Management and treatment algorithm of airway complications after anterior cervical spine surgery: systematic review.

Background: Airway-related complications are rare after cervical spine surgery but can be devastating and compromise a successful outcome. The objective of this systematic review is to provide an overview of the management of airway complications after anterior cervical spine surgery (ACSS) and propose a treatment algorithm for approaching the patient with a compromised airway.

Methods: A literature search was conducted in PubMed and adapted for use in other databases, including the Cochrane Register of Controlled Trials, Cochrane Library Health Technology Assessment Database, Embase, and the National Health Service (NHS) Economic Evaluation Database.

Preventing Unnecessary Surgery in Patients Presenting for Orthopedic Spine Surgery: Literature Review and Case Series.

Introduction: Almost 40% of patients who have been diagnosed with amyotrophic lateral sclerosis (ALS) may have been misdiagnosed. Some of these patients may have undergone surgical procedures to address symptoms that could have actually be early indications of ALS.Up to 40% of patients diagnosed with amyotrophic lateral sclerosis (ALS) have received an incorrect diagnosis, a number undergo surgical treatment for signs and symptoms that can be attributed to early manifestations of ALS.

Sacral Fractures: A Review.

At the cornerstone of the pelvis and spine, the sacrum may be fractured in patients of all ages. Sacral fractures range from high-energy injuries, with mortality rates of up to 18%, to low-energy insufficiency fractures. The intricate geometry of the sacrum, the breadth of morphotypes, and the presence of congenital anomalies all can complicate the treatment of these fractures.

Preoperative cross-sectional area of psoas muscle correlates with short-term functional outcomes after posterior lumbar surgery.

Purpose: To determine the optimal level for the measurement of psoas cross-sectional area and examine the correlation with short-term functional outcomes of posterior lumbar surgery.

Methods: Patients who underwent minimally invasive posterior lumbar surgery were included in this study. The cross-sectional area of psoas muscle was measured at each intervertebral level on T2-weighted axial images of preoperative MRI.

Airway Complications After Anterior Cervical Spine Surgery: Etiology and Risk Factors.

Study Design: Narrative Review.

Objective: To provide an overview of etiology and risk factors of airway complications after anterior cervical spine surgery (ACSS).

Methods: A search was performed in PubMed and adapted for use in other databases, including Embase, Cochrane Library, Cochrane Register of Controlled Trials, Health Technology Assessment database, and NHS Economic Evaluation Database.

Classification system for cervical spine deformity morphology: a validation study.

Objective: The objective of this study was to initially validate a recent morphological classification of cervical spine deformity pathology.

Methods: The records of 10 patients for each of the 3 classification subgroups (flat neck, focal deformity, and cervicothoracic), as well as for 8 patients with coronal deformity only, were extracted from a prospective multicenter database of patients with cervical deformity (CD). A panel of 15 physicians of various training and professional levels (i.

Computed Tomography and Magnetic Resonance Imaging Overlay in the Spine for Surgical Planning: A Technical Report.

Background: Computed tomography (CT) and magnetic resonance imaging (MRI) studies are used separately for surgical planning of spine surgery. Advanced techniques exist for creating CT-MR fusion images, but at this time these techniques are not easily accessible for large-scale use.

Technique: We propose a simple graphical technique for CT-MR image overlay, for use in the surgical planning of spinal decompression and guidance of intraoperative resection.

Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey.

Background: Cannabidiol (CBD) is a cannabis derivative that has been popularized as a medicinal product with analgesic and anti-inflammatory effects. Given the anecdotal observations that several patients have reported use of CBD for spine-related pain, this study was designed to characterize CBD consumption patterns and perceived effects in patients with spine-related complaints.

Methods: The study design was a cross-sectional survey.

A Primer on the Use of Artificial Intelligence in Spine Surgery.

Design: This was a narrative review.

Purpose: Summarize artificial intelligence (AI) fundamentals as well as current and potential future uses in spine surgery.

Summary Of Background Data: Although considered futuristic, the field of AI has already had a profound impact on many industries, including health care.

Alignment Targets, Curve Proportion and Mechanical Loading: Preliminary Analysis of an Ideal Shape Toward Reducing Proximal Junctional Kyphosis.

Study Design: Retrospective cohort study.

Objective: Investigate risk factors for PJK including theoretical kyphosis, mechanical loading at the UIV and age adjusted offset alignment.

Methods: 373 ASD patients (62.

Morphometric analysis of cervical interlaminar space for posterior surgical approach and decompression.

Purpose: The purpose of this study is to provide a morphometric description of the bony margins of the interlaminar spaces by level in the cervical spine for guidance of safe posterior cervical surgical dissection and decompression. We also aim to describe the impact of increasing static cervical lordosis on the overlap between the lamina.

Methods: Morphometric measurements of the interlaminar space were performed on 100 consecutive cervical spine CT scans of patients ranging in age from 18 to 50 years were selected.

The Spine Physical Examination Using Telemedicine: Strategies and Best Practices.

Study Design: Technical note.

Objectives: To provide spine surgeons new to telemedicine with a structured physical examination technique based on manual motor testing principles.

Methods: Expert experience describing a series of specific maneuvers for upper and lower extremity strength testing that can be performed using a telemedicine platform.

Early Failures After Lumbar Discectomy Surgery: An Analysis of 62 690 Patients.

Study Design: Retrospective cohort study.

Objective: To determine the rate of early failures (readmission or reoperation for new or recurrent pain/neurological symptoms) within 30 days after lumbar discectomy and identify associated risk factors.

Methods: A retrospective cohort study was conducted of patients undergoing lumbar discectomy in the National Surgical Quality Improvement Program database between 2013 and 2017.

Hypoglossal Nerve Palsy After Anterior Cervical Spine Surgery: A Case Report and Literature Review.

Case: A 37-year-old man was found to have hypoglossal nerve palsy after undergoing anterior cervical spine surgery at C3-C5, an injury that would cause him severe disability and further complications.

Conclusion: Knowledge of the hypoglossal nerve is crucial for cervical spine surgery even at lower levels (C4-C7), including variations in its course and potential displacement during the induction of anesthesia.

Shoulder Double Crush Syndrome: A Retrospective Study of Patients With Concomitant Suprascapular Neuropathy and Cervical Radiculopathy.

Purpose: While the double crush phenomena (compression along two points on a nerve) has been established between median neuropathy and cervical radiculopathy, combined suprascapular neuropathy (SSN) and cervical C5/C6 radiculopathy-so-called shoulder double crush syndrome-has not been well examined. We aim to identify the incidence of shoulder double crush syndrome in patients undergoing arthroscopic suprascapular nerve release for SSN.

Methods: One hundred consecutive patients >18 years of age who were positive for SSN on electromyography and motor nerve conduction studies (EMG/NCS) and underwent a suprascapular nerve release were included.

New Strategies in Enhancing Spinal Fusion.

The biologic steps involved in creating a bony fusion between adjacent segments of the spine are a complex and highly coordinated series of events. There have been significant advancements in bone grafts and bone graft substitutes in order to augment spinal fusion. While autologous bone grafting remains the gold standard, allograft bone grafting, synthetic bone graft substitutes, and bone graft enhancers are appropriate in certain clinical situations.

Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review.

Study Design: Systematic review.

Objective: To assess the current literature regarding the relationship between the shoulder and the spine with regard to (1) overlapping pain pathways; (2) differentiating history, exam findings, and diagnostic findings; (3) concomitant pathology and optimal treatments; and (4) cervical spine-based etiology for shoulder problems.

Methods: A systematic literature search was performed according to the guidelines set forth by the Cochrane Collaboration.

A retrospective review of 112 patients undergoing arthroscopic suprascapular nerve decompression.

Background: Arthroscopic suprascapular nerve release has yielded good results previously. However, comprehensive literature is still lacking.

Purpose: This study assessed results of suprascapular nerve release in patients with intractable shoulder pain with confirmed suprascapular neuropathy.

Additive Manufacturing for Metal Applications in Orthopaedic Surgery.

Metallic additive manufacturing, a process by which metal structures are created in a layered fashion, is poised to revolutionize orthopaedic implants and instruments. It allows for the design and manufacture of devices, which not only macroscopically more closely match patient-specific anatomy but also have improved microscopic detail for more rapid and durable host integration. In addition, additive manufacturing-designed implants have improved biomechanical properties and fixation systems allowing use in areas where current implants are not well suited.

Effect of Myelopathy on Early Clinical Improvement After Cervical Disc Replacement: A Study of a Local Patient Cohort and a Large National Cohort.

Objective: Cervical disc replacement (CDR) is an effective long-term treatment for both cervical radiculopathy and myelopathy. However, there may be unique differences in the early postoperative clinical improvement for patients with and without myelopathy. In addition, previous studies using CDR to treat cervical myelopathy were underpowered to determine risk factors for relatively postoperative medical complications.

Butterfly Vertebrae: A Systematic Review of the Literature and Analysis.

Study Design: Systematic review (Level 4).

Objective: To summarize the demographics, clinical presentations, and conditions associated with butterfly vertebrae.

Methods: A systematic search was performed of multiple databases.

Sagittal Reconstruction and Clinical Outcome Using Traditional ACDF, Versus Stand-alone ACDF Versus TDR: A Systematic Review and Quantitative Analysis.

Study Design: Systematic review.

Objective: To determine the difference in postoperative sagittal alignment when single level cervical radiculopathy or myelopathy is treated with an anterior cervical discectomy and fusion (ACDF) using a structural graft and plate, a stand-alone ACDF, or a total disc arthroplasty (TDR). We also wanted to determine if postoperative sagittal alignment impacted clinical outcomes in this patient population.