Development and reliability of the AOSpine CROST (Clinician Reported Outcome Spine Trauma): a tool to evaluate and predict outcomes from clinician's perspective.

Purpose: To report on the development of AOSpine CROST (Clinician Reported Outcome Spine Trauma) and results of an initial reliability study.

Methods: The AOSpine CROST was developed using an iterative approach of multiple cycles of development, review, and revision including an expert clinician panel. Subsequently, a reliability study was performed among an expert panel who were provided with 20 spine trauma cases, administered twice with 4-week interval.

Two-level ACDF with a zero-profile stand-alone spacer compared to conventional plating: a prospective randomized single-center study.

Purpose: Stand-alone zero-profile devices have already proven safety, and a reduced dysphagia rate was assumed. So far, no level-one evidence is available to prove the proposed advantages of zero-profile implants in multilevel procedures. The aim of this RCT was to compare the clinical and radiological outcome of a zero-profile spacer versus cage + plate in two-level ACDF.

Reliability and Validity of the English Version of the AOSpine PROST (Patient Reported Outcome Spine Trauma).

Study Design: Multicenter validation study.

Objective: The aim of this study was to translate and adapt the AOSpine PROST (Patient Reported Outcome Spine Trauma) into English, and test its psychometric properties among North-American spine trauma patients.

Summary Of Background Data: In the absence of an outcome instrument specifically designed and validated for traumatic spinal column injury patients, it is difficult to measure the effect size of various treatment options.

Anterior instrumented fusion for adolescent idiopathic scoliosis.

Adolescent idiopathic scoliosis (AIS) is a complex three-dimensional deformity of the spine consisting of a lateral curvature, apical vertebral rotation, and an impairment of the sagittal profile. Surgical options include anterior and posterior approaches. Anterior instrumented fusion is suitable in Lenke type 1 and 5 curves.

The European Robotic Spinal Instrumentation (EUROSPIN) study: protocol for a multicentre prospective observational study of pedicle screw revision surgery after robot-guided, navigated and freehand thoracolumbar spinal fusion.

Introduction: Robotic guidance (RG) and computer-assisted navigation (NV) have seen increased adoption in instrumented spine surgery over the last decade. Although there exists some evidence that these techniques increase radiological pedicle screw accuracy compared with conventional freehand (FH) surgery, this may not directly translate to any tangible clinical benefits, especially considering the relatively high inherent costs. As a non-randomised, expertise-based study, the European Robotic Spinal Instrumentation Study aims to create prospective multicentre evidence on the potential comparative clinical benefits of RG, NV and FH in a real-world setting.

Clinical and Radiological Outcomes of Corrective Surgery on Adult Spinal Deformity Patients: Comparison of Short and Long Fusion.

Despite the accumulated knowledge of spinal alignment and clinical outcomes the full corrective surgery cannot be applied to all the deformity patients as it requires considerable surgical burden to the patients. The aim of this study was to investigate the clinical and radiological outcomes of the patients who have received short and long fusion for ASD. A total of 21 patients who received surgical reconstructive spinal fusion procedures and were followed up for at least one year were retrospectively reviewed.

Does Riluzole Influence Bone Formation?: An In Vitro Study of Human Mesenchymal Stromal Cells and Osteoblast.

Study Design: A post-test design biological experiment.

Objective: The aim of this study was to evaluate the osteogenic effects of riluzole on human mesenchymal stromal cells and osteoblasts.

Summary Of Background Data: Riluzole may benefit patients with spinal cord injury (SCI) from a neurologic perspective, but little is known about riluzole's effect on bone formation, fracture healing, or osteogenesis.

Two-Nation Comparison of Classification and Treatment of Subaxial Cervical Spine Fractures: An Internet-Based Multicenter Study Among Spine Surgeons.

Background: To date, no evidence-based treatment algorithm is available for fractures of the subaxial spine. The aim of the present study was to assess and compare the management strategy for traumatic subaxial fractures among German and Dutch spine surgeons.

Methods: In our web-based multicenter study, German and Dutch spine surgeons evaluated the computed tomography data of traumatic subaxial fractures (C3-C7).

The use of the DTO™ hybrid dynamic device: a clinical outcome- and radiological-based prospective clinical trial.

Background: The purpose of this study was to assess the radiological and clinical outcome parameters following lumbar hybrid dynamic instrumentation with the focus on the adjacent segment degeneration (ASD) and adjacent segment disease (ASDi).

Methods: In this prospective trial all patients presenting with degenerative changes to the lumbar spine have been included. Precondition was a stable adjacent level with/without degenerative alteration.

Transoral Spine Surgery - an Update.

Even though in recent years the number of transoral spinal interventions has decreased in Europe and North America - mainly because of the progress in the drug therapy of rheumatism, there are still pathologies that can only be addressed by a transoral approach. The classical transoral approach can be expanded in collaboration with oral-maxillofacial surgery and ear, nose and throat surgery, but this is rarely necessary. The transoral approach is now mainly used for resection of pathological tissue.

Staged surgical treatment for infection of total disc arthroplasty: three cases and a narrative review of the literature.

Although total disc arthroplasty (TDA) is a common procedure for selected cases of degenerative disc disease, until today there are only two cases of TDA infections reported in the literature. We report three cases of postoperative TDA infections, two developed cutaneous fistulas. To eradicate the infectious site, a staged removal of the device, resolute debridement, and stabilization plus fusion is proposed.

Posterior Lumbar Interbody Fusion versus Dynamic Hybrid Instrumentation: A Prospective Randomized Clinical Trial.

Objective: The purpose of this study was to assess the radiologic and clinical outcomes after lumbar fusion intervention and to compare the established posterior lumbar interbody fusion (PLIF) technique and dynamic hybrid instrumentation (topping off).

Methods: In this prospective randomized trial, all patients who presented with degenerative changes to the lumbar spine (L2-S1) were included and randomized in 2 groups: patients who underwent the 360°-fusion procedure in PLIF (group 1: control group) and those patients who underwent fusion surgery with additional hybrid instrumentation (Dynesys-Transition-Optima [Zimmer Spine Inc., Denver, Colorado, USA]) cranial to the rigid fixed segment (group 2: intervention group).

Osteotomies in ankylosing spondylitis: where, how many, and how much?

Introduction: This article presents the current concepts of correction of spinal deformity in ankylosing spondylitis (AS) patients. Untreated AS can be a debilitating disease. In a few patients, disease progression results in severe spinal deformity affecting not only the thoracolumbar, but also the cervical spine.

Rheumatoid Arthritis Affecting the Upper Cervical Spine: Biomechanical Assessment of the Stabilizing Ligaments.

Diameters of anterior and posterior atlantodental intervals (AADI and PADI) are diagnostically conclusive regarding ongoing neurological disorders in rheumatoid arthritis. MRI and X-ray are mostly used for patients' follow-up. This investigation aimed at analyzing these intervals during motion of cervical spine, when transverse and alar ligaments are damaged.

Prospective randomized controlled comparison of posterior vs. posterior-anterior stabilization of thoracolumbar incomplete cranial burst fractures in neurological intact patients: the RASPUTHINE pilot study.

Purpose: If surgery for thoracolumbar incomplete cranial burst fractures (Magerl A3.1.1) is necessary, the ideal stabilization strategy still remains undetermined.

Sacral Fractures and Associated Injuries.

Study Design: Literature review.

Objective: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome.

Methods: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures.

Pathoanatomic Risk Factors for Instability and Adjacent Segment Disease in Lumbar Spine: How to Use Topping Off?

Purpose: The goal of this review is to identify criteria indicating implantation of hybrid system into lumbar spine and to evaluate general benefits of use.

Methods: A systematic review of literature was performed using current randomized clinical trials, reviews, and meta-analyses. Data sources included relevant literature of human studies identified through searches of Medline Library until May 2015.

Accuracy of 3D fluoro-navigated anterior transpedicular screws in the subaxial cervical spine: an experimental study on human specimens.

Introduction: Pedicle screw stabilization, the standard technique in the thoracic and lumbar spine, is increasingly used in the cervical spine. Initial studies on the use of anterior pedicle screws (ATPS) in the cervical spine have been recently published. ATPS use has theoretical advantages over posterior stabilization.

Development of the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST): a universal disease-specific outcome instrument for individuals with traumatic spinal column injury.

Purpose: To report on the multi-phase process used in developing the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST), as well as the results of its application in a pilot study.

Methods: The International Classification of Functioning, Disability and Health (ICF) methodology was used as the basis for the development of this tool. Four preparatory studies and a consensus conference were performed, and resulted in the selection of 25 core ICF categories as well as the scale for use.

The Development of a Universally Accepted Sacral Fracture Classification: A Survey of AOSpine and AOTrauma Members.

 Survey study.  To determine the global perspective on controversial aspects of sacral fracture classifications.  While developing the AOSpine Sacral Injury Classification System, a survey was sent to all members of AOSpine and AOTrauma.

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study.

Purpose: To investigate whether wide variations are seen in the measurement techniques preferred by spine surgeons around the world to assess traumatic fracture kyphosis and vertebral body height loss (VBHL).

Methods: An online survey was conducted at two time points among an international community of spine trauma experts from all world regions. The first survey (TL-survey) focused on the thoracic, thoracolumbar and lumbar spine, the second survey (C-survey) on the subaxial cervical spine.

Universal disease-specific outcome instruments for spine trauma: a global perspective on relevant parameters to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients.

Purpose: Besides a patient reported outcome measure, the AOSpine Knowledge Forum Trauma aims to develop a new concept of a surgeon reported outcome measure (SROM) for spine trauma patients. This study aims to identify parameters that spine surgeons consider relevant to evaluate clinical and functional outcomes of thoracic and lumbar spine trauma patients.

Methods: An international cross-sectional web-based survey was conducted among spine surgeons from the five AOSpine International world regions.