Finite Element Analysis Comparing the Biomechanical Parameters in Multilevel Posterior Cervical Instrumentation Model Involving Lateral Mass Screw versus Transpedicular Screw Fixation at the C7 Vertebra.

Study Design: Basic research.

Purpose: This finite element (FE) analysis (FEA) aimed to compare the biomechanical parameters in multilevel posterior cervical fixation with the C7 vertebra instrumented by two techniques: lateral mass screw (LMS) vs. transpedicular screw (TPS).

"Insert flipping technique:" An effective way of restoring segmental lordosis and disc height with tall bullet cages.

Study Design: The study design was a retrospective study.

Objective: The objectives of the present study are dual; to describe a simple and effective way of restoring intervertebral disc (IVD) height by the "Insert Flip Technique" of cage insertion and to demonstrate effective restoration of IVD height and segmental lordosis (SL) and their influence on the functional outcome postoperatively.

Methods: IVD height and SL were recorded pre- and postoperatively.

Multimodal Applications of 3D-Navigation in Single-Level Minimally Invasive Transforaminal Lumbar Interbody Fusion: Impacts on Precision, Accuracy, Complications, and Radiation Exposure.

Background: Three-dimensional (3D)-navigation in minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) is an evolving procedure. It is used not only for its accuracy of pedicle screw fixation but also for other major steps in transforaminal lumbar interbody fusion. Multimodal outcomes of this procedure are very limited in the literature.

Cervical facet joint effusion: A sign of instability in cervical degenerative spondylolisthesis.

Aims: The aim of this study was to trace the association between cervical facet joint effusion and cervical degenerative spondylolisthesis (CDS). CDS has not received as much attention as its lumbar counterpart. Identification of features of instability on magnetic resonance imaging (MRI) is crucial to avoid missing presence of CDS.

Comparison of Applied Anatomy at L4-L5 and L5-S1 in Context of Tubular Decompression for Lumbar Canal Stenosis.

Background: Tubular over-the-top decompression is getting popular in the management of lumbar canal stenosis (LCS). While L4-L5 is the most common level affected and operated for LCS, it is not uncommon to encounter patients with stenosis at L5-S1. No previous study has described the technical challenges of tubular decompression at the L5-S1 level as compared to at the L4-L5 level.

Baroreflex Failure After Anterior Cervical Discectomy and Fusion: A Case Report.

Case: A 58-year-old man underwent anterior cervical discectomy and fusion (ACDF) for the treatment of cervical spondylotic myelopathy. Immediately after surgery, the patient experienced elevated blood pressure with a fall in oxygen saturation which prevented extubation. He required admission to the critical care unit and was diagnosed with baroreflex failure syndrome (BFS).

Quiescent Andersson Lesion Simplifies Deformity Correction: A Case Report.

Case: We present a case of ankylosing spondylitis with sagittal imbalance and having a suspicious Andersson lesion (AL) on magnetic resonance imaging (MRI) at D12-L1. The segment did not reveal any potential mobility on erect radiographs and supine MRI. L2 pedicle subtraction osteotomy was planned.

A 2-Year Outcomes and Complications of Various Techniques of Lumbar Discectomy: A Multicentric Retrospective Study.

Objectives: Various techniques of performing lumbar discectomy are prevalent, each having its rationale and claimed benefits. The authors ventured to assess the perioperative factors, outcomes, and complications of each procedure and compare among them with 946 patients contributed by 10 centers and operated by experienced surgeons.

Methods: This was a retrospective study of patients operated using open discectomy, microdiscectomy, microendoscopic discectomy, interlaminar endoscopic lumbar discectomy, transforaminal endoscopic lumbar discectomy, and Destandau techniques with a follow-up of minimum 2 years.

Should Q-CT Be the Gold Standard for Detecting Spinal Osteoporosis?

Study Design: Prospective comparative study.

Objective: Refinement of the guidelines for screening of osteoporosis and considering quantitative computed tomography (Q-CT) for detecting spinal osteoporosis.

Summary Of Background Data: Spinal osteoporosis is often underestimated and under-evaluated due to either lack of availability of the diagnostic modality or lack of awareness about the possibility of overestimation by dual X-ray absorptiometry (DXA) scan.

The Practice of Continuation of Anti-platelet Therapy During the Perioperative Period in Lumbar Minimally Invasive Spine Surgery (MISS): How Different Is the Morbidity in This Scenario?

Study Design: Cohort.

Objective: To evaluate perioperative morbidity in patients undergoing minimally invasive spine surgery of the lumbar spine while continuing the antiplatelet drug (APD) perioperatively as compared with those not continuing these drugs and those not on these drugs.

Summary Of Background Data: While discontinuation of antiplatelet drugs carries with it the risk of thrombosis of the cardiac stents, myocardial infarction, peripheral vascular occlusion, cerebro-vascular events and other thrombotic complications, continuation of these drugs has the risk of intra spinal bleeding and the serious consequences of subsequent epidural hematoma with associated spinal cord compression.

Degenerative Spondylolisthesis: When to Fuse and When Not to? A New Scoring System.

Study Design: A prospective cohort.

Objective: The objective of this study was to develop a scoring system for lumbar degenerative spondylolisthesis (LDS) that would guide decision-making.

Background: The management protocol for LDS has been under debate, with no guidelines.

Nasogastric tube in anterior cervical spine surgery, is it necessary?

Background: The aim of this article was to verify the utility of nasogastric (NG) tube in primary anterior cervical surgeries. Palpating and identifying the NG tube introduced during induction is one of the ways of preventing esophageal injuries during surgery. It may also be used as a conduit for postoperative feeding.

Feasibility and Outcomes of Tubular Decompression in Extreme Stenosis.

Study Design: Retrospective cohort study.

Objectives: To report the feasibility, nuances, technical tips as well as outcomes of managing single-level grade D (extreme stenosis) and to compare the outcomes with nonextreme stenosis using the tubular retractor system.

Summary Of Background Data: Minimally invasive decompression in extreme stenosis is a challenge due to technical difficulty, feasibility of adequate decompression, and a steep learning curve.

Are There Differences Between Patients with Extreme Stenosis and Non-extreme Stenosis in Terms of Pain, Function or Complications After Spinal Decompression Using a Tubular Retractor System?

Background: Micro-tubular decompression in extreme lumbar spinal stenosis is challenging because it is technically difficult to achieve adequate decompression. Whether the results of micro-tubular decompression related to pain, function, and complications in lumbar spinal stenosis of the extreme and non-extreme varieties are different has not yet been conclusively established.

Questions/purposes: Are there differences between patients with extreme stenosis and non-extreme stenosis in terms of (1) VAS back or leg pain, (2) Oswestry Disability Index (ODI), or (3) complications when they were treated with spinal decompression using a tubular retractor system?

Methods: Between January 2007 and January 2017, one surgeon performed 325 single-level lumbar micro-tubular decompressions without fusion.

Minimally Invasive Transforaminal Lumbar Interbody Fusion: An Attractive Option for Select Failed Backs.

Study Design: Retrospective case series.

Purpose: To compare minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) outcomes in primary and revision surgeries.

Overview Of Literature: Revision spinal fusion is often associated with an increased risk of approach-related complications.

Stand-alone Lateral Recess Decompression Without Discectomy in Patients Presenting With Claudicant Radicular Pain and MRI Evidence of Lumbar Disc Herniation: A Prospective Study.

Study Design: A prospective study.

Objective: The aim of this study was to analyze the outcomes of stand-alone lateral recess decompression without discectomy in patients with claudicant radicular pain and magnetic resonance imaging (MRI) showing LRS (lateral recess stenosis) with lumbar disc herniation.

Summary Of Background Data: Discectomy is the gold standard treatment for symptomatic lumbar disc herniations refractory to conservative care.

Minimal invasive transforaminal lumbar interbody fusion versus open transforaminal lumbar interbody fusion.

Background: The aim of the present prospective study is to evaluate whether the touted advantages of minimal invasive-transforaminal lumbar interbody fusion (MI-TLIF) translate into superior, equal, or inferior outcomes as compared to open-transforaminal lumbar interbody fusion (O-TLIF). This is the first study from the Indian subcontinent prospectively comparing the outcomes of MI-TLIF and O-TLIF.

Materials And Methods: All consecutive cases of open and MI-TLIF were prospectively followed up.

Cervical Footprint Anthropometry in Indian Population: Implications on Design of Artificial Disc Replacement Devices.

Study Design: Cross-sectional study.

Purpose: To accurately measure the dimensions of cervical endplates based on computed tomography (CT) scans in Indian population and assess accuracy of match with currently available cervical disc prostheses.

Overview Of Literature: The dimensions of currently available cervical disc replacement implants are based on early published geometrical measurements of vertebrae endplates for Caucasian population.

Posterior Cervicothoracic Instrumentation: Testing the Clinical Efficacy of Tapered Rods (Dual-Diameter Rods).

Study Design: Prospective study.

Objective: To study the clinical efficacy of tapered rods in posterior cervicothoracic instrumentation.

Summary Of Background Data: The cervicothoracic spine is a junctional area with complex biomechanics.

Microendoscopic excision of C2 osteoid osteoma: a technical report.

Study Design: Case report and description of technique.

Objective: To describe a microendoscopic posterior approach for excision of an osteoid osteoma of C2.

Summary Of Background Data: Microendoscopic techniques are widely used in the management of degenerative disorders of the spine.