Does the interfacing angle between pedicle screws and support rods affect clinical outcomes after posterior thoracolumbar fusion? A retrospective clinical study.

Background Context: Proper alignment and tightening of the pedicle screw/rod assembly after instrumented posterior fusion of the lower spine is known to be crucial in order to achieve satisfactory clinical results. Such interfacing angle mismatches indicate stress overloading of the implant system.

Purpose: The objective of this study is to investigate the incidence of postoperative screw/rod interfacing angle mismatch and to analyze the impact of mismatches on clinical outcome in terms of (1) revision surgery, (2) adjacent segment degeneration (ASD), and (3) pain.

Inadvertent intrathecal administration of daunomycin resulting in fatality: Case report and therapeutic considerations.

Background: Daunomycin is a chemotherapeutic agent of the anthracycline family that is administered intravenously, most commonly in combination therapy. The authors report the first known adult case of inadvertently administered daunomycin directly into the human central nervous system and the neurologic manifestations and therapeutic interventions that followed.

Clinical Description: A 53-year-old male presenting to the hospital for his second cycle of consolidation therapy for acute promyelocytic leukemia t(15;17) was accidentally administered 93 mg of intrathecal (IT) daunomycin.

Crossing the Cervicothoracic Junction During Posterior Cervical Decompression and Fusion: Is It Necessary?

Background: Posterior cervical fusion (PCF) is performed to treat cervical myelopathy, radiculopathy, and/or deformity. Constructs ending at the cervicothoracic junction (CTJ) may lead to higher rates of adjacent segment disease, and much debate exists regarding crossing the CTJ due to paucity of data in the literature.

Objective: To determine whether extension of PCF constructs across the CTJ decreases incidence of adjacent segment disease and need for revision surgery.

Design and testing of a controlled electromagnetic spinal cord impactor for use in large animal models of acute traumatic spinal cord injury.

Background: Spinal cord injury (SCI) causes debilitating neurological dysfunction and has been observed in warfighters injured in IED blasts. Clinical benefit of SCI treatment remains elusive and better large animal models are needed to assess treatment options. Here, we describe a controlled electromagnetic spinal cord impactor for use in large animal models of SCI.

Factors associated with improved survival following surgery for renal cell carcinoma spinal metastases.

OBJECTIVE Renal cell carcinoma (RCC) frequently metastasizes to the spine, causing pain or neurological dysfunction, and is often resistant to standard therapies. Spinal surgery is frequently required, but may result in high morbidity rates. The authors sought to identify prognostic factors and determine clinical outcomes in patients undergoing surgery for RCC spinal metastases.

Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases.

Purpose: Renal cell carcinoma (RCC) is an aggressive disease that metastasizes to the spine often requiring surgery. However, selecting the appropriate surgical intervention can be challenging. The Tokuhashi scoring system can be used to predict survival and inform the surgical strategy.

Percutaneous "K-wireless" pedicle screw fixation technique: an evaluation of the initial experience of 100 screws with assessment of accuracy, radiation exposure, and procedure time.

Object: Percutaneous pedicle screws are used to provide rigid internal fixation in minimally invasive spinal procedures and generally require the use of Kirchner wires (or K-wires) as a guide for screw insertion. K-wires can bend, break, advance, or pull out during the steps of pedicle preparation and screw insertion. This can lead to increased fluoroscopic and surgical times and potentially cause neurological, vascular, or visceral injury.