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Spine surgery outcomes

Nikhil Jain, Frank M Phillips, Tristan Weaver, Safdar N Khan
STUDY DESIGN: Retrospective, economic analysis. OBJECTIVE: To study patient profile associated with preoperative chronic opioid therapy (COT), and study COT as a risk factor for 90-day complications, emergency department (ED) visits, and readmission after primary one- to two-level posterior lumbar fusion (PLF) for degenerative spine disease. We also evaluated associated costs, risk factors, and adverse events related to long-term postoperative opioid use. SUMMARY OF BACKGROUND DATA: Chronic opioid use is associated with poor outcomes and dependence after spine surgery...
March 20, 2018: Spine
Jeffrey A Zuccato, Christopher D Witiw, Julia Keith, Erin Dyer, Arjun Saghal, Leodante da Costa
Introduction: Pre-operative biopsy and diagnosis of chordomas of the mobile spine is indicated as en bloc resections improve outcomes. This review of the management of mobile spine chordomas includes two cases of unexpected mobile spine chordomas where a preoperative tissue diagnosis was decided against and may have altered surgical decision-making. Case presentation: Two lumbar spine chordomas thought to be metastatic and primary bony lesions preoperatively were not biopsied before surgery and eventual pathology revealed chordoma...
2018: Spinal Cord Series and Cases
Tao Yang, Fei Wang, Chaoshi Niu
The majority of spinal cavernous angiomas (CAs) originate from the vertebral bodies with or without epidural space extension. Solitary epidural CAs are rare. In the present study, we retrospectively reviewed the records of 12 patients who underwent microsurgery for solitary spinal epidural CAs. All patients had performed pre- and postoperative magnetic resonance imaging. The patients were 7 females and 5 males with the mean age of 52.1 years. Two tumors were located in the cervicothoracic spine, nine in the thoracic spine and one in the lumbar spine, respectively...
April 2018: Oncology Letters
Bastien Provost, Gilles Missenard, Ciprian Pricopi, Olaf Mercier, Sacha Mussot, Dominique Fabre, Nathaniel Langer, Olivier Mir, Cécile Le Pechoux, Philippe Dartevelle, Elie Fadel
BACKGROUND: Radiotherapy has long been the treatment of choice for local control of Ewing sarcoma of the chest wall (ESCW). However, there is debate regarding the use of surgery versus RT. Our objective was to identify risk factors that may affect long-term outcomes of non-metastatic ESCW all treated with preoperative chemotherapy followed by en-bloc resection and adjuvant Chemotherapy or Chemoradiation. METHODS: Between 1996 and 2014, 30 patients with a median age of 25 years (SD +/-8...
March 15, 2018: Annals of Thoracic Surgery
Che-Wei Hung, Ming-Fang Wu, Gwo-Fane Yu, Chin-Chu Ko, Cheng-Hsing Kao
PURPOSE: To analyze sagittal balance of the cervical spine after three operative methods for three consecutive levels. METHODS: A retrospective case selection and observational study was performed from December 2012 to December 2015: 20 patients underwent anterior cervical discectomy and fusion, 22 patients underwent hybrid surgery (HS), and 20 patients underwent total disc replacement (TDR). Perioperative parameters, clinical outcomes, and preoperative and postoperative sagittal parameters were recorded...
March 9, 2018: Clinical Neurology and Neurosurgery
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
Yang Xiong, Lin Xu, Xing Yu, Yongdong Yang, Dingyan Zhao, Zhengguo Hu, Chuanhong Li, He Zhao, Lijun Duan, Bingbing Zhang, Sixue Chen, Tao Liu
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the mid-term outcomes of hybrid surgery and anterior cervical discectomy and fusion for the treatment of contiguous 2-segment cervical degenerative disc diseases. SUMMARY OF BACKGROUND DATA: Hybrid surgery has become one of the most controversial subjects in spine communities, and the comparative studies of hybrid surgery and anterior cervical discectomy and fusion in the mid- and long-term follow-up are rarely reported...
March 15, 2018: Spine
Ahilan Sivaganesan, Brandon Hirsch, Frank M Phillips, Matthew J McGirt
Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings...
March 12, 2018: Neurosurgery
Micheal Raad, Amit Jain, Brian J Neuman, Hamid Hassanzadeh, Munish C Gupta, Douglas C Burton, Gregory M Mundis, Virginie Lafage, Eric O Klineberg, Richard A Hostin, Christopher P Ames, Shay Bess, Daniel M Sciubba, Khaled M Kebaish
STUDY DESIGN: Retrospective analysis of prospective registry OBJECTIVE.: To investigate associations of preoperative narcotic use with outcomes after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: We hypothesized that preoperative narcotic use would predict longer hospital stays, greater postoperative narcotic use, and greater disability 2 years after ASD surgery. METHODS: A multicenter database of surgical ASD patients was analyzed retrospectively for patients with self-reported data on preoperative narcotic use...
March 13, 2018: Spine
X Sun, L Xu, Z H Chen, X Chen, C Z Du, S Li, Z Liu, B P Qian, B Wang, Z Z Zhu, Y Qiu
Objective: To evaluate the correction result of traditional dual growing rods on apical vertebral rotation. Methods: This study recruited 19 early-onset scoliosis patients (6 boys and 13 girls) who had received traditional dual growing rods treatment at Department of Spine Surgery, Nanjing Drum Tower Hospital from January 2009 to July 2015. The age at initial surgery was (5.7±1.7)years(range, 3 to 9 years). Measurements of primary curve magnitude, height of T(1)-S(1), apical vertebral translation(AVR), apical vertebral body-rib ratio, apical vertebral rotation, thoracic rotation and rib hump were compared between pre-operatively, post-operatively, and at latest follow-up, through a paired- t test...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Rafet Ozay, Torel Ogur, Hasan Ali Durmaz, Erhan Turkoglu, Yusuf Sukru Caglar, Zeki Sekerci, Mehmet Sorar, Sahin Hanalioglu
OBJECTIVE: Preserving the ligamentum flavum (LF) during lumbar spine surgery may help limit the extent of postoperative epidural fibrosis (EF), a potential cause of persistent leg pain. We present a retrospective analysis of microdiscectomy with preservation of the LF in order to evaluate the effects of the two LF mobilizing techniques (reflecting inferiorly or medially vs. removing completely) on EF and clinical outcomes. METHODS: Microdiscectomy was performed through a unilateral laminotomy in 93 patients (52 male, 41 female; mean age 46; range 25-65 years) with L3-L4 (n=3), L4-L5 (n=40), and L5-S1 (n=50) lumbar disc herniation...
March 9, 2018: World Neurosurgery
Elliott J Kim, Joseph B Wick, David P Stonko, Silky Chotai, Thomas H Freeman, Diana G Douleh, Akshitkumar M Mistry, Scott L Parker, Clinton J Devin
BACKGROUND: Numerous studies have demonstrated the benefits of early decompression and stabilization in unstable spine injuries with incomplete neurological deficits. However, a clear consensus on timing to operative intervention still does not exist in those with a normal neurological exam and unstable spine. OBJECTIVE: To determine the optimal timing of operative intervention in traumatic spine injuries without neurological deficit. METHODS: Retrospective chart review at a single institution was performed including patients with traumatic spine injuries without neurological deficit admitted from December 2001 to August 2012...
February 24, 2018: Neurosurgery
Weiwei Lin, Hongtao Xu, Guman Duan, Jinjin Xie, Yisheng Chen, Baohua Jiao, Haitao Lan
Purpose Tethered cord syndrome (TCS) is the clinical manifestation of an abnormal stretch on the spinal cord, caused by several pathological conditions. Tethered cord release is the gold standard treatment for TCS. However, direct untethering carries potential risks of spinal cord injury, post-operative retethering, and CSF-related complications. Spine-shortening osteotomy (SSO) has recently been performed as an alternative technique to avoid these risks. We aimed to systematically review the literature on indications and outcome of SSO in TCS patients...
March 12, 2018: Neurological Research
P Elkan, T Lagerbäck, H Möller, Paul Gerdhem
PURPOSE: Quality registers give unique possibilities to achieve information from large groups of patients, but outcome must be interpreted carefully due to less stringent data collection and lower follow-up rates than in research projects. We tried to quantify any outcome differences between a national spine quality register and a prospective observational study. METHODS: Adult patients treated with lumbar discectomy between 2004 and 2010 were retrieved from the Swedish Spine register (Swespine) (n = 7791) and from the single center lumbar disc herniation study (LDHS) in Stockholm (n = 177)...
March 9, 2018: European Spine Journal
Soliman Oushy, Lucas P Carlstrom, William E Krauss
BACKGROUND AND IMPORTANCE: Transverse ligament cysts (TLC) are rare, surgically complex lesions arising posterior to the odontoid process of C2. Direct compression of the cervicomedullary junction is a devastating consequence of untreated lesions. We report the first case of spontaneous TLC regression without surgical intervention. CLINICAL PRESENTATION: A 75-yr-old woman presented to an outside hospital with acute episodes of left face and upper extremity numbness...
March 5, 2018: Neurosurgery
Jae-Kwang Kim, Bong Ju Moon, Sang-Deok Kim, Jung-Kil Lee
RATIONALE: In the treatment of noncontiguous lumbar burst fractures, there still remains controversy over proper surgical procedures. PATIENT CONCERNS: A 19-year-old female patient visited our hospital after fall down from 3 m high. DIAGNOSES: Initial neurologic examination revealed an incomplete spinal cord injury characterized by hypoesthesia and motor grade of 2 below the L2 segment. Lumbar computed tomography and magnetic resonance imaging demonstrated L2 and L5 burst fractures severely obliterating the spinal canal...
March 2018: Medicine (Baltimore)
Sara Khor, Danielle Lavallee, Amy M Cizik, Carlo Bellabarba, Jens R Chapman, Christopher R Howe, Dawei Lu, A Alex Mohit, Rod J Oskouian, Jeffrey R Roh, Neal Shonnard, Armagan Dagal, David R Flum
Importance: Functional impairment and pain are common indications for the initiation of lumbar spine surgery, but information about expected improvement in these patient-reported outcome (PRO) domains is not readily available to most patients and clinicians considering this type of surgery. Objective: To assess population-level PRO response after lumbar spine surgery, and develop/validate a prediction tool for PRO improvement. Design, Setting, and Participants: This statewide multicenter cohort was based at 15 Washington state hospitals representing approximately 75% of the state's spine fusion procedures...
March 7, 2018: JAMA Surgery
Ying-Chun Chen, Lin Zhang, Er-Nan Li, Li-Xiang Ding, Gen-Ai Zhang, Yu Hou, Wei Yuan
BACKGROUND: The optimal drainage after debridement for treating postoperative SSI is still controversial. We comprehensively compared single-tube drainage method with double-tube drainage method. MATERIALS AND METHODS: We retrospectively analyzed 1125 patients with lumbar degenerative disease who received lumbar surgery. Among them, 26 patients were diagnosed as postoperative SSI and divided into two groups, including single-tube drainage group (1 drain) and double-tube drainage group (2 drains)...
March 3, 2018: World Neurosurgery
M Dosani, S Lucas, J Wong, L Weir, S Lomas, C Cumayas, C Fisher, S Tyldesley
Background: The Spinal Instability Neoplastic Score (sins) was developed to identify patients with spinal metastases who may benefit from surgical consultation. We aimed to assess the distribution of sins in a population-based cohort of patients undergoing palliative spine radiotherapy (rt) and referral rates to spinal surgery pre-rt. Secondary outcomes included referral to a spine surgeon post-rt, overall survival, maintenance of ambulation, need for re-intervention, and presence of spinal adverse events...
February 2018: Current Oncology
Gilles Norotte, Carlos Barrios
OBJECTIVE: Recent improvements in cage designs with integral fixation and screw attachments have made stand-alone ALIF a viable option with several possible advantages. The aim of this study was to confirm the efficacy and safety of a PEEK cage filled with hydroxyapatite nanoparticles without adding a bone graft for stand-alone ALIF in the treatment of L5-S1 isolated degenerative disc discopathy (DDD). PATIENTS AND METHODS: Sixty-five patients who required surgery for DDD were evaluated...
January 31, 2018: Clinical Neurology and Neurosurgery
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