The utility of disc space and vertebral body specimens cell count differential for the diagnosis of native vertebral osteomyelitis: a prospective cohort study.

Background: Diagnostic methods for native vertebral osteomyelitis (NVO) often yield inconclusive results. Image-guided spine biopsies for culture are specific but diagnose NVO in only 50% of cases. Pre-exposure to antimicrobials further reduces diagnostic yield.

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.

MRI Vertebral Bone Quality Correlates With Interbody Cage Subsidence After Anterior Cervical Discectomy and Fusion.

Study Design: Retrospective observational study of consecutive patients.

Objective: The purpose of the study was to evaluate VBQ as a predictor of interbody subsidence and to determine threshold values that portend increased risk of subsidence.

Summary Of Background Data: Many risk factors have been reported for the subsidence of interbody cages in anterior cervical discectomy and fusion (ACDF).

Does Intrawound Vancomycin Decrease Postoperative Surgical Site Infection in Spine Surgery: A Retrospective Case-control Study.

Study Design: Retrospective Case-Control series.

Objective: The objective of this study is to define the overall postoperative rate of surgical site infection (SSI) in patients undergoing spine surgery and examine the effects of intrawound Vancomycin on postoperative infection rates.

Summary Of Background Data: Surgical site infections (SSI) account for 22% of all health care-associated infections.

Intraoperative Surgeon Assessment of Bone: Correlation to Bone Mineral Density, CT Hounsfield Units, and Vertebral Bone Quality.

Study Design: Retrospective observational study of consecutive patients.

Objective: The purpose of the study is to determine if a surgeon's qualitative assessment of bone intraoperatively correlates with radiologic parameters of bone strength.

Summary Of Background Data: Preoperative radiologic assessment of bone can include modalities such as computed tomography (CT) Hounsfield units (HUs), dual-energy x-ray absorptiometry (DXA) bone mineral density with trabecular bone score (TBS) and magnetic resonance imaging vertebral bone quality (VBQ).

Defeating the Hidden Foe: Antibiotic Therapy and Clinical Outcomes of Spinal Implant Infections.

Background: can cause spinal implant infections. However, little is known about the optimal medical management and outcomes of spinal implant infections (CSII). Our study aims to describe the management of patients with CSII and evaluate the clinical outcomes.

Utility of disc space aspirate cell counts and differentials in the diagnosis of native vertebral osteomyelitis.

: Aspiration of intervertebral disc space is often done to confirm the diagnosis of native vertebral osteomyelitis. A study has not been done examining the utility of cell counts and differentials of the aspirated fluid in diagnosing native vertebral osteomyelitis (NVO). : In this feasibility study, we prospectively enrolled patients with a suspected diagnosis of NVO referred to the Division of Neuroradiology for image-guided needle aspiration of the intervertebral disc.

Sacral Insufficiency Fracture Following Short-Segment Lumbosacral Fusion: Case Series and Review of the Literature.

Study Design: Retrospective case series.

Objective: Sacral insufficiency fracture is a rare and serious complication following lumbar spine instrumented fusion. The purpose of this study was to describe the patient characteristics, presentation, evaluation, treatment options, and outcomes for patients with sacral insufficiency fracture after short-segment lumbosacral fusion.

The System Is Broken: A Qualitative Assessment of Opioid Prescribing Practices After Spine Surgery.

Objective: To elucidate factors that influence opioid prescribing behaviors of key stakeholders after major spine surgery, with a focus on barriers to optimized prescribing.

Methods: In-person semi-structured interviews were performed with 20 surgical and medical professionals (January 23, 2019 to June 11, 2019) at a large academic medical center, including resident physicians, midlevel providers, attending physicians, and clinical pharmacists. Interviews centered on perceptions of postoperative prescribing practices were coded and analyzed using a qualitative inductive approach.

Association Between Spine Surgery and Availability of Opioid Medication.

Importance: Prolonged prescribing of opioids after spine surgery is often perceived as a negative outcome, but successful opioid reduction may occur despite continued prescribing. Improved characterization of opioid availability before and after surgery is necessary to identify these successes.

Objective: To evaluate the association between spine surgery and modification of opioid availability postoperatively by using consistent definitions to classify opioid availability before and after surgery.

An Objective and Reliable Method for Identifying Sarcopenia in Lumbar Spine Surgery Patients: Using Morphometric Measurements on Computed Tomography Imaging.

Study Design: A retrospective observational study.

Purpose: Establish a quantifiable and reproducible measure of sarcopenia in patients undergoing lumbar spine surgery based on morphometric measurements from readily available preoperative computed tomography (CT) imaging.

Overview Of Literature: Sarcopenia-the loss of skeletal muscle mass-has been linked with poor outcomes in several surgical disciplines; however, a reliable and quantifiable measure of sarcopenia for future assessment of outcomes in spinal surgery patients has not been established.

Implant Sonication versus Tissue Culture for the Diagnosis of Spinal Implant Infection.

Unlabelled: MINI: We compared the sensitivity and specificity of peri-implant tissue culture to the vortexing-sonication technique for the diagnosis of spinal implant infection (SII). Lower thresholds of sonicate fluid culture positivity showed increased sensitivity with maintained specificity. We recommend a threshold of 20 CFU/10 mL for sonicate culture positivity for the diagnosis of SII.

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.

Do Cervical Spine Surgery Patients Recall Their Preoperative Status?: A Cohort Study of Recall Bias in Patient-reported Outcomes.

Study Design: This is a prospective cohort study.

Objective: To characterize the accuracy of patient recollection of preoperative symptoms after cervical spine surgery.

Summary Of Background Data: Recall bias is a well-known source of systematic error.

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.

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.

Does Subcutaneous Infiltration of Liposomal Bupivacaine Following Single-Level Transforaminal Lumbar Interbody Fusion Surgery Improve Immediate Postoperative Pain Control?

Study Design: Retrospective case-control study using prospectively collected data.

Purpose: Evaluate the impact of liposomal bupivacaine (LB) on postoperative pain management and narcotic use following standardized single-level low lumbar transforaminal lumbar interbody fusion (TLIF).

Overview Of Literature: Poor pain control after surgery has been linked with decreased pain satisfaction and increased economic burden.

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

Objective: The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored.

Methods: We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients.

RNA sequencing identifies gene regulatory networks controlling extracellular matrix synthesis in intervertebral disk tissues.

Unlabelled: Degenerative disk disease of the spine is a major cause of back pain and disability. Optimization of regenerative medical therapies for degenerative disk disease requires a deep mechanistic understanding of the factors controlling the structural integrity of spinal tissues. In this investigation, we sought to identify candidate regulatory genes controlling extracellular matrix synthesis in spinal tissues.

Thromboembolic Disease after Cervical Spine Surgery: A Review of 5,405 Surgical Procedures and Matched Cohort Analysis.

Study Design: Retrospective matched cohort analysis.

Objective: The majority of the literature on venous thromboembolism (VTE) after spine surgery is limited to studies of thoracolumbar surgery. Less is known regarding the incidence of VTE and associated risk factors following cervical spine surgery.

Perioperative complications in open versus percutaneous treatment of spinal fractures in patients with an ankylosed spine.

We compared open stabilization of vertebral fractures to percutaneous spinal fixation techniques in patients with a diagnosis of either ankylosing spondylitis (AS) or diffuse idiopathic skeletal hyperostosis (DISH). A retrospective review of patients known to have AS or DISH treated for spinal column fracture at a single institution between 1995 and 2011 was performed. Patients were analyzed by the type of fixation, divided into either a percutaneous group (PG) or an open group (OG).

Risk factors for surgical site infection after posterior cervical spine surgery: an analysis of 5,441 patients from the ACS NSQIP 2005-2012.

Background Context: The incidence of surgical site infection (SSI) following posterior cervical surgery has been reported as high as 18% in the literature. Few large studies have specifically examined posterior cervical procedures.

Purpose: The study aims to examine the incidence, timing, and risk factors for SSI following posterior cervical surgery.