The Effect of Surgical Decompression on Functional Balance Testing in Patients With Cervical Spondylotic Myelopathy.

Study Design: A prospective cohort study.

Objective: Quantify the extent of change in dynamic balance and stability in a group of patients with cervical spondylotic myelopathy (CSM) after cervical decompression surgery and to compare them with matched healthy controls.

Summary Of Background Data: CSM is a naturally progressive degenerative condition that commonly results in loss of fine motor control in the hands and upper extremities and in gait imbalance.

Presurgical Psychological Evaluation: Risk Factor Identification and Mitigation.

Presurgical psychological evaluations (PPEs) are becoming an established component of the surgical process, though methods of conducting PPEs are variable. There is a lack of clarity about the goals of PPEs, the types of information that should be included, and the process for integrating information and making recommendations to the referring physicians/surgeons. This review proposes an empirically supported model for PPEs that is systematic, but flexible enough to be utilized across the broad range of surgical evaluations.

Kinematic assessment of an elastic-core cervical disc prosthesis in one and two-level constructs.

Introduction: Anterior cervical discectomy and fusion has been associated with the development of adjacent segment degeneration (ASD), with clinical incidence of approximately 3% per year. Cervical total disc arthroplasty (TDA) has been proposed as an alternative to prevent ASD.

Hypotheses: TDA in optimal placement using an elastic-core cervical disc (RHINE, K2M Inc.

Five-year Results of a Randomized Controlled Trial for Lumbar Artificial Discs in Single-level Degenerative Disc Disease.

Study Design: A prospective, multicenter, randomized, controlled, investigational device exemption (IDE) noninferiority trial.

Objective: The aim of this study was to compare the 5-year safety and effectiveness of the activL Artificial Disc with Control Total Disc Replacement (TDR) systems (ProDisc-L or Charité) in the treatment of patients with symptomatic single-level lumbar degenerative disc disease (DDD).

Summary Of Background Data: The activL Artificial Disc received Food and Drug Administration approval in 2015 based on 2-year follow-up data.

Complication avoidance in minimally invasive spinal surgery.

Minimally invasive techniques in spinal surgery allow surgeons to perform operations with less of the approach-related morbidity inherent to traditional open procedures. Yet these muscle-sparing procedures come with a unique set of risks that stem from the novel approaches, limited exposure, and/or a restricted working corridor that they employ. The literature suggests that these operations can be performed without an increased rate of complication once the associated learning curve has been surmounted, suggesting that knowledge of and experience with the nuances of these procedures are essential for patient safety.

The use of robotics in minimally invasive spine surgery.

The field of spine surgery has changed significantly over the past few decades as once technological fantasy has become reality. The advent of stereotaxis, intra-operative navigation, endoscopy, and percutaneous instrumentation have altered the landscape of spine surgery. The concept of minimally invasive spine (MIS) surgery has blossomed over the past ten years and now robot-assisted spine surgery is being championed by some as another potential paradigm altering technological advancement.

Characterizing gait abnormalities in patients with cervical spondylotic myelopathy: a neuromuscular analysis.

Background Context: Gait impairment is a hallmark of cervical spondylotic myelopathy (CSM). It has been shown to affect quality of life but has not been well defined. Further electromyographic (EMG) characterization of the gait cycle may help elucidate the true neuromuscular pathology with implications on prognosis and rehabilitation techniques.

Finite Element Based-Analysis for Pre and Post Lumbar Fusion of Adult Degenerative Scoliosis Patients.

Study Design: Pre-post cohort finite elements (FE).

Objectives: To investigate the effect of adjacent load transfer pre and post fusion surgery of lumbar scoliotic spines using FE models.

Summary Of Background Data: Adult degenerative scoliosis (ADS) results from age-related changes, leading to segmental instability, deformity, and stenosis.

Flexible and Conditional Administration of the Minnesota Multiphasic Personality Inventory-2-Restructured Form in Presurgical Psychological Evaluations of Spine Surgery Candidates.

The purpose of this study was to evaluate a flexible and conditional administration (FCA) for the MMPI-2-RF in archival samples of spine surgery and spinal cord simulator candidates presenting for presurgical psychological evaluations. The sample included 1,477 spine surgery candidates (709 male, 276 female) and 476 spinal cord stimulator candidates (178 male, 298 female). Using a simulation design, the results of this study indicated that an FCA of the MMPI-2-RF closely approximates the amount of information gained from a standard MMPI-2-RF administration.

A Comparison of Muscular Activity During Gait Between Walking Sticks and a Walker in Patients With Adult Degenerative Scoliosis.

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

Objective: The purpose of this study is to compare and contrast the benefits of walking sticks versus a walker on the trunk and lower extremity muscular control in patients with adult degenerative scoliosis (ADS).

Summary Of Background Data: ADS patients demonstrate an altered gait pattern.

Finite element method-based study of pedicle screw-bone connection in pullout test and physiological spinal loads.

Finite element (FE) method has been widely used to study the screw-bone connections. Screw threads are often excluded from the FE spine model to reduce computational cost. However, no study has been conducted to compare the effect of such simplification in the screw models on the predicting accuracy of the model.

The Change in Sway and Neuromuscular Activity in Adult Degenerative Scoliosis Patients Pre and Post Surgery Compared With Controls.

Study Design: Prospective cohort study.

Objective: The purpose of this study is to quantify the extent of change in sway associated with maintaining a balanced posture within the cone of economy (CoE), in a group of adult degenerative scoliosis (ADS) patients' pre and postsurgery and compare them to matched non-scoliotic controls.

Summary Of Background Data: Patients with spinal deformities adopt a variety of postural changes in the spine, pelvis, and lower extremities in their effort to compensate for the anterior shift in the gravity line.

Revision adult spinal deformity surgery: Does the number of previous operations have a negative impact on outcome?

Purpose: To study the effect of the number of previous operations on the outcome of revision adult spinal deformity (ASD) surgery.

Methods: One hundred and thirty-seven consecutive patients who underwent revision ASD surgery were classified as follows: those who had one previous operation (group 1), had two previous operations (group 2) and had three or more previous operations (group 3). Perioperative complications and additional surgeries were reviewed.

The Effect of Kyphoplasty on Mortality in Symptomatic Vertebral Compression Fractures: A Review.

Background: Vertebral compression fractures (VCFs) are common comorbidities encountered in the elderly, and they are on the rise. Kyphoplasty may be superior in VCF management compared with conservative management. A comprehensive review of literature was conducted, focusing on the effect of kyphoplasty on mortality and overall survivorship in patients with a diagnosis of symptomatic VCFs.

Stress distribution in vertebral bone and pedicle screw and screw-bone load transfers among various fixation methods for lumbar spine surgical alignment: A finite element study.

This paper examines the stress distribution in the posterior fusion fixation, spinal range of motion (ROM), and the screw-bone interaction force obtained from various fixation methods of short-segment spine surgical alignment (SA) under five loading conditions (axial compression, flexion, extension, lateral bending, and axial rotation) provided by a FE spine model. The implant-instrumented FE spine model was validated against the experimental data in the literature. Among different fixation methods, fusing more spinal segments might help distribute the spinal load on the pedicle-screw to reduce the stress, screw force, and instability of the spine (range of motion).

Suitability of Administrative Databases for Durotomy Incidence Assessment: Comparison to the Incidence Associated With Bone-Removal Devices, Calculated Using a Systemic Literature Review and Clinical Data.

Background: Durotomy is a major complication of spinal surgery, potentially leading to additional clinical complications, longer hospitalization, and increased costs. A reference durotomy incidence rate is useful for the evaluation of the safety of different surgical aspects. However, the literature offers a wide range of incidence rates, complicating this comparison.

Prevalence and Factors Affecting Cervical Deformity in Adolescent Idiopathic Scoliosis Patients: A Single-Center Retrospective Radiological Study.

Background: It has been reported that adult spinal deformity patients have a high prevalence of cervical kyphosis (CK) and cervical positive sagittal malalignment (CPSM). However, the prevalence and possible factors affecting CK and CPSM in patients with adolescent idiopathic scoliosis (AIS) are less clear.

Methods: We retrospectively analyzed a consecutive series of AIS patients from a single center.

Reliability and Validity of the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form (MMPI-2-RF) in Spine Surgery and Spinal Cord Stimulator Samples.

It is not uncommon for patients to report diminished outcomes as a result of spine surgery or a spinal cord stimulator implant. Presurgical psychological evaluations are increasingly used to identify patients at increased risk for such outcomes and use of personality assessment instruments in these evaluations provides incremental information beyond a clinical interview and medical chart review. This investigation explores the psychometric properties of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in a sample of spine surgery patients ( = 810) and in a sample of spinal cord stimulator patients ( = 533).

Effect of Cervical Decompression Surgery on Gait in Adult Cervical Spondylotic Myelopathy Patients.

Study Design: This is a prospective cohort study.

Objective: To evaluate the effect of cervical decompression surgery on the biomechanics of the spine and lower extremities in cervical spondylotic myelopathy (CSM) patients and compare with asymptomatic controls.

Summary Of Background Data: Difficulties with balance and gait are one of the most common manifestations of CSM.

Functional Balance Testing in Cervical Spondylotic Myelopathy Patients.

Study Design: A prospective cohort study.

Objective: The aim of this study was to quantify the amount of sway associated with maintaining a balanced posture in a group of untreated cervical spondylotic myelopathy (CSM) patients.

Summary Of Background Data: Balance is defined as the ability of the human body to maintain its center of mass (COM) within the base of support with minimal postural sway.

Patient Activation Mediates the Association Between Psychosocial Risk Factors and Spine Surgery Results.

Although spine surgery (SS) and spinal cord stimulators (SCSs) can provide significant relief for patients with intractable pain, their effectiveness is variable. Previously, a number of pre-operative psychosocial risk factors have predicted suboptimal outcomes of these procedures. However, recent research has found that "patient activation"-the extent to which patients are engaged and active in their own health care-can predict positive surgical results.

Revision spine surgery in patients without clinical signs of infection: How often are there occult infections in removed hardware?

Purpose: To examine the incidence of occult infection in revision spine surgeries and its correlation with preoperative inflammatory markers.

Methods: We retrospectively reviewed all patients who underwent revision spine surgery and hardware removal between 2010 and 2016. Patients who had preoperative clinical signs of infection were excluded.

Gait Alteration in Cervical Spondylotic Myelopathy Elucidated by Ground Reaction Forces.

Study Design: .: Prospective cohort study.

Objective: .