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International Journal of Spine Surgery

Daniel J Blizzard, Michael A Gallizzi, Charles Sheets, Benjamin T Smith, Robert E Isaacs, Megan Eure, Christopher R Brown
BACKGROUND: Sagittal balance restoration has been shown to be an important determinant of outcomes in corrective surgery for degenerative scoliosis. Lateral interbody fusion (LIF) is a less-invasive technique which permits the placement of a high lordosis interbody cage without risks associated with traditional anterior or transforaminal interbody techniques. Studies have shown improvement in lumbar lordosis following LIF, but only one other study has assessed sagittal balance in this population...
2016: International Journal of Spine Surgery
David W Polly, John Swofford, Peter G Whang, Clay J Frank, John A Glaser, Robert P Limoni, Daniel J Cher, Kathryn D Wine, Jonathan N Sembrano
BACKGROUND: Sacroiliac joint (SIJ) dysfunction is an important and underappreciated cause of chronic low back pain. OBJECTIVE: To prospectively and concurrently compare outcomes after surgical and non-surgical treatment for chronic SIJ dysfunction. METHODS: One hundred and forty-eight subjects with SIJ dysfunction were randomly assigned to minimally invasive SIJ fusion with triangular titanium implants (SIJF, n = 102) or non-surgical management (NSM, n = 46)...
2016: International Journal of Spine Surgery
Anthony J Boniello, Kushagra Verma, Austin Peters, Baron S Lonner, Thomas Errico
BACKGROUND: Pre-donation of autologous blood prior to spine fusion for adolescent idiopathic scoliosis (AIS) has been used in deformity surgery. The effect of pre-donation on pre-operative hematocrit (Hct) remains debated. Multiple factors may influence pre-operative Hct including intravascular volume status, patient factors, and timing of pre-operative blood donation. The purpose of this study was to determine if pre-donation significantly lowers pre-incision Hct in AIS patients. METHODS: A retrospective cohort study of a Level-1 prospective randomized trial was conducted...
2016: International Journal of Spine Surgery
Morgan P Lorio
The index 2014 ISASS Policy Statement - Minimally Invasive Sacroiliac Joint Fusion was generated out of necessity to provide an ICD9-based background and emphasize tools to ensure correct diagnosis. A timely ICD10-based 2016 Update provides a granular threshold selection with improved level of evidence and a more robust, relevant database.
2016: International Journal of Spine Surgery
Shardul Soman, G D Tharadara, Naitik Chhatrala, Shubham Jain
INTRODUCTION: Extramedullary hematopoeisis (EMH) is defined as formation of blood cells outside the bone marrow. It occurs most commonly in the liver and spleen in patients having disorders that lead to chronic anaemia. EMH in spinal canal is a very rare site and cauda equina syndrome due to EMH has very few cases presented in literature. CASE PRESENTATION: A 28 year old male patient presented with complain of incontinenance of bladder and bowel along with saddle anaesthesia from 10 days...
2016: International Journal of Spine Surgery
Matthew F Gornet, J Kenneth Burkus, Mark E Shaffrey, Hui Nian, Frank E Harrell
BACKGROUND: Cervical disc arthroplasty (CDA) has emerged as an alternative to anterior cervical discectomy and fusion (ACDF) for the treatment of cervical pathologies. Studies are on-going to assess the long term outcomes of CDA. This study assessed the safety and efficacy of the Prestige(®) LP Disc at 84-months follow up. METHODS: Prospective data from 280 CDA patients with single-level cervical disc disease with radiculopathy or myelopathy were compared with 265 historical control ACDF patients...
2016: International Journal of Spine Surgery
Cara L Sedney, Scott D Daffner, Abimbola Obafemi-Afolabi, Daniel Gelb, Steven Ludwig, Sanford E Emery, John C France
BACKGROUND: The operative care of patients with ankylosing spinal conditions such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) after a spine fracture is not well represented in the literature. This work seeks to determine the effect of minimally invasive techniques on patients with spinal fractures and ankylosing spinal conditions through a retrospective case-control analysis. METHODS: The operative logs from 1996-2013 of seven fellowship-trained spine surgeons from two academic, Level I trauma centers were reviewed for cases of operatively treated thoracic and lumbar spinal fractures in patients with ankylosing spinal disorders...
2016: International Journal of Spine Surgery
Daisuke Higuchi
BACKGROUND: Control over pain and pain coping strategies are associated with pain intensity as well as psychological status and subjective disability in patients experiencing pain. The present study assessed the clinical values of control over pain and pain coping strategies in surgical treatment for patients with lumbar spinal stenosis using mediation analysis. METHODS: Sixty-two patients with lumbar spinal stenosis (median age, 70 years; 34 men, 28 women) were evaluated before surgery...
2016: International Journal of Spine Surgery
Jonathan P Ng, Derek T Cawley, Suzanne M Beecher, Joseph F Baker, John P McCabe
BACKGROUND: Standard positioning for percutaneous balloon kyphoplasty requires placing a patient prone with supports under the iliac crests and upper thorax. The authors believe that hip hyperextension maximises pelvic anteversion creating anterior longitudinal ligamentotaxis, thus facilitating restoration of vertebral height. METHODS: Radiographic imaging including pre-operative, post-positioning, post balloon tamp inflation and post-operative lateral radiographs were analysed for anterior and posterior column height, wedge angle of the affected vertebra and 3-level Cobb angle in patients with recent fractures of T11-L1...
2016: International Journal of Spine Surgery
Boyle Cheng, Anthony E Castellvi, Reginald J Davis, David C Lee, Morgan P Lorio, Richard E Prostko, Chip Wade
BACKGROUND: While low back pain is one of the most prevalent, if not the most prevalent reasons for visits to physicians, a majority of patients with low back pain cannot be given a definitive diagnosis. While there have been substantial advances in imaging technologies over the past 30 years, relatively little has changed in the methodologies for evaluating functionality of the lumbar spine. The current standard of care for function assessment of the lumbar spine focuses on uncontrolled patient directed motion which results in increased inter-patient variability...
2016: International Journal of Spine Surgery
James M Mok, Maximilian Martinez, Harvey E Smith, Daniel M Sciubba, Peter G Passias, Andrew Schoenfeld, Robert E Isaacs, Alexander R Vaccaro, Kris E Radcliff
BACKGROUND: In a bundled payment system, a single payment covers all costs associated with a single episode of care. Spine surgery may be well suited for bundled payments because of clearly defined episodes of care, but the impact on current practice has not been studied. We sought to examine how a theoretical bundled payment strategy with financial disincentives to resource utilization would impact practice patterns. METHODS: A multiple-choice survey was administered to spine surgeons describing eight clinical scenarios...
2016: International Journal of Spine Surgery
Jun Seok Bae, Sang-Ho Lee
BACKGROUND: Obese patients are at risk of complications such as slower wound healing and increased infection rates after spinal surgery. Transforaminal full-endoscopic lumbar discectomy (ELD) has advantages over conventional microdiscectomy because it decreases perioperative complications and increases favorable clinical outcomes. No clinical studies have reported ELD in obese patients. The purpose of this study is to evaluate the clinical outcomes of transforaminal ELD in obese patients...
2016: International Journal of Spine Surgery
Subhadip Mandal, U Banerjee, A S Mukherjee, Subhajyoti Mandal, Srikanta Kundu
BACKGROUND: Chronic compression of the cervical spinal cord leads to a clinical syndrome of cervical spondylotic myelopathy (CSM). Clinical symptoms of cervical spondylotic myelopathy (CSM) or cervical myeloradiculopathies result in spinal cord and root dysfunction. The primary aims of surgical intervention for multilevel myelopathy are to decompress the spinal cord and maintain stability of the cervical spine. Secondary aims are to minimize complications which include long-term pain and motion loss...
2016: International Journal of Spine Surgery
Claire Bruna-Rosso, Pierre-Jean Arnoux, Rohan-Jean Bianco, Yves Godio-Raboutet, Léo Fradet, Carl-Éric Aubin
BACKGROUND: Sacroiliac joint (SIJ) is a known chronic pain-generator. The last resort of treatment is the arthrodesis. Different implants allow fixation of the joint, but to date there is no tool to analyze their influence on the SIJ biomechanics under physiological loads. The objective was to develop a computational model to biomechanically analyze different parameters of the stable SIJ fixation instrumentation. METHODS: A comprehensive finite element model (FEM) of the pelvis was built with detailed SIJ representation...
2016: International Journal of Spine Surgery
Warren F Neely, Frank Fichtel, Diana Cardenas Del Monaco, Jon E Block
BACKGROUND: Many first generation stand-alone fusion cages required endplate decortication and surgical impaction during the procedure resulting in segmental subsidence, implant migration and loss of lordosis postoperatively. The primary objective of this study was to evaluate radiographically, in a large series of patients, whether engineering and design modifications incorporated in a specific stand-alone, expandable interbody fusion device (VariLift(®)-L) adequately addressed previously recognized deficiencies of stand-alone interbody cages...
2016: International Journal of Spine Surgery
Shearwood McClelland, Richelle C Takemoto, Baron S Lonner, Tate M Andres, Justin J Park, Pedro A Ricart-Hoffiz, John A Bendo, Jeffrey A Goldstein, Jeffrey M Spivak, Thomas J Errico
INTRODUCTION: Wound infections following spinal surgery place a high toll on both the patient and the healthcare system. Although several large series studies have examined the incidence and distribution of spinal wound infection, the applicability of these studies varies greatly since nearly every study is either retrospective and/or lacks standard inclusion criteria for defining surgical site infection. To address this void, we present results from prospectively gathered thoracolumbar spine surgery data for which the Centers for Disease Control (CDC) criteria were stringently applied to define a surgical site infection (SSI)...
2016: International Journal of Spine Surgery
Bradley S Duhon, Fabien Bitan, Harry Lockstadt, Don Kovalsky, Daniel Cher, Travis Hillen
BACKGROUND: Sacroiliac joint (SIJ) dysfunction is an underdiagnosed condition. Several published cohorts have reported favorable mid-term outcomes after SIJ fusion using titanium implants placed across the SIJ. Herein we report long-term (24-month) results from a prospective multicenter clinical trial. METHODS: One hundred and seventy-two subjects at 26 US sites with SI joint dysfunction were enrolled and underwent minimally invasive SI joint fusion with triangular titanium implants...
2016: International Journal of Spine Surgery
Pierce D Nunley, Eubulus J Kerr, Philip A Utter, David A Cavanaugh, Kelly A Frank, Devan Moody, Brian McManus, Marcus B Stone
BACKGROUND: Bone graft material for lumbar fusion was historically autologous bone graft (ABG). In recent years alternatives such as allograft, demineralized bone matrix (DBM), ceramics, and bone morphogenetic protein (BMP) have gained favor, although the complications of these are not fully understood. Bioactive amniotic suspension (BAS) with allograft is a new class of material derived from human amniotic tissue. METHODS: Eligible patients receiving a one or two level lumbar interbody fusion with Nucel, a BAS with allograft, were contacted and scheduled for a mininmim 12 month follow-up visit...
2016: International Journal of Spine Surgery
Matthew F Gornet, Anne G Copay, Francine W Schranck, Branko Kopjar
BACKGROUND: Depression has been associated with inferior outcomes following lumbar spine surgery. Our purpose was to investigate the prevalence of depression and its impact on the outcomes of a large sample of cervical disc arthroplasty patients and to examine the change in depression occurring in conjunction with changes in disability and pain. METHODS: A cohort of 271 patients who underwent single or multi-level cervical disc arthroplasty at a single orthopedic center filled out the Neck Disability Index, Medical Outcomes Study SF-36, numerical rating scales for neck pain and arm pain, preoperatively and 12-month postoperatively...
2016: International Journal of Spine Surgery
Michael S Hisey, Jack E Zigler, Robert Jackson, Pierce D Nunley, Hyun W Bae, Kee D Kim, Donna D Ohnmeiss
INTRODUCTION: There is increasing interest in the role of cervical total disc replacement (TDR) as an alternative to anterior cervical discectomy and fusion (ACDF). Multiple prospective randomized studies with minimum 2 year follow-up have shown TDR to be at least as safe and effective as ACDF in treating symptomatic degenerative disc disease at a single level. The purpose of this study was to compare outcomes of cervical TDR using the Mobi-C(®) with ACDF at 5-year follow-up. METHODS: This prospective, randomized, controlled trial was conducted as a Food and Drug Administration regulated Investigational Device Exemption trial across 23 centers with 245 patients randomized (2:1) to receive TDR with Mobi-C(®) Cervical Disc Prosthesis or ACDF with anterior plate and allograft...
2016: International Journal of Spine Surgery
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