Cervical Disc Arthroplasty for the Treatment of Adjacent Segment Disease After Anterior Cervical Discectomy and Fusion.

Study Design: A retrospective chart review was conducted at a single institution.

Objective: The purpose of this study was to investigate the clinical outcomes of cervical disc arthroplasty (CDA) used for the treatment of symptomatic adjacent segment disease (ASD) developed after anterior cervical discectomy and fusion (ACDF).

Background: A major clinical concern following ACDF is the development of ASD.

Editorial Commentary: The Free Floating Disc Shaped Polycarbonate-Urethane Meniscal Implant Has High Reoperation Rates at 24 Months Follow-up.

A free-floating disc shaped polycarbonate-urethane ultra-high molecular weight polyethylene fiber reinforced medial compartment implant is designed for symptomatic postmedial meniscectomy syndrome. Because it is not sutured into place, an intact 2mm meniscus rim with intact anterior and posterior meniscal horns are required. In a recent 24-month follow-up study, only 64% of the original implants were retained.

Scoping review of robotics technology in spinal surgery with highlights of the Annual Seattle Science Foundation Course.

Background: Robotic assistance has become increasingly prevalent in spinal surgery in recent years, emerging as a tool to increase accuracy and precision and lower complication rates and radiation exposure. The 7 and 8 Annual Seattle Science Foundation (SSF) Robotics Courses showcased presentations and demonstrations from some of the field's most experiences leaders on latest topics in robotics and spinal surgery, including cutting-edge preoperative planning technologies, augmented reality (AR) in the operating room, cervical fusion with transpedicular screws, and neuro-oncologic management. We provide a scoping review of the use of robotics technology in spinal surgery featuring highlights from the 7 and 8 Annual SSF Robotics Courses.

Trochleoplasty Utilization in the Management of Patellofemoral Instability: Results From an International Survey of Surgeons.

Background: Considerable variability exists in the described clinical and radiographic indications for use, surgical techniques, postoperative management, and risk profile after trochleoplasty for the management of patellofemoral instability (PFI). In areas of clinical uncertainty, a cohesive summary of expert opinion and identification of areas of variation in current practice can be useful in guiding current practice and future research efforts.

Purpose: To assess the current indications for use, surgical techniques, postoperative rehabilitation practices, and observed complication profile for trochleoplasty in the management of PFI among surgeons who perform this procedure.

Comparison of clinical and radiological outcomes of three-column lumbar osteotomies with and without interbody cages for adult spinal deformity.

Background Context: Correcting sagittal malalignment in adult spinal deformity (ASD) is a challenging task, often requiring complex surgical interventions like pedicle subtraction osteotomies (PSOs). Different types of three-column osteotomies (3COs), including Schwab 3, Schwab 4, Schwab 4 with interbody cages, and the "sandwich" technique, aim to optimize alignment and fusion outcomes. The role of interbody cages in enhancing fusion and segmental correction remains unclear.

The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery.

Objective: Malalignment following cervical spine deformity (CSD) surgery can negatively impact outcomes and increase complications. Despite the growing ability to plan alignment, it remains unclear whether preoperative goals are achieved with surgery. The objective of this study was to assess how good surgeons are at achieving their preoperative goal alignment following CSD surgery.

Examining the Recovery Course of Adolescent Concussion Patients With Protracted Recovery Referred to a Specialty Concussion Clinic.

Objective: This study investigated the role of specialty concussion care on the clinical course of recovery in adolescent patients who initiated care beyond 3 weeks from their injury.

Design: Retrospective analysis of protracted recovery groups was based on the number of days in which a patient presented for care postinjury: early (22-35 days), middle (36-49 days), and late (50+ days).

Setting: Sports medicine and orthopedics clinic.

Factors that Influence Recovery From Concussion in Young Children and Preadolescents.

Objective: To examine differences in the presentation and management of concussion in younger children (aged 4-8 years) versus preadolescents (9-12 years) and identify factors that influence recovery time.

Design: Retrospective analysis of prospectively collected data.

Setting: Pediatric sports medicine and orthopedics clinic.

Redefining Clinically Significant Blood Loss in Complex Adult Spine Deformity Surgery.

Study Design: Retrospective analysis of prospectively-collected data.

Objective: This study aims to define clinically relevant blood loss in adult spinal deformity (ASD) surgery.

Background: Current definitions of excessive blood loss following spine surgery are highly variable and may be suboptimal in predicting adverse events (AE).

Challenges and Research Opportunities for Integrating Quantitative Electroencephalography Into Sports Concussion Rehabilitation.

Although concussion management and return to play/learn decision making focuses on reducing symptoms, there is growing interest in objective physiological approaches to treatment. Clinical and technological advancements have aided concussion management; however, the scientific study of the neurophysiology of concussion has not translated into its standard of care. This expert commentary is motivated by novel clinical applications of electroencephalographic-based neurofeedback approaches (eg, quantitative electroencephalography [QEEG]) for treating traumatic brain injury and emerging research interest in its translation for treating concussion.

Which Osteochondritis Dissecans Lesions Will Heal Nonoperatively? An Application of Machine Learning to the ROCK Prospective Cohort.

Background: There are limited evidence-based guidelines to predict which osteochondritis dissecans (OCD) lesions will heal with nonoperative treatment.

Purpose: To train a set of classification algorithms to predict nonoperative OCD healing while identifying new clinically meaningful predictors.

Study Design: Case-control study; Level of evidence, 3.

Comparison of Pain and Functional Outcomes Among Geriatric and Nongeriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology.

Background: Full endoscopic spine surgery (FESS) champions a rapid recovery and a low rate of overall complications. However, its efficacy in geriatric patients that might yield additional benefits from minimized invasiveness remains underexplored.

Methods: A multi-institutional prospective cohort study was conducted involving patients undergoing elective lumbar FESS.

Full-endoscopic spinal decompression or discectomy show benefits regarding 30-day readmission rates when compared to other spine surgery techniques: a propensity score matched analysis.

Background And Context: Unplanned readmission within 30 days following elective spine surgery is a key indicator of quality of care, as readmissions often signal early complications or poor recovery. The Hospital Readmission Reduction Program (HRRP) and the Centers for Medicare and Medicaid Services (CMS) utilizes this metric to assess hospital and surgeon performance.

Purpose: Here we aim to delineate quality of care metrics for full-endoscopic spine surgery (FESS) compared to traditional spine surgery.

Post-concussion changes in the N200 and P300 ERPs are associated with cognitive symptoms and performance.

Purpose: To examine how post-concussion changes to the N200 and P300 event-related potentials (ERPs) are associated with cognitive symptoms and neurocognitive performance.

Methods: High-density electroencephalography (EEG) was recorded during a Go/No-Go task from 16 young adults within one month after their concussion and 16 matched controls. Participants were also administered the Cognitive-Linguistic Quick Test (CLQT) and self-reported concussion-like symptoms.

Attitudes regarding barriers to entry and the learning curve associated with endoscopic decompression-only surgery: an international survey.

Background Context: Endoscopic spine decompression surgery (ESDS) offers numerous benefits, including reduced tissue damage, smaller incisions, shorter recovery times, and a lower risk of complications. However, its adoption among spine surgeons in the United States has been slow. The reluctance to adopt ESDS can be attributed to factors such as the learning curve, cost of equipment and training, and limited access to necessary resources.

A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee.

Background: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility.

Purpose: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings.

Nonunion and Calcaneocuboid Subluxation Are Minimal After Evans Osteotomy Without Fixation.

Background: Fixation of the Evans osteotomy for flatfoot correction has been advocated without supporting data to facilitate union and avoid calcaneocuboid subluxation. We examined these issues in the largest reported series of Evans procedures to date.

Methods: A total of 118 cases from a consecutive series of 137 patients who underwent Evans osteotomy without fixation by a single surgeon were available for review.

Impact of Knee Osteoarthritis and Arthroplasty on Full Body Sagittal Alignment in Adult Spinal Deformity Patients.

Study Design: Retrospective analysis of prospectively collected data.

Objective: This study evaluates the impact of knee osteoarthritis (OA) and knee arthroplasty on alignments and patient-reported outcomes measures (PROMS) of patients undergoing adult spinal deformity (ASD) corrective surgery.

Background: The relationship between knee OA and spinal alignment in patients with ASD is incompletely understood.

Pedicle screw placement in the cervical vertebrae using augmented reality-head mounted displays: a cadaveric proof-of-concept study.

Background: The accurate and safe positioning of cervical pedicle screws is crucial. While augmented reality (AR) use in spine surgery has previously demonstrated clinical utility in the thoracolumbar spine, its technical feasibility in the cervical spine remains less explored.

Purpose: The objective of this study was to assess the precision and safety of AR-assisted pedicle screw placement in the cervical spine.

Impact of Prior Cervical Fusion on Patients Undergoing Thoracolumbar Deformity Correction.

Study Design: Retrospective analysis of prospectively collected data.

Objective: Evaluate the impact of prior cervical constructs on upper instrumented vertebrae (UIV) selection and postoperative outcomes among patients undergoing thoracolumbar deformity correction.

Background: Surgical planning for adult spinal deformity (ASD) patients involves consideration of spinal alignment and existing fusion constructs.

Thoracolumbar fusions for adult lumbar deformity show superior QALY gain and lower costs compared with upper thoracic fusions.

Purpose: Adult spinal deformity (ASD) patients with sagittal plane deformity (N) or structural lumbar/thoraco-lumbar (TL) curves can be treated with fusions stopping at the TL junction or extending to the upper thoracic (UT) spine. This study evaluates the impact on cost/cumulative quality-adjusted life year (QALY) in patients treated with TL vs UT fusion.

Methods: ASD patients with > 4-level fusion and 2-year follow-up were included.

90-Day Emergency Department Utilization and Readmission Rate After Full-Endoscopic Spine Surgery: A Multicenter, Retrospective Analysis of 821 Patients.

Background And Objectives: Emergency department (ED) utilization and readmission rates after spine surgery are common quality of care measures. Limited data exist on the evaluation of quality indicators after full-endoscopic spine surgery (FESS). The objective of this study was to detect rates, causes, and risk factors for unplanned postoperative clinic utilization after FESS.