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Decompression alone versus decompression and instrumented fusion for the treatment of isthmic spondylolisthesis: a randomized controlled trial
Kayoumars Azizpour MSc1, Pieter Schutte MD1,6, Mark P. Arts MD, PhD3, Willem Pondaag MD, PhD1,6, Gerrit J. Bouma MD, PhD4, Maarten Coppes MD, PhD5, Erik van Zwet PhD2, Wilco C. Peul MD, PhD1,3,6, and Carmen L. A. Vleggeert-Lankamp MD, MSc, PhD1,3,7
doi : 10.3171/2021.1.SPINE201958
Volume 35: Issue 6, page: 687–697
Decompression alone versus decompression and instrumented fusion for the treatment of isthmic spondylolisthesis: a randomized controlled trial
National adverse event profile after lumbar spine surgery for lumbar degenerative disorders and comparison of complication rates between hospitals: a CSORN registry study
Oliver G. S. Ayling MD1, Raphaele Charest-Morin MD1, Matthew E. Eagles MD4, Tamir Ailon MD1, John T. Street MD1, Nicolas Dea MD, MSc, FRCSC1, Greg McIntosh MSc2, Sean D. Christie MD10, Edward Abraham MD3, W. Bradley Jacobs MD4, Christopher S. Bailey MD7, Michael G. Johnson MD5, Najmedden Attabib MBBcH10, Peter Jarzem MD11, Michael Weber MD11, Jerome Paquet MD6, Joel Finkelstein MD9, Alexandra Stratton MD, MSc8, Hamilton Hall MD9, Neil Manson MD3, Y. Raja Rampersaud MD9, Kenneth Thomas MD4, and Charles G. Fisher MD, MHSc1
doi : 10.3171/2021.2.SPINE202150
Volume 35: Issue 6, page: 698–703
Previous works investigating rates of adverse events (AEs) in spine surgery have been retrospective, with data collection from administrative databases, and often from single centers. To date, there have been no prospective reports capturing AEs in spine surgery on a national level, with comparison among centers.
Synovial facet joint cysts after lumbar posterior decompression surgery
Yuichiro Morishita MD, PhD1, Ryota Taniguchi MD1, Osamu Kawano MD, PhD1, and Takeshi Maeda MD, PhD1
doi : 10.3171/2021.2.SPINE201671
Volume 35: Issue 6, page: 704–709
Numerous studies have reported on synovial facet joint cysts of the spine as a primary lesion. The exact pathogenesis of those cysts is still controversial, but degeneration and destabilization seem to be underlying mechanisms. However, only a few reports have thus far investigated synovial cysts of the spine as postoperative complications of decompression surgery. In this retrospective clinical study, the authors focused on synovial cysts of the lumbar facet joints as complications after lumbar decompression surgery, with the aim of elucidating their pathophysiology.
Characteristics of postoperative opioid prescription use following lumbar discectomy
Chason Ziino MD1,2, Aditya V. Karhade MD, MBA1,2, Andrew J. Schoenfeld MD, MSc2, Mitchel B. Harris MD1, and Joseph H. Schwab MD, MS1
doi : 10.3171/2021.2.SPINE202041
Volume 35: Issue 6, page: 710–714
The role of spine surgeons in precipitating and mediating sustained prescription opioid use remains controversial at this time. The purpose of this study was to identify prescription opioid use following lumbar discectomy and characterize the source of opioid prescriptions by clinician specialty (surgeon vs nonsurgeon).
Low-back pain after lumbar discectomy for disc herniation: what can you tell your patient?
Christian Iorio-Morin MD, PhD, FRCSC1, Charles G. Fisher MD, MHSc, FRCSC2, Edward Abraham MD, FRCSC3,4, Andrew Nataraj MD, FRCSC5, Najmedden Attabib MD, MBBCH, FRCSC3,4, Jerome Paquet MD, FRCSC6, Thomas Guy Hogan MD, FRCSC7, Christopher S. Bailey MD, MSc, FRCSC8, Henry Ahn MD, PhD, FRCSC9, Michael Johnson MD, FRCSC10, Eden A. Richardson BA11, Neil Manson MD, FRCSC3,4,7, Ken Thomas MD, MHSc, FRCSC12, Y. Raja Rampersaud MD, FRCSC9, Hamilton Hall MD, FRCSC9, and Nicolas Dea MD, MSc, FRCSC2
doi : 10.3171/2021.2.SPINE201625
Volume 35: Issue 6, page: 715–721
Lumbar discectomy (LD) is frequently performed to alleviate radicular pain resulting from disc herniation. While this goal is achieved in most patients, improvement in low-back pain (LBP) has been reported inconsistently. The goal of this study was to characterize how LBP evolves following discectomy.
Lymphocele after anterior lumbar interbody fusion: a review of 1322 patients
Justin K. Scheer MD1, Alexander F. Haddad BS1, Andrew K. Chan MD1, Charles M. Eichler MD3, Bobby Tay MD2, Shane Burch MD2, Dean Chou MD1, Christopher P. Ames MD1, and Praveen V. Mummaneni MD, MBA1
doi : 10.3171/2021.2.SPINE201667
Volume 35: Issue 6, page: 722–728
Anterior lumbar interbody fusion (ALIF) is an effective surgical modality for many lumbar degenerative pathologies, but a rare and infrequently reported complication is postoperative lymphocele. The goals of the present study were to review a large consecutive series of patients who underwent ALIF at a high-volume institution, estimate the rate of lymphocele occurrence after ALIF, and investigate the outcomes of patients who developed lymphocele after ALIF.
Multicenter assessment of outcomes and complications associated with transforaminal versus anterior lumbar interbody fusion for fractional curve correction
Thomas J. Buell MD1, Christopher I. Shaffrey MD1, Shay Bess MD2, Han Jo Kim MD3, Eric O. Klineberg MD4, Virginie Lafage PhD3, Renaud Lafage MS3, Themistocles S. Protopsaltis MD5, Peter G. Passias MD5, Gregory M. Mundis Jr. MD6, Robert K. Eastlack MD6, Vedat Deviren MD7, Michael P. Kelly MD9, Alan H. Daniels MD10, Jeffrey L. Gum MD11, Alex Soroceanu MD, MPH12, D. Kojo Hamilton MD13, Munish C. Gupta MD9, Douglas C. Burton MD14, Richard A. Hostin MD15, Khaled M. Kebaish MD16, Robert A. Hart MD17, Frank J. Schwab MD3, Christopher P. Ames MD8, Justin S. Smith MD, PhD18, and the International Spine Study Group
doi : 10.3171/2020.11.SPINE201915
Volume 35: Issue 6, page: 729–742
Few studies have compared fractional curve correction after long fusion between transforaminal lumbar interbody fusion (TLIF) and anterior lumbar interbody fusion (ALIF) for adult symptomatic thoracolumbar/lumbar scoliosis (ASLS). The objective of this study was to compare fractional correction, health-related quality of life (HRQL), and complications associated with L4–S1 TLIF versus those of ALIF as an operative treatment of ASLS.
Orthopedic disease burden in adult patients with symptomatic lumbar scoliosis: results from a prospective multicenter study
Justin S. Smith MD, PhD1, Christopher I. Shaffrey MD2, Christine R. Baldus RN, MHS3, Michael P. Kelly MD3, Elizabeth L. Yanik PhD3, Jon D. Lurie MD4, Christopher P. Ames MD5, Shay Bess MD6, Frank J. Schwab MD7, and Keith H. Bridwell MD3
doi : 10.3171/2021.1.SPINE201911
Volume 35: Issue 6, page: 743–751
Although the health impact of adult symptomatic lumbar scoliosis (ASLS) is substantial, these patients often have other orthopedic problems that have not been previously quantified. The objective of this study was to assess disease burden of other orthopedic conditions in patients with ASLS based on a retrospective review of a prospective multicenter cohort.
Reduced proximal junctional failure with ligament augmentation in adult spinal deformity: a series of 242 cases with a minimum 1-year follow-up
Michael M. Safaee MD1, Alexander F. Haddad BS1, Marissa Fury BS1, Patrick R. Maloney MD1, Justin K. Scheer MD1, Darryl Lau MD1, Vedat Deviren MD2, and Christopher P. Ames MD1,2
doi : 10.3171/2021.2.SPINE201987
Volume 35: Issue 6, page: 752–760
Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-recognized complications of long-segment spinal fusion. Previous studies have suggested that ligament augmentation can decrease rates of PJF by reducing junctional stress and strengthening upper instrumented vertebrae (UIVs) and adjacent segments. However, there is a paucity of long-term data on the efficacy of ligament augmentation in preventing PJF. In this study, the authors sought to determine the effect of ligament augmentation on rates of PJF in a cohort of adult spinal deformity patients with at least 1 year of follow-up.
Global coronal decompensation and adult spinal deformity surgery: comparison of upper-thoracic versus lower-thoracic proximal fixation for long fusions
Thomas J. Buell MD1, Christopher I. Shaffrey MD1, Han Jo Kim MD2, Eric O. Klineberg MD3, Virginie Lafage PhD2, Renaud Lafage MS2, Themistocles S. Protopsaltis MD4, Peter G. Passias MD4, Gregory M. Mundis Jr. MD5, Robert K. Eastlack MD5, Vedat Deviren MD6, Michael P. Kelly MD7, Alan H. Daniels MD8, Jeffrey L. Gum MD9, Alex Soroceanu MD, MPH10, D. Kojo Hamilton MD11, Munish C. Gupta MD7, Douglas C. Burton MD12, Richard A. Hostin MD13, Khaled M. Kebaish MD14, Robert A. Hart MD15, Frank J. Schwab MD2, Shay Bess MD16, Christopher P. Ames MD17, Justin S. Smith MD, PhD18, and The International Spine Study Group (ISSG)
doi : 10.3171/2021.2.SPINE201938
Volume 35: Issue 6, page: 761–773
Deterioration of global coronal alignment (GCA) may be associated with worse outcomes after adult spinal deformity (ASD) surgery. The impact of fusion length and upper instrumented vertebra (UIV) selection on patients with this complication is unclear. The authors’ objective was to compare outcomes between long sacropelvic fusion with upper-thoracic (UT) UIV and those with lower-thoracic (LT) UIV in patients with worsening GCA ? 1 cm.
Preliminary experience using S1–alar iliac fixation with navigation: technical note
Bo Li MD1,2, Andrew K. Chan MD1, Praveen V. Mummaneni MD, MBA1, John F. Burke MD, PhD1, Michael M. Safaee MD1, and Dean Chou MD1
doi : 10.3171/2021.1.SPINE201744
Volume 35: Issue 6, page: 774–779
Traditional iliac screws and S2–alar iliac (S2-AI) screws are common methods used for pelvic fixation, and many surgeons advocate pelvic fixation for long-segment fixation to the sacrum. However, in patients without severe deformities and only degenerative conditions, many surgeons may choose S1 screws only. Moreover, even with S2-AI screws, there is more muscular dissection than with using S1 screws, and the rod connection can be cumbersome in both S2-AI fixation and placing iliac screws. Using a surgical video, artist’s illustration, and intraoperative photographs, the authors describe the S1-AI screw fixation technique that allows for single-screw sacral and iliac fixation, requires less distal dissection of the sacrum, allows for easier rod connection, and may be an option in degenerative conditions needing pelvic fixation. However, this is a preliminary feasibility study, and in long fusion constructs, this type of fixation has only been used in conjunction with L5–S1 anterior lumbar interbody fusion (ALIF), and there are no long-term data on the use of this screw fixation technique without ALIF. In short-segment revision fusions, this technique may be considered for salvage in cases of large halos in the sacrum from loosened S1 screw fixation.
Adult sports-related traumatic spinal injuries: do different activities predispose to certain injuries?
Blake M. Hauser BSPH, MPhil1, Saksham Gupta MD1, Samantha E. Hoffman BS1, Mark M. Zaki MD, MBA1, Anne A. Roffler BS3, David J. Cote MD, PhD1, Yi Lu MD, PhD1, John H. Chi MD, MPH1, Michael W. Groff MD1, Ayaz M. Khawaja MD1,2, Timothy R. Smith MD, PhD, MPH1, and Hasan A. Zaidi MD1
doi : 10.3171/2021.1.SPINE201860
Volume 35: Issue 6, page: 780–786
Sports injuries are known to present a high risk of spinal trauma. The authors hypothesized that different sports predispose participants to different injuries and injury severities.
Do all outpatient spine surgeries cost the same? Comparison of economic outcomes data from a state-level database for outpatient lumbar decompression performed in an ambulatory surgery center or hospital outpatient setting
Mohammed Ali Alvi MBBS, MS1,2, Waseem Wahood MS3, Shyam J. Kurian BA4, Jad Zreik BS1,2, Molly M. Jeffery PhD5, James M. Naessens ScD5,6, Robert J. Spinner MD2, and Mohamad Bydon MD1,2
doi : 10.3171/2021.2.SPINE201820
Volume 35: Issue 6, page: 787–795
Spinal procedures are increasingly conducted as outpatient procedures, with a growing proportion conducted in ambulatory surgery centers (ASCs). To date, studies reporting outcomes and cost analyses for outpatient spinal procedures in the US have not distinguished the various outpatient settings from each other. In this study, the authors used a state-level administrative database to compare rates of overnight stays and nonroutine discharges as well as index admission charges and cumulative 7-, 30-, and 90-day charges for patients undergoing outpatient lumbar decompression in freestanding ASCs and hospital outpatient (HO) settings.
Smartphone GPS signatures of patients undergoing spine surgery correlate with mobility and current gold standard outcome measures
Alessandro Boaro MD1,4, Jeffrey Leung BA1, Harrison T. Reeder AM2, Francesca Siddi MD1, Elisabetta Mezzalira RN, MSc1, Gang Liu MSc2, Rania A. Mekary PhD, MSc1,3, Yi Lu MD, PhD5, Michael W. Groff MD5, Jukka-Pekka Onnela DSc2, and Timothy R. Smith MD, PhD, MPH1,5
doi : 10.3171/2021.2.SPINE202181
Volume 35: Issue 6, page: 796–806
Patient-reported outcome measures (PROMs) are currently the gold standard to evaluate patient physical performance and ability to recover after spine surgery. However, PROMs have significant limitations due to the qualitative and subjective nature of the information reported as well as the impossibility of using this method in a continuous manner. The smartphone global positioning system (GPS) can be used to provide continuous, quantitative, and objective information on patient mobility. The aim of this study was to use daily mobility features derived from the smartphone GPS to characterize the perioperative period of patients undergoing spine surgery and to compare these objective measurements to PROMs, the current gold standard.
Effects of compressive lesions on intraoperative human spinal cord elasticity
Amro Al-Habib MD, FRCSC, MPH1, Wajda Alhothali MD1, Abdulrahman Albakr MD1, Sherif Elwatidy MD1, Ghaida Alawaji MD1, Hissah Alabdulsalam MD1, Fahad Albadr MD1, Metab Alkubeyyer MD2, Abdullah Abu Jamea PhD2, Waleed Awwad MD, FRCSC3, Anhar Ullah MSc4, Faisal Fakhouri PhD5, and Abdulrazag Ajlan MD, FRCSC1
doi : 10.3171/2021.1.SPINE201482
Volume 35: Issue 6, page: 807–816
Although evaluating tissue elasticity has various clinical applications, spinal cord elasticity (SCE) in humans has never been well documented. In this study, the authors aimed to evaluate the impact of compression on human SCE in vivo.
Use of an intraoperative sodium oxychlorosene–based infection prevention protocol to safely decrease postoperative wound infections after spine surgery
Vincent J. Alentado MD1,2,3, Robert P. Berwanger BA2, Anabel M. Konesco3, Alex J. Potts3, Caroline A. Potts3, David W. Stockwell MD1,2, Lana Dbeibo MD5, John J. DePowell MD3,4, Eric M. Horn MD3,4, Saad A. Khairi MD3,4, Shannon P. McCanna MD3,4, Jean-Pierre Mobasser MD3,4, Richard B. Rodgers MD3,4, and Eric A. Potts MD3,4
doi : 10.3171/2021.2.SPINE202133
Volume 35: Issue 6, page: 817–823
Postoperative infection remains prevalent after spinal surgical procedures. Institutional protocols for infection prevention have improved rates of infection after spine surgery. However, prior studies have focused on only elective surgical patients. The aim of this study was to determine the efficacy of a multiinstitutional intraoperative sodium oxychlorosene–based infection prevention protocol for decreasing rate of infection after instrumented spinal surgery.
Treatment strategies and prognostic factors for spinal cavernous malformation: a single-center retrospective cohort study
Tong Liu MD1, Kai Li MS1, Yongli Wang MD1, Zilong Zhao PhD1, Xin Chen MD1, Fanjian Li MD1, Lu Zhao MD2, Zhijun Peng MD2, Tao Zhu MD, PhD1, and Jianning Zhang MD, PhD1
doi : 10.3171/2021.2.SPINE201664
Volume 35: Issue 6, page: 824–833
The authors aimed to identify factors that influence neurological function after treatment in order to facilitate clinician decision-making during treatment of spinal cavernous malformation (SCM) and about when and whether to perform surgical intervention.
A multicenter analysis of the prognostic value of histone H3 K27M mutation in adult high-grade spinal glioma
Oluwaseun O. Akinduro MD1, Diogo P. Garcia MD1, Dominique M. O. Higgins MD, PhD2, Tito Vivas-Buitrago MD1, Mark Jentoft MD3, David A. Solomon MD, PhD4, David J. Daniels MD, PhD5, Zach Pennington MD6, Wendy J. Sherman MD7, Mychael Delgardo BS2, Mohamad Bydon MD5, Maziyar A. Kalani MD8, George Zanazzi MD, PhD9, Nadejda Tsankova MD, PhD10, Bernard R. Bendok MD8, Paul C. McCormick MD2, Daniel M. Sciubba MD6, Sheng-fu Larry Lo MHS, MD6, Jennifer L. Clarke MD, MPH11, Kingsley Abode-Iyamah MD1, and Alfredo Quiñones-Hinojosa MD1
doi : 10.3171/2021.2.SPINE201675
Volume 35: Issue 6, page: 834–843
High-grade spinal glioma (HGSG) is a rare but aggressive tumor that occurs in both adults and children. Histone H3 K27M mutation correlates with poor prognosis in children with diffuse midline glioma. However, the role of H3 K27M mutation in the prognosis of adults with HGSG remains unclear owing to the rarity of this mutation, conflicting reports, and the absence of multicenter studies on this topic.
Erratum. A multicenter analysis of the prognostic value of histone H3 K27M mutation in adult high-grade spinal glioma
Gillian Shasby EMBA1
doi : 10.3171/2021.8.SPINE201675a
Volume 35: Issue 6, page: 844
