Temporal changes and predictors of perioperative blood transfusion in elective spine surgery: a retrospective analysis of a large surgical database.

Background: Allogeneic blood transfusion used to be common in spine surgery. Patient blood management has been widely adopted, and it is important to reassess transfusion predictors in contemporary practice.

Methods: A retrospective study of inpatient spine surgery was performed using National Surgical Quality Improvement Program (NSQIP) data from 2011 to 2019.

Tension Pneumocephalus after Cervical Spine Surgery: A Case Report with Review of the Literature.

This is the case of a 66-year-old male with cervical myelopathy secondary to severe cervical stenosis manifesting as worsening dexterity and numbness in his right hand. The patient underwent C3-C6 laminoplasty with bilateral foraminotomies. During the procedure an incidental durotomy occurred which was patched intraoperatively with Duragen and Tisseel.

Pedicolaminar Fracture-Dislocation.

A 28-year-old man presented to a level 1 trauma center with significant cervical spine pain after sliding into third base during a softball game. He struck his head on the thigh of the defensive player and had immediate pain in his neck and arm. He reported no loss of consciousness, no transient tetraplegia/paraplegia, and no loss of bowel and bladder control.

Segmental stiffness achieved by three types of fixation for unstable lumbar spondylolytic motion segments.

Objective The objective of this study was to compare the relative stability in lumbar spondylolysis (SP) of a rigid anterior plate (with a novel compression slot) versus traditional posterior pedicle screw (PS) fixation. Summary of Background Data Arthrodesis has been a mainstay of treatment for symptomatic isthmic spondylolisthesis in adults. Posterior PS fixation has become a commonly used adjunct.

Allograft compared with autograft infection rates in primary anterior cruciate ligament reconstruction.

Background: Injuries to the anterior cruciate ligament are the most common surgically treated knee ligament injury. There is no consensus regarding the optimal graft choice between allograft and autograft tissue. Postoperative septic arthritis is an uncommon complication after anterior cruciate ligament reconstruction.

Comparison of augmentation methods for internal fixation of osteoporotic ankle fractures.

Background: Internal fixation of osteoporotic ankle fractures is associated with failure of fixation. This study compared different augmentation methods biomechanically.

Materials And Methods: In nine paired fresh-frozen cadaver legs, an identical supination-external rotation type II ankle fracture was created.

Screw fixation compared with suture-button fixation of isolated Lisfranc ligament injuries.

Background: A cannulated screw is currently used to reduce and stabilize diastasis at the Lisfranc joint. The screw requires removal and may break in situ. A suture button does not have these disadvantages, but it is not known if it can provide stability similar to that provided by a cannulated screw or an intact Lisfranc ligament.

Use of a patient-controlled stretching device to improve the ankle range of motion.

Background: Ankle and subtalar stiffness are widely associated with many foot and ankle conditions and functional deficits. Loss of range of motion, particularly dorsiflexion, results in significant gait dysfunction. A variety of methods have been evaluated to address this problem, including yoga, manipulation, dance training, jogging and static stretching exercises.

Ethnic radiographic foot differences.

Background: The prevalence of foot and ankle conditions varies among different ethnic groups. It is not known if this difference is due to any distinctive skeletal morphological characteristics of the foot. The purpose of this study was to determine if ethnic differences exist in the morphometric measurements on radiographs of the weightbearing foot.

A minimally disruptive model and three-dimensional evaluation of Lisfranc joint diastasis.

Background: There is no model that can reproduce the diastasis at the Lisfranc joint after isolated transection of the Lisfranc ligament. Prior models required extensive sectioning of ligaments in the midfoot and represent injuries that cause extensive tarsometatarsal fracture-dislocations. They do not represent a subset of injuries that cause subtle or limited disruption at the Lisfranc joint.

Tensioning of anterior cruciate ligament hamstring grafts: comparing equal tension versus equal stress.

Purpose: A biomechanical study was undertaken to determine whether equal-stress or equal-tension tensioning of anterior cruciate ligament 4-stranded semitendinosus and gracilis grafts provides a stronger graft construct when testing to ultimate failure.

Methods: Eighteen fresh-frozen cadaveric semitendinosus and gracilis tendons were each positioned over a cylinder rod/cryo-clamp connected to an MTS machine (MTS Systems, Eden Prairie, MN) by another cryo-clamp. In the equal-tension group the 4 strands were equally tensioned by weights.

Minimally invasive total hip arthroplasty with the anterior approach.

Background: Total hip athroplasty with the anterior surgical approach is advised because the dissection is entirely within intermuscular planes. In this report we describe a minimally invasive technique of anterior total hip arthroplasty, with the early outcomes.

Materials And Methods: The technique of minimally invasive total hip arthroplasty with anterior approach (Smith-Petersen) is described.

A modified two-incision technique for primary total hip arthroplasty.

Background: Minimally invasive surgery can be technically demanding but minimizes surgical trauma, pain and recovery. Two-incision minimally invasive surgery allows only intermittent visualization and may require fluoroscopy for implant positioning. We describe a modified technique for primary total hip arthroplasty, using two small incisions with a stepwise approach and adequate visualization to reliably and reproducibly perform the surgery without fluoroscopy.

The use of calcium sulfate and calcium phosphate composite graft to augment screw purchase in osteoporotic ankles.

Background: Screws placed in the distal fibula may not have satisfactory purchase during internal fixation of an osteoporotic ankle fracture. Tibia-pro-fibula screws that extend from the fibula into the distal tibial metaphysis provide additional purchase. The purpose of this study was to investigate if purchase of these screws can be enhanced further by injecting calcium sulfate and calcium phosphate composite graft into the drill holes prior to insertion of the screws.

Minimally invasive method of harvesting the flexor digitorum longus tendon: a cadaver study.

Background: The flexor digitorum longus (FDL) tendon is harvested for use in the reconstruction of dysfunctional adjacent tendons such as the posterior tibial and the Achilles tendons. The approach to harvest the FDL tendon in the midfoot region is through an incision along the medial border of the foot. This approach involves dissection quite deep in the foot across neurovascular structures in the vicinity placing them at risk.