Publications by authors named "Muhammad M Abd-El-Barr"

Background: Recent studies highlight the increasing adoption of single-position prone lateral(SP-PL) and single-position lateral decubitus(SP-LD) in Minimally Invasive Spine Surgery(MISS) to reduce operative time, enhance patient safety, and improve surgical accessibility.

Objective: To assess the differences between SP-PL and SP-LD achievement of optimal postoperative outcomes and post-operative complication rates.

Study Design: Retrospective review of prospectively collected MIS database.

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  • Anterior column realignment (ACR) is a minimally invasive technique used to correct spinal alignment in adults with deformities, showing promising results similar to more invasive surgeries but with less blood loss.
  • A study analyzed 19 patients who underwent ACR for flatback deformity, noting significant improvements in spinal alignment and reduced back pain after surgery over an average follow-up of 19 months.
  • The procedure had a major complication rate of 15.8%, with no serious long-term neurological or vascular injuries observed, supporting ACR as a safe option for correcting spinal issues in patients with previous surgeries.
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Background: The use of plate-cage systems in anterior cervical discectomy and fusion (ACDF) has been shown to produce fusion and good clinical outcomes though it has been associated with complications such as dysphagia at higher rates than stand-alone implant devices. This study aimed to assess the incidence of dysphagia and radiographic outcomes in adult patients who have undergone ACDF with interbody spacer with integrated anchor fixation (ISa).

Methods: Patients who underwent index ACDF with a commercially available ISa by a fellowship-trained spine surgeon between January 2018 and December 2021 were retrospectively included.

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Background: Minimally-invasive trans-facet lumbar interbody fusion (LIF) is an emerging technique that offers the advantages of being safe, enabling decompression, and facilitating patient recovery. An innovative cage that expands in two dimensions has been introduced to restore segmental lordosis and disc height while minimizing the risk of cage subsidence. This study aimed to report our surgical technique of trans-facet LIF utilizing the innovative cag and to report the early clinical outcomes.

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  • A 53-year-old man experienced bilateral sacroiliac fracture-dislocations and initially had open reduction internal fixation but faced loss of fixation afterwards.
  • A revision procedure was performed using pelvic brim screws and robotic-assisted lumbopelvic fixation, resulting in minimal blood loss and soft-tissue injury.
  • At a 3-month follow-up, the patient had fully healed and was able to bear weight, demonstrating that the combination of percutaneous SI screws and robotic techniques effectively managed his injuries with fewer complications.
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Background Context: Low back pain (LBP) remains the leading cause of disability globally. In recent years, machine learning (ML) has emerged as a potentially useful tool to aid the diagnosis, management, and prognostication of LBP.

Purpose: In this review, we assess the scope of ML applications in the LBP literature and outline gaps and opportunities.

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Article Synopsis
  • - A systematic review compared different surgical approaches for fixing traumatic thoracolumbar fractures without neurological injury, focusing on traditional open, mini-open Wiltse, and percutaneous methods.
  • - Results showed the Wiltse approach had advantages such as lower operative time, blood loss, and hospital stay compared to the traditional open method, while also performing better in certain metrics against the percutaneous approach.
  • - The study concludes that minimally invasive techniques may reduce patient complications and improve care, recommending a prospective trial for better evaluation of outcomes and surgical choices.
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Cervical spine injuries (CSIs) are heterogeneous in nature and often lead to long-term disability and morbidity. However, there are few recent and comprehensive epidemiological studies on CSI. The objective of this study was to characterize recent trends in CSI patient demographics, incidence, etiology, and injury level.

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  • Ultra-minimally invasive percutaneous lumbar interbody fusion (percLIF) is shown to reduce tissue trauma and improve recovery outcomes compared to minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
  • A retrospective study analyzed opioid consumption within the first 24 hours post-surgery for patients undergoing either procedure, with results indicating percLIF patients used significantly less narcotics on average.
  • The analysis showed that while percLIF patients had lower narcotic consumption in the immediate post-operative period, the difference in overall opioid use at discharge and 30 days later was not statistically significant.
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Background: The rise of minimally invasive lumbar fusions and advanced imaging technologies has facilitated the introduction of novel surgical techniques with the trans-facet approach being one of the newest additions. We aimed to quantify any pathology-driven anatomic changes to the trans-facet corridor, which could thereby alter the ideal laterality of approach to the disc space.

Methods: In this retrospective cohort study, we measured the areas and maximum permissible cannula diameters of the trans-facet corridor using commercially available software (BrainLab, Munich, Germany).

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The introduction of minimally invasive surgery ushered in a new era of spine surgery by minimizing the undue iatrogenic injury, recovery time, and blood loss, among other complications, of traditional open procedures. Over time, technological advancements have further refined the care of the operative minimally invasive spine patient. Moreover, pre-, and postoperative care have also undergone significant change by way of artificial intelligence risk stratification, advanced imaging for surgical planning and patient selection, postoperative recovery pathways, and digital health solutions.

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Lateral spine surgery offers effective minimally invasive deformity correction, but traditional approaches often involve separate anterior, lateral, and posterior procedures. The prone lateral technique streamlines this process by allowing single-position access for lateral and posterior surgery, potentially benefiting from the lordosing effect of prone positioning. While previous studies have compared prone lateral to direct lateral for adult degenerative diseases, this retrospective review focuses on the outcomes of adult deformity patients undergoing prone lateral interbody fusion.

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The transforaminal lumbar interbody fusion (TLIF) has seen significant evolution since its early inception, reflecting advancements in surgical techniques, patient safety, and outcomes. Originally described as an improvement over the posterior lumbar interbody fusion (PLIF), the TLIF began as an open surgical procedure, that notably reduced the need for the extensive neural retractation that hindered the PLIF. In line with the broader practice of surgery, trending toward minimally invasive access, the TLIF was followed by the development of the minimally invasive TLIF (MIS-TLIF), a technique that further decreased tissue trauma and postoperative complications.

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Purpose: The role of robotics in spine surgery remains controversial, especially for scoliosis correction surgery. This study aims to assess the safety and efficacy of robotic-assisted (RA) surgery specifically for scoliosis surgery by comparing RA to both navigation systems (NS) and conventional freehand techniques (CF).

Methods: As per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a systematic review and meta-analysis were conducted via an electronic search of the following databases: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL).

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Article Synopsis
  • Cervical endoscopic spine surgery is gaining traction for treating conditions like cervical radiculopathy and myelopathy due to its reduced muscular damage, less blood loss, and quicker recovery times.
  • * New techniques such as endoscopic-assisted fusion and unilateral laminotomy for bilateral decompression aim to improve outcomes and expand the range of treatable issues.
  • * Challenges like a steep learning curve and increased radiation exposure exist, but advancements in imaging, navigation technologies, and anesthesia are set to improve the procedure's future effectiveness and safety.
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The transfacet minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is a novel approach available for the management of lumbar spondylolisthesis. It avoids the need to manipulate either of the exiting or traversing nerve roots, both protected by the bony boundaries of the approach. With the advancement in operative technologies such as navigation, mapping, segmentation, and augmented reality (AR), surgeons are prompted to utilize these technologies to enhance their surgical outcomes.

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Background: Robot-assisted sacroiliac joint (SIJ) fusion has gained popularity, but it carries the risk of complications such as injury to the superior gluteal artery (SGA). The authors present the case of an awake percutaneous robot-assisted SIJ fusion leading to an SGA pseudoaneurysm.

Observations: An 80-year-old male, who had undergone an awake percutaneous robot-assisted SIJ fusion, experienced postoperative left hip pain and bruising.

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Background: Opioids are often prescribed for patients who eventually undergo lumbar decompression. Given the potential for opioid-related morbidity and mortality, postoperative weaning is often a goal of surgery. The purpose of this study was to examine the relationship between preoperative opioid use and postoperative complete opioid weaning among lumbar decompression patients.

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  • This study conducted a systematic literature review and meta-analysis to understand factors predicting intraoperative neuromonitoring (IONM) alerts during scoliosis surgery.
  • Significant findings indicated that axial-MRI-defined spinal cord types, specifically types 1 and 2, had lower odds of IONM alerts compared to type 3.
  • Key radiographic measurements and clinical factors such as Cobb angles, operation duration, and number of levels fused were associated with these alerts, providing insights for better patient counseling and surgical planning.
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The Prone Transpsoas (PTP) approach to lumbar spine surgery, emerging as an evolution of lateral lumbar interbody fusion (LLIF), offers significant advantages over traditional methods. PTP has demonstrated increased lumbar lordosis gains compared to LLIF, owing to the natural increase in lordosis afforded by prone positioning. Additionally, the prone position offers anatomical advantages, with shifts in the psoas muscle and lumbar plexus, reducing the likelihood of postoperative femoral plexopathy and moving critical peritoneal contents away from the approach.

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Background: Postoperative spinal epidural hematomas (pSEHs) are a rare complication of microdiscectomy surgery. The hematoma may be unnoticed intraoperatively, but timely treatment may prevent permanent neurologic impairment. Airway management in patients with a full stomach is generally performed with rapid sequence intubation and general anesthesia.

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Background And Objectives: There has been a rise in minimally invasive methods to access the intervertebral disk space posteriorly given their decreased tissue destruction, lower blood loss, and earlier return to work. Two such options include the percutaneous lumbar interbody fusion through the Kambin triangle and the endoscopic transfacet approach. However, without accurate preoperative visualization, these approaches carry risks of damaging surrounding structures, especially the nerve roots.

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Surgical correction of fixed kyphotic deformity or severe sagittal imbalance traditionally involves three column osteotomies, which are associated with high morbidity rates. Anterior column realignment (ACR) has emerged as a minimally invasive alternative for restoring segmental lordosis. This technique involves a lateral approach and release of the anterior longitudinal ligament (ALL), followed by placement of a hyperlordotic interbody cage.

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Introduction: Anterior cervical discectomy and fusion (ACDF) is among the most common spine procedures. Adjacent segment disease (ASD), characterized by degenerative disease at an adjacent spinal level to a prior fusion, is a well-recognized and significant sequela following ACDF. Adjacent segment ACDF may be considered after the failure of non-surgical options for patients with symptomatic ASD.

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