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.

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.

Assessing bone quality in hounsfield units using computed tomography: what value should be used to classify bone as normal or osteoporotic?

Purpose: The purpose of this study was to investigate threshold values for classifying bone as normal or osteoporotic based on Computed Tomography (CT) Hounsfield Units (HU) and to determine if clinically applicable values could be derived to aid spine surgeons evaluating bone quality using CT.

Methods: This literature review was completed using PubMed and Ovid (MedLine), using syntax specific to bone quality and CT. The included articles were original clinical studies assessing bone quality and utilized composite L1-L4 HU values compared against dual-energy X-ray absorptiometry (DEXA) values.

Five-year Follow-up of a Prospective Food and Drug Administration Investigational Device Exemption Trial Evaluating a PEEK-on-Ceramic Cervical Disk Replacement.

Study Design: Prospective trial comparing the investigation group to propensity-matched historic control group.

Objective: To evaluate five-year results of single-level PEEK-on-ceramic cervical total disc replacement (TDR) compared with a propensity-matched anterior cervical discectomy and fusion (ACDF) control group.

Summary Of Background Data: Cervical TDR has gained acceptance as a treatment for symptomatic disk degeneration.

Navigation and Robotic Single-Position Prone LLIF: First Cases in Brazil.

Objective: has been rapid technological advancement in navigation-guided minimally invasive surgery over the past two decades, making these advancements an invaluable aid for surgeons by essentially providing real-time virtual reconstruction of patient anatomy. The objectives of these navigation- and robot-guided procedures are to reduce the likelihood of neural and vascular injury, minimize hospitalization time, decrease bleeding and postoperative pain, shorten healing time, and lower infection rates.

Methods: A unicentric, retrospective cohort study was conducted to evaluate the preoperative and postoperative clinical and radiographic outcomes of the first Latin American patients diagnosed with lumbar degenerative disease who underwent lumbar interbody fusion at the L4-L5 level via prone-position lateral lumbar interbody fusion-single position prone access.

Treatment of failed cervical total disc replacements in a series of 53 cases and description of a management strategy.

Purpose: To describe modes of failure of cervical TDR, their related treatment strategies, and to describe a management strategy for the treatment of failed cervical TDR.

Methods: This retrospective study was based on a consecutive series of 53 cervical TDR patients who underwent removal or revision surgery. Chart review was conducted to collect general descriptive data, reasons for TDR removal/revision, duration from index implantation to re-operation, and the subsequent procedure performed.

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.

Endoscopic Spine Surgery on Instagram: Analysis of Content and Engagement.

Introduction Social media platforms have changed the way society communicates and collaborates. Prior research in healthcare discusses how social media can empower patients, dispel health-related misinformation, and help maintain a patient-centered practice. The goal of this study was to evaluate the use of #endoscopicspinesurgery on Instagram and create a blueprint for creating engaging posts on the social media platform.

The Occurrence of Dropped Head Syndrome After a Cervical Medial Branch Nerve Block in a Patient With Cervicothoracic Kyphotic Deformity: A Case Report.

Complications from medial branch blocks (MBBs) are rare when following proper procedural protocol. Dropped head syndrome (DHS) is characterized by profound muscle weakness in the cervical spine, resulting in a failure to maintain a level horizontal gaze and, in the worst cases, a chin-on-chest deformity. In this case report, we described DHS developing after cervical MBBs using short-acting anesthetic agents and subsequent management.

Clinical Outcome of Lumbar Hybrid Surgery in a Consecutive Series of Patients With Long-term Follow-up.

Study Design: This was a retrospective study combined with attempted prospective patient contact to collect current data.

Objective: The purpose of this study was to investigate the long-term clinical outcomes of patients undergoing lumbar hybrid surgery (total disk replacement (TDR) at one level and fusion at an adjacent level.

Summary Of Background Data: Many patients with symptomatic lumbar disk degeneration are affected at more than one level.

Removals and Revisions of Cervical Total Disc Replacement Devices in a Consecutive Series of 1626 Patients Beginning With the First Case Experience in 2003.

Study Design: Retrospective cohort study.

Objective: The purpose of this study was to investigate the rate of cervical total disc replacement (TDR) device removal or revision.

Background: Cervical TDR has gained acceptance as an alternative to anterior cervical discectomy and fusion in appropriately selected patients.

Impact of Age on the Occurrence of Vascular Complications in Patients Undergoing Anterior Lumbar Approach Surgery.

Study Design: Retrospective cohort study.

Objective: To investigate the impact of age on the incidence of vascular complications in patients undergoing anterior lumbar approach surgery.

Background: Anterior approach lumbar spinal surgery may facilitate the use of intervertebral devices with larger endplate coverage and increased lordosis.

Is the Use of Intraoperative Neuromonitoring Justified During Lumbar Anterior Approach Surgery?

Background: Intraoperative neuromonitoring (IONM) became widely used in spine surgery to reduce the risk of iatrogenic nerve injury. However, the proliferation of IONM has fallen into question based on effectiveness and costs, with a lack of evidence supporting its benefit for specific spine surgery procedures. The purpose of this study was to evaluate the use of IONM and the rate of neurological injury associated with anterior lumbar spinal surgery.

Minimally Invasive Revision of Luque Plate Instrumentation: A Case Report.

Extension of existing spinal fusions may necessitate the removal of or linkage to prior constructs. Knowledge of previously placed instrumentation is critical to success in these revision scenarios. The Luque spinal instrumentation system, developed in the late 1980s, is a legacy pedicle screw and plate system that may be encountered during revision operations today.

Randomized Trial of Augmented Pelvic Fixation in Patients Undergoing Thoracolumbar Fusion for Adult Spine Deformity: Initial Results from a Multicenter Randomized Trial.

Background: The optimal configuration for spinopelvic fixation during multilevel spine fusion surgery for adult spine deformity remains unclear. Postoperative sacroiliac (SI) joint pain, S2AI screw loosening and implant breakage could be related to continued motion of the SI joint with use of only a single point of fixation across the SI joint.

Methods: Prospective, international, multicenter randomized controlled trial of 222 patients with adult spine deformity scheduled for multilevel (4 or more levels) spine fusion surgery with pelvic fixation.

Prosthesis design and likelihood of achieving physiological range of motion after cervical disc arthroplasty: analysis of range of motion data from 1,173 patients from 7 IDE clinical trials.

Background Context: The functional goals of cervical disc arthroplasty (CDA) are to restore enough range of motion (ROM) to reduce the risk of accelerated adjacent segment degeneration but limit excessive motion to maintain a biomechanically stable index segment. This motion-range is termed the "Physiological mobility range." Clinical studies report postoperative ROM averaged over all study subjects but they do not report what proportion of reconstructed segments yield ROM in the Physiological mobility range following CDA surgery.

Lumbar Total Disk Replacement Device Removals and Revisions Performed During a 20-Year Experience with 2141 Patients.

Study Design: This was a retrospective study with prospective patient contact attempted to collect current data.

Objective: The purpose was to investigate the incidence and reasons for lumbar total disk replacement (TDR) removal or revision.

Summary Of Background Data: A concern regarding lumbar TDR was safety, particularly the need for device removal or revision.

Differences in presurgical MMPI-3 scores across trajectories of recovery from spine surgery.

Approximately 30% of patients who undergo spinal surgery for chronic back pain continue to experience significant pain and disability up to 2 months following surgery. Prior studies have identified mental health variables including depression and anxiety as predictors of poorer postsurgical outcomes using screening instruments, but no studies have examined long-term outcomes using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3), a commonly used tool used in presurgical psychological evaluations (PPE). Using group-based trajectory modeling and a sample of 404 spine surgery evaluees, the present study examined the trajectories of changes in disability scores from presurgery through 3, 12, and 24 months postsurgery.

Effect of sacroiliac fusion on gait, standing balance, and pelvic mobility for unilateral sacroiliac joint dysfunction.

Background: Sacroiliac joint fusion (SIF) has been shown to effectively alleviate pain and improve functional deficits associated with sacroiliac joint dysfunction (SIJD). Previous studies have demonstrated significant improvements in gait function, however, none have reported both over-ground walking and quiescent standing, and additionally, none have included analysis of pelvic kinematics which may contain important information regarding pain avoidant compensatory behaviors. The purpose of this study was to identify objective functional differences between symptomatic and asymptomatic sides of unilateral sacroiliac joint dysfunction (SIJD) patients and to demonstrate the effectiveness of unilateral sacroiliac fusion (SIF) to improve gait and balance function compared to matched controls.

Informed Consent for Spine Procedures: Best Practice Guideline from the American Society of Pain and Neuroscience (ASPN).

Introduction: The evolution of treatment options for painful spinal disorders in diverse settings has produced a variety of approaches to patient care among clinicians from multiple professional backgrounds. The American Society of Pain and Neuroscience (ASPN) Best Practice group identified a need for a multidisciplinary guideline regarding appropriate and effective informed consent processes for spine procedures.

Objective: The ASPN Informed Consent Guideline was developed to provide clinicians with a comprehensive evaluation of patient consent practices during the treatment of spine pathology.

Evaluating alternatives to dual-energy x-ray absorptiometry for assessing bone quality in patients undergoing spine surgery.

Objective: The purpose of this study was to compare and contrast lumbar bone quality and osteoporosis/osteopenia screening results via dual-energy x-ray absorptiometry (DEXA), CT, and MRI.

Methods: A consecutive series of 426 candidates screened for lumbar disc replacement over a 5-year period beginning in 2018 was reviewed. Patients with a preoperative lumbar spine DEXA scan and a CT and/or MRI scan were included.

Development of an Endoscopic Spine Surgery Program: Overview and Basic Considerations for Implementation.

Endoscopic spine surgery (ESS) is an innovative technique allowing for minimally invasive, direct visualization of spinal abnormalities. The growth of ESS in the United States has been stunted by high start-up costs, low reimbursement rates, and the steep learning curve associated with mastering endoscopic techniques. Hergrae, we describe the current state and future direction of ESS and provide key action items for ESS program implementation.