Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study.

Purpose: To evaluate the safety and efficacy of radiofrequency (RF) ablation of the basivertebral nerve (BVN) for the treatment of chronic low back pain (CLBP) in a Food and Drug Administration approved Investigational Device Exemption trial. The BVN has been shown to innervate endplate nociceptors which are thought to be a source of CLBP.

Methods: A total of 225 patients diagnosed with CLBP were randomized to either a sham (78 patients) or treatment (147 patients) intervention.

The Timing of Surgery Affects Return to Work Rates in Patients With Degenerative Lumbar Stenosis in a Workers' Compensation Setting.

Study Design: Retrospective Cohort Study.

Objective: The objective of this study is to determine how time to surgery affects outcomes for degenerative lumbar stenosis (DLS) in a workers' compensation (WC) setting.

Summary Of Background Data: WC subjects are known to be a clinically distinct population with variable outcomes following lumbar surgery.

Preoperative Opioid Use is a Predictor of Poor Return to Work in Workers' Compensation Patients After Lumbar Diskectomy.

Study Design: A retrospective cohort.

Objective: The aim of this study was to determine the impact of preoperative opioid use in workers' compensation (WC) patients undergoing lumbar diskectomy (LD).

Summary Of Background Data: The prevalence of back pain among opioid users approached 60%.

Treatment of Recurrent Lumbar Disc Herniation With or Without Fusion in Workers' Compensation Subjects.

Study Design: Retrospective cohort study.

Objective: To determine outcomes after reoperation discectomy with or without fusion surgery for recurrent lumbar disc herniation (RLDH) in the workers' compensation (WC) population.

Summary Of Background Data: RLDH is estimated to occur in 7% to 24% of patients after discectomy.

Preoperative Opioid Use: A Risk Factor for Poor Return to Work Status After Single-level Cervical Fusion for Radiculopathy in a Workers' Compensation Setting.

Study Design: Retrospective comparative case-control study.

Objectives: The objectives of this study are: (1) How preoperative opioid use impacts RTW status after single-level cervical fusion for radiculopathy? and (2) What are other postsurgical outcomes affected by preoperative opioid use?

Summary Of Background Data: Opioid use has increased significantly in the past decade. The use of opioids has a drastic impact on workers' compensation population, an at-risk cohort for poorer surgical and functional outcomes than the general population.

Surgical and Functional Outcomes After Multilevel Cervical Fusion for Degenerative Disc Disease Compared With Fusion for Radiculopathy: A Study of Workers' Compensation Population.

Study Design: Retrospective cohort comparative study.

Objective: To evaluate presurgical and surgical factors that affect return to work (RTW) status after multilevel cervical fusion, and to compare outcomes after multilevel cervical fusion for degenerative disc disease (DDD) versus radiculopathy.

Summary Of Background Data: Cervical fusion provides more than 90% of symptomatic relief for radiculopathy and myelopathy.

Glioblastoma spheroids produce infiltrative gliomas in the rat brainstem.

Purpose: Diffuse intrinsic pontine glioma (DIPG) is universally fatal without proven therapy other than radiation therapy for palliation. Representative animal models will play an essential role in the preclinical stage of future therapy development. To address the shortage of representative models, we created a novel infiltrative brainstem glioma model in rats based on glioblastoma spheroids.

Prolonged Preoperative Opioid Therapy in Patients With Degenerative Lumbar Stenosis in a Workers' Compensation Setting.

Study Design: Retrospective cohort study.

Objective: To investigate the impact of prolonged opioid use in the preoperative treatment plan of degenerative lumbar stenosis (DLS).

Summary Of Background Data: Patients undergoing operative treatment for DLS with concomitant opioid use represent a clinically challenging population.

Vertebroplasty and Return to Work for Thoracolumbar Fractures Within the Workers' Compensation Population.

Study Design: Retrospective cohort study.

Objective: Analyze efficacy of vertebroplasty and its affect on return to work (RTW) in a workers' compensation (WC) population SUMMARY OF BACKGROUND DATA.: Vertebroplasty remains a controversial treatment modality for vertebral compression fractures (VCFs).

Does Tobacco Use Attenuate Benefits of Early Decompression in Patients With Cervical Myelopathy?

Study Design: A retrospective cohort.

Objective: This study investigates the interplay between duration of preoperative symptoms and smoking status with respect to postoperative outcomes in patients with cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Many studies have established the harms of smoking and several have identified the benefits of early decompression in patients with cervical myelopathy, but to our knowledge, none have assessed the relationship between these two variables.

Intervertebral Micro Access Surgery for Transforaminal Lumbar Interbody Fusion.

Background: Minimally invasive spine surgery (MIS) has undergone tremendous progress in the past 2 decades. The intervertebral micro access surgery (iMAS) technique represents a hybrid of both open and minimally invasive techniques.

Objective: To describe the surgical technique and operative nuances of the iMAS technique.

Return to Work Rates After Single-level Cervical Fusion for Degenerative Disc Disease Compared With Fusion for Radiculopathy in a Workers' Compensation Setting.

Study Design: A retrospective comparative cohort study.

Objective: To compare return to work (RTW) rates for patients who underwent single-level cervical fusion for radiculopathy compared with fusion for degenerative disc disease (DDD) as an indication for surgery.

Summary Of Background Data: Studies have shown that workers' compensation subjects have less favorable surgical and functional outcomes compared with the general population.

Prolonged Preoperative Opioid Therapy Associated With Poor Return to Work Rates After Single-Level Cervical Fusion for Radiculopathy for Patients Receiving Workers' Compensation Benefits.

Study Design: Retrospective comparative cohort study.

Objective: Examine the effect of prolonged preoperative opioid use on return to work (RTW) status after single-level cervical fusion for radiculopathy.

Summary Of Background Data: The use of opioids has a dramatic effect in a workers' compensation population.

Return to Work and Multilevel Versus Single-Level Cervical Fusion for Radiculopathy in a Workers' Compensation Setting.

Study Design: Retrospective comparative cohort study.

Objective: Examine the impact of multilevel fusion on return to work (RTW) status and compare RTW status after multi- versus single-level cervical fusion for patients with work-related injury.

Summary Of Background Data: Patients with work-related injuries in the workers' compensation systems have less favorable surgical outcomes.

The Influence of Diabetes on Surgical Outcomes in Cervical Myelopathy.

Study Design: A retrospective cohort.

Objective: The objective of the study was to determine what effect, if any, diabetes has on surgical outcomes in patients with cervical spondylotic myelopathy (CSM).

Summary Of Background Data: Diabetes is known to impair healing and has been shown to affect outcomes in lumbar surgery, but few studies have assessed outcomes in cervical surgery, and cervical myelopathy in particular.

Smoking is Associated with Increased Blood Loss and Transfusion Use After Lumbar Spinal Surgery.

Background: Little is known about the association between smoking and intraoperative blood loss and perioperative transfusion use in patients undergoing spinal surgery. However, we found that although many of the common complications and deleterious effects of smoking on surgical patients had been well documented, the aspect of blood loss seemingly had been overlooked despite data reported in nonorthopaedic sources to suggest a possible connection.

Questions/purposes: We asked: (1) Is smoking associated with increased estimated blood loss during surgery in patients undergoing lumbar spine surgery? (2) Is smoking associated with increased perioperative transfusion usage?

Methods: Between 2005 and 2009, 581 lumbar decompression procedures (with or without fusion) were performed at one academic spine center.

The Effect of Smoking on Spinal Cord Healing Following Surgical Treatment of Cervical Myelopathy.

Study Design: Retrospective cohort.

Objective: The purpose of this study was to compare outcomes of surgical treatment of cervical myelopathy between smokers and nonsmokers as assessed by the Nurick score.

Summary Of Background Data: The harmful effects of smoking on healing have been well established.

Bilateral Pars Defects at the L4 Vertebra Result in Increased Degeneration When Compared With Those at L5: An Anatomic Study.

Background: Cadaveric studies have examined disc degeneration at the L4-L5 and L5-S1 motion segments; however, we are not aware of another study that has examined the relationship between bilateral spondylolysis and its effect on degenerative disc disease at those levels. This may have been overlooked by researchers owing to the majority of spondylolysis occurring at the L5 vertebra.

Questions/purposes: Using osteologic specimens from a collection that included individuals who died in one city in the USA between 1893 and 1938, we asked: (1) do specimens with bilateral spondylolysis (bilateral pars defects) have increased levels of disc degeneration, at their respective motion segments, when compared with matched controls without spondylolysis, and (2) is the finding of a bilateral pars defect associated with more severe arthritis at L4-L5 than at L5-S1?

Methods: An observational study was performed on 665 skeletal lumbar spines from the Hamann-Todd Osteologic Collection at the Cleveland Museum of Natural History (Cleveland, OH, USA).

Pedicle Morphometry of Lumbar Vertebrae: Male, Taller, and Heavier Specimens Have Bigger Pedicles.

Study Design: An anatomic study of pedicle dimensions was performed for lumbar vertebrae from American subjects.

Objective: To quantify the dimensions of the lumbar pedicles and to better define the demographic factors that could ultimately govern the caliber selection of pedicle screws.

Summary Of Background Data: Transpedicular screw fixation allows for segmental instrumentation into multiple vertebrae across multilevel fusion area, offering considerable biomechanical advantage over the conventional hook and lateral mass fixation.

Chronic Opioid Therapy After Lumbar Fusion Surgery for Degenerative Disc Disease in a Workers' Compensation Setting.

Study Design: Retrospective cohort study.

Objective: To evaluate prescription opioid use after lumbar fusion for degenerative disc disease in a workers' compensation (WC) setting.

Summary Of Background Data: Use of opioids for treating chronic low back pain has increased greatly.

Clinical depression is a strong predictor of poor lumbar fusion outcomes among workers' compensation subjects.

Study Design: Retrospective cohort study.

Objective: Determine how psychosocial factors, particularly depression, impact lumbar fusion outcomes in a workers' compensation (WC) setting.

Summary Of Background Data: WC patients are less likely to return to work (RTW) after fusion.

Lower thoracic pedicle morphometry: male, taller, and heavier specimens have bigger pedicles.

Study Design: An anatomic study of pedicle dimensions was performed for lower thoracic vertebrae from American human subjects.

Objective: To quantify the dimensions of the lower thoracic pedicles and to better define the demographic factors that could ultimately govern the caliber selection of pedicle screws.

Summary Of Background Data: Transpedicular screw fixation allows for segmental instrumentation into multiple vertebrae across multilevel fusion area, offering considerable biomechanical advantage over the conventional hook and lateral mass fixation.

Single-level lumbar fusion for degenerative disc disease is associated with worse outcomes compared with fusion for spondylolisthesis in a workers' compensation setting.

Study Design: Retrospective cohort study.

Objective: Compare lumbar fusion outcomes, return-to-work (RTW) status in particular, between workers' compensation (WC) subjects undergoing single-level posterolateral fusion for either spondylolisthesis or degenerative disc disease (DDD).

Summary Of Background Data: Lumbar fusion for spondylolisthesis tends to yield more consistent outcomes than fusion for DDD and discogenic low back pain.

Pedicle morphometry of upper thoracic vertebrae: an anatomic study of 503 cadaveric specimens.

Study Design: An anatomic study of pedicle dimensions was performed for upper thoracic vertebrae from American human subjects.

Objective: To quantify the dimensions of the upper thoracic pedicles and to better define the demographic factors that could ultimately govern the caliber selection of pedicle screws.

Summary Of Background Data: Transpedicular screw fixation allows for segmental instrumentation into multiple vertebrae across multilevel fusion area, offering considerable biomechanical advantage over the conventional hook and lateral mass fixation.