documented in the literature. However, the literature is not very exhaustive when it comes to VTE associated with traumatic spine fractures. Thus the purpose of this systematic review analyzing the incidence of VTE associated with spinal trauma.