Impact of patient age on morbidity and mortality in adults with acute traumatic cervical spinal cord injury: An ACS trauma quality programs database study.

Background: This study aimed to examine associations between age and outcomes in acute cervical SCI (cSCI) patients.

Methods: We conducted a retrospective cohort study using the American College of Surgeons Trauma Quality Programs database to compare outcomes for acute cSCI patients stratified by age: 18-44, 45-65, and > 65 years. Patient demographics, comorbidities, injury type, treatment modality, AEs, and length of stay (LOS) were assessed.

Risk Factors for the Development of Neurological Deficits in Metastatic Spinal Disease: An International, Multicenter Delphi Study.

Study Design: Delphi study.

Objective: The objective of this study was to identify risk factors associated with the development and/or progression of neurological deficits in patients with metastatic spinal disease.

Methods: A three-round Delphi study was conducted between January-May 2023 including AO Spine members, comprising mainly neurosurgeons and orthopedic surgeons.

Defining Spine Cancer Pain Syndromes: A Systematic Review and Proposed Terminology.

Study Design: Systematic Review.

Objectives: Formalized terminology for pain experienced by spine cancer patients is lacking. The common descriptors of spine cancer pain as mechanical or non-mechanical is not exhaustive.

Analysis of short- and delayed unplanned readmission rates after anterior discectomy and fusion for CSM.

Introduction: Many patients with cervical spondylotic myelopathy (CSM) undergo anterior cervical discectomy and fusion (ACDF). Many of these patients are readmitted, but there is no clear understanding of drivers of readmission. The aim of this study was to assess the patient- and hospital-level factors that contribute to 7-, 30-, and 90-day readmissions after treatment of CSM.

Analysis of ChatGPT in the Triage of Common Spinal Complaints.

Background: ChatGPT is a natural language processing chatbot with a significant prevalence in modern media with a clear application in the medical triage workflow. ChatGPT has shown significant capacity for understanding clinical vignettes, radiology reports, and even passing the American Board of Neurological Surgery board examination. There has never been an evaluation of the chatbot in triage and diagnosing spinal vignettes common to primary and urgent care practice.

Assessing a revised-risk analysis index for morbidity and mortality after spine surgery for metastatic spinal tumors.

Background: Risk Analysis Index (RAI) has been increasingly used to assess surgical frailty in various procedures, but its effectiveness in predicting mortality or in-patient hospital outcomes for spine surgery in metastatic disease remains unclear. The aim of this study was to compare the predictive values of the revised RAI (RAI-rev), the modified frailty index-5 (mFI-5), and advanced age for extended length of stay, 30-day readmission, complications, and mortality among patients undergoing spine surgery for metastatic spinal tumors.

Methods: A retrospective cohort study was performed using the 2012-2022 ACS NSQIP database to identify adult patients who underwent spinal surgery for metastatic spinal pathologies.

ChatGPT as a Decision Support Tool in the Management of Chiari I Malformation: A Comparison to 2023 CNS Guidelines.

Objective: ChatGPT has been increasingly investigated for its ability to provide clinical decision support in the management of neurosurgical pathologies. However, concerns exist regarding the validity of its responses. To assess the reliability of ChatGPT, we compared its responses against the 2023 Congress of Neurological Surgeons (CNS) guidelines for patients with Chiari I Malformation (CIM).

A Bibliometric Analysis of the 20 Most Cited Articles on Sacrococcygeal Chordomas.

This study aims to summarize sacrococcygeal chordoma literature through bibliometric analysis and to offer insights into key studies to guide clinical practices and future research. The Web of Science database was searched using the terms "sacral chordoma", "chordomas of the sacrum", "chordomas of the sacral spine", "chordomas of the sacrococcygeal region", "coccygeal chordoma", and "coccyx chordoma". Articles were analyzed for citation count, authorship, publication date, journal, research area tags, impact factor, and evidence level.

Direct (D)-Wave Monitoring Enhancement With Subdural Electrode Placement: A Case Series.

Purpose: Direct-wave (D-wave) neuromonitoring is a direct measure of corticospinal tract integrity that detects potential injury during spinal cord surgery. Epidural placement of electrodes used for D-wave measurements can result in high electrical impedances resulting in substantial signal noise that can compromise signal interpretation. Subdural electrode placement may offer a solution.

The diagnostic accuracy of neuromonitoring for detecting postoperative bowel and bladder dysfunction in spinal oncology surgery: a case series.

Purpose: Postoperative bowel and bladder dysfunction (BBD) poses a significant risk following surgery of the sacral spinal segments and sacral nerve roots, particularly in neuro-oncology cases. The need for more reliable neuromonitoring techniques to enhance the safety of spine surgery is evident.

Methods: We conducted a case series comprising 60 procedures involving 56 patients, spanning from September 2022 to January 2024.

A comparison of transforaminal lumbar interbody fusion (TLIF) cage material on fusion rates: A systematic review and network meta-analysis.

Background: A wide variety of materials are used for lumbar interbody fusion, but there is no unified consensus on the superiority of one material over another. The aim of this systematic review and network meta-analysis (NMA) is to compare and rank the various TLIF interbody materials based on fusion rates.

Methods: We queried PubMed, EMBASE and Scopus from inception until August 2023, in which 2135 studies were identified.

Racial disparities in the management and outcomes of primary osseous neoplasms of the spine: a SEER analysis.

Purpose: Primary osseous neoplasms of the spine, including Ewing's sarcoma, osteosarcoma, chondrosarcoma, and chordoma, are rare tumors with significant morbidity and mortality. The present study aims to identify the prevalence and impact of racial disparities on management and outcomes of patients with these malignancies.

Methods: The 2000 to 2020 Surveillance, Epidemiology, and End Results (SEER) Registry, a cancer registry, was retrospectively reviewed to identify patients with Ewing's sarcoma, osteosarcoma, chondrosarcoma, or chordoma of the vertebral column or sacrum/pelvis.

Impact of Preoperative Frailty on Outcomes in Patients with Cervical Spondylotic Myelopathy Undergoing Anterior vs. Posterior Cervical Surgery.

: Frailty has been shown to negatively influence patient outcomes across many disease processes, including in the cervical spondylotic myelopathy (CSM) population. The aim of this study was to assess the impact that frailty has on patients with CSM who undergo anterior cervical discectomy and fusion (ACDF) or posterior cervical decompression and fusion (PCDF). : A retrospective cohort study was performed using the 2016-2019 national inpatient sample.

Treatment of intramedullary spinal cord tumors: a modified Delphi technique of the North American Spine Society Section of Spine Oncology.

Objective: Intramedullary spinal cord tumors (IMSCTs) are rare tumors with heterogeneous presentations and natural histories that complicate their management. Standardized guidelines are lacking on when to surgically intervene and the appropriate aggressiveness of resection, especially given the risk of new neurological deficits following resection of infiltrative tumors. Here, the authors present the results of a modified Delphi method using input from surgeons experienced with IMSCT removal to construct a framework for the operative management of IMSCTs based on the clinical, radiographic, and tumor-specific characteristics.

Extreme lateral infracondylar approach for internal jugular vein compression syndrome: A case series with preliminary clinical outcomes.

Background And Objectives: Internal jugular vein (IJV) stenosis is associated with several neurological disorders including idiopathic intracranial hypertension (IIH) and pulsatile tinnitus. In cases of extreme bony compression causing stenosis in the infracondylar region, surgical decompression might be necessary. We aim to examine the safety and efficacy of surgical IJV decompression.

Novel Standalone Motion-Sparing Pelvic Fixation Prevents Short-Term Insufficiency Fractures After Midsacrectomies Without Sacrificing Normal, Mobile Lumbar Segments Traditionally Used for Stabilization.

Background And Objectives: Sacrectomy is often the treatment of choice to provide the greatest chance of progression-free and overall survival for patients with primary malignant bone tumors of the sacrum. After midsacrectomy, the stability of the sacropelvic interface is diminished, resulting in insufficiency fractures. Traditional stabilization involves lumbopelvic fixation but subjects normal mobile segments to fusion.

Radiotherapy for Mobile Spine and Sacral Chordoma: A Critical Review and Practical Guide from the Spine Tumor Academy.

Chordomas are rare tumors of the embryologic spinal cord remnant. They are locally aggressive and typically managed with surgery and either adjuvant or neoadjuvant radiation therapy. However, there is great variability in practice patterns including radiation type and fractionation regimen, and limited high-level data to drive decision making.

Socioeconomic and Racial/Ethnic Disparities in Perception of Health Status and Literacy in Spine Oncological Patients: Insights from the All of Us Research Program.

Study Design: A cross-sectional study was performed using the National Institutes of Health All of Us survey database.

Objective: The aim of this study was to assess socioeconomic and racial disparities in the perception of personal health, health literacy, and healthcare access among spine oncology patients.

Summary Of Background Data: Racial, ethnic, and socioeconomic disparities in health literacy and perception of health status have been described for many disease processes.

Safety and clinical efficacy of immune checkpoint inhibition and stereotactic body radiotherapy in patients with spine metastasis.

Objective: Immunotherapy, particularly immune checkpoint inhibitors (ICIs), has revolutionized the treatment of patients with many tumor histologies. Simultaneously, stereotactic body radiotherapy (SBRT) provides excellent local control (LC) and plays an important role in the management of spine metastasis. Promising preclinical work suggests the potential therapeutic benefit of combining SBRT with ICI therapy, but the safety profile of combined therapy is unclear.

Differences in Outcomes and Health Care Resource Utilization After Surgical Intervention for Metastatic Spinal Column Tumor in Safety-Net Hospitals.

Study Design: Observational cohort study.

Objective: The aim of this study was to investigate the association between safety-net hospital (SNH) status and hospital length of stay (LOS), cost, and discharge disposition in patients undergoing surgery for metastatic spinal column tumors.

Summary Of Background Data: SNHs serve a high proportion of Medicaid and uninsured patients.

Prevalence and Influence of Frailty on Hospital Outcomes After Surgical Resection of Spinal Meningiomas.

Objective: Frailty has been shown to affect patient outcomes after medical and surgical interventions. The Hospital Frailty Risk Score (HFRS) is a growing metric used to assess patient frailty using International Classification of Diseases, Tenth Revision codes. The goal of this study was to investigate the impact of frailty, assessed by HFRS, on health care resource utilization and outcomes in patients undergoing surgery for spinal meningiomas.