دسترسی یکساله به بیش از ۵۰۰ ژورنال روز جهان موجود در سامانه
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Adjacent-segment effects of lumbar cortical screw–rod fixation versus pedicle screw–rod fixation with and without interbody support
Piyanat Wangsawatwong MD1, Anna G. U. Sawa MS1, Bernardo de Andrada Pereira MD1, Jennifer N. Lehrman MS1, Luke K. O’Neill BS1,Jay D. Turner MD, PhD1, Juan S. Uribe MD1, and Brian P. Kelly PhD1
doi : 10.3171/2020.11.SPINE20977
Volume 35: Issue 3 (Sep 2021) Page Range: 263–269
Cortical screw–rod (CSR) fixation has emerged as an alternative to the traditional pedicle screw–rod (PSR) fixation for posterior lumbar fixation. Previous studies have concluded that CSR provides the same stability in cadaveric specimens as PSR and is comparable in clinical outcomes. However, recent clinical studies reported a lower incidence of radiographic and symptomatic adjacent-segment degeneration with CSR. No biomechanical study to date has focused on how the adjacent-segment mobility of these two constructs compares. This study aimed to investigate adjacent-segment mobility of CSR and PSR fixation, with and without interbody support (lateral lumbar interbody fusion [LLIF] or transforaminal lumbar interbody fusion [TLIF]).
Incidence of adjacent-segment surgery following stand-alone lateral lumbar interbody fusion
Gautam Nayar MD1, Souvik Roy BS1, Waseem Lutfi MD1, Nitin Agarwal MD1, Nima Alan MD1, Alp Ozpinar MD1, D. Kojo Hamilton MD1, David O. Okonkwo MD, PhD1, and Adam S. Kanter MD1
doi : 10.3171/2020.12.SPINE201218
Volume 35: Issue 3 (Sep 2021) Page Range: 270–274
Adjacent-segment disease (ASD) requiring operative intervention is a relatively common long-term consequence of lumbar fusion surgery. Although the incidence of ASD requiring reoperation is well described for traditional posterior lumbar approaches (2.5%–3.9% per year), it remains poorly characterized for stand-alone lateral lumbar interbody fusion (LLIF). In this study, the authors report their institutional experience with ASD requiring reoperation after LLIF over an extended follow-up period of 4 years.
The change in postoperative opioid prescribing after lumbar decompression surgery following state-level opioid prescribing reform
Robert D. Winkelman MD, MS1,2,4, Michael D. Kavanagh MD1,4, Joseph E. Tanenbaum MD, PhD1,4,5, Dominic W. Pelle MD1,3, Edward C. Benzel MD1,2, Thomas E. Mroz MD1,3, and Michael P. Steinmetz MD1,2
doi : 10.3171/2020.11.SPINE201046
Volume 35: Issue 3 (Sep 2021) Page Range: 275–283
On August 31, 2017, the state of Ohio implemented legislation limiting the dosage and duration of opioid prescriptions. Despite the widespread adoption of such restrictions, few studies have investigated the effects of these reforms on opioid prescribing and patient outcomes. In the present study, the authors aimed to evaluate the effect of recent state-level reform on opioid prescribing, patient-reported outcomes (PROs), and postoperative emergency department (ED) visits and hospital readmissions after elective lumbar decompression surgery.
Prone transpsoas lumbar corpectomy: simultaneous posterior and lateral lumbar access for difficult clinical scenarios
Sapan D. Gandhi MD1, David S. Liu MD1, Evan D. Sheha MD2, and Matthew W. Colman MD3
doi : 10.3171/2020.12.SPINE201913
Volume 35: Issue 3 (Sep 2021) Page Range: 284–291
Lateral lumbar corpectomy with interbody fusion has been well described via a transpsoas approach in the lateral position, as has lumbar interbody fusion with posterior fixation in the prone position. However, no previous report has described the use of both an open posterior approach and a lateral transpsoas approach simultaneously in the prone position. Here, the authors describe their technique of performing transpsoas lumbar corpectomy in the prone position in order to have simultaneous posterior and lateral access for difficult clinical scenarios, and they report their early clinical experience.
A novel endoscope-assisted technique for lateral lumbar interbody fusion: feasibility study, technical note, and operative video
Irene Say MD1, Tianyi Niu MD1, Jasmine A. Thum MS, MD1, Mark M. Archie MD2, David C. Chen MD2, and Daniel C. Lu MD, PhD1,3,4
doi : 10.3171/2020.12.SPINE201326
Volume 35: Issue 3 (Sep 2021) Page Range: 292–298
Factors associated with using an interbody fusion device for low-grade lumbar degenerative versus isthmic spondylolisthesis: a retrospective cohort study
Clayton Inculet MD, FRCSC1, Jennifer C. Urquhart PhD2, Parham Rasoulinejad MD1,2, Hamilton Hall MD, FRCSC3, Charles Fisher MD, MHSc, FRCSC4,Najmedden Attabib MD5, Kenneth Thomas MD6,Henry Ahn MD3, Michael Johnson MD7, Andrew Glennie MD8, Andrew Nataraj MD11, Sean D. Christie MD8, Alexandra Stratton MD, FRCSC9, Albert Yee MD3, Neil Manson MD, FRCSC5, Jérôme Paquet MD, FRCSC10, Y. Raja Rampersaud MD, FRCSC3, and Christopher S. Bailey MD1,2
doi : 10.3171/2020.11.SPINE201261
Volume 35: Issue 3 (Sep 2021) Page Range: 299–307
Many studies have utilized a combined cohort of patients with degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) to evaluate indications and outcomes. Intuitively, these are very different populations, and rates, indications, and outcomes may differ. The goal of this study was to compare specific patient characteristics associated with the utilization of a posterior lumbar interbody device between cohorts of patients with DS and IS, as well as to compare rates of interbody device use and patient-rated outcomes at 1 year after surgical treatment.
The associations between radiological and neurological findings of degenerative cervical myelopathy: radiological analysis based on kinematic CT myelography and evoked potentials of the spinal cord
Masahiro Funaba MD, PhD1, Yasuaki Imajo MD, PhD1,Hidenori Suzuki MD, PhD1, Norihiro Nishida MD, PhD1,Yuji Nagao MD, PhD1, Takuya Sakamoto MD1, Kazuhiro Fujimoto MD, PhD1, and Takashi Sakai MD, PhD1
doi : 10.3171/2020.11.SPINE201626
Volume 35: Issue 3 (Sep 2021) Page Range: 308–319
Neurological and imaging findings play significant roles in the diagnosis of degenerative cervical myelopathy (DCM). Consistency between neurological and imaging findings is important for diagnosing DCM. The reasons why neurological findings exhibit varying sensitivity for DCM and their associations with radiological findings are unclear. This study aimed to identify associations between radiological parameters and neurological findings in DCM and elucidate the utility of concordance between imaging and neurological findings for diagnosing DCM.
Biomechanical effects of a novel posteriorly placed sacroiliac joint fusion device integrated with traditional lumbopelvic long-construct instrumentation
Bernardo de Andrada Pereira MD1, Jennifer N. Lehrman MS1, Anna G. U. Sawa MS1, Derek P. Lindsey MS3, Scott A. Yerby PhD3, Jakub Godzik MD2,Alexis M. Waguespack MD4, Juan S. Uribe MD2, andBrian P. Kelly PhD1
doi : 10.3171/2020.11.SPINE201540
Volume 35: Issue 3 (Sep 2021) Page Range: 320–329
S2-alar-iliac (S2AI) screw fixation effectively ensures stability and enhances fusion in long-segment constructs. Nevertheless, pelvic fixation is associated with a high rate of mechanical failure. Because of the transarticular nature of the S2AI screw, adding a second point of fixation may provide additional stability and attenuate strains. The objective of the study was to evaluate changes in stability and strain with the integration of a sacroiliac (SI) joint fusion device, implanted through a novel posterior SI approach, supplemental to posterior long-segment fusion.
Should L3 be selected as the lowest instrumented vertebra in patients with Lenke type 5C adolescent idiopathic scoliosis whose lowest end vertebra is L4?
Tomohiro Banno MD, PhD1, Yu Yamato MD, PhD1,Hiroki Oba MD, PhD2, Tetsuro Ohba MD, PhD3,Tomohiko Hasegawa MD, PhD1, Go Yoshida MD, PhD1,Hideyuki Arima MD, PhD1, Shin Oe MD, PhD1, Yuki Mihara MD, PhD1, Hiroki Ushirozako MD, PhD1, Jun Takahashi MD, PhD2, Hirotaka Haro MD, PhD3, andYukihiro Matsuyama MD, PhD1
doi : 10.3171/2020.11.SPINE201807
Volume 35: Issue 3 (Sep 2021) Page Range: 330–339
L3 is most often selected as the lowest instrumented vertebra (LIV) to conserve mobile segments in fusion surgery; however, in cases with the lowest end vertebra (LEV) at L4, LIV selection as L3 could have a potential risk of correction loss and coronal decompensation. This study aimed to compare the clinical and radiographic outcomes depending on the LEV in adolescent idiopathic scoliosis (AIS) patients with Lenke type 5C curves.
Surgical outcomes for late neurological deficits after long segment instrumentation for degenerative adult spinal deformity
Kee-Yong Ha MD, PhD1, Eung-Ha Kim MD, PhD2,Young-Hoon Kim MD, PhD3, Hae-Dong Jang MD2,Hyung-Youl Park MD4, Chang-Hee Cho MD3, Ryu-Kyoung Cho MD3, and Sang-Il Kim MD, PhD3
doi : 10.3171/2020.12.SPINE20604
Volume 35: Issue 3 (Sep 2021) Page Range: 340–346
The most catastrophic symptom of proximal junctional failure (PJF) following long instrumented fusion surgery for adult spinal deformity (ASD) is neurological deficits. Although previous reports have shown that PJF usually developed during the early postoperative period, some patients showed late neurological deficits. The aim of this study was to report the incidence, characteristics, and surgical outcomes of PJF with late neurological deficits.
Biomechanics of open versus minimally invasive deformity correction:? comparison of stability and rod strain between pedicle subtraction osteotomy and anterior column realignment
Jakub Godzik MD1, Bernardo de Andrada Pereira MD2,Anna G. U. Sawa MS2, Jennifer N. Lehrman MS2,Gregory M. Mundis Jr. MD3, Randall J. Hlubek MD1,Juan S. Uribe MD1, Brian P. Kelly PhD2, and Jay D. Turner MD, PhD1
doi : 10.3171/2020.12.SPINE201306
Volume 35: Issue 3 (Sep 2021) Page Range: 347–355
Anterior column realignment (ACR) is a new minimally invasive approach for deformity correction that achieves a degree of lordosis similar to that obtained with pedicle subtraction osteotomy (PSO). This study compared the biomechanical profiles of ACR with PSO using range of motion (ROM) and posterior rod strain (RS) to gain insight into the ACR technique and the necessary surgical strategies to optimize longevity and stability.
The effectiveness of systemic therapies after surgery for metastatic renal cell carcinoma to the spine: a propensity analysis controlling for sarcopenia, frailty, and nutrition
Elie Massaad MD1, Philip J. Saylor MD4, Muhamed Hadzipasic MD, PhD1, Ali Kiapour PhD1, Kevin Oh MD2,Joseph H. Schwab MD3, Andrew J. Schoenfeld MD, MSc5, Ganesh M. Shankar MD, PhD1, and John H. Shin MD1
doi : 10.3171/2020.12.SPINE201896
Volume 35: Issue 3 (Sep 2021) Page Range: 356–365
The effectiveness of starting systemic therapies after surgery for spinal metastases from renal cell carcinoma (RCC) has not been evaluated in randomized controlled trials. Agents that target tyrosine kinases, mammalian target of rapamycin signaling, and immune checkpoints are now commonly used. Variables like sarcopenia, nutritional status, and frailty may impact recovery from spine surgery and are considered when evaluating a patient’s candidacy for such treatments. A better understanding of the significance of these variables may help improve patient selection for available treatment options after surgery. The authors used comparative effectiveness methods to study the treatment effect of postoperative systemic therapies (PSTs) on survival.
Antimicrobial prophylaxis in noninstrumented spine surgery: a prospective study to determine efficacy and drawbacks
Aymeric Amelot MD, PhD1,2, Maximilien Riche MD1,Samuel Latreille MD3, Vincent Degos MD, PhD3,4,Alexandre Carpentier MD, PhD1,4, Bertrand Mathon MD1,4, and Anne-Marie Korinek MD3
doi : 10.3171/2020.11.SPINE201891
Volume 35: Issue 3 (Sep 2021) Page Range: 366–375
The authors sought to evaluate the roles of perioperative antibiotic prophylaxis in noninstrumented spine surgery (NISS), both in postoperative infections and the impact on the selection of resistant bacteria. To the authors’ knowledge, only one prospective study recommending preoperative intravenous (IV) antibiotics for prophylaxis has been published previously.
Removal of instrumentation for postoperative spine infection: systematic review
Andrew Hersh AB1, Robert Young BS1, Zach Pennington BS1, Jeff Ehresman BS1, Andy Ding BA1,Srujan Kopparapu BS, BA1, Ethan Cottrill MS1, Daniel M. Sciubba MD1, and Nicholas Theodore MD1
doi : 10.3171/2020.12.SPINE201300
Volume 35: Issue 3 (Sep 2021) Page Range: 376–388
Currently, no consensus exists as to whether patients who develop infection of the surgical site after undergoing instrumented fusion should have their implants removed at the time of wound debridement. Instrumentation removal may eliminate a potential infection nidus, but removal may also destabilize the patient’s spine. The authors sought to summarize the existing evidence by systematically reviewing published studies that compare outcomes between patients undergoing wound washout and instrumentation removal with outcomes of patients undergoing wound washout alone. The primary objectives were to determine 1) whether instrumentation removal from an infected wound facilitates infection clearance and lowers morbidity, and 2) whether the chronicity of the underlying infection affects the decision to remove instrumentation.
Safety of direct injection of oligodendrocyte progenitor cells into the spinal cord of uninjured Göttingen minipigs
Richard G. Fessler MD, PhD1, Charles Y. Liu MD, PhD2,Stephen McKenna MD3, R. David Fessler MD, PhD1,Jane S. Lebkowski PhD4, Catherine A. Priest PhD4, and Edward D. Wirth III MD, PhD4
doi : 10.3171/2020.12.SPINE201853
Volume 35: Issue 3 (Sep 2021) Page Range: 389–397
This study was conducted as a final proof-of-safety direct injection of oligodendrocyte progenitor cells into the uninjured spinal cord prior to translation to the human clinical trials.
