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Clinical Spine Surgery

Kyle Mombell, Nicholas Perry, Sean M Wade, Donald Fredericks, David Glassman, Patrick Morrissey
No abstract text is available yet for this article.
September 5, 2018: Clinical Spine Surgery
Arif Musa, Jeffrey C Wang, Frank L Acosta, Rana Movahedi, Adana Melkonian, Alan Shahbazi, David Safani, Gligor Gucev
STUDY DESIGN: This is a cross-sectional study. OBJECTIVE: To investigate spine surgeons' attitudes regarding preoperative anxiety measurement, management, and responsibility. SUMMARY OF BACKGROUND DATA: The vast majority of patients scheduled for spine surgery experience preoperative anxiety. However, there are currently no consensus guidelines for measure or management of preoperative anxiety in spinal operations. MATERIALS AND METHODS: An anonymous questionnaire was sent online to spine surgeons of AO Spine North America to capture their views regarding preoperative anxiety...
August 24, 2018: Clinical Spine Surgery
Kimberly Ashayeri, Nikhil Sahasrabudhe, Vladimir Galic, Aleksandar Beric, Michael Smith
STUDY DESIGN: This is a retrospective analysis of electromyographic (EMG) stimulation thresholds of 64 cortical bone trajectory (CBT) screws. OBJECTIVE: The authors seek to determine whether recordings below stimulation threshold correlate with CBT screw pedicle breach on computed tomographic imaging, and to explore which specific nerve roots are most at risk with this new trajectory. SUMMARY OF BACKGROUND DATA: Intraoperative EMG monitoring has been utilized to verify accurate placement of pedicle screws...
August 21, 2018: Clinical Spine Surgery
Soraya Nishimura, Narihito Nagoshi, Akio Iwanami, Ayano Takeuchi, Takashi Hirai, Toshitaka Yoshii, Kazuhiro Takeuchi, Kanji Mori, Tsuyoshi Yamada, Shoji Seki, Takashi Tsuji, Kanehiro Fujiyoshi, Mitsuru Furukawa, Kanichiro Wada, Masao Koda, Takeo Furuya, Yukihiro Matsuyama, Tomohiko Hasegawa, Katsushi Takeshita, Atsushi Kimura, Masahiko Abematsu, Hirotaka Haro, Tetsuro Ohba, Masahiko Watanabe, Hiroyuki Katoh, Kei Watanabe, Hiroshi Ozawa, Haruo Kanno, Shiro Imagama, Kei Ando, Shunsuke Fujibayashi, Masashi Yamazaki, Kota Watanabe, Morio Matsumoto, Masaya Nakamura, Atsushi Okawa, Yoshiharu Kawaguchi
STUDY DESIGN: This was a retrospective multicenter study. OBJECTIVE: To clarify the progression of diffuse idiopathic skeletal hyperostosis (DISH) using whole-spine computed tomography in patients with cervical ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF BACKGROUND DATA: DISH and cervical OPLL frequently coexist, and can cause ankylosing spinal fractures due to biomechanical changes and fragility of the affected vertebrae...
August 14, 2018: Clinical Spine Surgery
Eijiro Okada, Kenshi Daimon, Hirokazu Fujiwara, Yuji Nishiwaki, Kenya Nojiri, Masahiko Watanabe, Hiroyuki Katoh, Kentaro Shimizu, Hiroko Ishihama, Nobuyuki Fujita, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
STUDY DESIGN: A 20-year longitudinal study. OBJECTIVE: To evaluate the long-term effect of sagittal alignment of the cervical spine on intervertebral disk degeneration in healthy asymptomatic subjects. SUMMARY OF BACKGROUND DATA: This study continues a previous 10-year longitudinal study to determine whether sagittal alignment affects disk degeneration during normal aging. MATERIALS AND METHODS: We assessed 90 healthy subjects (30 men and 60 women) from among 497 volunteers who underwent magnetic resonance imaging (MRI) and plain radiographs of the cervical spine between 1994 and 1996 (follow-up rate 18...
August 10, 2018: Clinical Spine Surgery
Koji Ishikawa, Tomoaki Toyone, Toshiyuki Shirahata, Yoshifumi Kudo, Akira Matsuoka, Hiroshi Maruyama, Chikara Hayakawa, Soji Tani, Masaya Sekimizu, Koki Tsuchiya, Takeshi Eguro, Yusuke Oshita, Tomoyuki Ozawa, Yusuke Nakao, Shigeo Sano, Takashi Nagai, Koji Kanzaki, Katsunori Inagaki
STUDY DESIGN: Prospective feasibility study on consecutive patients. OBJECTIVE: The aim of this study was to investigate the ability of regional BMD around the pedicle screw to predict the screw fixation. SUMMARY OF BACKGROUND DATA: Pedicle screw fixation is the gold standard technique for spinal fusion. Despite the advantage of biomechanical stability, screw loosening is a common complication. In previous studies, pullout strength and screw insertional torque were correlated, and most importantly, affected by bone mineral density (BMD)...
August 10, 2018: Clinical Spine Surgery
Alexandre Rasouli, Jason M Cuellar, Lea Kanim, Rick Delamarter
BACKGROUND: Recent studies demonstrate the efficacy of lumbar arthroplasty using the ProDisc-L. Patients frequently present with multilevel pathology and may be candidates for multilevel disk replacement. PURPOSE: To evaluate clinical outcomes and sagittal range of motion of operated levels and adjacent lumbar motion segments in multiple-level ProDisc-L constructs after 2-6 years follow-up. PATIENT SAMPLE: A total of 159 patients underwent adjacent 2-level (n=114), 3-level (n=41), or 4-level (n=4) lumbar total disk replacement (TDR)...
August 7, 2018: Clinical Spine Surgery
Tetsuro Ohba, Shigeto Ebata, Hiroki Oba, Kensuke Koyama, Hirotaka Haro
STUDY DESIGN: This was a retrospective cohort study using consecutive patients. OBJECTIVES: The objectives of this study were to evaluate the effect of lumbar lordosis (LL) construction on postoperative reciprocal progression of thoracic kyphosis (TK) and occurrence of proximal junctional kyphosis (PJK) following surgery for adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA: A large postoperative TK has been reported as an iatrogenic risk factor for PJK following surgery for ASD...
August 7, 2018: Clinical Spine Surgery
Casey Slattery, Samantha Sokol, Kushagra Verma
Classification systems provide organization for pathologic conditions and guide treatment for similar disease states. Spine deformity is a growing field with newer classification systems being developed as our surgical techniques and clinical understanding advances. The evolution of these classification systems reflects our current knowledge and are used to better understand the evolving field of spine surgery. Currently, classification systems in spine surgery range from describing deformity in different age groups and different regions of the spine to describing various osteotomies and the severity of proximal junctional kyphosis...
August 4, 2018: Clinical Spine Surgery
Jennifer C Urquhart, Nabeel Alnaghmoosh, Kevin R Gurr, Stewart I Bailey, Corinne Tallon, Shauna Dehens, M Patricia Rosas Arellano, Christopher S Bailey
STUDY DESIGN: This was a retrospective study of 2 different fusion techniques for the treatment of lumbar degenerative spondylolisthesis. OBJECTIVE: To determine whether posterior lumbar interbody fusion (IF) is associated with improved patient-rated satisfaction and functional outcome when compared with posterolateral fusion (PLF). SUMMARY OF BACKGROUND DATA: IF and PLF are widely used surgical approaches in the treatment of spondylolisthesis...
July 31, 2018: Clinical Spine Surgery
Azeem T Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: The main objective of this article was to investigate the impact of discharge destination on postdischarge outcomes following an elective 1- to 2-level posterior lumbar fusion (PLF) for degenerative pathology. BACKGROUND DATA: Discharge to an inpatient care facility may be associated with adverse outcomes as compared with home discharge. MATERIALS AND METHODS: The 2012-2016 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was used to query for patients undergoing PLFs using Current Procedural Terminology (CPT) codes (22612, 22630, and 22633)...
July 31, 2018: Clinical Spine Surgery
Haariss Ilyas, Jason Savage
The Spine Patient Outcomes Related Trial (SPORT) is arguably one of the most impactful and insightful studies conducted in spine surgery. Designed as a prospective, multicenter study with a randomized and observational cohort, SPORT has provided vast data on the pathogenesis, treatment effects, clinical outcomes, cost effectiveness of both disk herniation and lumbar spinal stenosis. With regards to lumbar disk herniation, SPORT has demonstrated a sustained benefit from surgical intervention and acceptable cost-effectiveness at 2, 4, and 8 years postoperatively...
July 24, 2018: Clinical Spine Surgery
Kivanc Atesok, Walter Smith, Ross Jones, Thomas Niemeier, Sakthivel R R Manoharan, Gerald McGwin, Jason Pittman, Steven Theiss
STUDY DESIGN: This is a retrospective matched-pair cohort study. OBJECTIVE: To investigate the significance of upper extremity (UE) neuromonitoring changes in patients undergoing thoracolumbar surgery in prone position. SUMMARY OF BACKGROUND DATA: Peripheral nerve injuries in the UEs due to the prone positioning during prolonged thoracolumbar spinal procedures can cause diminished postsurgical outcomes. Intraoperative neuromonitoring has been utilized to alert the surgeon of the development of such injuries...
July 21, 2018: Clinical Spine Surgery
Federico Solla, Antoine Tran, Domenico Bertoncelli, Charles Musoff, Carlo M Bertoncelli
BACKGROUND: All doctors know that P-value<0.05 is "the Graal," but publications require further parameters [odds ratios, confidence interval (CI), etc.] to better analyze scientific data. AIM: The aim of this study was to present P-values, CI, and common effect-sizes (Cohen d, odds ratio, and various coefficients) in a simple way. DESCRIPTION: The P-value is the probability, when the null hypothesis is true (eg, no difference or no association), of obtaining a result equal to or more extreme than what we actually observed...
July 21, 2018: Clinical Spine Surgery
Turgay Tuna, Sibel Boz, Luc Van Obbergh, Alphonse Lubansu, Edgard Engelman
STUDY DESIGN: This was a prospective study evaluating the Pain Sensitivity Questionnaire (PSQ) in 110 patients undergoing spine surgery. OBJECTIVE: The purpose of this study was to compare the ability of the PSQ-total and PSQ-minor scores with the Pain Catastrophizing Scale (PCS) in predicting the immediate postoperative pain of patients after spinal surgery and their risk of developing a chronically painful state. SUMMARY OF BACKGROUND DATA: Studies evaluating the PSQ as a preoperative determinant for the development of chronic pain are lacking...
July 21, 2018: Clinical Spine Surgery
Yu-Cheng Yao, Hsi-Hsien Lin, Ming-Chau Chang
STUDY DESIGN: This is a prospective, randomized trial. OBJECTIVE: This study aimed to evaluate the outcome of bracing following transforaminal lumbar interbody fusion (TLIF) in patients with degenerative lumbar spine diseases. SUMMARY OF BACKGROUND DATA: Bracing following spinal fusion for lumbar degenerative disease is common. However, the necessity of postoperative bracing is still controversial. A paucity of high-quality studies have assessed the efficacy of bracing...
July 17, 2018: Clinical Spine Surgery
Hiroyuki Yoshihara, Daisuke Yoneoka
STUDY DESIGN: A retrospective analysis of population-based national hospital discharge data collected for the nationwide inpatient sample (NIS). OBJECTIVES: To examine the in-hospital outcomes of patients with advanced chronic kidney disease (CKD), dialysis, and kidney transplant undergoing spinal fusion on a national level. SUMMARY OF BACKGROUND DATA: Patients with advanced CKD have been living longer with the support and improvement of medical treatment, dialysis, and organ transplant...
July 17, 2018: Clinical Spine Surgery
Sebastian A Ahmadi, Amin Hashemi, J├╝rgen Harms, Berk Orakcioglu
STUDY DESIGN: Presentation of a surgical technique with accompanying video (Supplemental Digital Content 1, of an illustrative case. OBJECTIVE: The objective of this study was to present a helpful and easy-to-implement technique for improving initial referencing accuracy, as well as rereferencing accuracy in cases of multilevel instrumentation or in cases of dislocation of the reference array. SUMMARY OF BACKGROUND DATA: Navigation-assisted spine surgery has become standard of care in most hospitals performing complex spine interventions...
July 17, 2018: Clinical Spine Surgery
Srikanth N Divi, Ananth S Eleswarapu, Christopher E Stout, Michael J Lee
STUDY DESIGN: Retrospective cohort study (Level of evidence-3). OBJECTIVE: The objective of this study was to investigate the real-life effectiveness of physical therapy (PT) for patients initially presenting with common neck pain diagnoses. SUMMARY OF BACKGROUND DATA: Neck pain is a common cause of morbidity and a leading cause of disability in the United States. PT is prescribed as a first-line treatment for the vast majority of patients with neck pain; however, there is limited literature supporting the effectiveness of these treatments...
July 13, 2018: Clinical Spine Surgery
Huseyin Yener Erken, Junseok Bae, Sang-Ho Lee, Jin Suk Seo, Sang Ha Shin
STUDY DESIGN: This was a prospective clinical study. OBJECTIVE: The aim of this study was to evaluate the influence of a preoperative conference on spine surgeons' decision-making in the treatment of adult spinal disorders. SUMMARY AND BACKGROUND DATA: There are several factors that spine surgeons have to consider when determining a surgical plan for the treatment of spinal disorders, which include surgical approach, application of fusion or nonfusion surgery, levels to be treated, treatment of accompanying spinal conditions, the need for further preoperative imaging, and the implant type to be used...
July 13, 2018: Clinical Spine Surgery
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