Hangman's Fractures: A Review of Current Concepts in Evaluation and Management.

Study Design: Review article.

Objective: To provide a comprehensive review and update on the evaluation and management of Hangman's fractures.

Summary Of Background Data: Hangman's fractures are the second most common fracture of the C2 vertebrae, and the prevalence is increasing with our aging population.

Factors Related to Clinical Performance in Spine Surgery Fellowship: Can We Predict Success.

Introduction: The factors most important in the spine fellowship match may not ultimately correlate with quality of performance during fellowship. This study examined the spine fellow applicant metrics correlated with high application rank compared with the metrics associated with the strongest clinical performance during fellowship.

Methods: Spine fellow applications at three academic institutions were retrieved from the San Francisco Match database (first available to 2021) and deidentified for application review.

Response to Preoperative Steroid Injections Predicts Surgical Outcomes in Patients Undergoing Fusion for Isthmic Spondylolisthesis.

Study Design: Retrospective cohort study.

Objective: The decision to pursue operative intervention for patients with isthmic spondylolisthesis is complex. Although steroid injections are a well-accepted therapeutic modality that may delay or obviate surgery, little is known regarding their ability to predict surgical outcomes.

Considerations for Lumbar Medial Branch Nerve Radiofrequency at Spinal Motion Segments Adjacent to a Fusion Construct.

Instrumented lumbar spinal fusion is common and results in biomechanical changes at adjacent spinal segments that increase facet load bearing. This can cause facet-mediated pain at levels adjacent to the surgical construct. Medial branch nerve radiofrequency ablation (RFA) exists as a treatment for some cases.

Cost analysis of primary single-level lumbar discectomies using the Value Driven Outcomes database in a large academic center.

Background Context: Improving value is an established point of emphasis to reduce the rapidly rising health care costs in the United States. Back pain is a major driver of costs with a substantial fraction caused by lumbar radiculopathy. The most common surgical treatment for lumbar radiculopathy is microdiscectomy.

What Does Your PROMIS Score Mean? Improving the Utility of Patient-Reported Outcomes at the Point of Care.

Study Design: Prospective cohort.

Objectives: Patient-Reported Outcome Measurement Information System (PROMIS) has been validated for lumbar spine. Use of patient-reported outcome (PRO) measures can improve clinical decision making and health literacy at the point of care.

Predictors of Readmission and Prolonged Length of Stay After Cervical Disc Arthroplasty.

Study Design: Retrospective cohort study.

Objective: The aim of the study was to assess which factors increase risk of readmission within 30 days of surgery or prolonged length of stay (LOS) (≥2 days) after cervical disc arthroplasty (CDA).

Summary Of Background Data: Several studies have shown noninferiority at mid- and long-term outcomes after cervical disc arthroplasty (CDA) compared to anterior cervical discectomy and fusion ACDF, but few have evaluated short-term outcomes regarding risk of readmission or prolonged LOS after surgery.

Hangman's Fracture.

Study Design: Review article.

Objective: A review and update of the treatment of Hangman's fractures including the indications for both nonoperative and operative treatment of typical and atypical fractures.

Summary Of Background Data: Hangman's fractures are the second most common fracture pattern of the C2 vertebrae following odontoid fractures.

Biomechanical effects of laminectomies in the human lumbar spine: a finite element study.

Background Context: Previous studies have analyzed the effect of laminectomy on intervertebral disc (IVD), facet-joint-forces (FJF), and range of motion (ROM), while only two have specifically reported stresses at the pars interarticularis (PI) with posterior element resection. These studies have been performed utilizing a single subject, questioning their applications to a broader population.

Purpose: We investigate the effect of graded PI resection in a three-dimensional manner on PI stress to provide surgical guidelines for avoidance of iatrogenic instability following lumbar laminectomy.

The Impact of Preoperative Mindfulness-Based Stress Reduction on Postoperative Outcomes in Lumbar Spine Degenerative Disease: 3-Month and 12-Month Results of a Pilot Study.

Background: We previously reported inpatient and 30-day postoperative patient-reported outcomes (PROs) of a controlled, noncrossover pilot study using preoperative mindfulness-based stress reduction (MBSR) training for lumbar spine surgery. Our goal here was to assess 3-month and 12-month postoperative PROs of preoperative MBSR in lumbar spine surgery for degenerative disease.

Methods: Intervention group participants were prospectively enrolled in a preoperative online MBSR course.

The impact of the lordosis distribution index on failure after surgical treatment of adult spinal deformity.

Background Context: Proximal junctional failure (PFJ) is a common and dreaded complication of adult spinal deformity. Previous research has identified parameters associated with the development of PJF and the search for radiographic and clinical variables continues in an effort to decrease the incidence of PFJ. The lordosis distribution index (LDI) is a parameter not based on pelvic incidence.

Potential Selection Bias in Observational Studies Comparing Cervical Disc Arthroplasty to Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective study using a national administrative database.

Objective: To define the cohort differences in patient characteristics between patients undergoing cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) in a large national sample, and to describe the impact of those baseline patient characteristics on analyses of costs and complications.

Summary Of Background Data: CDA was initially studied in high quality, randomized trials with strict inclusion criteria.

Defining Instability in Degenerative Spondylolisthesis: Surgeon Views.

Study Design: Surgeon survey.

Objective: To examine factors influencing surgeons' definition of instability in grade 1 degenerative spondylolisthesis (DS) and assess treatment preferences for both stable and unstable DS.

Summary Of Background Data: DS treatment options are broadly classified as decompression with or without fusion.

Composer-Visual Cohort Analysis of Patient Outcomes.

Objective: Visual cohort analysis utilizing electronic health record data has become an important tool in clinical assessment of patient outcomes. In this article, we introduce Composer, a visual analysis tool for orthopedic surgeons to compare changes in physical functions of a patient cohort following various spinal procedures. The goal of our project is to help researchers analyze outcomes of procedures and facilitate informed decision-making about treatment options between patient and clinician.

Software-Based Postoperative Communication With Patients Undergoing Spine Surgery.

Study Design: Observational study.

Objectives: Perioperative patient anxiety is a major concern in orthopedic surgery. Mobile messaging applications have been used in a number of healthcare settings.

Surgical Site Infections in Spine Surgery: Preoperative Prevention Strategies to Minimize Risk.

Study Design: Literature review.

Objectives: A review of the literature identifying preoperative risk factors for developing surgical site infections after spine surgery and discussion of the preventive strategies to minimize risks.

Methods: A review of the literature and synthesis of the data to provide an updated review on the preoperative management of surgical site infection.

Physical function computer adaptive test outcomes in diabetic lumbar spine surgical patients.

Background Context: Diabetes is a highly prevalent comorbid condition among patients undergoing spine surgery. Several studies have used legacy patient-reported outcome measures to implicate diabetes as a predictor of increased disability, pain, and decreased physical function and quality of life following spine surgery. The effect of diabetes on postoperative physical function has not yet been studied using the PROMIS Physical Function Computer Adaptive Test (PF CAT).

The Impact of Preoperative Mindfulness-Based Stress Reduction on Postoperative Patient-Reported Pain, Disability, Quality of Life, and Prescription Opioid Use in Lumbar Spine Degenerative Disease: A Pilot Study.

Background: Prescription opioid medications negatively affect postoperative outcomes after lumbar spine surgery. Furthermore, opioid-related overdose death rates in the United States increased by 200% between 2000 and 2014. Thus, alternatives are imperative.

Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015.

Study Design: Analysis of National Inpatient Sample (NIS), 2004 to 2015.

Objective: Describe recent trends in US rates of lumbar fusion procedures and associated costs, by surgical indication.

Summary Of Background Data: Spinal fusion is appropriate for spinal deformity and instability, but evidence of effectiveness is limited for primary disc herniation and spinal stenosis without instability.