Optimization of 3D-titanium interbody cage design. Part 1: in vitro biomechanical study of subsidence.

Background Context: Cage subsidence is a complication of interbody fusion associated with poor clinical outcomes. 3D-printed titanium interbody cages allow for the alteration of features such as stiffness and porosity. However, the influence of these features on subsidence and their biological effects on fusion have not been rigorously evaluated.

The Green Heart Project: Objectives, Design, and Methods.

The Green Heart Project is a controlled, community-based clinical trial to evaluate the effects of increasing greenery on community health. The study was initiated in 2018 in a low-to-middle-income residential area of nearly 30,000 racially diverse residents in Louisville, KY. Community engagement was maintained throughout the project, with feedback integrated into its design and implementation.

Floral Volatile Organic Compounds of (Rubiaceae).

(partridgeberry; family Rubiaceae) is a creeping, understory plant native to eastern North America. The twinned, tubular flowers of this distylous plant are bright white and produce volatile organic compounds (VOCs). Partridgeberry has intermorph incompatibility and thus requires pollinators to move pollen from one morph to the other.

Optimization of 3D-titanium interbody cage design. Part 1: in vitro biomechanical study of subsidence: Optimizing 3D-titanium interbody cage design.

Background Context: 3D-printed titanium cage designs can incorporate complex, porous features for bone ingrowth and a greater surface area for minimizing subsidence. In a companion study (Part 1), we determined that increased surface area leads to decreased subsidence; however, it remains unclear how increasing the cage surface area, resulting in a smaller graft aperture, influences fusion.

Purpose: We evaluated the effects of surface area of 3D-printed titanium cages and the use of autologous bone grafts on spinal fusion in sheep.

Enhancing the Technical Pearls for L5-S1 Anterior Lumbar Interbody Fusion in Patients with Body Mass Index More Than 30: Clinical and Radiographic Outcomes at 1-Year Follow-Up.

Background: Performing anterior lumbar interbody fusion (ALIF) in patients with a body mass index (BMI) >30 presents surgical challenges. To overcome those challenges, a modified procedure is described.

Methods: This study retrospectively reviewed patients with a BMI >30 who underwent the modified L5-S1 ALIF procedure from August 2017 to September 2023.

Prevalence and Prognosis of Coronal Malalignment Following Lateral Lumbar Interbody Fusion for Minimally Invasive Treatment of Adult Spinal Deformity.

Study Design: Retrospective analysis of prospective multicenter adult spinal deformity (ASD) database.

Objective: To determine the prevalence and prognosis of postoperative coronal malalignment following LLIF for ASD with Qiu type A coronal alignment.

Summary Of Background Data: Qiu Type A coronal alignment is defined as coronal vertical axis (CVA) <30mm.

Preoperative Multifidus and Psoas Major Muscle Quality and Patient-Reported Outcomes After Anterolateral Lumbar Interbody Fusion: Predictors for Preoperative Disability and Back Pain Improvement.

Objective: To investigate associations between preoperative lumbar multifidus muscle (LMM) and psoas major muscle qualities and preoperative and postoperative patient-reported outcomes (PROs) after anterolateral lumbar interbody fusion (A-LLIF).

Methods: A retrospective review was conducted of patients with A-LLIF between L1 and S1 during 2017-2022 at a single institution who had at least approximately 1 year of follow-up and preoperative magnetic resonance imaging available. Preoperative magnetic resonance imaging was analyzed using 2 image analysis platforms (AMBRA and ImageJ).

Defining modern iatrogenic flatback syndrome: examination of segmental lordosis in short lumbar fusion patients undergoing thoracolumbar deformity correction.

Purpose: Understanding the mechanism and extent of preoperative deformity in revision procedures may provide data to prevent future failures in lumbar spinal fusion patients.

Methods: ASD patients without prior spine surgery (PRIMARY) and with prior short (SHORT) and long (LONG) fusions were included. SHORT patients were stratified into modes of failure: implant, junctional, malalignment, and neurologic.

Do class III obese patients achieve similar outcomes and satisfaction to nonobese patients following surgery for cervical myelopathy? A QOD study.

Objective: The aim of this study was to compare the rate of achievement of the minimal clinically important difference (MCID) in patient-reported outcomes (PROs) and satisfaction between cervical spondylotic myelopathy (CSM) patients with and without class III obesity who underwent surgery.

Methods: The authors analyzed patients from the 14 highest-enrolling sites in the prospective Quality Outcomes Database CSM cohort. Patients were dichotomized based on whether or not they were obese (class III, BMI ≥ 35 kg/m2).

Does comorbid depression and anxiety portend poor long-term outcomes following surgery for lumbar spondylolisthesis? Five-year analysis of the Quality Outcomes Database.

Objective: Depression and anxiety are associated with poor outcomes following spine surgery. However, the influence of these conditions on achieving a minimal clinically important difference (MCID) following lumbar spine surgery, as well as the potential compounding effects of comorbid depression and anxiety, is not well understood. This study explores the impact of comorbid depression and anxiety on long-term clinical outcomes following surgical treatment for degenerative lumbar spondylolisthesis.

Comparative analysis of patient-reported outcomes in myelopathy and myeloradiculopathy: a Quality Outcomes Database study.

Objective: Myelopathy in the cervical spine can present with diverse symptoms, many of which can be debilitating for patients. Patients with radiculopathy symptoms demonstrate added complexity because of the overlapping symptoms and treatment considerations. The authors sought to assess outcomes in patients with myelopathy presenting with or without concurrent radiculopathy.

Predictors of patient satisfaction in the surgical treatment of cervical spondylotic myelopathy.

Objective: Patients with cervical spondylotic myelopathy (CSM) experience progressive neurological impairment. Surgical intervention is often pursued to halt neurological symptom progression and allow for recovery of function. In this paper, the authors explore predictors of patient satisfaction following surgical intervention for CSM.

Incidence of radiographic and clinically significant pneumothorax or hemothorax after thoracic discectomy via mini-open lateral retropleural approach without prophylactic chest tube placement.

Objective: The mini-open lateral retropleural (MO-LRP) approach is an effective option for surgically treating thoracic disc herniations, but the approach raises concerns for pneumothorax (PTX). However, chest tube placement causes insertion site tenderness, necessitates consultation services, increases radiation exposure (requires multiple radiographs), delays the progression of care, and increases narcotic requirements. This study examined the incidence of radiographic and clinically significant PTX and hemothorax (HTX) after the MO-LRP approach, without the placement of a prophylactic chest tube, for thoracic disc herniation.

Reciprocal Changes in Sagittal Spinal Alignment After L5-S1 Anterior Lumbar Interbody Fusion.

Objective: Degenerative diseases of the lumbar spine decrease lumbar lordosis (LL). Anterior lumbar interbody fusion (ALIF) at the L5-S1 disc space improves segmental lordosis, LL, and sagittal balance. This study investigated reciprocal changes in spinopelvic alignment after L5-S1 ALIF.

Is Upper Extremity or Lower Extremity Function More Important for Patient Satisfaction? An Analysis of 24-Month Outcomes from the QOD Cervical Spondylotic Myelopathy Cohort.

Study Design: Retrospective analysis of a prospective, multicenter registry.

Objective: To assess whether upper or lower limb mJOA improvement more strongly associates with patient satisfaction after surgery for cervical spondylotic myelopathy (CSM).

Summary Of Background Data: The modified Japanese Orthopaedic Association (mJOA) is commonly used to assess functional status in patients with CSM.

Elemental Characterization of Ambient Particulate Matter for a Globally Distributed Monitoring Network: Methodology and Implications.

Global ground-level measurements of elements in ambient particulate matter (PM) can provide valuable information to understand the distribution of dust and trace elements, assess health impacts, and investigate emission sources. We use X-ray fluorescence spectroscopy to characterize the elemental composition of PM samples collected from 27 globally distributed sites in the Surface PARTiculate mAtter Network (SPARTAN) over 2019-2023. Consistent protocols are applied to collect all samples and analyze them at one central laboratory, which facilitates comparison across different sites.

What is the effect of preoperative depression on outcomes after minimally invasive surgery for adult spinal deformity? A prospective cohort analysis.

Objective: Depression has been implicated with worse immediate postoperative outcomes in adult spinal deformity (ASD) correction, yet the specific impact of depression on those patients undergoing minimally invasive surgery (MIS) requires further clarity. This study aimed to evaluate the role of depression in the recovery of patients with ASD after undergoing MIS.

Methods: Patients who underwent MIS for ASD with a minimum postoperative follow-up of 1 year were included from a prospectively collected, multicenter registry.

Lumbar Lordosis Redistribution and Segmental Correction in Adult Spinal Deformity: Does it Matter?

Study Design: Retrospective analysis of prospectively collected data.

Objective: Evaluate the impact of correcting normative segmental lordosis values on postoperative outcomes.

Background: Restoring lumbar lordosis magnitude is crucial in adult spinal deformity surgery, but the optimal location and segmental distribution remain unclear.

Does the number of social factors affect long-term patient-reported outcomes and satisfaction in those with cervical myelopathy? A QOD study.

Objective: It is not clear whether there is an additive effect of social factors in keeping patients with cervical spondylotic myelopathy (CSM) from achieving both a minimum clinically important difference (MCID) in outcomes and satisfaction after surgery. The aim of this study was to explore the effect of multiple social factors on postoperative outcomes and satisfaction.

Methods: This was a multiinstitutional, retrospective study of the prospective Quality Outcomes Database (QOD) CSM cohort, which included patients aged 18 years or older who were diagnosed with primary CSM and underwent operative management.

What predicts the best 24-month outcomes following surgery for cervical spondylotic myelopathy? A QOD prospective registry study.

Objective: The aim of this study was to identify predictors of the best 24-month improvements in patients undergoing surgery for cervical spondylotic myelopathy (CSM). For this purpose, the authors leveraged a large prospective cohort of surgically treated patients with CSM to identify factors predicting the best outcomes for disability, quality of life, and functional status following surgery.

Methods: This was a retrospective analysis of prospectively collected data.