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Clinical Spine Surgery

Alexander Y Li, Tej D Azad, Anand Veeravagu, Inderpreet Bhatti, Amy Li, Tyler Cole, Atman Desai, John K Ratliff
STUDY DESIGN: Propensity score matched retrospective study using a nationwide longitudinal database. OBJECTIVE: To quantify the longitudinal economic impact of venous thromboembolism (VTE) complications in spinal fusion patients. SUMMARY OF BACKGROUND DATA: VTE is a rare and serious complication that may occur after spine surgery. The long-term socioeconomic impact understanding of these events has been limited by small sample sizes and a lack of longitudinal follow-up...
October 12, 2016: Clinical Spine Surgery
Chengjie Xiong, Michael D Daubs, Trevor P Scott, Kevin H Phan, Akinobu Suzuki, Monchai Ruangchainikom, Allison K Roe, Bayan Aghdasi, Yanlin Tan, Jeffrey C Wang
PURPOSE: The purpose of this study was to examine the movement of the spinal cord and its relationship to the spinal canal in patients with mild spondylosis using kinetic magnetic resonance imaging (kMRI). METHODS: Weight-bearing, multiposition kMRI was performed on symptomatic patients through a full range of flexion-extension. A total of 52 study patients were selected based on the C2-C7 Cobb angle of sagittal alignment: lordotic (from 30 to 45 degrees). We evaluated dynamic changes in different parameters from flexion-extension: spinal canal diameter (CD), spinal cord diameter (SCD), space available for the cord, anterior space available for the cord (ASAC), posterior space available for the cord (PSAC), average distance between the anterior canal and the cord (d-value), and global angle for the spinal canal and cord...
September 27, 2016: Clinical Spine Surgery
Xiaoxiao Zhou, Pan Cai, Yuwei Li, Haijiao Wang, Shengli Xia, Xiuhui Wang
STUDY DESIGN: A single-center, retrospective, longitudinal matched cohort clinical study of prospectively collected outcomes. OBJECTIVE: To compare retrospectively the clinical outcomes and complications of the posterior approach laminoplasty and single-stage anterior approach laminoplasty combined with anterior cervical corpectomy and fusion and anterior cervical discectomy and fusion for treating patients with cervical spondylotic myelopathy coincident multilevel anterior and posterior compression, known as complex cervical spondylotic myelopathy (cCSM) here...
September 27, 2016: Clinical Spine Surgery
Sangbong Ko, Seungbum Chae
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine the correlation between SF-36 (a measure for overall health status in patients) and Oswestry-Disability Index (ODI) or Rolland-Morris Disability Questionnaire (RMDQ) confined to spine according to the type of pain from the spine. SUMMARY OF BACKGROUND DATA: Data showed moderate correlation between ODI and SF-36 Physical Component Score (PCS), Physical Functioning (PF) (r=-0.46), Physical Role Functioning (RP) (r=-0...
September 21, 2016: Clinical Spine Surgery
Yuichiro Morishita, Muneaki Masuda, Takeshi Maeda, Takayoshi Ueta, Keiichiro Shiba
STUDY DESIGN: The prospective cohort study. OBJECTIVE OF THE STUDY: The objective was to evaluate the relationships between local pressure changes of the intervertebral foramen during lumbar spine extension and lumbar foraminal morphology. SUMMARY OF BACKGROUND DATA: The physiological states of lumbosacral nerve roots in the vertebral foramen remain controversial. METHODS: We evaluated 56 lumbosacral vertebral foramens in 21 patients with L4-degenerative spondylolisthesis...
September 16, 2016: Clinical Spine Surgery
Daniel G Tobert, Valentin Antoci, Shaun P Patel, Ehsan Saadat, Christopher M Bono
Adjacent segment disease (ASD) is disappointing long-term outcome for both the patient and clinician. In contrast to adjacent segment degeneration, which is a common radiographic finding, ASD is less common. The incidence of ASD in both the cervical and lumbar spine is between 2% and 4% per year, and ASD is a significant contributor to reoperation rates after spinal arthrodesis. The etiology of ASD is multifactorial, stemming from existing spondylosis at adjacent levels, predisposed risk to degenerative changes, and altered biomechanical forces near a previous fusion site...
September 16, 2016: Clinical Spine Surgery
Varun Puvanesarajah, Rabia Qureshi, Jourdan M Cancienne, Hamid Hassanzadeh
Cervical spine trauma in the athlete is not an insignificant occurrence with possibly catastrophic results. Football remains one of the most common and most well studied sporting activities associated with spine injuries. Transient spinal cord and peripheral nerve injuries may manifest as quadriparesis or burners/stingers with symptoms that resolve completely. More severe spinal cord injuries, typically from axial loading on the cervical spine, will cause bilateral symptoms with residual neurological deficit...
September 16, 2016: Clinical Spine Surgery
Yuanyuan Chen, Yang Liu, Huajiang Chen, Peng Cao, Wen Yuan
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare clinical and radiologic outcomes of 3-level anterior cervical discectomy and fusion between a zero-profile (Zero-P) spacer and a traditional plate in cases of symptomatic cervical spine spondylosis. SUMMARY OF BACKGROUND DATA: Anterior cervical decompression and fusion is indicated for patients with anterior compression or stenosis of the spinal cord. The Zero-P spacers have been used for anterior cervical interbody fusion of 1 or 2 segments...
September 16, 2016: Clinical Spine Surgery
Hai-Ming Jin, Dao-Liang Xu, Jun Xuan, Jiao-Xiang Chen, Kai Chen, Amit Goswami, Yu Chen, Qiu-Yan Kong, Xiang-Yang Wang
STUDY DESIGN: Digitally reconstructed radiograph-based study. OBJECTIVE: Using a computer-based method to determine what degree of pelvic rotation is acceptable for measuring the pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). The effectiveness of a geometrical formula used to calculate the angle of pelvic rotation proposed in a previous article was assessed. SUMMARY OF BACKGROUND DATA: It is unclear whether PI, PT, and SS are valid with pelvic rotation while acquiring a radiograph...
September 16, 2016: Clinical Spine Surgery
Kingsley R Chin, Fabio J R Pencle, André V Coombs, Mohamed Elsharkawy, Corrine F Packer, Elijah A Hothem, Jason A Seale
STUDY DESIGN: Level III. OBJECTIVE: To report on the outcomes of midline cortical bone trajectory (CBT) pedicle screw surgical technique for posterior lumbar fixation in the outpatient surgery center (OSC) compared with traditional pedicle screws in the hospital. SUMMARY OF BACKGROUND DATA: Traditional pedicle screws have been the gold standard for posterior lumbar fusion. Advances in spine surgery, including less invasive procedures have propelled the design of instruments and implants to achieve greater posterior spinal fixation, with decreased tissue destruction and higher safety margins...
September 16, 2016: Clinical Spine Surgery
Shinji Takahashi, Zorica Buser, Jeremiah R Cohen, Allison Roe, Sue L Myhre, Hans-Joerg Meisel, Darrel S Brodke, S Tim Yoon, Jong-Beom Park, Jeffrey C Wang, Jim A Youssef
STUDY DESIGN: A retrospective cohort study. OBJECTIVE: To compare the complications between posterior cervical fusions with and without recombinant human bone morphogenetic protein 2 (rhBMP2). SUMMARY OF BACKGROUND DATA: Use of rhBMP2 in anterior cervical spinal fusion procedures can lead to potential complications such as neck edema, resulting in airway complications or neurological compression. However, there are no data on the complications associated with the "off-label" use of rhBMP2 in upper and lower posterior cervical fusion approaches...
September 14, 2016: Clinical Spine Surgery
Michael H Weber, Maryse Fortin, Jian Shen, Bobby Tay, Serena S Hu, Sigurd Berven, Shane Burch, Dean Chou, Christopher Ames, Vedat Deviren
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess the subsidence and revision rates associated with different interbody cages following anterior cervical corpectomy and reconstruction. SUMMARY OF BACKGROUND DATA: Different interbody cages are currently used for surgical reconstruction of the anterior and middle columns of the spine following anterior cervical corpectomy. However, subsidence and delayed union/nonunion associated with allograft and cage reconstruction are common complications, which may require revision with instrumentation...
September 10, 2016: Clinical Spine Surgery
Tae Keun Park, Sung Joon Shin, Jae Hyup Lee
STUDY DESIGN: This is a retrospective case-control study. OBJECTIVE: To evaluate the influence of medication-related bleeding tendency on the clinical outcomes and complications of transforaminal epidural steroid injection (TFESI). SUMMARY OF BACKGROUND DATA: TFESI may result in serious complications such as epidural hematoma or adhesions in patients with medication-related bleeding tendency. However, little is known about the true relationship between medication-related bleeding tendency and postprocedural complications...
September 10, 2016: Clinical Spine Surgery
Xin Zheng, Bang-Ping Qian, Zhen Liu, Xu Sun, Ze-Zhang Zhu, Bin Wang, Yang Yu, Yong Qiu
STUDY DESIGN: Retrospective study. OBJECTIVE OF THE STUDY: The objective was to investigate the effect of apical pedicle screw placement on surgical outcomes of Lenke 1 adolescent idiopathic scoliosis (AIS). SUMMARY OF THE BACKGROUND DATA: Pedicle screw instrumentation achieves satisfactory correction of scoliosis in thoracic AIS patients, but the effect of apical screw placement is unclear. MATERIALS AND METHODS: Lenke 1 AIS patients with all pedicle screw instrumentation between January 2009 and January 2011 were reviewed...
September 10, 2016: Clinical Spine Surgery
Man Kyu Choi, Sung Bum Kim, Chang Kyu Park, Hridayesh P Malla, Sung Min Kim
STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate the relationship between trunk muscle cross-sectional area (MCSA) and fusion rate after posterior lumbar interbody fusion using pedicle screw fixation (PLIF-PSF). SUMMARY OF BACKGROUND DATA: Although trunk muscles of the lumbar spine contribute to spinal stability and alignment, effect of trunk muscles on spinal fusion rate and time to fusion is unclear. METHODS: A total of 192 adult patients with degenerative lumbar disease who underwent PLIF-PSF at L3-L4 or L4-L5 were included...
September 10, 2016: Clinical Spine Surgery
Qian Chen, Lu Cao, Chong Bian, Hui-Ren Wang, Hong Lin, Xi-Lei Li, Yun-Qi Jiang, Jian Dong
STUDY DESIGN: A retrospective study. OBJECTIVE: This study aimed to analyze the relationships between degenerative spondylolisthesis in the fifth lumbar vertebra (L5-DS) and radiographic parameters and to further determine the radiographic predictors of the development of L5-DS. SUMMARY OF BACKGROUND DATA: Degenerative lumbar spondylolisthesis (DLS) is a common degenerative disease of the spine; however, the correlations between L5-DS and radiographic parameters remain controversial...
September 10, 2016: Clinical Spine Surgery
Marjan Alimi, Rodrigo Navarro-Ramirez, Karishma Parikh, Innocent Njoku, Christoph P Hofstetter, Apostolos J Tsiouris, Roger Härtl
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate the radiographic and clinical outcome of silicate-substituted calcium phosphate (Si-CaP), utilized as a graft substance in spinal fusion procedures. SUMMARY OF BACKGROUND DATA: Specific properties of Si-CaP provide the graft with negative surface charge that can result in a positive effect on the osteoblast activity and neovascularization of the bone. METHODS: This study included those patients who underwent spinal fusion procedures between 2007 and 2011 in which Si-CaP was used as the only bone graft substance...
September 10, 2016: Clinical Spine Surgery
Akira Shinohara, Koichi Sairyo, Takuya Mishiro, Takashi Chikawa, Shigeru Soshi
STUDY DESIGN: This is a prospective multicenter comparison study. OBJECTIVE: To measure the insertional torque (IT) for cervical vertebra lateral mass screw (LMS) fixation using the Magerl and Roy-Camille methods, at the discretion of the surgeon. SUMMARY OF BACKGROUND DATA: Current fixation methods for patients with preoperative cervical spine instability use LMSs; however, few studies have closely examined intraoperative IT. Patients' bone quality was not measured...
September 10, 2016: Clinical Spine Surgery
Tarub Mabud, Justin Norden, Anand Veeravagu, Christian Swinney, Tyler Cole, Brandon A McCutcheon, John Ratliff
STUDY DESIGN: Retrospective database analysis. OBJECTIVE: To examine the impact of training pathway, either neurosurgical or orthopedic, on complications, readmissions, and revisions in spine surgery. SUMMARY OF BACKGROUND DATA: Training pathway has been shown to have an impact on outcomes in various surgical subspecialties. Although training pathway has not been shown to have a significant impact on spine surgery outcomes in the perioperative period, long-term results are unknown...
September 10, 2016: Clinical Spine Surgery
Alok D Sharan, Gregory D Schroeder, Michael E West, Alexander R Vaccaro
As spinal care transitions from individual practitioners working in a volume-based reimbursement system toward multidisciplinary health care organizations working in a population-based model with value-based reimbursement, it is critical that insurance companies, administrators, and spine care provider have a clear understanding of how incentives change physician behavior. This article will introduce the concept of behavior economics, and discuss 9 principles relevant to physician decision-making.
August 19, 2016: Clinical Spine Surgery
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