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Journal of Neurosurgery. Spine

Mayur Sharma, Beatrice Ugiliweneza, Zaid Aljuboori, Miriam A Nuño, Doniel Drazin, Maxwell Boakye
OBJECTIVE The opioid crisis is identified as a national emergency and epidemic in the United States. The aim of this study was to identify risk factors associated with opioid dependence in patients undergoing surgery for degenerative spondylolisthesis (DS). METHODS The authors queried MarketScan databases to investigate the factors affecting postsurgery opioid use in patients with DS between 2000 and 2012. The outcome of interest was opioid dependence, which was defined as continued opioid use, > 10 opioid prescriptions, or diagnosis of or prescription for opioid dependence disorder in the period of 1 year before or 3-15 months after the procedure...
June 19, 2018: Journal of Neurosurgery. Spine
Amirali Toossi, Dirk G Everaert, Peter Seres, Jacob L Jaremko, Kevin Robinson, C Chris Kao, Peter E Konrad, Vivian K Mushahwar
OBJECTIVE The overall goal of this study was to develop an image-guided spinal stereotactic setup for intraoperative intraspinal microstimulation (ISMS). System requirements were as follows: 1) ability to place implants in various segments of the spinal cord, targeting the gray matter with a < 0.5-mm error; 2) modularity; and 3) compatibility with standard surgical tools. METHODS A spine-mounted stereotactic system was developed, optimized, and tested in pigs. The system consists of a platform supporting a micromanipulator with 6 degrees of freedom...
June 15, 2018: Journal of Neurosurgery. Spine
Kei Ito, Keiji Nihei, Takuya Shimizuguchi, Hiroaki Ogawa, Tomohisa Furuya, Shurei Sugita, Takahiro Hozumi, Keisuke Sasai, Katsuyuki Karasawa
OBJECTIVE This study aimed to clarify the outcomes of postoperative re-irradiation using stereotactic body radiotherapy (SBRT) for metastatic epidural spinal cord compression (MESCC) in the authors' institution and to identify factors correlated with local control. METHODS Cases in which patients with previously irradiated MESCC underwent decompression surgery followed by spine SBRT as re-irradiation between April 2013 and May 2017 were retrospectively reviewed. The surgical procedures were mainly performed by the posterior approach and included decompression and fixation...
June 15, 2018: Journal of Neurosurgery. Spine
Eric Z Herring, Matthew R Peck, Caroline E Vonck, Gabriel A Smith, Thomas E Mroz, Michael P Steinmetz
OBJECTIVE Spine surgeons in the United States continue to be overwhelmed by an aging population, and patients are waiting weeks to months for appointments. With a finite number of clinic visits per surgeon, analysis of referral sources needs to be explored. In this study, the authors evaluated patient referrals and their yield for surgical volume at a tertiary care center. METHODS This is a retrospective study of new patient visits by the spine surgery group at the Cleveland Clinic Center for Spine Health from 2011 to 2016...
June 15, 2018: Journal of Neurosurgery. Spine
Nicolas W Villelli, David M Lewis, Thomas J Leipzig, Andrew J DeNardo, Troy D Payner, Charles G Kulwin
OBJECTIVE Intraoperative angiography can be a valuable tool in the surgical management of vascular disorders in the CNS. This is typically accomplished via femoral artery puncture; however, this can be technically difficult in patients in the prone position. The authors describe the feasibility of intraoperative angiography via the popliteal artery in the prone patient. METHODS Three patients underwent intraoperative spinal angiography in the prone position via vascular access through the popliteal artery. Standard angiography techniques were used, along with ultrasound and a micropuncture needle for initial vascular access...
June 15, 2018: Journal of Neurosurgery. Spine
Zin Z Khaing, Lindsay N Cates, Dane M DeWees, Alexander Hannah, Pierre Mourad, Matthew Bruce, Christoph P Hofstetter
OBJECTIVE Traumatic spinal cord injury (tSCI) causes an almost complete loss of blood flow at the site of injury (primary injury) as well as significant hypoperfusion in the penumbra of the injury. Hypoperfusion in the penumbra progresses after injury to the spinal cord and is likely to be a major contributor to progressive cell death of spinal cord tissue that was initially viable (secondary injury). Neuroprotective treatment strategies seek to limit secondary injury. Clinical monitoring of the temporal and spatial patterns of blood flow within the contused spinal cord is currently not feasible...
June 15, 2018: Journal of Neurosurgery. Spine
Seba Ramhmdani, Marc Comair, Camilo A Molina, Daniel M Sciubba, Ali Bydon
Interspinous process devices (IPDs) have been developed as less-invasive alternatives to spinal fusion with the goal of decompressing the spinal canal and preserving segmental motion. IPD implantation is proposed to treat symptoms of lumbar spinal stenosis that improve during flexion. Recent indications of IPD include lumbar facet joint syndrome, which is seen in patients with mainly low-back pain. Long-term outcomes in this subset of patients are largely unknown. The authors present a previously unreported complication of coflex (IPD) placement: the development of a large compressive lumbar synovial cyst...
June 15, 2018: Journal of Neurosurgery. Spine
Scott L Parker, Ahilan Sivaganesan, Silky Chotai, Matthew J McGirt, Anthony L Asher, Clinton J Devin
OBJECTIVE Hospital readmissions lead to a significant increase in the total cost of care in patients undergoing elective spine surgery. Understanding factors associated with an increased risk of postoperative readmission could facilitate a reduction in such occurrences. The aims of this study were to develop and validate a predictive model for 90-day hospital readmission following elective spine surgery. METHODS All patients undergoing elective spine surgery for degenerative disease were enrolled in a prospective longitudinal registry...
June 15, 2018: Journal of Neurosurgery. Spine
Martin H Pham, Joshua Bakhsheshian, Patrick C Reid, Ian A Buchanan, Vance L Fredrickson, John C Liu
OBJECTIVE Freehand placement of C2 instrumentation is technically challenging and has a learning curve due the unique anatomy of the region. This study evaluated the accuracy of C2 pedicle screws placed via the freehand technique by neurosurgical resident trainees. METHODS The authors retrospectively reviewed all patients treated at the LAC+USC Medical Center undergoing C2 pedicle screw placement in which the freehand technique was used over a 1-year period, from June 2016 to June 2017; all procedures were performed by neurosurgical residents...
June 8, 2018: Journal of Neurosurgery. Spine
Siddhartha Singh, Rodney Sparapani, Marjorie C Wang
OBJECTIVE Pay-for-performance programs are targeting hospital readmissions. These programs have an underlying assumption that readmissions are due to provider practice patterns that can be modified by a reduction in reimbursement. However, there are limited data to support the role of providers in influencing readmissions. To study this, the authors examined variations in readmission rates by spine surgeon within 30 days among Medicare beneficiaries undergoing elective lumbar spine surgery for degenerative conditions...
June 1, 2018: Journal of Neurosurgery. Spine
Carlo Brembilla, Luigi Andrea Lanterna, Emanuele Costi, Claudio Bernucci
No abstract text is available yet for this article.
June 1, 2018: Journal of Neurosurgery. Spine
Chao-Hung Kuo, Wen-Cheng Huang, Jau-Ching Wu, Tsung-Hsi Tu, Li-Yu Fay, Ching-Lan Wu, Henrich Cheng
OBJECTIVE Pedicle screw-based dynamic stabilization has been an alternative to conventional lumbar fusion for the surgical management of low-grade spondylolisthesis. However, the true effect of dynamic stabilization on adjacent-segment degeneration (ASD) remains undetermined. Authors of this study aimed to investigate the incidence of ASD and to compare the clinical outcomes of dynamic stabilization and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). METHODS The records of consecutive patients with Meyerding grade I degenerative spondylolisthesis who had undergone surgical management at L4-5 in the period from 2007 to 2014 were retrospectively reviewed...
June 1, 2018: Journal of Neurosurgery. Spine
Sergey Mlyavykh, Steven C Ludwig, Christopher K Kepler, D Greg Anderson
OBJECTIVE Lumbar spinal stenosis (LSS) is a common condition that leads to significant disability, particularly in the elderly. Current therapeutic options have certain drawbacks. This study evaluates the 5-year clinical and radiographic results of a minimally invasive pedicle-lengthening osteotomy (PLO) for symptomatic LSS. METHODS A prospective, single-arm, clinical pilot study was conducted involving 20 patients (mean age 61.7 years) with symptomatic LSS treated by a PLO procedure at 1 or 2 lumbar levels...
June 1, 2018: Journal of Neurosurgery. Spine
Sanjeev Ariyandath Sreenivasan, Kanwaljeet Garg, Manmohan Singh, Poodipedi Sarat Chandra
No abstract text is available yet for this article.
June 1, 2018: Journal of Neurosurgery. Spine
Sebastian Ruetten, Patrick Hahn, Semih Oezdemir, Xenophon Baraliakos, Harry Merk, Georgios Godolias, Martin Komp
OBJECTIVE Surgery for thoracic disc herniation and spinal canal stenosis is comparatively rare and often challenging. Individual planning and various surgical techniques and approaches are required. The key factors for selecting the technique and approach are anatomical location, consistency of the pathology, general condition of the patient, and the surgeon's experience. The objective of the study was to evaluate the technical implementation and outcomes of a full-endoscopic uniportal technique via the interlaminar, extraforaminal, or transthoracic retropleural approach in patients with symptomatic disc herniation and stenosis of the thoracic spine, taking specific advantages and disadvantages and literature into consideration...
June 1, 2018: Journal of Neurosurgery. Spine
Carl M Brophy, Daniel J Hoh
Cervical disc arthroplasty (CDA) has received widespread attention as an alternative to anterior fusion due to its similar neurological and functional improvement, with the advantage of preservation of segmental motion. As CDA becomes more widely implemented, the potential for unexpected device-related adverse events may be identified. The authors report on a 48-year-old man who presented with progressive neurological deficits 3 years after 2-level CDA was performed. Imaging demonstrated periprosthetic osteolysis of the vertebral endplates at the CDA levels, with a heterogeneously enhancing ventral epidural mass compressing the spinal cord...
June 1, 2018: Journal of Neurosurgery. Spine
Kenji Masuda, Takayuki Higashi, Katsutaka Yamada, Tatsuhiro Sekiya, Tomoyuki Saito
OBJECTIVE The aim of this study was to assess the usefulness of radiological parameters for surgical decision-making in patients with degenerative lumbar scoliosis (DLS) by comparing the clinical and radiological results after decompression or decompression and fusion surgery. METHODS The authors prospectively planned surgical treatment for 298 patients with degenerative lumbar disease between September 2005 and March 2013. The surgical method used at their institution to address intervertebral instability is precisely defined based on radiological parameters...
June 1, 2018: Journal of Neurosurgery. Spine
Elyne N Kahn, Chandy Ellimoottil, James M Dupree, Paul Park, Andrew M Ryan
OBJECTIVE Spine surgery is expensive and marked by high variation across regions and providers. Bundled payments have potential to reduce unwarranted spending associated with spine surgery. This study is a cross-sectional analysis of commercial and Medicare claims data from January 2012 through March 2015 in the state of Michigan. The objective was to quantify variation in payments for spine surgery in adult patients, document sources of variation, and determine influence of patient-level, surgeon-level, and hospital-level factors...
May 25, 2018: Journal of Neurosurgery. Spine
Micheal Raad, Callum J Donaldson, Mostafa H El Dafrawy, Daniel M Sciubba, Lee H Riley, Brian J Neuman, Khaled M Kebaish, Richard L Skolasky
OBJECTIVE Recommendations for the surgical treatment of isolated lumbar spinal stenosis (LSS) (i.e., in the absence of concomitant scoliosis or spondylolisthesis) are unclear. The aims of this study were to investigate trends in the surgical treatment of isolated LSS in US adults and determine implications for outcomes. METHODS The authors analyzed inpatient and outpatient claims from the Truven Health Analytics MarketScan Commercial Claims and Encounters Database for 20,279 patients aged 40-64 years who underwent surgery for LSS between 2010 and 2014...
May 25, 2018: Journal of Neurosurgery. Spine
Andrew S Moon, Sakthivel R Manoharan
No abstract text is available yet for this article.
May 25, 2018: Journal of Neurosurgery. Spine
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