Osteoporosis Treatment and Outcomes in Patients Undergoing Adult Spinal Deformity Surgery.

Background: This study aims to evaluate the prevalence and treatment of osteoporosis in patients undergoing long spinal fusion for adult spinal deformity (ASD) and compare the impact of osteoporosis treatment on surgical and radiographic outcomes.

Methods: We conducted a retrospective study of adult patients aged ≥40 years who underwent thoracolumbar ASD surgery at a single academic center between 2015 and 2021. We recorded demographic information, procedural details, and pharmacologic treatments.

Laminoplasty versus laminectomy with fusion for treating multilevel degenerative cervical myelopathy.

Background: Laminectomy with fusion (LF) and laminoplasty (LP) are common posterior decompression procedures used to treat multilevel degenerative cervical myelopathy (DCM). There is debate on their relative efficacy and safety for treatment of DCM. The goal of this study is to examine outcomes and costs of LF and LP procedures for DCM.

A Comparison of Prognostic Models to Facilitate Surgical Decision-Making for Patients With Spinal Metastatic Disease.

Study Design: Retrospective cohort.

Objective: Compare the performance of and provide cutoff values for commonly used prognostic models for spinal metastases, including Revised Tokuhashi, Tomita, Modified Bauer, New England Spinal Metastases Score (NESMS), and Skeletal Oncology Research Group model, at three- and six-month postoperative time points.

Summary Of Background Data: Surgery may be recommended for patients with spinal metastases causing fracture, instability, pain, and/or neurological compromise.

Factors Associated With Total Discharge Opioid Prescription Morphine Milligram Equivalent Amounts Following Primary Anterior Cervical Spine Surgery.

Background: Opioid overuse is a substantial cause of morbidity and mortality in the United States, and orthopaedic surgeons are the third highest prescribers of opioids. Postoperative prescribing patterns vary widely, and there is a paucity of data evaluating patient and surgical factors associated with discharge opioid prescribing patterns after elective anterior cervical surgery (ACS). The purpose of this study was to evaluate the volume of postoperative opioids prescribed and factors associated with discharge opioid prescription volumes after elective ACS.

Gender, Racial, and Ethnic Differences in the Utilization of Cervical Disk Replacement for Cervical Radiculopathy.

Introduction: Cervical radiculopathy (CR) is commonly treated by spine surgeons, with surgical options including anterior cervical diskectomy and fusion (ACDF) and cervical disk replacement (CDR). CDR is a motion-sparing alternative to ACDF and was approved by the US FDA in 2007. CDR utilization has increased because evidence has emerged demonstrating its long-term efficacy.

Efficacy of Routine Intraoperative Cranio-Femoral Traction in Surgical Treatment of Adolescent Idiopathic Scoliosis Curves Measuring Between 50° and 90°.

Study Design: Retrospective Comparative Study, Level III.

Objective: In patients with scoliosis >90°, cranio-femoral traction (CFT) has been shown to obtain comparable curve correction with decreased operative time and blood loss. Routine intraoperative CFT use in the treatment of AIS <90° has not been established definitively.

Povidone-iodine irrigation combined with Vancomycin powder lowers infection rates in pediatric deformity surgery.

Background: Surgical site infection is a morbid, devastating complication after spinal procedures. Studies have investigated the effect of wound lavage with 3.5% Povidone-iodine solution or the use of intrawound Vancomycin powder.

Osteoporosis Is Undertreated After Low-energy Vertebral Compression Fractures.

Introduction: Despite guidelines recommending postfracture bone health workup, multiple studies have shown that evaluation and treatment of osteoporosis has not been consistently implemented after fragility fractures. The primary aim of this study was to evaluate rates of osteoporosis evaluation and treatment in adult patients after low-energy thoracolumbar vertebral compression fractures (VCFs).

Methods: We retrospectively reviewed all patients ≥60 years old presenting to a single academic trauma center with acute thoracolumbar VCFs after a ground-level fall from 2016 to 2020 .

Prevention of spinal fusion post-operative wound infections in pediatric patients with scoliosis: a quality improvement initiative.

Purpose: Post-operative wound infections increase patient morbidity and mortality as well as the length of hospital stay, with a profound personal and institutional cost. The aim of this study was to decrease post-operative infections through development of a surgical antibiotic prophylaxis policy based on institution-specific risk factors and microbiology data.

Methods: We conducted a retrospective review of deep wound infections at our institution over a 5-year period (2014-2018).

Efficacy, Cost, and Complications of Demineralized Bone Matrix in Instrumented Lumbar Fusion: Comparison With rhBMP-2.

Study Design: Retrospective cohort study.

Objectives: To evaluate demineralized bone matrix as an adjunct for instrumented lumbar spine fusion compared with recombinant human bone morphogenetic protein-2 (rhBMP-2).

Methods: Clinical and radiographic review was performed of 43 patients with degenerative spine disease treated with posterolateral spinal fusion with or without posterior or transforaminal lumbar interbody fusion.

Temporary Endobronchial Stent as a Bridge to Corrective Surgery For Severe Kyphoscoliosis-associated Central-Airway Extrinsic Compression.

Kyphoscoliosis is known to compromise lung function, with the primary mechanism being reduced chest wall compliance with a resultant restrictive pulmonary physiology. Severe scoliosis can also cause extrinsic compression of the central airways, leading to recurrent respiratory infections, lobar atelectasis, and potentially acute respiratory failure. Definitive therapy is corrective surgery of the spine.

The utility and accuracy of computed tomography in the diagnosis of occipitocervical dissociation.

Background Context: Atlantooccipital dislocation (AOD) results in profound patient morbidity and mortality and is difficult to accurately diagnose using current evaluation techniques.

Purpose: To evaluate the utility of computed tomography (CT) images in the diagnosis of AOD and compare the revised occipital condyle-C1 interval (CCI) and the condylar sum to the current radiographic criteria used to detect AOD.

Study Design: Retrospective review to evaluate the sensitivity, specificity, and the interobserver reliability of eight radiographic criteria as applied to CT imaging.

Treatment of spine deformity in neuromuscular diseases.

Surgical management of spinal deformity in neuromuscular diseases (NMDs) often requires a multidisciplinary approach beginning in the preoperative surgical planning period, owing to concomitant restrictive lung disease and cardiomyopathy in selected NMD conditions. The need for thorough and thoughtful discussions must occur with the family and other caregivers before any scheduled surgery. The decision to proceed with spinal instrumentation may alter functional abilities in weak and marginally ambulatory NMD patients.

Case report: incisional hernia as a complication of extreme lateral interbody fusion.

Background Context: Minimal access surgery is becoming more popular for spinal fusion because of a lower theoretical risk of complications and shorter postoperative recovery period, compared with the traditional open approach. The lateral approach uses retroperitoneal transpsoas access to the vertebra, obviating the need for an approach surgeon and minimizing muscular disruption, thus allowing a quicker recovery. Initial reports of the lateral transpsoas procedure described few complications.

Kinematics of progressive circumferential ligament resection (decompression) in conjunction with cervical disc arthroplasty in a spondylotic spine model.

Study Design: Benchtop biomechanics study examining kinematic effects of progressive resection in a human cadaveric spine model.

Objective: To determine the effects of posterior longitudinal ligament (PLL) resection, unilateral and bilateral foraminotomy, and laminectomy on cervical intervertebral rotation and translation after cervical disc arthroplasty (CDA).

Summary Of Background Data: Although the clinical results after CDA have been studied, there remain unanswered questions regarding the surgical techniques used at the time of device insertion.

In vivo strain measurements from hardware and lamina during spine fusion.

Currently, spine fusion is determined using radiography and clinical evaluation. There are discrepancies between radiographic evidence and direct measurements of fusion, such as operative exploration and biomechanical or histological measurements. In order to facilitate the rapid return of patients to normal activities, a monitoring technique to accurately detect fusion in vivo and to prevent overload during the postoperative period would be useful.

The unique complications of coccidioidomycosis of the spine: a detailed time line of disease progression and suppression.

Study Design: A case report is presented.

Objective: We report a detailed time-line of disease progression and suppression in a patient with disseminated Coccidioidomycosis of the spine. The importance of consistent and thorough treatment to prevent disease recurrence is underscored.

An implantable strain measurement system designed to detect spine fusion: preliminary results from a biomechanical in vivo study.

Study Design: The strain distribution on the thoracic vertebrae during anteroposterior bending and torsion was examined for use with an implantable strain gauge system and miniature radio transmitter, which also were evaluated.

Objectives: To identify strain gauge placement sites by testing cadaver spines in vivo, and to evaluate an implantable gauge bonding technique and subminiature radio transmitter for accurate strain monitoring.

Summary Of Background Data: Fusion is determined currently through the use of radiographic techniques.