Moderate scoliosis continues to progress at 30-year follow-up: a call for concern?

Purpose: This natural history study reports long-term radiographic and clinical outcomes of patients with diagnosis of AIS with curves between 30° and 50°. Our purpose was to determine if any intervention in the natural history is warranted.

Methods: This was a longitudinal descriptive study at a single institution.

Choose Wisely: Surgical Selection of Candidates for Outpatient Anterior Cervical Surgery Based on Early Complications Among Inpatients.

Background: Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are attractive targets for transition to the outpatient setting. We assessed the prevalence of rapid responses and major complications in the inpatient setting following 1 or 2-level ACDFs and CDAs. We evaluated factors that may place patients at greater risk for a rapid response or a postoperative complication.

Does pelvic incidence tell us the risk of proximal junctional kyphosis in adult spinal deformity surgery?

Purpose: To investigate the relationship between pelvic incidence (PI) and proximal junctional kyphosis (PJK) in patients treated surgically for adult spinal deformity (ASD) with fusion from thoracolumbar junction to sacrum.

Methods: A consecutive series of ASD patients who underwent fusion from the thoracolumbar junction to the sacrum with a minimum of 2-year follow-up was studied. Patients were divided into low PI (≤ 50°) and high PI (> 50°) groups.

Surgical Treatment of Single Level Cervical Radiculopathy: A Comparison of Anterior Cervical Decompression and Fusion (ACDF) Versus Cervical Disk Arthroplasty (CDA) Versus Posterior Cervical Foraminotomy (PCF).

Study Design: This was a retrospective cohort study.

Objective: The objective of this study is to retrospectively compare the clinical outcomes, complication rates, and reoperation rates among the 4 treatments in patients with cervical radiculopathy.

Summary Of Background Data: Surgical options for cervical radiculopathy include anterior cervical discectomy and fusion (ACDF), open posterior cervical foraminotomy (O-PCF), minimally invasive posterior cervical foraminotomy (MI-PCF), and cervical disk arthroplasty (CDA).

Do Preoperative Nasal Antiseptic Swabs Reduce the Rate of Surgical Site Infections After Adult Thoracolumbar Spine Surgery?

Introduction: Surgical site infection (SSI) remains a major complication after adult spinal surgery. We investigated whether adding preoperative nasal decontamination by antiseptic swab (skin and nasal antiseptic povidone-iodine, SNA-PI) to our antimicrobial protocol reduces the SSI rate among our patients undergoing thoracolumbar spinal surgery.

Methods: We retrospectively reviewed all adult thoracolumbar spinal surgeries performed between June 2015 and May 2017 at a single hospital.

Posterolateral Versus Transforaminal Interbody L4/5 Fusion: Correlation With Subsequent Surgery.

Study Design: This is a retrospective cohort study.

Objective: To compare posterolateral versus transforaminal interbody fusion (PLF vs. PLF+TLIF) of the L4/5 segment regarding rates of subsequent surgery, clinical and radiographic parameters, and patient satisfaction.

Validation of the Fusion Risk Score for Thoracic and Lumbar Spine Fusion Procedures.

Study Design: This is a retrospective cohort study.

Objective: This study aimed to determine whether the Fusion Risk Score (FRS) is valid for perioperative complications.

Summary Of Background Data: The FRS was previously formulated from a retrospective review of 364 fusion surgeries in patients over age 65.

Recurrent Surgical Site Infections in the Spine After Treatment With the Vacuum-assisted Closure (VAC) System.

Study Design: This study retrospectively reviewed recurrences of surgical site infections (SSI) in spinal patients treated with vacuum-assisted closure (VAC) technology.

Objective: Identify patient and treatment factors associated with recurrence of SSI after VAC treatment.

Summary Of Background Data: Patients treated with VAC can achieve healing of deep spine wound infections; however, some patients develop a recurrent infection.

Prediction of health status based on postoperative radiographic variables in adult scoliosis.

Objective: To evaluate the effect of surgical treatment on health related quality of life (HRQOL) and radiographic variables in patients with adult scoliosis.

Methods: Sixty-eight patients with adult spinal deformities underwent radiographic analysis. The enrollment criteria were as follows: age older than 18 years, adult degenerative or progressive idiopathic scoliosis (Cobb angle >10°), and surgical treatment within one year before this study was undertaken.

Fusion risk score: evaluating baseline risk in thoracic and lumbar fusion surgery.

Study Design: Retrospective cohort study.

Objective: The fusion risk score (FRS) is introduced to assess baseline risk of spine fusion surgery preoperatively. An objective method of stratifying risk allows the surgeon to control risk through tailoring intervention and explain differences in complication profile in high-complexity practice.

MRI measurement of neuroforaminal dimension at the index and supradjacent levels after anterior lumbar interbody fusion: a prospective study.

Background: Anterior interbody fusion has previously been demonstrated to increase neuroforaminal height in a cadaveric model using cages. No prior study has prospectively assessed the relative change in magnetic resonance imaging (MRI) demonstrated neuroforaminal dimensions at the index and supradjacent levels, after anterior interbody fusion with a corticocancellous allograft in a series of patients without posterior decompression. The objective of this study was to determine how much foraminal dimension can be increased with indirect foraminal decompression alone via anterior interbody fusion, and to determine the effect of anterior lumbar interbody fusion on the dimensions of the supradjacent neuroforamina.

Mechanical Load Study of Lumbar Center of Rotation and Lordosis and Its Potential Relationship to Formation of Rotatory Olisthesis.

Introduction: Rotatory olisthesis is a common finding of adult degenerative scoliosis. An in vitro model of rotatory olisthesis of the lumbar spine and its correlation with the center of rotation (COR) and lumbosacral lordosis (L3-S1) are presented.

Methods: Different centers of rotation and various angles of lumbosacral lordosis were tested for the production of rotatory olisthesis.

Spinal cord injury from electrocautery: observations in a porcine model using electromyography and motor evoked potentials.

We have previously investigated electromyographic (EMG) and transcranial motor evoked potential (MEP) abnormalities after mechanical spinal cord injury. We now report thermally generated porcine spinal cord injury, characterized by spinal cord generated hindlimb EMG injury activity and spinal cord motor conduction block (MEP loss). Electrocautery (EC) was delivered to thoracic level dural root sleeves within 6-8 mm of the spinal cord (n = 6).

Supervised exercise with and without spinal manipulation performs similarly and better than home exercise for chronic neck pain: a randomized controlled trial.

Study Design: Randomized controlled trial using mixed methods.

Objective: To evaluate the relative effectiveness of high-dose supervised exercise with and without spinal manipulation and low-dose home exercise for chronic neck pain.

Summary Of Background Data: Neck pain is a common global health care complaint with considerable social and economic impact.

Supervised exercise, spinal manipulation, and home exercise for chronic low back pain: a randomized clinical trial.

Background Context: Several conservative therapies have been shown to be beneficial in the treatment of chronic low back pain (CLBP), including different forms of exercise and spinal manipulative therapy (SMT). The efficacy of less time-consuming and less costly self-care interventions, for example, home exercise, remains inconclusive in CLBP populations.

Purpose: The purpose of this study was to assess the relative efficacy of supervised exercise, spinal manipulation, and home exercise for the treatment of CLBP.

The effect on the pullout strength by the timing of pedicle screw insertion after calcium phosphate cement injection.

Study Design: Biomechanical Cadaveric Study.

Objective: To characterize the pullout strength of calcium phosphate cement augmented screws between 0 and 6 minutes after cement injection.

Summary Of Background Data: Earlier studies with calcium phosphate cement on pedicle screws inserted into a metal mold or sawbone have shown that the augmentation strength can be affected by the time between cement injection and screw insertion.

Repeatability test of C7 plumb line and gravity line on asymptomatic volunteers using an optical measurement technique.

Study Design: Prospective cohort evaluation of C7 plumb line (C7PL) and gravity line (GL) in different standing positions in asymptomatic volunteers.

Objective: To evaluate the repeatability of C7PL and GL in different standing positions using an optical method.

Summary Of Background Data: Both C7PL and GL have been used to assess spinal balance.

Effect of number of fusion levels on S1 screws in long fusion construct in a calf spine model.

Study Design: In vitro biomechanical study evaluating the effect of fusion levels on simulated S1 screws on calf spines.

Objective: To measure the stresses of simulated S1 screws as a function of increasing fusion levels in long-fusion construct.

Summary Of Background Data: Extension of long fusion to sacrum remains a difficult clinical challenge despite the recent knowledge and technology.

Radiculopathy in degenerative lumbar scoliosis: correlation of stenosis with relief from selective nerve root steroid injections.

Objective: The purpose is to define the origin of radiculopathy of patients with degenerative lumbar scoliosis-stenosis and to assess the correlation between percentage of initial radicular leg pain relief with selective nerve root injections and lateral canal dimensions.

Design: Retrospective clinical study.

Setting And Patients: Thirty-six consecutive patients (average age 72) from Twin Cities Spine Center with degenerative lumbar scoliosis (average major curve 25°) and radicular symptoms were studied.

Is it safe to back out pedicle screws after augmentation with polymethyl methacrylate or calcium phosphate cement? A biomechanical study.

Study Design: Biomechanical cadaveric study.

Objective: To determine the torque required to remove pedicle screws augmented with polymethyl methacrylate (PMMA) or calcium phosphate cement (CPC); thus, proving the safety of back out of augmented screws in the osteopotoric model, which would be a more dangerous setting than the nonosteoporotic model.

Summary Of Background Data: To our knowledge, no earlier study has characterized the safety of backing out pedicle screw augmented with PMMA or CPC.

Biomechanical evaluation of an expandable meshed bag augmented with pedicle or facet screws for percutaneous lumbar interbody fusion.

Objective: To evaluate the biomechanics of lumbar motion segments instrumented with stand-alone OptiMesh system augmented with posterior fixation using facet or pedicle screws and the efficacy of discectomy and disc distraction.

Background Context: OptiMesh bone graft containment system has been used for vertebral compression fractures and percutaneous lumbar interbody fusion. The filled mesh bag serves as the interbody device providing structural support to the motion segment being fused.

Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy.

Study Design: A retrospective clinical cohort study at a single spine center of patients with degenerative scoliosis and radiculopathy severe enough to require surgery.

Objective: To evaluate the functional outcomes of 3 surgeries for degenerative scoliosis with radiculopathy; decompression alone, decompression and limited fusion, and decompression and full curve fusion.

Summary Of Background Data: Although these 3 surgical treatments have all been described for this problem, there exists little information as to what outcomes to expect.

Healos graft carrier with bone marrow aspirate instead of allograft as adjunct to local autograft for posterolateral fusion in degenerative lumbar scoliosis: a minimum 2-year follow-up study.

Object: The objective of this study was to examine the efficacy and safety of Healos graft carrier with bone marrow aspirate and local autograft compared with the results of allograft in patients with lumbar degenerative scoliosis undergoing posterolateral fusion.

Methods: Twenty-eight patients with degenerative scoliosis underwent posterolateral instrumented fusion and decompression. Patients were grouped according to the graft used.

Biomechanical comparison of transpedicular versus extrapedicular vertebroplasty using polymethylmethacrylate.

Study Design: An in vitro biomechanical study using osteoporotic cadaveric vertebrae.

Objective: To compare the biomechanics of transpedicular and extrapedicular approaches in polymethylmethacrylate vertebroplasty in terms of height restoration, strength, and stiffness.

Summary Background Data: Cement is typically injected through a transpedicular approach in both vertebroplasty and kyphoplasty procedures.

Revision of transforaminal lumbar interbody fusion using anterior lumbar interbody fusion: a biomechanical study in nonosteoporotic bone.

Object: Transforaminal lumbar interbody fusion (TLIF) is a popular fusion technique for treating chronic low-back pain. In cases of interbody nonfusion, revision techniques for TLIF include anterior lumbar interbody fusion (ALIF) approaches. Biomechanical data of the revision techniques are not available.