Are the Umbilicus and Iliac Crests Truly at the Level of L4 to L5? A Computed Tomography-Based Study of Surface Anatomy of the Anterior Lumbar Spine.

Background: This study aimed to determine whether the iliac crests are truly at the level of L4 to L5, accounting for patient demographic and anthropometric characteristics.

Methods: We measured the umbilicus and iliac crests relative to the lumbar spine using computed tomography of patients without spinal pathology, accounting for the influences of patient height, weight, body mass index (BMI), sex, race, and ethnicity.

Results: A total of 834 patients (391 men and 443 women) were reviewed.

Analysis of reasons for medical malpractice litigation due to spinal cord stimulator.

Study Design: Retrospective cohort study.

Introduction: Malpractice claims analysis is performed by several specialties to improve quality of patient care and to identify areas where physicians can improve their practice to mitigate the incidence of committing malpractice. The Food and Drug Administration has flagged over 80,000 injuries caused by spinal cord stimulator (SCS), making them the 3rd most flagged medical device.

Anatomic Parameters for Diagnosing Congenital Lumbar Stenosis Based on Computed Tomography of 1,000 Patients.

Introduction: Quantitative parameters for diagnosis of congenital lumbar stenosis (CLS) have yet to be universally accepted. This study establishes parameters for CLS using CT, assessing the influences of patient sex, race, ethnicity, and anthropometric characteristics.

Methods: Interpedicular distance (IPD), pedicle length, canal diameter, and canal area were measured using 1,000 patients between 18 and 35 years of age who were without spinal pathology.

Morphometric analysis of cervical disc space height and interpedicular distance using computed tomography.

Background: This study utilized computed tomography (CT) to establish normative radiographic morphometric measurements of cervical disc space height (DSH) and interpedicular distance (IPD) and document the influence of patient sex, race, ethnicity, and anthropometric characteristics.

Methods: Cervical CTs of 1000 patients between 18 and 35 years of age without known spinal pathology were reviewed. Statistical analyses included the assessment of associations between patient height, weight, sex, race, and ethnicity regarding DSH and IPD.

Correlations among MRI-based cervical and thoracic vertebral bone quality score, CT-based Hounsfield Unit score, and DEXA t-score in assessment of bone mineral density.

Background: Further optimization of the validated vertebral bone quality (VBQ) score using magnetic resonance imaging (MRI) may expand its clinical utility for bone mineral density (BMD) assessment. This study evaluated the correlations among cervical and thoracic VBQ scores, the validated Hounsfield Unit (HU) measured on computed tomography (CT), and dual-energy x-ray absorptiometry (DEXA) values.

Methods: We retrieved the medical and radiographic records of 165 patients who underwent synchronous MRI of the cervical and thoracic spine, as well as DEXA and CT imaging of the spine obtained within 1 year of each other between 2015 and 2022.

Morphometric analysis of cervical neuroforaminal dimensions from C2-T1 using computed tomography of 1,000 patients.

Background: Race and sex differences are not consistently reported in the literature. Fundamentally, anatomical differences of cervical neuroforaminal dimensions (CNFD) amongst these groups would be important to know.

Purpose: To establish normative radiographic morphometric measurements of CNFD and uncover the influence of patient sex, race, and ethnicity while also considering anthropometric characteristics.

Analysis of reasons for medical malpractice litigation due to anterior cervical discectomy and fusion.

Background: Anterior cervical discectomy and fusions (ACDF) are among the most common cervical spine operations, with over 137,000 surgeries performed annually. Understanding reasons underlying malpractice pertaining to ACDF may inform physicians of practices to improve delivery of patient care and mitigate malpractice. The aim of our study was to analyze the causes and outcomes for lawsuits pertaining to ACDF.

Application of machine learning algorithms to predict 30-day hospital readmission following cement augmentation for osteoporotic vertebral compression fractures.

Objective: Osteoporosis is a common skeletal disease that greatly increases the risk of pathologic fractures and accounts for approximately 700,000 vertebral compression fractures (VCFs) annually in the United States. Cement augmentation procedures such as balloon kyphoplasty (KP) and percutaneous vertebroplasty (VP) have demonstrated efficacy in the treatment of VCFs, however, some studies report rates of readmission as high as 10.8% following such procedures.

Correlations among Cervical, Thoracic, and lumbar Hounsfield Unit measurements for assessment of bone mineral density.

Objective: Bone mineral density assessment using Hounsfield Unit (HU) currently depends upon the availability of computed tomography (CT) of the lumbar spine. The primary aim of this study was to evaluate the associations among HU measurements of the cervical (CHU), thoracic (THU), and lumbar (LHU) spine. The secondary aim of this study was to analyze the influence of patient demographic and anthropometric characteristics on HU measurements.

Anatomic Assessment of L1-S1 Neuroforaminal Dimensions Using Computed Tomography in 1,000 Patients: A Follow-Up Study.

Objectives: While the radiographic criteria for diagnosing central lumbar stenosis are well described, criteria for diagnosing neuroforaminal stenosis (NFS) are unclear. Prior research has utilized magnetic resonance imaging (MRI) to characterize neuroforaminal dimensions (NFDs). However, this approach has inherent limitations that can adversely impact measurement accuracy.

Surface anatomical landmarks for spine surgery: A CT-based study of the sternal notch and sternal angle in 1,035 patients.

Background: Understanding the location of surface anatomical landmarks in relation to the cervical and thoracic spine is important for a wide array of clinical applications. The objective of this study was to investigate the influence of patient demographic and anthropometric characteristics on the locations of the sternal notch and sternal angle in relation to the spine using computed tomography (CT) of a large cohort of young adult patients without spinal pathology.

Methods: Vertebral levels corresponding to the sternal notch and sternal angle were analyzed using CT of 1,035 patients.

Proton beam radiotherapy versus transarterial chemoembolization for hepatocellular carcinoma: Results of a randomized clinical trial.

Background: This study compares survival rates, recurrence patterns, toxicity, and treatment cost in patients with hepatocellular carcinoma (HCC) treated with either transarterial chemoembolization (TACE) or proton beam radiotherapy (PBT).

Methods: Subjects with untreated HCC meeting Milan or San Francisco transplant criteria were recruited. Subjects were randomized to receive PBT (n = 36) or TACE (n = 40).

Spin in the Abstracts of Meta-analyses and Systematic Reviews: Quadriceps Tendon Graft for Anterior Cruciate Ligament Reconstruction.

Background: Spin is a reporting bias that misrepresents research. Ultimately it can affect surgeon decision making and patient care. Anterior cruciate ligament (ACL) reconstruction is common, but debate continues over optimal treatment modalities.

Analysis of the Reasons for Medical Malpractice Litigation Due to Facet Injections.

Introduction As the use of facet joint injections (FJI) increases, practitioners performing FJI may be at increased risk of legal liability. Malpractice claim analysis is performed by several specialties as it provides valuable insight into patient values and methods to mitigate the risk of malpractice litigation pertaining to a specific procedure or treatment. Malpractice analysis regarding FJI may provide clinicians with a better understanding of the reasons that lead to malpractice due to FJI, thereby allowing practitioners to improve the quality of care delivered to patients whilst mitigating the incidence of malpractice.

Biomechanical Comparison of Adjustable-Loop Femoral Cortical Suspension Devices for Soft Tissue ACL Reconstruction.

Background: Several new adjustable-loop devices (ALDs) for anterior cruciate ligament reconstruction (ACLR) have not been tested in vitro.

Purpose: To compare the biomechanical performances of 5 ALDs under a high cyclic load and forces representative of the return-to-play conditions seen in the recovering athlete.

Study Design: Controlled laboratory study.

Analysis of reasons for medical malpractice litigation due to laminectomy.

Objective: The aim of this study was to identify the incidence and characteristics of malpractice lawsuits pertaining to laminectomy performed either as a stand-alone operation or concurrent with another procedure by querying the Westlaw Edge and VerdictSearch databases. Malpractice claims analysis is performed by several medical specialties to provide insight into patient values, methods to improve quality of care, and risk factors for litigation pertaining to specific procedures or treatments.

Methods: Westlaw and VerdictSearch were queried using the keywords "laminectomy" and "spine.

Outcomes with catheter-directed thrombolysis vs. catheter-directed embolectomy among patients with high-risk pulmonary embolism: a nationwide analysis.

Aims: To examine the shot-term outcomes with catheter-directed thrombolysis (CDT) vs. catheter-directed embolectomy (CDE) for high-risk pulmonary embolism (PE).

Methods And Results: The Nationwide Readmissions Database was utilized to identify hospitalizations with high-risk PE undergoing CDE or CDT from 2016 to 2019.

Medical Malpractice Litigation Due to Off-Label Use of Bone Morphogenetic Protein.

Study Design: Retrospective cohort study.

Objective: To analyze the incidence and characteristics of malpractice lawsuits pertaining to the off-label use of Bone morphogenetic protein (BMP).

Summary Of Background Data: BMP continues to be a popular alternative to the use of autologous bone graft during spinal fusion procedures.

Preoperative Cannabis Use Associated With an Increased Rate of Reoperation and Postoperative Opioid Use Following Anterior Cervical Decompression and Fusion.

Objectives The objective of this retrospective cohort study was to evaluate the associations among preoperative cannabis use, postoperative opioid use, and postoperative outcomes following elective anterior cervical decompression and fusion (ACDF). Methods Patients who underwent one- or two-level ACDF were characterized preoperatively as active cannabis users, former users, or nonusers. Patients were also classified based on history of preoperative opioid use as chronic users, acute users, or nonusers.

Use of random forest machine learning algorithm to predict short term outcomes following posterior cervical decompression with instrumented fusion.

Random Forest (RF) is a widely used machine learning algorithm that can be utilized for identification of patient characteristics important for outcome prediction. Posterior cervical decompression with instrumented fusion (PCDF) is a procedure for the management of cervical spondylosis, cervical spinal stenosis, and degenerative disorders that can cause cervical myelopathy or radiculopathy. An RF algorithm was employed to predict and describe length of stay (LOS), readmission, reoperation, transfusion, and infection rates following elective PCDF using The American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database 2008 through 2018.

The Cotton Osteotomy as an Adjunct Procedure in Hallux Valgus and Hallux Limitus Surgery.

The Cotton osteotomy, as described in 1936 by Frederic Cotton, consisted of a medial cuneiform opening base wedge osteotomy. This Cotton osteotomy served to restore the "triangle of support" of the foot. In his address to the New England Surgical Society, he described this osteotomy as being multipurpose; it can be used for plantarflexion in hallux valgus surgery and has use in hallux rigidus conditions.