Representative dynamic ranges of spinal alignment during gait in patients with mild and severe adult spinal deformities.

Background Context: Surgical correction strategies for adult spinal deformity (ASD) relies heavily on radiographic alignment goals, however, there is often debate regarding degree of correction and how static alignment translates to physical ability in daily life. Kinematic analysis has the potential to improve the concept of ideal spinal alignment by providing clinically meaningful estimates of dynamic changes in spinal alignment during activities of daily life.

Purpose: Estimate representative dynamic ranges of spinal alignment during gait among ASD patients using 3D motion tracking; compare dynamic alignment between mild and severe deformity patients and to healthy adults.

Robotic-Assisted Pedicle Screw Placement During Spine Surgery.

Unlabelled: Preoperative planning software and a robotic device facilitate the placement of pedicle screws, especially in patients with difficult anatomy, thereby increasing the feasibility, accuracy, and efficiency of the procedure. The robot functions as a semiactive surgical assistive device whose goal is not to substitute but to offer the surgeon a set of versatile tools that can broaden his or her ability to treat patients.

Description: The robotic guidance system consists of a bed-mounted surgical arm and a workstation.

The Effect of Surgical Decompression and Fusion on Functional Balance in Patients With Degenerative Lumbar Spondylolisthesis.

Study Design: Prospective cohort study.

Objective: To quantify the effect of lumbar decompression and fusion surgery on balance and stability in patients with degenerative lumbar spondylolisthesis (DLS) and compare them to controls.

Summary Of Background Data: DLS is a condition in which one vertebra subluxates relative to an adjacent vertebra in the absence of a disruption in the neural arch.

Clinical Outcomes of Idiopathic Scoliosis Surgery: Is There a Difference Between Young Adult Patients and Adolescent Patients?

Background Surgical outcomes of adolescent idiopathic scoliosis (AIS) patients have been well studied. However, few studies have examined the surgical outcomes of young adult idiopathic scoliosis (YAdIS) patients. This study analyzed and compared the surgical outcomes of young adult (19-30 years) and adolescent (10-18 years) idiopathic scoliosis patients.

Surgical Strategies for the Treatment of Lumbar Pseudarthrosis in Degenerative Spine Surgery: A Literature Review and Case Study.

Background: Pseudarthrosis after lumbar fusion can generate pain and disability and often requires revision. However, results of revision procedures have historically been relatively poor.

Questions/purpose: The aim of this review was to examine the current evidence related to the management of lumbar pseudarthrosis, with a focus on revision after failure of posterolateral fusion or lumbar interbody fusion.

Are Clinicians Contributing to Excess African American COVID-19 Deaths? Unbeknownst to Them, They May Be.

African Americans are overrepresented among reported coronavirus disease 2019 (COVID-19) cases and deaths. There are a multitude of factors that may explain the African American disparity in COVID-19 outcomes, including higher rates of comorbidities. While individual-level factors predictably contribute to disparate COVID-19 outcomes, systematic and structural factors have not yet been reported.

Cervical Decompression Surgery Normalizes Gait Ground Reaction Forces in Patients With Cervical Spondylotic Myelopathy.

Study Design: Prospective cohort study.

Objective: Investigate the effect of surgical decompression and fusion on gait ground reaction forces (GRFs) parameters in patients with cervical spondylotic myelopathy (CSM) and to compare these values to those of healthy controls.

Summary Of Background Data: Surgical intervention to alleviate spinal cord compression is typically recommended in cases of CSM.

What is actually happening inside the "cone of economy": compensatory mechanisms during a dynamic balance test.

Study Design: A nonrandomized, prospective, concurrent control cohort study.

Objective: To further develop cone of economy (CoE) measurements by identifying compensatory mechanisms at the extremes of the CoE and comparing balance control strategies in a group of adult degenerative scoliosis (ADS) patients with non-scoliotic controls. The CoE concept was first proposed by Dubousset and is frequently referred to when assessing balance in spinal deformity patients.

Analysis of re-operations after cervical total disc replacement in a consecutive series of 535 patients receiving the ProDisc-C device.

Introduction: One important factor in evaluating the safety of an implant is the rate of subsequent surgery and the reasons for surgery, particularly those that are related to possible problems with the implant. The purpose of this study was to determine the overall re-operation rate (including revisions, removals, device-related, procedure-related, adjacent segment, and others) for a large consecutive series of cervical TDR patients beginning with the first case experience, using a single device at a single institution.

Methods: Surgery records were reviewed to identify cervical TDR patients and those who underwent subsequent surgery.

Biomechanics of prophylactic tethering for proximal junctional kyphosis: effects of cyclic loading on tether strength and failure properties.

Study Design: Biomechanical evaluation of woven polyester tethers.

Objectives: To quantify changes in tether elongation, stiffness, and failure characteristics after cyclic loading. Ligamentous augmentation is gaining interest as a technique to prevent proximal junctional kyphosis (PJK) in adult spinal fusions.

Kinematic comparison of the use of walking sticks versus a rolling walker during gait in adult degenerative scoliosis patients.

Study Design: A repeated-measurement, single-center, prospective study.

Objective: To compare the spatiotemporal and kinematic data using gait analysis in adult degenerative scoliosis (ADS) patients using walking sticks (WS) versus rolling walkers (RW). ADS patients undergo compensatory changes that can result in an altered gait pattern.

Does improved radiographic alignment truly enhance dynamic functional balance?

Study Design: Prospective concurrent cohort study.

Objective: To establish the relationship between radiographic alignment parameters and functional CoE measurements at 1 week before and at 3 months after realignment surgery in ADS patients. Adult degenerative scoliosis (ADS) represents a significant healthcare burden with exceedingly high and increasing prevalence, particularly among the elderly.

Screw-Related Complications After Instrumentation of the Osteoporotic Spine: A Systematic Literature Review With Meta-Analysis.

Study Design: Systematic literature review with meta-analysis.

Objective: Osteoporosis is common in elderly patients, who frequently suffer from spinal fractures or degenerative diseases and often require surgical treatment with spinal instrumentation. Diminished bone quality impairs primary screw purchase, which may lead to loosening and its sequelae, in the worst case, revision surgery.

The Correlation of Spinopelvic Parameters With Biomechanical Parameters Measured by Gait and Balance Analyses in Patients With Adult Degenerative Scoliosis.

Study Design: A prospective cohort study.

Objective: The objective of this study was to establish the correlation between radiographic spinopelvic parameters with objective biomechanical measures of function in patients with adult degenerative scoliosis (ADS).

Summary Of Background Data: Gait and balance analyses can provide an objective measure of function.

Sagittal Spinal and Pelvic Parameters in Patients With Scheuermann's Disease: A Preliminary Study.

Background: Sagittal spinopelvic parameters remain poorly defined in patients with Scheuermann disease (SD). For example, although pelvic incidence (PI) should approximate lumbar lordosis (LL) by 10°, this is not true in patients with SD. This retrospective radiographic study was conducted to propose a new mathematical relationship between sagittal spinopelvic parameters in skeletally mature patients with SD.

A New High-Speed Shielded Curved Device Allowing Safe Posterior Thoracic Discectomy Through a Modified Transforaminal Thoracic Interbody Fusion Approach: Technique Description and Case Series.

Background: The appropriate approach for surgical removal of thoracic disc herniations is controversial. The posterior approach historically acquired a bad reputation due to high rates of neurologic deterioration subsequent to spinal cord manipulation. The anterior approach has consequently gained popularity but entails a larger magnitude of surgery if open and is technically demanding if approached thoracoscopically.

In which cases do surgeons specializing in total disc replacement perform fusion in patients with cervical spine symptoms?

Purpose: The purpose was to investigate reasons and their frequency for why total disc replacement (TDR) specialty surgeons performed anterior cervical discectomy and fusion (ACDF) rather than TDR.

Methods: A consecutive series of 464 patients undergoing cervical spine surgery during a 5-year period by three TDR specialty surgeons was reviewed. For each ACDF, the reason for not performing TDR was recorded.

The Gait Deviation Index as an indicator of gait abnormality among degenerative spinal pathologies.

Introduction: The Gait Deviation Index (GDI) is a composite measure of gait abnormality derived from lower-limb joint range-of-motion which is increasingly being reported for clinical gait analysis among neurologic and orthopedic patients. A GDI score of 100 is representative of healthy individuals and decreasing scores represent a greater abnormality. Preliminary data is needed to help assess the utility of GDI as a measure of compromised gait among spine patients and to provide reference values for commonly treated pathologies.

Postoperative Care Pathways Following Lumbar Total Disc Replacement: Results of a Modified Delphi Approach.

Study Design: A modified Delphi method was used to establish consensus. Subject matter experts were invited to participate as the expert panel. Best practice statements were distributed to the panel.

Cost and Clinical Outcome of Adolescent Idiopathic Scoliosis Surgeries-Experience From a Nonprofit Community Hospital.

Background: Recognition of the variables that drive the cost of adolescent idiopathic scoliosis (AIS) surgeries will help physicians and hospitals to initiate cost-effective measures. The purpose of this study is to analyze the hospital costs and clinical outcome for AIS surgeries.

Methods: A total of 6417 individual hospital costs and charges for 42 consecutive AIS surgeries were reviewed.

Opioid Consumption Patterns After Lumbar Microdiscectomy or Decompression.

Study Design: Prospective observational study OBJECTIVE.: The aim of this study was to record daily opioid use and pain levels after 1-level lumbar decompression or microdiscectomy.

Summary Of Background Data: The standardization of opioid-prescribing practices through guidelines can decrease the risk of misuse and lower the number of pills available for diversion in this high-risk patient population.

Giant cell tumor of the thoracic spine in a 30-year-old woman.

Giant cell tumor (GCT) of the spine is a rare, benign tumor. Patients typically present with pain and also may experience neurologic deficits from spinal cord and/or nerve root compression. This article describes a patient who presented with acute mid-back pain, was diagnosed with spinal GCT through biopsy, and was treated successfully with surgical resection and instrumentation.

Complication avoidance and management in ambulatory spine surgery.

The positive safety profile and potential cost savings associated with ambulatory spine surgery have resulted in an increasing number of spine procedures being performed on an outpatient basis. As indications become more inclusive and the variety and volume of ambulatory procedures grow, the incidence of complications may rise. Limiting adverse events in the outpatient setting starts with patient selection.