Geometric analysis of pedicle subtraction osteotomy (PSO) for Kyphosis correction: anterior lengthening may occur at the osteotomized body as well as at the discs above and below.

Objective: To validate the authors kyphosis correction formula for pedicle subtraction osteotomy (PSO) cases. Additionally, to use the formula to evaluate the safety of PSO by determining if there is anterior lengthening.

Methods: Twenty-two patients with primarily kyphosis corrected by PSO and with clear landmarks on preoperative and postoperative x-rays were selected.

Alvimopan for the reduction of postoperative ileus after long posterior spinal fusion: placebo-controlled double-blind randomized trial.

Objective: The aim of this study was to evaluate the efficacy of alvimopan administration after posterior spinal fusion (PSF) in adult spine surgery patients who are taking opioid agents.

Methods: In this placebo-controlled, double-blind randomized trial, PSF patients were randomized in blocks to placebo or study drug. Primary and secondary outcome measures were return to normal bowel function, including time to passage of flatus and stool, time to tolerance of oral nutrition, and time to hospital discharge.

Integrin-mediated interactions with a laminin-presenting substrate modulate biosynthesis and phenotypic expression for cells of the human nucleus pulposus.

With aging and pathology, cells of the nucleus pulposus (NP) de-differentiate towards a fibroblast-like phenotype, a change that contributes to degeneration of the intervertebral disc (IVD). Laminin isoforms are a component of the NP extracellular matrix during development but largely disappear in the adult NP tissue. Exposing human adult NP cells to hydrogels made from PEGylated-laminin-111 (PEGLM) has been shown to regulate NP cell behaviors and promote cells to assume a biosynthetically active state with gene/protein expression and morphology consistent with those observed in juvenile NP cells.

Reciprocal Changes in Cervical Alignment After Thoracolumbar Arthrodesis for Adult Spinal Deformity.

Study Design: Multicenter database review of consecutive adult spinal deformity (ASD) patients.

Objective: The aim of this study was to identify associations between changes in spinopelvic parameters and cervical alignment after thoracolumbar arthrodesis for ASD.

Summary Of Background Data: Reciprocal cervical changes occur after instrumented thoracic spinal arthrodesis.

Mechanosensitive transcriptional coactivators MRTF-A and YAP/TAZ regulate nucleus pulposus cell phenotype through cell shape.

Cells of the adult nucleus pulposus (NP) are critically important in maintaining overall disc health and function. NP cells reside in a soft, gelatinous matrix that dehydrates and becomes increasingly fibrotic with age. Such changes result in physical cues of matrix stiffness that may be potent regulators of NP cell phenotype and may contribute to a transition toward a senescent and fibroblastic NP cell with a limited capacity for repair.

PROMIS correlation with NDI and VAS measurements of physical function and pain in surgical patients with cervical disc herniations and radiculopathy.

Objective: The aim of this study was to compare the patient-reported outcome measures Neck Disability Index (NDI) and visual analog scale (VAS) with the Patient Reported Outcomes Measurement Information System (PROMIS) physical function (PF) and pain interference (PI) measures, respectively, and to determine their correlations in a surgical population longitudinally.Legacy outcome measures such as NDI and VAS are essential for analyzing treatments in spine surgery for cervical disc herniations with radiculopathy. Despite their usefulness, administrative burdens impose limits on completion of these measures.

Reliability of the Neck Disability Index and Japanese Orthopedic Association questionnaires in adult cervical radiculopathy and myelopathy patients when administered by telephone or via online format.

Background: The internal validity of long-term studies is significantly affected by the high loss to follow-up in the spine surgery population (>20%). Phone and email-based administration of patient-reported outcomes instruments is a less cumbersome approach for increasing response rates and assessment frequency while potentially decreasing follow-up burden on patients and physicians.

Purpose: This study sought to validate simultaneous administration of the Neck Disability Index (NDI) and Japanese Orthopedic Association (JOA) questionnaires in patients with either cervical myelopathy and/or radiculopathy.

Operative Versus Nonoperative Treatment for Adult Symptomatic Lumbar Scoliosis.

Background: The effectiveness of operative compared with nonoperative treatment at initial presentation (no prior fusion) for adult lumbar scoliosis has not, to our knowledge, been evaluated in controlled trials. The goals of this study were to evaluate the effects of operative and nonoperative treatment and to assess the benefits of these treatments to help treating physicians determine whether patients are better managed operatively or nonoperatively.

Methods: Patients with adult symptomatic lumbar scoliosis (aged 40 to 80 years, with a coronal Cobb angle measurement of ≥30° and an Oswestry Disability Index [ODI] score of ≥20 or Scoliosis Research Society [SRS]-22 score of ≤4.

Rod fracture in adult spinal deformity surgery fused to the sacrum: prevalence, risk factors, and impact on health-related quality of life in 526 patients.

Background Context: Risk factors associated with rod fracture (RF) following adult spinal deformity (ASD) surgery fused to the sacrum remain debatable, and the impact of RF on patient-reported outcomes (PROs) after ASD surgery has not been investigated.

Purpose: We aimed to evaluate the prevalence of and risk factors for RF and determine PROs changes associated with RF after ASD surgery fused to the sacrum.

Study Design/setting: A retrospective single-center cohort study was performed.

Dural Tears in Adult Deformity Surgery: Incidence, Risk Factors, and Outcomes.

Study Design: Retrospective cohort study.

Objectives: Describe the rate of dural tears (DTs) in adult spinal deformity (ASD) surgery. Describe the risk factors for DT and the impact of this complication on clinical outcomes.

Serious Adverse Events Significantly Reduce Patient-Reported Outcomes at 2-Year Follow-up: Nonoperative, Multicenter, Prospective NIH Study of 105 Patients.

Study Design: This is an analysis of a prospective 2-year study on nonoperative patients enrolled in the Adult Symptomatic Lumbar Scoliosis (ASLS) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) trial.

Objective: The purpose was to evaluate the impact of serious adverse events (SAEs) on patient-reported outcomes (PROs) in nonoperative management of ASLS as measured by Scoliosis Research Society-22 (SRS-22), Oswestry Disability Index (ODI), and Short Form-12 (SF-12) at 2-year follow-up.

Summary Of Background Data: Little is known about PROs in the nonoperative management of ASLS or the prevalence and impact of SAEs on PROs.

Comparison of transforaminal lumbar interbody fusion outcomes in patients receiving rhBMP-2 versus autograft.

Background Context: Recombinant human bone morphogenetic protein 2 (rhBMP-2) plays a pivotal role in complex spine surgery. Despite its limited approval, the off-label use of rhBMP-2 is prevalent, particularly in transforaminal lumbar interbody fusions (TLIFs).

Purpose: To determine the effectiveness and safety of rhBMP-2 use in TLIF procedures versus autograft.

PROMIS Physical Function Correlation With NDI and mJOA in the Surgical Cervical Myelopathy Patient Population.

Study Design: Retrospective review.

Objective: To determine the correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) physical function with Neck Disability Index (NDI) and Modified Japanese Orthopedic Association (mJOA) scores in the surgical cervical myelopathy patient population.

Summary Of Background Data: Outcome measures such as NDI and mJOA are essential for analyzing treatments for cervical myelopathy.

Impact of Depression on Patient-Reported Outcome Measures After Lumbar Spine Decompression.

Study Design: A retrospective cohort study.

Objective: The aim of this study was to investigate the effect depression has on the improvement of patient-reported outcome measures (PROMs) following lumbar decompression.

Summary Of Background Data: Decompression without fusion is a viable treatment option for lumbar spine stenosis.

Development and Validation of a Novel Adult Spinal Deformity Surgical Invasiveness Score: Analysis of 464 Patients.

Background: A surgical invasiveness index (SII) has been validated in general spine procedures but not adult spinal deformity (ASD).

Objective: To assess the ability of the SII to determine the invasiveness of ASD surgery and to create and validate a novel ASD index incorporating deformity-specific factors, which could serve as a standardized metric to compare outcomes and risk stratification of different ASD procedures for a given deformity.

Methods: Four hundred sixty-four patients who underwent ASD surgery between 2009 and 2012 were identified in 2 multicenter prospective registries.

Perioperative Complications of Spinal Metastases Surgery.

The incidence of symptomatic spinal metastasis has increased due to treatment improvements and longer patient survival. More patients with spinal tumors are choosing operative treatment with an associated increased rate of perioperative complications. Operative metastatic disease treatment complication rates have also increased with overall rates ranging from 5.

Adult Spinal Deformity Surgeons Are Unable to Accurately Predict Postoperative Spinal Alignment Using Clinical Judgment Alone.

Object: Adult spinal deformity (ASD) surgery seeks to reduce disability and improve quality of life through restoration of spinal alignment. In particular, correction of sagittal malalignment is correlated with patient outcome. Inadequate correction of sagittal deformity is not infrequent.

Subaxial cervical spine trauma.

Subaxial cervical spine trauma is common and an often missed diagnosis. Accurate and efficient diagnosis and management is necessary to avoid devastating complications such as spinal cord injury. Several classification schemes have been devised to help categorize fractures of the subaxial spine and define treatment algorithms.

Preoperative Fiducial Marker Placement in the Thoracic Spine: A Technical Report.

Study Design: A retrospective review.

Objective: The aim of this study was to demonstrate proof-of-concept of preoperative percutaneous intraosseous fiducial marker placement before thoracic spine surgery.

Summary Of Background Data: Wrong-level spine surgery is defined as a never event by Center for Medicare Services, yet the strength of data supporting the implementation of Universal Protocol to limit wrong level surgery is weak.

Perioperative Neurologic Complications in Adult Spinal Deformity Surgery: Incidence and Risk Factors in 564 Patients.

Study Design: Prognostic study-case controlled.

Objective: Describe the rate of neurologic complications in adult spinal deformity surgery and describe the effect of these complications on clinical outcomes.

Summary Of Background Data: The incidence of neurologic complications and the risk factors for neurologic complications have not been reported in a large series of patients with adult spinal deformity (ASD).

Can standard anterior Smith-Robinson supramanubrial approach be utilized for approach down to T2 or T3?

Purpose: The aim of this study was to determine a plain radiographic criterion for determining the feasibility of using the standard anterior Smith-Robinson supramanubrial approach for anterior surgery down to T2 or T3.

Methods: The surgical database (2002-2014) was searched to identify patients with anterior cervical surgery to T2 or T3. A method to determine whether a standard anterior Smith-Robinson approach can be used to operate on the upper thoracic levels was evaluated.

Granulomatosis with polyangiitis (Wegener's granulomatosis) causing atlantoaxial instability: a case report.

Background Context: No previous cases of atlantoaxial instability due to granulomatosis with polyangiitis have been reported.

Purpose: The aim of this study was to report a case of granulomatosis with polyangiitis causing atlantoaxial instability.

Study Design: This is a case report.

Fractional anisotropy to quantify cervical spondylotic myelopathy severity.

Background: A number of clinical tools exist for measuring the severity of cervical spondylotic myelopathy (CSM). Several studies have recently described the use of non-invasive imaging biomarkers to assess severity of disease. These imaging markers may provide an additional tool to measure disease progression and represent a surrogate marker of response to therapy.