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International Journal of Spine Surgery

Matthew F Gornet, Glenn R Buttermann, Richard Wohns, Jason Billinghurst, Darrell C Brett, Richard Kube, J Rafe Sales, Nicholas J Wills, Ross Sherban, Francine W Schranck, Anne G Copay
Background: Outpatient surgery has been shown safe and effective for anterior cervical discectomy and fusion (ACDF), and more recently, for 1-level cervical disc arthroplasty (CDA). The purpose of this analysis is to compare the safety and efficiency of 1-level and 2-level CDA performed in an ambulatory surgery center (ASC) and in a hospital setting. Methods: The study was a retrospective collection and analysis of data from consecutive CDA patients treated in ASCs compared to a historical control group of patients treated in hospital settings who were classified as outpatient (0 or 1-night stay) or inpatient (2 or more nights)...
October 2018: International Journal of Spine Surgery
William W Cross, Sigurd H Berven, Nick Slater, Jennifer N Lehrman, Anna G U S Newcomb, Brian P Kelly
Background: Sacroiliac (SI) joint pathology may result in low-back pain, which causes substantial disability. Treatment failure with operative management of SI pain may be related to incomplete fusion of the joint and to fixation failure. The objective of this study was to evaluate the initial biomechanical stability of SI joint fixation with a novel implantable device in an in vitro human cadaveric model. Methods: The right and left sides of 3 cadaveric L4-pelvis specimens were tested (1) intact, (2) destabilized, and (3) instrumented with an implantable SI joint fixation device using a simulated single-stance load condition...
October 2018: International Journal of Spine Surgery
Dustin H Massel, Ankur S Narain, Fady Y Hijji, Benjamin C Mayo, Daniel D Bohl, Gregory D Lopez, Kern Singh
Background: Several studies have compared outcomes between hospital-based (HBCs) and ambulatory surgery centers (ASCs) following anterior cervical discectomy and fusion (ACDF). However, the association between narcotic consumption and pain in the early postoperative period has not been well characterized. As such, the purpose of this study is to compare pain, narcotic consumption, and length of stay (LOS) between HBC and ASC patients undergoing same-day-discharge following ACDF. Methods: A surgical registry of patients who underwent a primary, 1- or 2-level ACDF during 2013-2015 was reviewed...
October 2018: International Journal of Spine Surgery
Nathaniel T Ondeck, Daniel D Bohl, Patawut Bovonratwet, Ryan P McLynn, Jonathan J Cui, Andre M Samuel, Matthew L Webb, Jonathan N Grauer
Background: Postoperative complications and risks factors for adverse events play an important role in both decision making and patient expectation setting. The present study serves to contrast surgeons' perceived and reported rates of postoperative adverse events following posterior lumbar fusion (PLF) and to assess the accuracy of predicting the impact of patient factors on such outcomes. Methods: A survey investigating perceived rates of adverse events and the impact of patient risk factors on them following PLF for degenerative conditions was distributed to spine surgeons at the Lumbar Spine Research Society (LSRS) 2016 annual meeting...
October 2018: International Journal of Spine Surgery
Manan Sunil Patel, Alexander Ghasem, Dylan N Greif, Samuel R Huntley, Sheila A Conway, Motasem Al Maaieh
Background: Vertebral disease is a major cause of morbidity in 70% of patients diagnosed with multiple myeloma (MM). Associated osteolytic lesions and vertebral fractures are well documented in causing debilitating pain, functional restrictions, spinal deformity, and cord compression. Currently, treatment modalities for refractory MM spinal pain include systemic therapy, radiotherapy, cementoplasty (vertebroplasty/kyphoplasty), and radio frequency ablation. Our objectives were to report on the efficacy of existing treatments for MM patients with refractory spinal pain, to determine if a standardized treatment algorithm has been described, and to set the foundation upon which future prospective studies can be designed...
October 2018: International Journal of Spine Surgery
Kazuta Yamashita, Fumitake Tezuka, Hiroaki Manabe, Masatoshi Morimoto, Fumio Hayashi, Yoichiro Takata, Toshinori Sakai, Hiroshi Yonezu, Kosaku Higashino, Takashi Chikawa, Akihiro Nagamachi, Koichi Sairyo
Background: We report the case of a professional baseball player who had severe leg pain due to lumbar lateral disc herniation at L4-5 and isthmic spondylolisthesis at L5 (double crash syndrome). For early recovery to competitive level, we performed minimally invasive endoscopic decompression surgery without fusion. There are few reports to discuss the usefulness of minimally invasive treatment for top athletes. Methods: A 29-year-old professional baseball player who played catcher was referred to us with a complaint of right leg pain...
October 2018: International Journal of Spine Surgery
Fred Mo, Philip Yuan, Ali Araghi, Hassan Serhan
Background: Performing an adequate transforaminal lumbar interbody fusion (TLIF) discectomy requires numerous instrument passes, increasing surgical time and the risk of complications. The purpose of this study was to evaluate the efficacy and efficiency of discectomy and endplate preparation during TLIF using traditional manual instrumentation versus a novel suction discectomy curette. The direct economic benefit with use of the suction discectomy curette is calculated. Methods: Three experienced, spine-fellowship-trained surgeons performed TLIF discectomies on 3 cadaveric specimens from T12 to S1 using either traditional manual discectomy instruments or CONCORD Clear (Xtool) devices supplemented with manual discectomy instruments...
October 2018: International Journal of Spine Surgery
Peter G Passias, Saqib Hasan, Kris Radcliff, Robert Isaacs, Kristina Bianco, Cyrus M Jalai, Gregory W Poorman, Nancy J Worley, Samantha R Horn, Anthony Boniello, Peter L Zhou, Paul M Arnold, Patrick Hsieh, Alexander R Vaccaro, Michael C Gerling
Background: Informed patient selection and counseling is key in improving surgical outcomes. Understanding the impact that certain baseline variables can have on postoperative outcomes is essential in optimizing treatment for certain symptoms, such as radiculopathy from cervical spine pathologies. The aim was to identify baseline characteristics that were related to improved or worsened postoperative outcomes for patients undergoing surgery for cervical spine radiculopathic pain. Methods: Retrospective review of prospectively collected data...
October 2018: International Journal of Spine Surgery
Swamy Kurra, Umesh Metkar, Isador H Lieberman, William F Lavelle
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. Methods: A comprehensive literature search was conducted to find recently published literature on kyphoplasty effects on mortality using the following keywords: "kyphoplasty," "mortality," "morbidity," "vertebral compression fractures," and "survivorship...
October 2018: International Journal of Spine Surgery
Falko Schwarz, Michaela Burckhart, Aaron Lawson McLean, Rolf Kalff, Albrecht Waschke
Background: The aim of our study was to identify factors that influence the occurrence of adjacent fractures in patients with cement-augmented pedicle screw instrumentation. Methods: Data were retrospectively collected from medical charts and operative reports for every surgery in which cement-augmented instrumentation was used in our hospital of 4 consecutive years. A total of 93 operations were included and examined for gender, age, T-score, number of fused segments, number of implanted screws, broken screws, loosening of screws, leakage and distribution pattern of cement, pre- and postoperative kyphosis angle, revision surgery and adjacent fractures in follow-up...
October 2018: International Journal of Spine Surgery
Kris Siemionow, Piotr Janusz, Steven Mardjetko
Background: Instrumentation of the axis can be accomplished through a variety of techniques including transarticular screw fixation, pars and pedicle screw fixation, translaminar screw fixation, and posterior wiring. We report on the evolution of the axial 4-screw technique. Methods: Retrospective case review. After exposure of posterior spinal elements, the medial and superior walls of the C2 pedicle were identified from within the spinal canal. A high-speed drill was then advanced under lateral fluoroscopy, which guided craniocaudal angulation...
October 2018: International Journal of Spine Surgery
Abolfazl Rahimizadeh, Walter L Williamson, Shaghayegh Rahimizadeh, Mahan Amirzadeh
Background: In a small percentage of children born with congenital hydrocephalus, enlargement of the head and the presence of ventriculomegaly may halt and ultimately stabilize the condition designated as arrested hydrocephalus. Arrested hydrocephalus in children is typically due to congenital aqueduct stenosis, which can be described appropriately as a stasis existing within the channel between the third and fourth ventricles. Os odontoideum (OO) is an uncommonly occurring pathology at the craniovertebral junction...
October 2018: International Journal of Spine Surgery
Gregory Wyatt Poorman, John Y Moon, Charles Wang, Samantha R Horn, Bryan M Beaubrun, Olivia J Bono, Anne-Marie Francis, Cyrus M Jalai, Peter G Passias
Background: The rate of mortality in surgical procedures involving the lumbar spine has historically been low, and as a result, there has been difficulty providing accurate quantitative mortality rates to patients in the preoperative planning phase. Awareness of these mortality rates is essential in reducing postoperative complications and improving outcomes. Additionally, mortality rates can be influenced by procedure type and patient profile, including demographics and comorbidities...
October 2018: International Journal of Spine Surgery
I David Kaye, Scott C Wagner, Joseph S Butler, Arjun Sebastian, Patrick B Morrissey, Christopher Kepler
Background: To determine the incidence and risk factors for adverse cardiac events after lumbar spine fusion. Methods: A total of 50 495 patients were identified through the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database who underwent lumbar spine fusion between 2005 and 2015. The 30-day postoperative data were analyzed to assess for the incidence of adverse cardiac events including cardiac arrest or myocardial infarction...
October 2018: International Journal of Spine Surgery
Pavan S Upadhyayula, Erik I Curtis, John K Yue, Nikki Sidhu, Joseph D Ciacci
Background: Operative management of lower back pain often necessitates anterior lumbar interbody fusion (ALIF) or transforaminal lumbar interbody fusion (TLIF). Specific pathoanatomic advantages and indications exist for both approaches, and few studies to date have characterized comparative early outcomes. Methods: Adult patients undergoing elective ALIF or TLIF operations were abstracted from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) years 2011-2014...
October 2018: 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
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