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Is single-level cervical disc arthroplasty associated with a lower reoperation rate than anterior cervical discectomy and fusion? J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-15 Alexander Tuchman, Ida Chen, Corey T. Walker, Linda E. Kanim, Hyun W. Bae, David L. Skaggs
OBJECTIVE Long-term meta-analysis of cervical disc arthroplasty (CDA) trials report lower rates of subsequent cervical spine surgical procedures with CDA compared with anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the rate of subsequent cervical spine surgery in single-level CDA–treated patients to that of a matched cohort of single-level ACDF–treated patients
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Sacral Tarlov perineurial cysts: a systematic review of treatment options J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-15 Jan Alberto Paredes Mogica, Frank Feigenbaum, Julie G. Pilitsis, Rudolph J. Schrot, Anne Louise Oaklander, Elise J. B. De
Tarlov perineurial spinal cysts (TCs) are an underrecognized cause of spinal neuropathic symptoms. TCs form within the sensory nerve root sleeves, where CSF extends distally and can accumulate pathologically. Typically, they develop at the sacral dermatomes where the nerve roots are under the highest hydrostatic pressure and lack enclosing vertebral foramina. In total, 90% of patients are women, and
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A quantitative analysis of surgical smoke–derived particulate matter and formaldehyde exposure during spine surgery: a possible occupational hazard J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-15 Seung Jin Choi, Dongmin Seo, Chang Hwa Ham, Joo Han Kim, Woo-Keun Kwon
OBJECTIVE Since its introduction, electrocautery has served as a valuable surgical tool, enabling precise tissue cutting and effective hemostasis in spine surgery. While there have been numerous efforts to elucidate the possible hazardous effects of surgical smoke in various surgical fields, there has been very little discussion in the context of spine surgery. The objective of this study was to measure
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Risk factors for not reaching minimal clinically important difference at 90 days and 1 year after elective lumbar spine surgery: a cohort study J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-08 Travis Hamilton, Seokchun Lim, Edvin Telemi, Ho Jun Yun, Mohamed Macki, Lonni Schultz, Hsueh-Han Yeh, Kylie Springer, Kevin Taliaferro, Miguelangelo Perez-Cruet, Ilyas Aleem, Paul Park, Richard Easton, David R. Nerenz, Jason M. Schwalb, Muwaffak Abdulhak, Victor Chang
OBJECTIVE Patient-perceived functional improvement is a core metric in lumbar surgery for degenerative disease. It is important to identify both modifiable and nonmodifiable risk factors that can be evaluated and possibly optimized prior to elective surgery. This case-control study was designed to study risk factors for not achieving the minimal clinically important difference (MCID) in Patient-Reported
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Postoperative quality of life in patients with ankylosing spondylitis and thoracolumbar kyphosis: risk factors and personalized sagittal reconstruction strategy J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-08 Xin Lv, Renyuan Huang, Ziliang Zeng, Di Zhang, Bo Li, Yuhong Lin, Zhilei Zhang, Qiwei Wang, Yelidana Nuertai, Zhihao Huang, Zheyu Wang, Canchun Yang, Haolin Yan, Xiaoshuai Peng, Qiancheng Zhao, Wenpeng Li, Xu Jiang, Xumin Hu, Liangbin Gao
OBJECTIVE The aim of this study was to investigate the factors affecting postoperative quality of life in patients with ankylosing spondylitis (AS) and thoracolumbar kyphosis (TLK), and establish a personalized sagittal reconstruction strategy.METHODS Patients with AS and TLK who underwent pedicle subtraction osteotomy (PSO) from February 2009 to May 2019 were retrospectively included. Quality of life
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Localization of spinal dural arteriovenous fistulas from the spatial relationships of perimedullary vessels on standard MRI J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-08 Ali Moosavi, Paul Kalapos, Ephraim W. Church, Kevin M. Cockroft, Krishnamoorthy Thamburaj
OBJECTIVE The goal in this study was to explore the spatial relationship of perimedullary vessels visualized on MRI to localize the side and the site of spinal dural arteriovenous fistula (SDAVF).METHODS A retrospective analysis of 30 consecutive patients diagnosed with SDAVF on MRI was undertaken. Two experienced reviewers blinded to all reports and angiographic images analyzed T2-weighted as well
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Assessing the impact of obesity on full endoscopic spine surgery: surgical site infections, surgery durations, early complications, and short-term functional outcomes J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-08 Jannik Leyendecker, Braeden Benedict, Chayanne Gumbs, Peer Eysel, Jan Bredow, Albert Telfeian, Peter Derman, Osama Kashlan, Anubhav Amin, Sanjay Konakondla, Christoph P. Hofstetter, John Ogunlade
OBJECTIVE An increasing number of obese patients undergoing elective spine surgery has been reported. Obesity has been associated with a substantially higher number of surgical site infections and a longer surgery duration. However, there is a lack of research investigating the intersection of obesity and full endoscopic spine surgery (FESS) in terms of functional outcomes and complications. The aim
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Comparison of lumbar microdiscectomy and unilateral biportal endoscopic discectomy outcomes: a single-center experience J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-08 Mehmet İlker Özer, Oğuz Kağan Demirtaş
OBJECTIVE Lumbar microdiscectomy (LMD) is still the gold-standard treatment for lumbar disc herniations with progressive neurological deficits that are refractory to conservative treatment. With improvement of endoscopic systems in recent years, endoscopic discectomy techniques have been developed as an alternative to LMD. The unilateral biportal endoscopic discectomy (UBE) technique is one of these
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The iterative implementation of a comprehensive enhanced recovery after surgery protocol in all spinal surgery in Korea: a comparative analysis of clinical outcomes and medical costs between primary spinal tumors and degenerative spinal diseases J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-08 Woon Tak Yuh, Jun-Hoe Kim, Junghoon Han, Tae-Shin Kim, Young Il Won, Yunhee Choi, Hyun Jung Noh, Chang-Hyun Lee, Chi Heon Kim, Chun Kee Chung
OBJECTIVE Most studies on the enhanced recovery after surgery (ERAS) protocol in spine surgery have focused on patients with degenerative spinal diseases (DSDs), resulting in a lack of evidence for a comprehensive ERAS protocol applicable to patients with primary spine tumors (PSTs) and other spinal diseases. The authors had developed and gradually adopted components of the comprehensive ERAS protocol
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Machine learning–based detection of sarcopenic obesity and association with adverse outcomes in patients undergoing surgical treatment for spinal metastases J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-01 Syed I. Khalid, Elie Massaad, Ali Kiapour, Christopher P. Bridge, Grant Rigney, Akeive Burrows, Jane Shim, Rafael De la Garza Ramos, Daniel G. Tobert, Andrew J. Schoenfeld, Theresa Williamson, Ganesh M. Shankar, John H. Shin
OBJECTIVE The distributions and proportions of lean and fat tissues may help better assess the prognosis and outcomes of patients with spinal metastases. Specifically, in obese patients, sarcopenia may be easily overlooked as a poor prognostic indicator. The role of this body phenotype, sarcopenic obesity (SO), has not been adequately studied among patients undergoing surgical treatment for spinal
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Does diabetes affect outcome or reoperation rate after lumbar decompression or arthrodesis? A matched analysis of the Quality Outcomes Database data set J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-01 James Mooney, Karim Rizwan Nathani, Daniel Zeitouni, Giorgos D. Michalopoulos, Michael Y. Wang, Domagoj Coric, Andrew K. Chan, Daniel C. Lu, Brandon A. Sherrod, Oren N. Gottfried, Christopher I. Shaffrey, Khoi D. Than, Jacob L. Goldberg, Ibrahim Hussain, Michael S. Virk, Nitin Agarwal, Steven D. Glassman, Mark E. Shaffrey, Paul Park, Kevin T. Foley, Dean Chou, Jonathan R. Slotkin, Luis M. Tumialán
OBJECTIVE Diabetes mellitus (DM) is a known risk factor for postsurgical and systemic complications after lumbar spinal surgery. Smaller studies have also demonstrated diminished improvements in patient-reported outcomes (PROs), with increased reoperation and readmission rates after lumbar surgery in patients with DM. The authors aimed to examine longer-term PROs in patients with DM undergoing lumbar
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C2 versus C3 or C4 as the upper instrumented vertebra for long-segment cervical fusions: a systematic review and meta-analysis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-01 Esteban Quiceno, Amna Hussein, Annie Pico, Ebtesam Abdulla, Isabel L. Bauer, Kristin Nosova, Jose Orenday-Barraza, Alexandros Moniakis, Monis Ahmed Khan, Michael Prim, Ali A. Baaj
OBJECTIVE Selecting C2 versus C3 or C4 (i.e., C3/C4) as the rostral anchoring level in long-segment cervical fusions is a common clinical conundrum. The data regarding proximal failure in long constructs of the cervical spine is scarce. The objective of this study was to systematically review the published literature and perform a meta-analysis of the incidence for proximal adjacent-segment disease
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Epigenetic age biomarkers and risk assessment in adult spinal deformity: a novel association of biological age with frailty and disability J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-12-01 Michael M. Safaee, Varun B. Dwaraka, Justin M. Lee, Marissa Fury, Tavis L. Mendez, Ryan Smith, Jue Lin, Dana L. Smith, John F. Burke, Justin K. Scheer, Hannah Went, Christopher P. Ames
OBJECTIVE Surgery for spinal deformity has the potential to improve pain, disability, function, self-image, and mental health. These surgical procedures carry significant risk and require careful selection, optimization, and risk assessment. Epigenetic clocks are age estimation tools derived by measuring the methylation patterns of specific DNA regions. The study of biological age in the adult deformity
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Comparison of intraoperative cone-beam CT versus preoperative fan-beam CT for navigated spine surgery: a prospective randomized study J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-24 Tsung-Hsi Tu, Yi-Hsuan Kuo, Chih-Chang Chang, Chao-Hung Kuo, Hsuan-Kan Chang, Li-Yu Fay, Mei-Yin Yeh, Chin-Chu Ko, Wen-Cheng Huang, Jau-Ching Wu
OBJECTIVE This prospective randomized study aimed to investigate the accuracy, radiation exposure, and surgical workflow optimization of a novel intraoperative spinal navigation system using preoperative fan-beam (FB) CT versus the classic intraoperative cone-beam (CB) CT in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).METHODS In this two-arm, single-center
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Radiographic outcomes following surgical correction for lumbar degenerative kyphosis: the impact of supine pelvic tilt J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-24 Jae-Koo Lee, Do-Hyoung Kim, Seung-Jae Hyun, Seung Heon Yang, Ki-Jeong Kim
OBJECTIVE Lumbar degenerative kyphosis (LDK), a flexible deformity, is a common form of sagittal imbalance in Asian countries. Assessing a patient’s spine prior to surgery by using positional radiographs is becoming more crucial in determining surgical planning to achieve favorable clinical and radiographic outcomes, especially in patients with flexible deformities. This study aims to identify radiographic
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Lumbar lordosis restoration by minimally invasive short-segment fusion with anterior column realignment for adult spinal deformity: minimum 2-year follow-up J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-17 Yoichi Tani, Nobuhiro Naka, Naoto Ono, Koki Kawashima, Masaaki Paku, Masayuki Ishihara, Takashi Adachi, Shinichirou Taniguchi, Muneharu Ando, Takanori Saito
OBJECTIVE The efficacy of anterior column realignment (ACR) remains relatively unclear, possibly because some safety concerns have limited its adoption and extensive evaluation. The authors aimed to study whether a minimally invasive surgery (MIS) triad consisting of ACR, lateral lumbar interbody fusion, and percutaneous pedicle screw fixation in a select group of adult spinal deformity (ASD) patients
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Incidence of postoperative neurological deficit with the use of an intraoperative neuromonitoring protocol for lateral lumbar interbody fusion J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-17 Gregory M. Mundis, Nicole C. Record, Bahar Shahidi, Nikita Lakomkin, Alissa Carnelian, Kristina C. Brady, Michael Jelousi, Behrooz A. Akbarnia, Robert K. Eastlack
OBJECTIVE Intraoperative neuromonitoring (IONM) has become commonplace in assessing neurological integrity during lateral approaches to lumbar interbody fusion surgeries. Neuromonitoring is designed to aid surgeons in identifying the potential for intraoperative nerve injury and reducing associated postoperative complications. However, standardized protocols for neuromonitoring have not been provided
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Shorter survival time of adolescents and young adult patients than older adults with spinal cord glioblastoma: a multicenter study J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-17 Tomoo Inoue, Toshiki Endo, Jun Muto, Daisuke Umebayashi, Takafumi Mitsuhara, Seiji Shigekawa, Ryo Kanematsu, Motoyuki Iwasaki, Toshihiro Takami, Kazutoshi Hida, Masaki Mizuno
OBJECTIVE Cancers in adolescents and young adults (AYAs) (age 15–39 years) often present with unique characteristics and poor outcomes. To date, spinal cord glioblastoma, a rare tumor, remains poorly understood across all age groups, including AYAs. This comparative study aimed to investigate the clinical characteristics and outcomes of spinal cord glioblastoma in AYAs and older adults (age 40–74 years)
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Risk factors for C5 palsy: a systematic review and multivariate analysis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-17 Vincent C. Traynelis, Ricardo B. V. Fontes, Manish K. Kasliwal, Won Hyung A. Ryu, Lee A. Tan, Christopher D. Witiw, Joseph R. Dettori, Erika D. Brodt, Andrea C. Skelly
OBJECTIVE Postoperative C5 palsy (C5P) is a known complication in cervical spine surgery. However, its exact pathophysiology is unclear. The authors aimed to provide a review of the current understanding of C5P by performing a comprehensive, systematic review of the existing literature and conducting a critical appraisal of existing evidence to determine the risk factors of C5P.METHODS A systematic
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What factors influence surgical decision-making in anterior versus posterior surgery for cervical myelopathy? A QOD analysis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-10 Christine Park, Christopher I. Shaffrey, Khoi D. Than, Giorgos D. Michalopoulos, Sally El Sammak, Andrew K. Chan, Erica F. Bisson, Brandon A. Sherrod, Anthony L. Asher, Domagoj Coric, Eric A. Potts, Kevin T. Foley, Michael Y. Wang, Kai-Ming Fu, Michael S. Virk, John J. Knightly, Scott Meyer, Paul Park, Cheerag Upadhyaya, Mark E. Shaffrey, Avery L. Buchholz, Luis M. Tumialán, Jay Turner, Nitin Agarwal
OBJECTIVE The aim of this study was to explore the preoperative patient characteristics that affect surgical decision-making when selecting an anterior or posterior operative approach in patients diagnosed with cervical spondylotic myelopathy (CSM).METHODS This was a multi-institutional, retrospective study of the prospective Quality Outcomes Database (QOD) Cervical Spondylotic Myelopathy module. Patients
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Risk factor analysis of refracture in the same cemented vertebra after percutaneous kyphoplasty for Kümmell’s disease J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-10 Tangyiheng Chen, Genglei Chu, Yimeng Qu, Yujie Wang, Cheng Lin, Nan Hu, Huilin Yang, Xuefeng Li, Weimin Jiang, Yijie Liu
OBJECTIVE The objective of this study was to evaluate the factors that affect refracture in the same cemented vertebra after percutaneous kyphoplasty (PKP) for Kümmell’s disease (KD) and establish a risk prediction score.METHODS A total of 2932 patients who were treated with PKP for KD between January 2019 and December 2021 were retrospectively reviewed. After inclusion and exclusion criteria were
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Reducing the rate of surgical site infection using iodophor-impregnated adhesive incision draping in spine surgery compared with standard adhesive incision draping: a study in 2279 patients J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-10 Aylin Gencer, Christian Schichor, Joerg-Christian Tonn, Sebastian Siller
OBJECTIVE While adhesive incision drapes are widely used for reducing surgical site infection (SSI), evidence remains scarce on whether impregnated adhesive incision draping can further reduce the rate of SSI in spine surgery. METHODS All patients treated surgically in the authors’ high-volume university spine center from January 2018 to December 2021 were retrospectively evaluated and divided into
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Comparison of clinical outcomes in patients undergoing one- and two-level minimally invasive lumbar microdiscectomy J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-11-03 Zakariah K. Siyaji, Austin Q. Nguyen, Vincent P. Federico, Shadi Zbeidi, Athan G. Zavras, James D. Baker, Bryce A. Basques, Arash J. Sayari, Frank M. Phillips
OBJECTIVE Herniated nucleus pulposus (HNP) is one of the most common lumbar spine conditions treated surgically, often through a minimally invasive surgery (MIS) microdiscectomy approach. This technique attempts to reduce damage to the paraspinal muscular-ligamentous envelope. However, there are currently limited data regarding comparative outcomes using patient-reported outcome measures (PROMs) for
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Treatment of ambulatory patients with metastatic epidural spinal cord compression: a systematic review and meta-analysis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-27 Ruben Van den Brande, Dieter Thijs, Mark Bilsky, Marc Peeters, Charlotte Billiet, Erik Van de Kelft
OBJECTIVE Approximately 10% of patients with spinal metastases develop metastatic epidural spinal cord compression (MESCC), which left undiagnosed and untreated can lead to the loss of ambulation. Timely diagnosis and efficient multidisciplinary treatment are critically important to optimize neurological outcomes. This meta-analysis aimed to determine the most efficient treatment for ambulatory patients
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Antithrombotic therapy and spinal surgery: a retrospective cohort study of 289 consecutive elderly patients with degenerative lumbar stenosis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-27 Giuseppe Corazzelli, Mara Capece, Valentina Pizzuti, Settimio Leonetti, Alessandro D’Elia, Marco Santilli, Fulvio Aloj, Gualtiero Innocenzi
OBJECTIVE Lumbar spinal stenosis (LSS) is a disabling degenerative process of the spine, mainly affecting older patients. LSS manifests with low-back and leg pain and neurogenic claudication. Disability and impairment in activities of daily living are consequences of the progressive narrowing of the lumbar spinal canal. Surgical decompression has been shown to be superior to conservative management
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Evaluating alternatives to dual-energy x-ray absorptiometry for assessing bone quality in patients undergoing spine surgery J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-20 Emily C. Courtois, Iyooh (Uche) Davidson, Donna D. Ohnmeiss, Richard D. Guyer
OBJECTIVE The purpose of this study was to compare and contrast lumbar bone quality and osteoporosis/osteopenia screening results via dual-energy x-ray absorptiometry (DEXA), CT, and MRI.METHODS A consecutive series of 426 candidates screened for lumbar disc replacement over a 5-year period beginning in 2018 was reviewed. Patients with a preoperative lumbar spine DEXA scan and a CT and/or MRI scan
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Determining the best vertebra for measuring pelvic incidence and spinopelvic parameters in adult spinal deformity patients with transitional anatomy J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-20 Fares Ani, Themistocles S. Protopsaltis, Yesha Parekh, Khalid Odeh, Renaud Lafage, Justin S. Smith, Robert K. Eastlack, Lawrence Lenke, Frank Schwab, Gregory M. Mundis, Munish C. Gupta, Eric O. Klineberg, Virginie Lafage, Robert Hart, Douglas Burton, Christopher P. Ames, Christopher I. Shaffrey, Shay Bess
OBJECTIVE The aim of this study was to determine if spinal deformity patients with L5 sacralization should have pelvic incidence (PI) and other spinopelvic parameters measured from the L5 or S1 endplate.METHODS This study was a multicenter retrospective comparative cohort study comprising a large database of adult spinal deformity (ASD) patients and a database of asymptomatic individuals. Linear regression
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Surgical management of malignant melanotic nerve sheath tumors: an institutional experience and systematic review of the literature J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-20 Abdul Karim Ghaith, Sarah E. Johnson, Victor Gabriel El-Hajj, Oluwaseun O. Akinduro, Marc Ghanem, Gaetano De Biase, Loizos Michaelides, Antonio Bon Nieves, W. Richard Marsh, Bradford L. Currier, John L. Atkinson, Robert J. Spinner, Mohamad Bydon
OBJECTIVE Malignant melanotic nerve sheath tumors are rare tumors characterized by neoplastic melanin-producing Schwann cells. In this study, the authors report their institution’s experience in treating spinal and peripheral malignant melanotic nerve sheath tumors and compare their results with the literature. METHODS Data were collected from 8 patients who underwent surgical treatment for malignant
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Hospital cost differences between open and endoscopic lumbar spine decompression surgery J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-13 Matthew C. Findlay, Forrest A. Hamrick, Robert B. Kim, Spencer Twitchell, Mark A. Mahan
OBJECTIVE In recent years, fully endoscopic decompression surgery for degenerative spine disease has become increasingly popular in the US. Although an endoscopic approach has demonstrated some benefits compared with open procedures in randomized controlled trials, the cost of advanced technologies remains contested. The authors evaluated the differences in costs and cost drivers between open and endoscopic
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Comparison of Hounsfield units and vertebral bone quality score for the prediction of time to pathologic fracture in mobile spine metastases treated with radiotherapy J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-13 Zach Pennington, Anthony L. Mikula, Nikita Lakomkin, Michael Martini, Michelle J. Clarke, Arjun S. Sebastian, Brett A. Freedman, Peter S. Rose, S. Mohammed Karim, Ahmad Nassr, Mohamad Bydon, Roman O. Kowalchuk, Kenneth W. Merrell, William E. Krauss, Jeremy L. Fogelson, Benjamin D. Elder
OBJECTIVE Spine metastases are commonly treated with radiotherapy for local tumor control; pathologic fracture is a potential complication of spinal radiotherapy. Both Hounsfield units (HUs) on CT and vertebral bone quality (VBQ) on MRI have been argued to predict stability as measured by odds of pathologic fracture, although it is unclear if there is a difference in the predictive power between the
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Treatment of intramedullary spinal cord tumors: a modified Delphi technique of the North American Spine Society Section of Spine Oncology J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-13 Andrew M. Hersh, Zach Pennington, Daniel Lubelski, Aladine A. Elsamadicy, Nicolas Dea, Atman Desai, Ziya L. Gokaslan, C. Rory Goodwin, Wesley Hsu, George I. Jallo, Ajit Krishnaney, Ilya Laufer, Sheng-Fu Larry Lo, Mohamed Macki, Ankit I. Mehta, Ali Ozturk, John H. Shin, Hesham Soliman, Daniel M. Sciubba
OBJECTIVE Intramedullary spinal cord tumors (IMSCTs) are rare tumors with heterogeneous presentations and natural histories that complicate their management. Standardized guidelines are lacking on when to surgically intervene and the appropriate aggressiveness of resection, especially given the risk of new neurological deficits following resection of infiltrative tumors. Here, the authors present the
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Association between the upper instrumented vertebra screw angles and proximal junctional complications in patients with de novo degenerative lumbar scoliosis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-06 Weipeng Qiu, Zhuoran Sun, Siyu Zhou, Gengyu Han, Zimu Chen, Yan Zeng, Miao Yu, Weishi Li
OBJECTIVE The aim of this study was to investigate the impact of upper instrumented vertebra (UIV) screw angles on proximal junctional complications in patients with de novo degenerative lumbar scoliosis (DNDLS).METHODS A total of 120 patients with DNDLS who underwent posterior long-segment instrumentation and fusion were included. Patients were divided into a proximal junctional kyphosis/failure (PJK/PJF)
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A guide to finite element analysis models of the spine for clinicians J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-10-06 Marjorie C. Wang, Ali Kiapour, Elie Massaad, John H. Shin, Narayan Yoganandan
Finite element analysis (FEA) is a computer-based mathematical method commonly used in spine and orthopedic biomechanical research. Advances in computational power and engineering modeling and analysis software have enabled many recent technical applications of FEA. Through the use of FEA, a wide range of scenarios can be simulated, such as physiological processes, mechanisms of disease and injury
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Academic career progression in AANS/CNS Spine Section award recipients J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-29 Aladine A. Elsamadicy, Josiah J. Z. Sherman, Samuel Craft, Michael Virk, Benjamin D. Elder, Christopher M. Bonfield, Laura A. Snyder, Wilson Z. Ray, Kristen E. Jones, Won Hyung A. Ryu
OBJECTIVE The American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) Joint Spine Section awards highlight outstanding abstracts submitted to the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves by trainees interested in spine surgery, although the academic trajectory of awardees has not been studied. The aim of this study was to assess the academic
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Medicare procedural costs in ambulatory surgery centers versus hospital outpatient departments for spine surgeries J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-29 Vincent P. Federico, James W. Nie, Divesh Sachdev, Timothy J. Hartman, Noe Trevino, Samy Gabriel, Alexander J. Butler, Gregory D. Lopez, Howard S. An, Matthew W. Colman, Frank M. Phillips
OBJECTIVE Multiple studies have demonstrated the safety of outpatient spine surgery, with reports of equivalent to improved patient outcomes compared with inpatient procedures. This has resulted in the increased use of outpatient surgery over time. However, there remains a paucity of literature evaluating the difference in costs between ambulatory surgery center (ASC)– and hospital outpatient department
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Nonoperative versus operative management of type II odontoid fracture in older adults: a systematic review and meta-analysis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-29 Mauricio J. Avila, S. Harrison Farber, Nicholas M. Rabah, Morgan J. Hopp, Kristina M. Chapple, R. John Hurlbert, Luis M. Tumialán
OBJECTIVE Odontoid fractures are the most common fracture of the cervical spine in adults older than 65 years of age. Fracture management remains controversial, given the inherently increased surgical risks in older patients. The objective of this study was to compare fusion rates and outcomes between operative and nonoperative treatments of type II odontoid fractures in the older population.METHODS
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Halo-gravity traction combined with growing rod treatment: an effective preoperative management for severe early-onset scoliosis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-22 Xiaojiang Pu, Bo Yang, Qingshuang Zhou, Haojie Chen, Bin Wang, Zezhang Zhu, Yong Qiu, Xu Sun
OBJECTIVE The aim of this study was to investigate the effectiveness of preoperative halo-gravity traction (HGT) with subsequent growing rod (GR) treatment in patients with severe early-onset scoliosis (EOS).METHODS The authors retrospectively reviewed a cohort of patients with severe EOS who had received preoperative HGT with subsequent GR treatment at their center between January 2008 and January
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Economic burden of nonoperative treatment of adult spinal deformity J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-15 Peter G. Passias, Waleed Ahmad, Pooja Dave, Renaud Lafage, Virginie Lafage, Jamshaid Mir, Eric O. Klineberg, Khaled M. Kabeish, Jeffrey L. Gum, Breton G. Line, Robert Hart, Douglas Burton, Justin S. Smith, Christopher P. Ames, Christopher I. Shaffrey, Frank Schwab, Richard Hostin, Thomas Buell, D. Kojo Hamilton, Shay Bess
OBJECTIVE The purpose of this study was to investigate the cost utility of nonoperative treatment for adult spinal deformity (ASD).METHODS Nonoperatively and operatively treated patients who met database criteria for ASD and in whom complete radiographic and health-related quality of life data at baseline and at 2 years were available were included. A cost analysis was completed on the PearlDiver database
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The life and legacy of John Robert Cobb: the man behind the angle J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-08 Kathleen S. Botterbush, Justin K. Zhang, Pranav S. Chimakurty, Philippe Mercier, Tobias A. Mattei
In 1934, Dr. John Robert Cobb moved to New York to serve as the Gibney Orthopedic Fellow at the Hospital for the Ruptured and Crippled, now known as the Hospital for Special Surgery. In this role, Cobb was faced with a unique task that would shape not only his personal career but also the fields of scoliosis and spine care: to design the first scoliosis specialty clinic. He critically reviewed the
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Bone morphogenetic protein and cancer in spinal fusion: a propensity score–matched analysis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-01 David J. Mazur-Hart, Erin A. Yamamoto, Jung Yoo, Josiah N. Orina
OBJECTIVE Bone morphogenetic protein (BMP) has been increasingly used in spinal surgery to promote arthrodesis. Because BMP stimulates cellular proliferation, its association with tumorigenesis is a concern. Previous research has generated conflicting conclusions on the risk of cancer in patients receiving BMP. The authors aimed to compare the incidence of solid organ and hematopoietic malignancies
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Risk factors for radiographic progression of proximal junctional fracture in patients undergoing surgical treatment for adult spinal deformity J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-09-01 Se-Jun Park, Chong-Suh Lee, Jin-Sung Park, Chung-Youb Jeon, Chang-Hyun Ma, Tae Soo Shin
OBJECTIVE Proximal junctional fracture (PJFx) at the uppermost instrumented vertebra (UIV) or UIV+1 is the most common mechanism of proximal junctional failure (PJF). Few studies have assessed radiographic progression after PJFx development. Therefore, this study sought to identify the risk factors for radiographic progression of PJFx in the surgical treatment for adult spinal deformity.METHODS In
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Genomic analysis of spinal meningiomas: correlation with histopathological grade J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-25 Joseph Driver, Sandro Santagata, Wenya Linda Bi, John H. Chi
OBJECTIVE Spinal meningiomas are one of the most common primary intradural tumors of the adult spine. Spinal meningiomas typically have a benign course with low rates of recurrence. Recent advances in genomic profiling have provided valuable information on meningioma biology and natural history, but these studies have focused primarily on cranial meningiomas. Chromosomal copy number analysis of meningiomas
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Optimizing surgical management of facet cysts of the lumbar spine: systematic review, meta-analysis, and local case series of 1251 patients J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-18 Arjun Ganga, Owen P. Leary, Aayush Setty, Kevin Xi, Albert E. Telfeian, Adetokunbo A. Oyelese, Tianyi Niu, Joaquin Q. Camara-Quintana, Ziya L. Gokaslan, Patricia Zadnik Sullivan, Jared S. Fridley
OBJECTIVE Lumbar facet cysts (LFCs) can cause neurological dysfunction and intractable pain. Surgery is the current standard of care for patients in whom conservative therapy fails, those with neurological deficits, and those with evidence of spinal instability. No study to date has comprehensively examined surgical outcomes comparing the multiple surgical treatment options for LFCs. Therefore, the
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Adverse effects of frailty on the outcomes of surgery for degenerative cervical myelopathy: results from a prospective multicenter international data set of 757 patients J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-18 Jamie R. F. Wilson, Jetan H. Badhiwala, Ali Moghaddamjou, Alexander R. Vaccaro, Paul M. Arnold, Ronald H. M. A. Bartels, Giuseppe Barbagallo, Michael G. Fehlings
OBJECTIVE The goal of this study was to determine the effect of the degree of frailty on long-term neurological and functional outcomes after surgery for degenerative cervical myelopathy (DCM).METHODS A combined database of patients enrolled in the Cervical Spondylotic Myelopathy–North America and Cervical Spondylotic Myelopathy–International prospective international multicenter observational studies
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Characterization of the influence of spinopelvic parameters on thoracolumbar trauma J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-11 Joseph S. Withrow, Michael D. Monterey, Analisa Narro, Lauren Haley, Marco Martinez Cruz, Bradley Budde, Duncan Trimble, Dallas Sheinberg, Jennifer Zaragoza, Wen Li, Zhouxuan Li, John Caridi, John C. Quinn
OBJECTIVE The current Roussouly classification identifies four groups of “normal” sagittal spine morphology, which has greatly expanded the understanding of normal heterogeneity of the spine. While there has been extensive characterization of the influence of spinopelvic parameters on outcomes after degenerative spine surgery, the influence of spinopelvic parameters on thoracolumbar trauma has yet
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Cervical laminoplasty versus laminectomy and posterior cervical fusion for cervical myelopathy: propensity-matched analysis of 24-month outcomes from the Quality Outcomes Database J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-11 Eunice Yang, Praveen V. Mummaneni, Dean Chou, Mohamad Bydon, Erica F. Bisson, Christopher I. Shaffrey, Oren N. Gottfried, Anthony L. Asher, Domagoj Coric, Eric A. Potts, Kevin T. Foley, Michael Y. Wang, Kai-Ming Fu, Michael S. Virk, John J. Knightly, Scott Meyer, Paul Park, Cheerag D. Upadhyaya, Mark E. Shaffrey, Avery L. Buchholz, Luis M. Tumialán, Jay D. Turner, Giorgos D. Michalopoulos, Brandon
OBJECTIVE Compared with laminectomy with posterior cervical fusion (PCF), cervical laminoplasty (CL) may result in different outcomes for those operated on for cervical spondylotic myelopathy (CSM). The aim of this study was to compare 24-month patient-reported outcomes (PROs) for laminoplasty versus PCF by using the Quality Outcomes Database (QOD) CSM data set.METHODS This was a retrospective study
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Association between immunohistochemical markers and tumor progression following resection of spinal chordomas: a multicenter study J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-11 Abdul Karim Ghaith, Oluwaseun O. Akinduro, Carlos Perez-Vega, Antonio Bon Nieves, Kingsley Abode-Iyamah, Naresh Patel, Maziyar Kalani, Michelle J. Clarke, Peter Rose, Mohamad Bydon
OBJECTIVE Chordomas are slow-growing tumors derived from notochord remnants. Despite margin-negative excision and postoperative radiation therapy, spinal chordomas (SCs) often progress. The potential of immunohistochemical (IHC) markers, such as epithelial membrane antigen (EMA), combined with machine learning algorithms to predict long-term (≥ 12 months) postoperative tumor progression, has been understudied
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Should realignment goals vary based on patient frailty status in adult spinal deformity? J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-11 Peter G. Passias, Jamshaid M. Mir, Tyler K. Williamson, Peter S. Tretiakov, Pooja Dave, Virginie Lafage, Renaud Lafage, Andrew J. Schoenfeld
OBJECTIVE The objective of this study was to adjust the sagittal age-adjusted score (SAAS) to accommodate frailty in alignment considerations and thereby increase the predictability of clinical outcomes and junctional failure.METHODS Surgical adult spinal deformity (ASD) patients with 2-year data were included. Frailty was assessed with the continuous ASD modified frailty index (ASD-mFI). Two-year
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Selective thoracolumbar fusion in adult spinal deformity double curves with circumferential minimally invasive surgery: 2-year minimum follow-up J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-11 Neel Anand, Jerry Robinson, Andrew Chung, David Gendelberg, José H. Jiménez-Almonte, Sheila Kahwaty, Babak Khandehroo, Corey Walker
OBJECTIVE Selection of the upper instrumented vertebra (UIV) level for adult spinal deformity (ASD) remains controversial. Although selective fusion attempts have been described for fractional curves or adolescent curves, no authors have described selective thoracolumbar fusion performance for ASD with double curves. This study evaluated the clinical impact of selective fusion constructs within the
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Promotion of higher rates of early fusion using activated titanium versus polyetheretherketone cages in adults undergoing 1- and 2-level transforaminal lumbar interbody fusion procedures: a randomized controlled trial J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-08-04 Nathaniel Toop, Joravar Dhaliwal, Connor S. Gifford, David Gibbs, Alex Keister, Shelby Miracle, Reza Forghani, Andrew J. Grossbach, H. Francis Farhadi
OBJECTIVE There is ongoing debate on the relative benefits and drawbacks of polyetheretherketone (PEEK) versus titanium (Ti) in generating a bone-to-implant surface microenvironment conducive to osseointegration. Micro- and nanoscale internal and topographic cage modifications have recently been posited to facilitate osseointegration and fusion, but human in vivo confirmation remains lacking. The authors
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Limited number of spine surgeons among recipients of National Institutes of Health grants awarded for degenerative spine disease research J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-28 Jason Silvestre, James A. Clemmons, Hao-Hua Wu, Kyra Caldwell, James D. Kang
OBJECTIVE Surgeon scientists remain underrepresented among recipients of National Institutes of Health (NIH) grants despite their unique ability to perform translational research. This study elucidates the portfolio of NIH grants awarded for degenerative spine diseases and the role of spine surgeons in this portfolio.METHODS The most common diagnoses and surgical procedures for degenerative spine diseases
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A comparison of modern-era anterior lumbar interbody fusion and minimally invasive transforaminal lumbar interbody fusion at the lumbosacral junction J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-28 S. Harrison Farber, Robert K. Dugan, Michael D. White, Corey T. Walker, Luke K. O’Neill, Nima Alan, James J. Zhou, Jay D. Turner, Luis M. Tumialán, Juan S. Uribe
OBJECTIVE Interbody fusion is the primary method for achieving arthrodesis across the lumbosacral junction in the setting of degenerative pathologies, such as spondylosis and spondylolisthesis. Two common techniques are anterior lumbar interbody fusion (ALIF) and posterior transforaminal lumbar interbody fusion (TLIF). In recent years, interbody design and technology have advanced, and most earlier
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Are we improving in the optimization of surgery for high-risk adult cervical spine deformity patients over time? J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-28 Peter G. Passias, Peter S. Tretiakov, Justin S. Smith, Renaud Lafage, Bassel Diebo, Justin K. Scheer, Robert K. Eastlack, Alan H. Daniels, Eric O. Klineberg, Khaled M. Khabeish, Gregory M. Mundis, Jay D. Turner, Munish C. Gupta, Han Jo Kim, Frank Schwab, Shay Bess, Virginie Lafage, Christopher P. Ames, Christopher I. Shaffrey
OBJECTIVE The aim of this study was to investigate whether surgery for high-risk patients is being optimized over time and if poor outcomes are being minimized.METHODS Patients who underwent surgery for cervical deformity (CD) and were ≥ 18 years with baseline and 2-year data were stratified by year of surgery from 2013 to 2018. The cohort was divided into two groups based on when the surgery was performed
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Effect of workers’ compensation status on pain, disability, quality of life, and return to work after anterior cervical discectomy and fusion: a 1-year propensity score–matched analysis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-21 Ummey Hani, Steve H. Monk, Deborah Pfortmiller, Gerry Stanley, Paul K. Kim, Michael A. Bohl, Christopher M. Holland, Matthew J. McGirt
OBJECTIVE Patients with workers’ compensation (WC) claims are reported to demonstrate poorer surgical outcomes after lumbar spine surgery. However, outcomes after anterior cervical discectomy and fusion (ACDF) in WC patients remain debatable. The authors aimed to compare outcomes between a propensity score–matched population of WC and non-WC patients who underwent ACDF. METHODS Patients who underwent
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Clinical outcomes and proximal junctional failure in adult spinal deformity patients corrected to normative alignment versus functional alignment J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-21 Themistocles S. Protopsaltis, Fares Ani, Alexandra Soroceanu, Renaud Lafage, Han Jo Kim, Eaman Balouch, Zoe Norris, Justin S. Smith, Alan H. Daniels, Eric O. Klineberg, Christopher P. Ames, Robert Hart, Shay Bess, Christopher I. Shaffrey, Frank J. Schwab, Lawrence G. Lenke, Virginie Lafage, Munish C. Gupta
OBJECTIVE The objective of this study was to explore the rate of proximal junctional failure (PJF) and functional outcomes of normative alignment goals compared with alignment targets based on age-appropriate physical function.METHODS Baseline relationships between age, pelvic incidence (PI), and a component of the T1 pelvic angle (TPA) within the fusion were analyzed in adult spinal deformity (ASD)
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The impact of baseline cervical malalignment on the development of proximal junctional kyphosis following surgical correction of thoracolumbar adult spinal deformity J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-21 Lara Passfall, Bailey Imbo, Virginie Lafage, Renaud Lafage, Justin S. Smith, Breton Line, Andrew J. Schoenfeld, Themistocles Protopsaltis, Alan H. Daniels, Khaled M. Kebaish, Jeffrey L. Gum, Heiko Koller, D. Kojo Hamilton, Richard Hostin, Munish Gupta, Neel Anand, Christopher P. Ames, Robert Hart, Douglas Burton, Frank J. Schwab, Christopher I. Shaffrey, Eric O. Klineberg, Han Jo Kim, Shay Bess, Peter
OBJECTIVE The objective of this study was to identify the effect of baseline cervical deformity (CD) on proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) in patients with adult spinal deformity (ASD).METHODS This study was a retrospective analysis of a prospectively collected, multicenter database comprising ASD patients enrolled at 13 participating centers from 2009 to 2018
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Trends in costs, reimbursements, and surgeon payments for cervical disc arthroplasty cost of care from 2009 to 2019 J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-14 Jerry Y. Du, Karim Shafi, Collin W. Blackburn, Han Jo Kim, Sravisht Iyer, Sheeraz Qureshi, Randall E. Marcus, Todd J. Albert
OBJECTIVE The use of cervical disc arthroplasty (CDA) continues to increase in the Medicare population. As healthcare costs continue to rise, payors have begun to implement bundled payment structures for spine surgery. While Medicare has steadily decreased reimbursements for cervical fusions, Medicare reimbursements for CDA have not been studied. The purpose of this study was to assess trends in 1)
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Proximal forearm nerve branching patterns: an anatomical study and its clinical significance J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-14 Pablo Zancolli, Benjamin R. Johnston, Ezequiel F. Martinez, Justin M. Brown
OBJECTIVE The aim of this study was to add to the understanding of nerve branching patterns in the proximal forearm and consider optimal nerve transfer options to address the various injuries that affect the function of the upper extremity.METHODS Eleven upper-extremity cadaveric specimens were dissected to expose the radial, median, and ulnar nerves in the proximal forearm. The site of origin of nerve
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Does low-back pain improve after decompressive spinal surgery? A prospective observational study from the British Spine Registry J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-14 James Knight, Ranjit Rangnekar, Daniel Richardson, Suzanne McIlroy, David Bell, Aminul I. Ahmed
OBJECTIVE Lumbar spine decompression surgery, in the form of laminectomy or discectomy, is known to be effective in improving symptoms of radiculopathy and neurogenic claudication. However, it is less clear how it impacts coexisting low-back pain (LBP). The aim of this study was to quantify the change in LBP after lumbar decompression.METHODS This study analyzed data from the British Spine Registry
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Improvement in predominant back pain following minimally invasive decompression for spinal stenosis J. Neurosurg. Spine (IF 3.467) Pub Date : 2023-07-14 Maximilian K. Korsun, Pratyush Shahi, Daniel J. Shinn, Anthony Pajak, Kasra Araghi, Omri Maayan, Nishtha Singh, Olivia Tuma, Tomoyuki Asada, Sumedha Singh, Ashley Yeo Eun Kim, Eric Mai, Amy Z. Lu, Evan Sheha, James Dowdell, Sheeraz Qureshi, Sravisht Iyer
OBJECTIVE The objective of this study was to assess the outcomes of patients with predominant back pain (pBP) undergoing minimally invasive decompression surgery compared with patients with nonpredominant back pain (npBP).METHODS This was a retrospective cohort study. Patients were divided into two groups based on the presenting complaint: 1) pBP, defined as visual analog scale (VAS) back pain score