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Clinical Spine Surgery

Benjamin Khechen, Brittany E Haws, Dil V Patel, Kaitlyn L Cardinal, Jordan A Guntin, Kern Singh
STUDY DESIGN: Retrospective cohort. OBJECTIVE: The objective of this study was to determine if an association exists between gender and postoperative improvements in patient-reported outcomes (PRO) measures following minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: Current spine literature presents conflicting findings regarding the influence of gender on clinical outcomes. METHODS: Patients undergoing primary, single-level MIS TLIF were retrospectively reviewed...
November 6, 2018: Clinical Spine Surgery
Daniel D Bohl, Brittany E Haws, Benjamin Khechen, Dil V Patel, Benjamin C Mayo, Junyoung Ahn, Philip K Louie, Kaitlyn L Cardinal, Jordan A Guntin, Kern Singh
STUDY DESIGN: Retrospective SUMMARY OF BACKGROUND DATA:: Little is known regarding the impact of the number of operative levels on the risk for adverse events following spinal procedures. OBJECTIVE: The objective of this study was to test for associations between the number of operative levels and occurrence of adverse events following posterior lumbar fusion (PLF). METHODS: Patients undergoing 1-, 2-, or 3-level PLFs were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
November 6, 2018: Clinical Spine Surgery
Jianning Shao, Bryan S Lee, Dominic Pelle, Maxwell Y Lee, Jason Savage, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
The use of intraoperative multimodal monitoring (IOM) in spinal deformity surgeries is well documented. In particular, pedicle subtraction osteotomy (PSO), a corrective procedure for sagittal deformity of the spine, often involves IOM usage. By providing immediate feedback to the operating surgeon, IOM has the potential to eliminate or at least minimize the risk of iatrogenic neurological injury. However, despite the widespread usage of IOM, there is currently no standardization of IOM usage in complex spine surgeries, including lumbar PSOs, and decisions concerning IOM utilization are often driven by surgeon experience and preference...
November 6, 2018: Clinical Spine Surgery
Wencheng Yang, Jianyi Yang, Ming Liang
STUDY DESIGN: This was a clinical retrospective study. OBJECTIVES: This retrospective study aimed to investigate the incidence of new vertebral compression fractures (NVCFs) and analyze the risk factors that influence the secondary fractures in adjacent and nonadjacent levels after percutaneous vertebroplasty (PVP) and conservative treatment (CT). SUMMARY OF BACKGROUND DATA: PVP is an effective procedure to alleviate the pain caused by osteoporotic vertebral compression fractures...
November 1, 2018: Clinical Spine Surgery
Christian J Gaffney, Manuel R Pinto, Abdul F Buyuk, Timothy A Garvey, Benjamin Mueller, James D Schwender, Ensor E Transfeldt, Harrison K Tam, John M Dawson
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To compare posterolateral versus transforaminal interbody fusion (PLF vs. PLF+TLIF) of the L4/5 segment regarding rates of subsequent surgery, clinical and radiographic parameters, and patient satisfaction. SUMMARY OF BACKGROUND DATA: Surgical treatment of lumbar stenosis, decompression with or without fusion, is an efficacious treatment in select patients. Reoperation is thought to be a problem after lumbar fusion...
November 1, 2018: Clinical Spine Surgery
Nicholas N DePhillipo, Donald S Corenman, Eric L Strauch, Lisa A Zalepa King
BACKGROUND: The currently reported incidence of primary sacroiliac joint (SIj) pathology ranges from 15% to 30%. The differential diagnosis of SIj region pain includes pain generated from the lumbar spine, the SIj, and the hip joint. The origins of SIj dysfunctions are controversial and pain generation from this joint has been questioned. PURPOSE: Retrospectively analyze the relative incidence of lumbar spine, SIj, and hip joint etiologies in patients complaining of ≥50% SIj region pain...
October 30, 2018: Clinical Spine Surgery
Bhaveen H Kapadia, Samuel I Decker, Matthew R Boylan, Neil V Shah, Carl B Paulino
STUDY DESIGN/SETTING: This was a retrospective cohort study. PURPOSE: The purpose of this study was to examine the association between postoperative cerebrospinal fluid (CSF) leak and anterior cervical discectomy and fusion (ACDF). Specifically, we evaluated: (1) demographic risk factors; (2) comorbid risk factors; (3) indications for surgery; and (4) lengths of stay. SUMMARY OF BACKGROUND DATA: CSF leak is a rare but serious complication of ACDF...
October 30, 2018: Clinical Spine Surgery
Masashi Uehara, Jun Takahashi, Shota Ikegami, Shugo Kuraishi, Toshimasa Futatsugi, Hiroki Oba, Takashi Takizawa, Ryo Munakata, Michihiko Koseki, Hiroyuki Kato
STUDY DESIGN: This is a retrospective single-center and single-surgeon study. OBJECTIVE: The present study examined for preoperative parameters having the highest correlation with compensatory thoracolumbar/lumbar (TL/L) curve correction 2 years after surgery in adolescent idiopathic scoliosis (AIS) patients with Lenke type 1 curves. SUMMARY OF BACKGROUND: Several parameters have been considered to evaluate the flexibility of compensatory TL/L curve in AIS patients with Lenke type 1 curves...
October 30, 2018: Clinical Spine Surgery
Matthew F Gornet, Jeffrey R McConnell, K Daniel Riew, Todd H Lanman, J Kenneth Burkus, Scott D Hodges, Randall F Dryer, Anne G Copay, Francine W Schranck
STUDY DESIGN: Analysis of 2- and 7-year outcomes from a clinical trial comparing 2-level cervical disk arthroplasty (CDA) to anterior cervical discectomy and fusion (ACDF) in 287 patients with radiculopathy alone, and 110 patients with myelopathy alone or myelopathy with radiculopathy. OBJECTIVE: To compare the long-term safety and effectiveness of CDA for myelopathy versus radiculopathy. SUMMARY OF BACKGROUND DATA: CDA for myelopathy is safe and effective in short term...
October 26, 2018: Clinical Spine Surgery
Peter G Passias, Frank A Segreto, Cole A Bortz, Samantha R Horn, Nicholas J Frangella, Bassel G Diebo, Aaron Hockley, Charles Wang, Nicholas Shepard, Renaud Lafage, Virginie Lafage
STUDY DESIGN: This is a retrospective review of a single surgeon cervical deformity (CD) database. OBJECTIVE: Quantitatively describe the cervical extensor musculature in a CD population, and delineate associations between posterior musculature atrophy and progressive sagittal deformity. SUMMARY OF BACKGROUND DATA: While fatty infiltration (FI; ie, posterior musculature atrophy) of lumbar extensor musculature has been associated with pain and deformity, little is known of the relationship between FI, CD, cervical sagittal alignment, and functionality...
October 26, 2018: Clinical Spine Surgery
Peter G Passias, Gregory W Poorman, Virginie Lafage, Justin Smith, Christopher Ames, Frank Schwab, Chris Shaffrey, Frank A Segreto, Samantha R Horn, Cole A Bortz, Christopher G Varlotta, Aaron Hockley, Charles Wang, Alan Daniels, Brian Neuman, Robert Hart, Douglas Burton, Yashar Javidan, Breton Line, Renaud LaFage, Shay Bess, Daniel Sciubba
STUDY DESIGN: Retrospective analysis of 2 prospectively collected multicenter databases, one for cervical deformity (CD) and the other for general adult spinal deformity. OBJECTIVE: To investigate the relative quality-of-life and disability burden in patients with uncompensated cervical, thoracolumbar, or cervical and thoracolumbar deformities. SUMMARY OF BACKGROUND DATA: The relative quality-of-life burden of cervical and thoracolumbar deformities have never been compared with each other...
October 26, 2018: Clinical Spine Surgery
Sohaib Z Hashmi, Angelo Marra, Louis G Jenis, Alpesh A Patel
Central cord syndrome (CCS) represents a clinical phenomenon characterized by disproportionately greater motor impairment of the upper than of the lower extremities, bladder dysfunction. CSS is the most common form of incomplete traumatic spinal cord injury. The initial description of CSS was reported in 1887 secondary to cervical spinal trauma. However, recent literature describes a heterogenous injury patterns including high-energy and low-energy mechanisms and bimodal patient age distributions. Pathophysiology of clinical symptoms and neurological deficits often is affected by preexisting cervical spondylosis...
October 22, 2018: Clinical Spine Surgery
Kyle Schoell, Christopher Wang, Anthony D'Oro, Patrick Heindel, Larry Lee, Jeffrey C Wang, Zorica Buser
STUDY DESIGN: This was a retrospective database study. OBJECTIVE: The aim of this study was to use a large sample to accurately determine risk factors and rates of neurological complications in patients undergoing commonly performed lumbar spine surgeries. SUMMARY OF BACKGROUND DATA: Damage to neurological structures and failed back surgery syndrome (FBSS) are among the most feared complications of lumbar spine surgery. Despite the large impact on quality of life these complications have, reported rates of neurological complications vary immensely, ranging from 0...
October 22, 2018: Clinical Spine Surgery
Matthew W Colman, Lon M Baronne, Darrel S Brodke, Ashley M Woodbury, Prokopis Annis, Brandon D Lawrence
STUDY DESIGN: This is a retrospective analysis. OBJECTIVE: The purpose of this study was to compare the clinical, radiographic, and perioperative complication profiles of performing an interbody and posterior arthrodesis (CAGE) versus posterolateral lumbar fusion (PLF) alone in patients undergoing surgery for degenerative spondylolisthesis (DS). SUMMARY OF BACKGROUND DATA: DS is a common disorder that, failing nonoperative treatment, may be managed with surgical decompression and concomitant posterior arthrodesis...
October 16, 2018: Clinical Spine Surgery
Myung-Soo Jang, Jin-Hee Han, SangHo Lee, Sung-Eun Kim
STUDY DESIGN: Retrospective analysis. OBJECTIVE: The objective of this study was to investigate the effects of intraoperative balanced 6% hydroxyethyl starch (HES) 130/0.4 on postoperative blood loss and the coagulation profile. SUMMARY OF BACKGROUND DATA: The safety of colloid versus crystalloid transfusion for bleeding and coagulation during major spine surgery remains controversial and only a few studies exist. Thus, we compared the effects of balanced 6% HES 130/0...
October 16, 2018: Clinical Spine Surgery
Gregory D Schroeder, Alan S Hilibrand, Christopher K Kepler, James C McKenzie, Kristen J Nicholson, Christie Stawicki, Jonathan Paul, Priyanka Kumar, Douglas A Hollern, Hamadi Murphy, Paul W Milhouse, Mark F Kurd, Barret I Woods, Kris E Radcliff, David G Anderson, Alexander R Vaccaro, Jeffery A Rihn
STUDY DESIGN: This is a prospective case series. OBJECTIVE: To determine the actual cost of performing 1- or 2-level anterior cervical discectomy and fusion (ACDF) using actual patient data and the time-driven activity-based cost methodology. SUMMARY OF BACKGROUND DATA: As health care shifts to use value-based reimbursement, it is imperative to determine the true cost of surgical procedures. Time-driven activity-based costing determines the cost of care by determining the actual resources used in each step of the care cycle...
October 9, 2018: Clinical Spine Surgery
Ilyas S Aleem, Bradford L Currier, Michael J Yaszemski, Heidi Poppendeck, Paul Huddleston, Jason Eck, John Rhee, Mohamad Bydon, Brett Freedman, Ahmad Nassr
STUDY DESIGN: This is a prospective cohort study. OBJECTIVE: To characterize the accuracy of patient recollection of preoperative symptoms after cervical spine surgery. SUMMARY OF BACKGROUND DATA: Recall bias is a well-known source of systematic error. The accuracy of patient recall after cervical spine surgery remains unknown. METHODS: Consecutive patients undergoing cervical spine surgery for myelopathy or radiculopathy were enrolled...
October 5, 2018: Clinical Spine Surgery
Seung-Jin Choi, Kyung-Soo Suk, Jae-Ho Yang, Hak-Sun Kim, Hwan-Mo Lee, Seong-Hwan Moon, Byung-Ho Lee, Sang-Jun Park
STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: To evaluate the sagittal alignment and T1 slope after multilevel posterior cervical fusion surgery depending on the distal fusion level; C7 or T1, and find out the appropriate distal fusion level. SUMMARY OF BACKGROUND DATA: The sagittal balance of the cervical spine is known to be affected by cervical lordosis and T1 slope. However, T1 slope is not a constant parameter that can be frequently changed after the surgery...
October 5, 2018: Clinical Spine Surgery
Donald R Fredericks, Sean M Wade, Alfred J Pisano, Husain Bharmal
No abstract text is available yet for this article.
October 3, 2018: Clinical Spine Surgery
Ziming Yao, Dong Guo, Hao Li, Yunsong Bai, Baosheng Sun, Xuejun Zhang, Chengxin Li, Xinyu Qi
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To investigate surgical outcomes and instrumentation-related complications (IRCs) of dystrophic scoliosis associated with neurofibromatosis type 1 (NF-1). SUMMARY OF BACKGROUND DATA: Surgical management, including the growing rod technique and early definitive fusion, has been recommended to avoid progression of NF-1 scoliosis. However, no study has investigated the outcomes and complications of different surgical interventions...
September 29, 2018: Clinical Spine Surgery
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