Comparison of intra-operative skull fixation techniques on cervical sagittal parameters.

Background: There is limited literature concerning the use of bi-vector traction to a Mayfield following posterior cervical fusion with respect to cervical alignment parameters. The objective of this study was to determine how variability of intra-operative fixation methods for posterior cervical fusion affects post-operative cervical sagittal alignment parameters.

Methods: After institutional review board (IRB) approval, retrospective chart review of a total of 54 patients who underwent posterior cervical fusion from July 2017 to December 2019 was conducted.

Thoracic root-related intradural extramedullary cavernoma presenting with subarachnoid hemorrhage: illustrative case.

Background: Just 5% of all cavernomas are located in the spine. Thoracic root-related subtypes are the rarest, with a total of 14 cases reported in the literature to date. Among them, only 4 presented with subarachnoid hemorrhage (SAH).

Impact of obesity on adult spinal deformity (ASD) long-segment spinal fusion radiographic and clinical outcomes.

Study Design: Retrospective chart review of patients receiving long-segment fusion during a five-year period.

Objective: To determine whether obese patients receive comparable benefits when receiving long-segment fusion compared to non-obese patients and to identify factors that may predict hardware failure and post-surgical complications among obese patients.

Methods: Demographic, spinopelvic radiographic, patient-reported outcome measures (PROMs), and complications data was retrospectively collected from 120 patients who underwent long-segment fusion during a five-year period at one tertiary care medical center.

Promotion of higher rates of early fusion using activated titanium versus polyetheretherketone cages in adults undergoing 1- and 2-level transforaminal lumbar interbody fusion procedures: a randomized controlled trial.

Objective: There is ongoing debate on the relative benefits and drawbacks of polyetheretherketone (PEEK) versus titanium (Ti) in generating a bone-to-implant surface microenvironment conducive to osseointegration. Micro- and nanoscale internal and topographic cage modifications have recently been posited to facilitate osseointegration and fusion, but human in vivo confirmation remains lacking. The authors of this study sought to directly compare early radiological outcomes in adults undergoing 1- and 2-level transforaminal lumbar interbody fusion (TLIF) procedures using either PEEK or nano-etched Ti interbody cages with an incorporated microlattice structure.

Delayed stenosis associated with sublaminar band placement in the thoracic spine for proximal junctional kyphosis.

Background: Proximal junctional thoracic kyphosis (PJK) is common following adult spinal deformity (ASD) surgery and may require revision operations. In this case series, we present delayed complications associated with the use of sublaminar banding (SLBs) for PJK prophylaxis.

Case Description: Three patients underwent long-segment thoracolumbar decompression and fusions for ASD.

Subsidence Rates Associated With Porous 3D-Printed Versus Solid Titanium Cages in Transforaminal Lumbar Interbody Fusion.

Study Design: Retrospective Cohort Study.

Objective: To determine whether 3D-printed porous titanium (3DPT) interbody cages offer any clinical or radiographic advantage over standard solid titanium (ST) interbody cages in transforaminal lumbar interbody fusions (TLIF).

Methods: A consecutive series of adult patients undergoing one- or two-level TLIF with either 3DPT or ST "banana" cages were analyzed for patient reported outcome measures (PROMs), radiographic complications, and clinical complications.

Electronic versus paper patient-reported outcome measure compliance rates: A retrospective analysis.

Objective: Patient-reported outcome measures (PROMs) are key tools used to inform clinical research and patient-centered care. Application of data collected from PROMs, however, may be limited by incomplete responses, and little is known regarding the efficacy of varied PROM delivery methods. The objective of this study was to compare PROMs compliance when delivered via paper and electronic formats.

Early Postural Stability Changes in Patients Undergoing Correction of Spinal Deformity: A Prospective, Controlled Pilot Study.

Background Context: Adult spinal deformity (ASD) is a prevalent condition often requiring surgical intervention. Improved outcomes among ASD patients have been shown to correlate with postoperative spinopelvic parameters, yet little is currently known about the role of postural stability and balance assessment for ASD patients.

Purpose: Explore early changes in postural stability following ASD correction.

Association between synthetic sealants and increased complication rates in posterior fossa decompression with duraplasty for Chiari malformations regardless of graft type.

Objective: Dural sealants are commonly used in posterior fossa decompression with duraplasty (PFDD) for Chiari malformation type I (CMI). Prior evidence suggests that combining certain sealants with some graft material is associated with an increased rate of complications. In 2018, the authors noted an increased rate of symptomatic pseudomeningocele and aseptic meningitis after PFDD in CMI patients.

Influence of clinical and radiological parameters on the likelihood of neurological improvement after surgery for degenerative cervical myelopathy.

Objective: Degenerative cervical myelopathy (DCM) is routinely treated with surgical decompression, but disparate postoperative outcomes are frequently observed, ranging from complete neurological recovery to persistent decline. Although numerous clinical and radiological factors have been independently associated with failure to improve, the relative impact of these proposed risk factors remains obscure. In this study, the authors assess the combined role of clinical and radiographic parameters in contributing to failure to attain neurological improvement after surgery.

Spinal deformity correction in ankylosing spondylitis.

Background: Ankylosing spondylitis (AS) is a complex, debilitating disease with few available medical therapies in its later stages.

Methods: We reviewed current clinical approaches for caring for AS patients with an emphasis on the risks and outcomes associated with surgical intervention.

Results: It is critical to understand the natural history and surgical outcomes of patient with AS.

Static Cage Morphology in Short-Segment Transforaminal Lumbar Interbody Fusions Is Associated With Alterations in Foraminal Height But Not Clinical Outcomes.

Introduction: Steerable "banana" cages have been posited to increase segmental lordosis in short-segment transforaminal lumbar interbody fusions (TLIF). The same is not necessarily true for straight "bullet" cages. Although increased lordosis is generally thought to be advantageous, a potential complication is decreased foraminal height.

Can activated titanium interbody cages accelerate or enhance spinal fusion? a review of the literature and a design for clinical trials.

While spinal interbody cage options have proliferated in the past decade, relatively little work has been done to explore the comparative potential of biomaterial technologies in promoting stable fusion. Innovations such as micro-etching and nano-architectural designs have shown purported benefits in in vitro studies, but lack clinical data describing their optimal implementation. Here, we critically assess the pre-clinical data supportive of various commercially available interbody cage biomaterial, topographical, and structural designs.

Radiographic and clinical outcomes in one- and two-level transforaminal lumbar interbody fusions: a comparison of bullet versus banana cages.

Objective: The aim of this study was to determine whether cage morphology influences clinical and radiographic outcomes following short-segment transforaminal lumbar interbody fusion (TLIF) procedures.

Methods: The authors retrospectively reviewed one- and two-level TLIFs at a single tertiary care center between August 2012 and November 2019 with a minimum 1-year radiographic and clinical follow-up. Two cohorts were compared based on interbody cage morphology: steerable "banana" cage or straight "bullet" cage.

Gliosarcoma with PNET features mimicking a metastatic neuroendocrine carcinoma: A diagnostic dilemma.

Objective: Gliosarcomas (GS) comprise ~ 2 - 8% of glioblastomas and are associated with a similar poor prognosis. GS have rarely been found with a primitive neuroectodermal component (PNET). We present a case of gliosarcoma with PNET features (GS-PNET) that mimicked a neuroendocrine carcinoma on initial biopsy.

Negative pressure wound therapy in spinal fusion patients.

Post-operative wound complications are some of the most common acute complications following spine surgery. These surgical site infections (SSI) contribute to increased healthcare related costs. Negative pressure wound therapy (NPWT) has long been used for treatment of soft tissue injury or defects.

Damned if you monitor, damned if you don't: medical malpractice and intraoperative neuromonitoring for spinal surgery.

Objective: The aim of this study was to identify trends in medical malpractice litigation related to intraoperative neuromonitoring.

Methods: The Westlaw Edge legal research service was queried for malpractice litigation related to neuromonitoring in spine surgery. Cases were reviewed to determine if the plaintiff's assertion of negligence was due to either failure to use neuromonitoring or negligent monitoring.