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International Journal of Spine Surgery

Keisan Moazzeni, Kasra Amin Kazemi, Ramin Khanmohammad, Mohammad Eslamian, Mohsen Rostami, Morteza Faghih-Jouibari
Background: The prevalence of diabetes mellitus (DM) is increasing worldwide. Thereby, an increasing rate of patients with DM are subjecting to spine surgery. Reviewing the literature, a higher rate of surgery-related complications is reported in DM patients. There is no prospective study comparing the outcomes of lumbar fusion surgery in patients with and without DM. We aimed to investigate whether DM is associated with worse patient-reported outcomes, lower fusion rate, and higher complication rate in subjects undergoing spinal lumbar fusion surgery...
August 2018: International Journal of Spine Surgery
Michael Conti Mica, Leonard I Voronov, Gerard Carandang, Robert M Havey, Bartosz Wojewnik, Avinash G Patwardhan
Background: A novel expandable lumbar interbody fusion cage has been developed which allows for a broad endplate footprint similar to an anterior lumbar interbody fusion; however, it is deployed from a minimally invasive transforaminal unilateral approach. The perceived benefit is a stable circumferential fusion from a single approach that maintains the anterior tension band of the anterior longitudinal ligament. The purpose of this biomechanics laboratory study was to evaluate the biomechanical stability of an expandable lumbar interbody cage inserted using a transforaminal approach and deployed in situ compared to a traditional lumbar interbody cage inserted using an anterior approach (control device)...
August 2018: International Journal of Spine Surgery
Catherine W Cahill, Kristen E Radcliff, Charles A Reitman
Background: Very little normative computed tomography (CT) scan data exist defining expected relationships of vertebral structures in the intact cervical spine. Better understanding of normal relationships should improve sensitivity of injury detection, particularly for facet subluxation. The purpose of this paper was to describe the normal anatomical relationships and most sensitive measurements to detect abnormal alignment in the subaxial cervical spine. Methods: A group of 30 CT scans with no documented cervical spine injury were utilized from an established database in a trauma population...
August 2018: International Journal of Spine Surgery
Robert Pflugmacher, Angelo Franzini, Shaked Horovitz, Richard Guyer, Ely Ashkenazi
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. Theoretically, a reference incidence value can be extracted from administrative databases, containing a large number of procedures...
August 2018: International Journal of Spine Surgery
Krishn Khanna, Abhinav Janghala, David Sing, Brennan Vail, Grigoriy Arutyunyan, Bobby Tay, Vedat Deviren
Background: It is unclear whether patients can be taken off suppressive antibiotics with infected retained instrumentation. This study aimed to retrospectively analyze the perioperative course and antibiotic regimen that led to the clinical intervention of patients with infected spinal instrumentation. Methods: Consecutive adult patients with spine instrumentation who suffered surgical site infections (SSI) requiring debridement were retrospectively analyzed. The patients were grouped into 4 cohorts based on their clinical intervention: removal of instrumentation, reinstrumentation, retention of instrumentation with continued antibiotic suppression, and retention of instrumentation with no antibiotic suppression...
August 2018: International Journal of Spine Surgery
Kris Radcliff, Palaniswamy Vijay, Ruba F Sarris, Molly Speltz, Joshua G Vose
Background: Exposure of the anterior cervical spine requires dissection in proximity to critical neurovascular structures. Monopolar electrosurgical (ES) devices generate heat in contacted tissues, resulting in thermal damage and temperature change. This study examined depth of thermal injury and temperature change associated with use of a low-temperature electrosurgical device (LTD) compared to traditional electrosurgery during a cadaveric anterior cervical discectomy and fusion (ACDF) dissection...
August 2018: International Journal of Spine Surgery
Stylianos Kapetanakis, Grigorios Gkasdaris, Tryfon Thomaidis, Georgios Charitoudis, Konstantinos Kazakos
Background: Studies describing the efficacy of transforaminal percutaneous endoscopic discectomy (TPED) on shortness of recovery and improvement of postoperative quality of life are limited, especially regarding gender, something that has never been reported before in the literature. The purpose of this study is to evaluate, in accordance with the sex of the patients, possible differences in the health-related quality of life of those who underwent TPED for lumbar disc herniation (LDH)...
August 2018: International Journal of Spine Surgery
Deeptee Jain, Kushagra Verma, Jeffrey Mulvihill, Jun Mizutani, Bobby Tay, Shane Burch, Vedat Deviren
Study Design: Retrospective cohort study. Objective: To compare outcomes and complications of stand-alone minimally invasive lateral interbody fusion (LIF) vs revision posterior surgery for the treatment of lumbar adjacent segment disease. Methods: Adults who underwent LIF or transforaminal lumbar interbody fusion (TLIF) for adjacent segment disease were compared. Exclusion criteria: >grade 1 spondylolisthesis, posterior approach after LIF, and L5/S1 surgery...
August 2018: International Journal of Spine Surgery
Vaneet Singh, Anastasia K Skipor, Abdulhafez A Selim, Joshua J Jacobs
Background: Cervical disc arthroplasty (CDA) has emerged as an alternative to anterior cervical discectomy and fusion for degenerative cervical disc disease. The artificial discs provide intervertebral motion using multicomponent articulation and thus tend to generate particulate debris and soluble metal ions. Limited information is available on the long-term metal concentrations and associated systemic adverse events observed in metal-on-metal CDA. Serum chromium (Cr) and nickel (Ni) concentrations were assessed in patients implanted with ball-in-trough stainless steel-based cervical disc through 7 years...
August 2018: International Journal of Spine Surgery
Rafael DE LA Garza Ramos, Jonathan Nakhla, Niketh Bhashyam, Adam E Ammar, Aleka N Scoco, Merrit D Kinon, Reza Yassari
Background: Bone morphogenetic protein-2 (BMP-2) is an available bone graft option in spinal fusion surgery. The purpose of this study is to investigate the trends of BMP-2 utilization in adult spinal deformity (ASD) surgery. Methods: The Nationwide Inpatient Sample database from 2002 to 2011 was reviewed. Inclusion criteria were patients over 18 years of age who underwent spinal fusion for ASD. Trends of BMP-2 use were examined over time, as well as stratified based on patient and surgical characteristics...
August 2018: International Journal of Spine Surgery
Pooria Hosseini, Allen Carl, Michael Grevitt, Colin Nnadi, Martin Repko, Dennis G Crandall, Ufuk Aydinli, Ľuboš Rehák, Martin Zabka, Steven Seme, Behrooz A Akbarnia
Background: This trial reports the 2-year and immediate postremoval clinical outcomes of a novel posterior apical short-segment (PASS) correction technique allowing for correction and stabilization of adolescent idiopathic scoliosis (AIS) with limited fusion. Methods: Twenty-one consecutive female AIS patients were treated at 4 institutions with this novel technique. Arthrodesis was limited to the short apical curve after correction with translational and derotational forces applied to upper and lower instrumented levels...
August 2018: International Journal of Spine Surgery
Luke Brown, Tristan Weir, Mark Shasti, Omer Yousaf, Imran Yousaf, Oliver Tannous, Eugene Koh, Kelley Banagan, Daniel Gelb, Steven Ludwig
Background: Postoperative pain management in spine surgery holds unique challenges. The purpose of this study is to determine if the local anesthetic liposomal bupivacaine (LB) reduces the total opioid requirement in the first 3 days following posterior lumbar decompression and fusion (PLDF) surgery for degenerative spondylosis. Methods: Fifty patients underwent PLDF surgery in a prospective randomized control pilot trial between August 2015 and October 2016 and were equally allocated to either a treatment (LB) or a control (saline) group...
August 2018: International Journal of Spine Surgery
Paula M McQuail, Ben S McCartney, Joseph F Baker, Mutaz Jaadan, John P McCabe
Background: The National Institute of Health and Clinical Excellence (NICE) provide a framework of evidence-based guidelines for the management of metastatic spinal cord compression (MSCC). We aimed to compare our center's provision of service to these best practice guidelines and discuss key shortcomings with their implications for the spinal surgeon. Methods: Patients with radiologic evidence of MSCC over a 30-month period were identified using the hospital electronic radiological database...
August 2018: International Journal of Spine Surgery
Rachel B Simon, Christina Dowe, Samuel Grinberg, Frank P Cammisa, Celeste Abjornson
Background: To alleviate the symptoms of lumbar spinal stenosis, widely accepted methods of surgical treatment include decompression alone and decompression with fusion. As an alternative to these methods, interlaminar stabilization (ILS) devices with decompression were introduced. There is a large amount of research dedicated to examining the efficacy of ILS devices in single-level procedures, but fewer studies focus on their efficacy in 2-level procedures. The purpose of this study was to compare decompression with instrumented posterolateral fusion to decompression with interlaminar stabilization in patients who require surgical treatment at 2 levels for lumbar spinal stenosis at 5 years postoperation...
August 2018: International Journal of Spine Surgery
Amit R Persad, Richard J Fox, Jeremy L Rempel
Vertebral hemangiomas are common lesions usually restricted to the vertebral body. They are characterized by proliferation of endothelial cells and subsequent expansion of vascular spaces within the bone. These lesions are usually clinically silent and are discovered incidentally. Only rarely are vertebral hemangiomas symptomatic. Here, we present the case of a 68-year-old female with an aggressive hemangioma causing neurologic deficit. The lesion was localized within the posterior spinal elements, with no involvement of the vertebral body...
August 2018: International Journal of Spine Surgery
Anthony Yeung, Vit Kotheeranurak
The first author's series has reported and published his 5- to 10-year results in a preliminary review of endoscopic transforaminal decompression for degenerative and isthmic spondylolisthesis causing sciatica and back pain. This study was initiated due to favorable results in relieving both back and leg pain after a spine surgeon with isthmic spondylolisthesis who wanted to avoid fusion requested consideration for an endoscopic procedure for his own isthmic spondylolisthesis condition. After listening to the first author's podium presentation on selective endoscopic discectomy and foraminal decompression under local anesthesia in 1995, he requested consideration for transforaminal endoscopic decompression for recent onset of progressive sciatica from his isthmic spondylolisthesis...
June 2018: International Journal of Spine Surgery
Pramod K Sudarshan, Hardik R Suthar, Vamsi K Varma, Appaji Krishnan, Sajan K Hegde
Background: Surgical management of high-grade spondylolisthesis in the young is not only challenging but also controversial, from in-situ fusion to complete reduction. It is fraught with dangers such as neurological injury, pseudoarthrosis, and progressive deformity with subsequent global sagittal imbalance. We describe our experience of progressive reduction technique and restoration of lumbosacral alignment. Methods: This study is a retrospective review of patients who underwent surgery between 1998 and 2012...
June 2018: International Journal of Spine Surgery
Remi M Ajiboye, Howard Y Park, Jeremiah R Cohen, Evan E Vellios, Elizabeth L Lord, Adedayo O Ashana, Zorica Buser, Jeffrey C Wang
Background: Intraoperative neuromonitoring (ION), such as motor-evoked potential (MEP), somatosensory evoked potentials (SSEP), and electromyography (EMG), is used to detect impending neurological injuries during spinal surgery. To date, little is known about the trends in the use of ION for scoliosis surgery in the United States. Methods: A retrospective review was performed using the PearlDiver Database to identify patients that had scoliosis surgery with and without ION from years 2005 to 2011...
June 2018: International Journal of Spine Surgery
Sreedharan Namboothiri, Sathishchandra Gore, Ganesh Veerasekhar
Background: The study design was a retrospective case series. The objective was to find the clinical success rate of percutaneous transforaminal endoscopic disc surgery in patients suffering from discogenic chronic low back pain who were showing high intensity zone (HIZ) with degenerated disc as the only abnormality in the magnetic resonance imaging (MRI). The HIZ in the posterior annulus in degenerated disc is recognized as a pain generator. There are only a few studies available in the literature addressing the effect of identification and treatment of HIZ in the chronic low back pain patient...
June 2018: International Journal of Spine Surgery
Alexander Vaccaro, William Beutler, Walter Peppelman, Joseph Marzluff, Andrew Mugglin, Prem S Ramakrishnan, Jacqueline Myer, Kelly J Baker
Background: This research was initiated to compare the long-term clinical safety and effectiveness of the selectively constrained SECURE-C (Globus Medical, Audubon, Pennsylvania) Cervical Artificial Disc to anterior cervical discectomy and fusion (ACDF). To preserve segmental motion, cervical total disc replacement (CTDR) was developed as an alternative to ACDF. Current CTDR designs incorporate constrained and unconstrained metal-on-metal or metal-on-polymer articulation with various means of fixation...
June 2018: International Journal of Spine Surgery
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