Evaluation of bone mineral density after instrumented lumbar fusion with computed tomography.

Background Context: Computed tomography (CT) measurement of Hounsfield Units (HU) has been described as a tool for assessing BMD. For surgeons considering a revision lumbar fusion, knowledge of the BMD of the UIV is of value for surgical planning. However, the presence of metal artifact from instrumentation presents a potential confounder, and prior studies have not validated measurements of HU in this setting.

Use of teriparatide prior to lumbar fusion surgery lowers two-year complications for patients with poor bone health.

Introduction: Poor bone health can create challenges in management which are amplified for patients undergoing spinal fusion. Although previously shown to improve outcomes postoperatively, the impact of preoperative teriparatide use on long-term complications remains unclear. In this study, we investigated the complication rates within two years of surgery for osteoporotic and osteopenic patients using teriparatide prior to lumbar fusion procedures.

Opportunistic Computed Tomography and Spine Surgery: A Narrative Review.

Study Design: Narrative review.

Objective: This article seeks to provide a narrative review regarding the ability of opportunistic information available from computed tomography (CT) scans to guide decisions in spine surgery related to patient bone quality.

Methods: A review of the literature (limited to human and English language) was performed via PubMed and Google Scholar using the search terms; "osteoporosis" AND "opportunistic" AND "computed tomography" AND "spine surgery.

Abaloparatide and the Spine: A Narrative Review.

Osteoporosis is a common and debilitating condition characterized by diminished bone mass and architecture leading to bone fragility. Antiresorptive medicines like bisphosphonates (and less commonly denosumab) are the typical first-line agents for the medical treatment of osteoporosis. However, newer anabolic agents have been shown to improve bone mass and architecture, as well as reduce fracture risk, to a greater degree than traditional antiresorptive therapies.

Osteoporosis-related Vertebral Fragility Fractures: A Review and Analysis of the American Orthopaedic Association's Own the Bone Database.

Study Design: Retrospective cohort study of the Own the Bone database which is a fracture liaison service designed to improve recognition and treatment of osteoporosis.

Objective: To use the Own the Bone (OTB) database to 1) examine the specific demographics of patients presenting with a low-energy clinical vertebral fracture (VFX) and 2) compare demographic and fracture-specific risk factors between patients with clinical VFX versus patients with nonvertebral low-energy fracture (NVFX).

Summary Of Background Data: Large database studies have described risk factors for developing VFX.

Reverse shoulder arthroplasty for patients with glenohumeral osteoarthritis secondary to glenoid dysplasia.

The purpose is to report the clinical and radiographic outcomes, complications and reoperations of reverse shoulder arthroplasty (RSA) for glenoid dysplasia. All patients who had undergone RSA for osteoarthritis secondary to underlying glenoid dysplasia were retrospectively identified. The study included twelve shoulders (11 patients), with a mean (SD) patient age of 62.

Outcomes and Direct Costs of Needle Aponeurotomy, Collagenase Injection, and Fasciectomy in the Treatment of Dupuytren Contracture.

Purpose: The aims of our study were to evaluate the rates and predictors of reinterventions and direct costs of 3 common treatments of Dupuytren contractures-needle aponeurotomy, collagenase injection, and surgical fasciectomy.

Methods: A retrospective review identified 848 interventions for Dupuytren contracture in 350 patients treated by a single surgeon from 2005 to 2016. The treatments included needle aponeurotomy (NA) (n = 444), collagenase injection (n = 272), and open fasciectomy (n = 132).

A Review and Clinical Perspective of the Impact of Osteoporosis on the Spine.

Introduction: Osteopenia and osteoporosis are common conditions in the United States. The health consequences of low bone density can be dire, from poor surgical outcomes to increased mortality rates following a fracture.

Significance: This article highlights the impact low bone density has on spine health in terms of vertebral fragility fractures and its adverse effects on elective spine surgery.

Tranexamic Acid in Thoracic and Lumbar Fusions and Perioperative Blood Loss.

Study Design: This study was a retrospective cohort design.

Objective: The objective of this study was to examine the impact of tranexamic acid (TXA) on total perioperative wound output following thoracic and lumbar spinal fusions.

Summary Of Background Data: TXA has been extensively studied with regard to intraoperative blood loss and transfusion rates.

Prospective Evaluation of Radiculitis following Bone Morphogenetic Protein-2 Use for Transforaminal Interbody Arthrodesis in Spine Surgery.

Study Design: Prospective observational cohort study.

Purpose: This study aims to evaluate the safety and efficacy of bone morphogenetic protein-2 (BMP-2) in transforaminal lumbar interbody fusion (TLIF) with regard to postoperative radiculitis.

Overview Of Literature: Bone morphogenetic protein (BMP) is being used increasingly as an alternative to iliac crest autograft in spinal arthrodesis.

Is Teriparatide Beneficial to Spinal Fusion Surgery in the Older Patient?: A Narrative Review.

Since FDA approval in 2002, teriparatide has gained popularity as an anabolic therapy for the treatment of osteoporosis. Animal studies have suggested a role for teriparatide in spine surgery. Several recent studies have demonstrated adjunctive use of teriparatide in osteoporotic patients undergoing spine fusions improves fusion rates, decreases time to union, and decreases osteoporosis-related complications such as proximal junctional kyphosis.

Effect of teriparatide use on bone mineral density and spinal fusion: a narrative review of animal models.

Teriparatide (Human recombinant Parathyroid Hormone 1-34) is an anabolic agent that is frequently used in patients with osteoporosis and has been extensively investigated with animal model and clinical studies in current literature. The purpose of the study was to evaluate the impact of teriparatide on bone mineral density and fusion. The findings from preclinical studies that have investigated the role of teriparatide in animal models are summarized in presented review.

Enterobacter Infection after Spine Surgery: An Institutional Experience.

Background: Gram-negative surgical site infections (SSI) following spine surgery are becoming increasingly more common owing to a broad perioperative antibiotic usage targeting gram-positive organisms. Enterobacter species have been reported to be the most common gram-negative bacteria following spine surgery.

Methods: We queried our institutional database for Enterobacter SSIs after spine surgery at a single institution from 2009-2016.

Does Recombinant Human Bone Morphogenic Protein 2 Affect Perioperative Blood Loss after Lumbar and Thoracic Spinal Fusion?

Study Design: Retrospective cohort design.

Purpose: This study aimed to determine whether recombinant human bone morphogenic protein 2 (rhBMP-2) reduces total perioperative blood loss during lumbar and thoracic fusion.

Overview Of Literature: Previous studies on rhBMP-2 versus iliac crest bone grafting in thoracic and lumbar fusions have yielded mixed results regarding reductions in blood loss and have largely neglected the postoperative period when analyzing total blood loss.

Revision anatomic shoulder arthroplasty with posterior capsular plication for correction of posterior instability.

Background: Revision of failed anatomic total shoulder arthroplasty or hemiarthroplasty is a challenging procedure. Restoring adequate soft tissue balance in the revision setting can be particularly problematic. When persistent posterior instability is encountered in the revision setting, options include changing component position or size, posterior capsular plication (PCP), or conversion to a reverse arthroplasty.

An empiric analysis of 5 counter measures against surgical site infections following spine surgery-a pragmatic approach and review of the literature.

Background Context: Surgical site infections (SSI) following spine surgery are debilitating complications to patients and costly to the healthcare system.

Purpose: Review the impact and cost effectiveness of 5 SSI prevention interventions on SSI rates in an orthopedic spine surgery practice at a major quaternary healthcare system over a 10-year period.

Study Design: Retrospective observational study.

Anatomic total shoulder arthroplasty with posterior capsular plication versus reverse shoulder arthroplasty in patients with biconcave glenoids: A matched cohort study.

Purpose: To compare the outcomes of total shoulder arthroplasty (TSA) with posterior capsule plication (PCP) and reverse shoulder arthroplasty (RSA) in patients with primary osteoarthritis, posterior subluxation, and bone loss (Walch B2).

Patients And Methods: All shoulders undergoing anatomic TSA with PCP were retrospectively identified (group 1, G1) and compared to shoulders undergoing RSA (group 2, G2) for Walch B2 osteoarthritis. There were 15 patients in G1 (mean (SD) age and follow-up of 70.

An Ovariectomy-Induced Rabbit Osteoporotic Model: A New Perspective.

Study Design: Experimental Animal Model.

Purpose: The aim of our study was to validate a pure bilateral ovariectomy (OVX) female New Zealand white rabbit model of postmenopausal osteoporosis utilizing animal-sparing techniques for evaluating bone mineral density (BMD). We also sought to demonstrate that bilateral OVX in female New Zealand white rabbits can produce diminished BMD in the spinal column and simulate osteoporosis, without the need for adjuvant chemotherapeutic agents (i.

Outcomes Following Acute Metacarpophalangeal Joint Arthroplasty Dislocation: An Analysis of 37 Cases.

Purpose: There remains a paucity of information regarding the treatment outcomes of dislocation after metacarpophalangeal (MCP) joint arthroplasty. The purpose of this study was to assess the outcomes of surgical and nonsurgical treatment modalities of MCP arthroplasty dislocations.

Methods: Of 816 MCP joint arthroplasties over a 14-year period, there were 37 (4%) acute MCP joint dislocations that required intervention by a health care professional.

Reverse Shoulder Arthroplasty in Weight-Bearing Shoulders of Wheelchair-Dependent Patients: Outcomes and Complications at 2 to 5 years.

Background: Wheelchair-dependent patients rely on their upper extremities for mobility and transfers. This entails the heavy use of upper extremities as weight-bearing joints, leading to shoulder overuse with increased prevalence of rotator cuff-related disorders and ultimately to challenging cases for shoulder surgeons when a joint replacement is needed.

Objective: To report the outcomes of reverse shoulder arthroplasty (RSA) in wheelchair-dependent patients with arthritis and rotator cuff tears.