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Editorial. Lost in translation: recognition of the “ceiling effectâ€� as a potential barrier to the success of neuroprotective strategies in spinal cord injury
Dominic J. Gessler  MD, PhD and Ann M. Parr  MD, PhD, FRCSC
doi : 10.3171/2022.8.SPINE22774
Volume 38: Issue 3 (Mar 2023)
A decrease in the neuroprotective effects of acute spinal cord decompression according to injury severity: introducing the concept of a ceiling effect
Tobias Prasse MD , Zin Z. Khaing PhD , Lindsay N. Cates BS , Dane M. Dewees MS , Jeffrey E. Hyde BS , Jan Bredow MD , and Christoph P. Hofstetter MD, PhD
doi : 10.3171/2022.6.SPINE22383
Acute traumatic spinal cord injury (tSCI) is followed by a prolonged period of secondary neuroglial cell death. Neuroprotective interventions, such as surgical spinal cord decompression, aim to mitigate secondary injury. In this study, the authors explore whether the effect size of posttraumatic neuroprotective spinal cord decompression varies with injury severity.
Postoperative ileus risk after posterior thoracolumbar fusion performed with total intravenous anesthesia versus inhaled anesthesia
Brandon A. Sherrod MD , Robert Kim MD , Joshua Hunsaker BS , Courtney Rada BS , Clint Christensen MD , Gregory J. Stoddard MBA, MPH , Darrel Brodke MD , Mark A. Mahan MD , Marcus D. Mazur MD , Erica F. Bisson MD, MPH , and Andrew T. Dailey MD
doi : 10.3171/2022.9.SPINE22520
There has been an increase in the use of total intravenous anesthesia (TIVA) for intraoperative neuromonitoring during thoracolumbar posterior spinal fusion (PSF). Although prior studies have identified risk factors for postoperative ileus (PI) after PSF, to the authors’ knowledge, PI rates in patients receiving inhaled anesthetic versus TIVA have not been evaluated. In this study the authors analyzed whether TIVA is associated with greater risk of PI in PSF patients.
Impaction grafting of lumbar pedicle defects: a biomechanical study of a novel technique for pedicle screw revision
Francis H. Shen MD , Gerald M. Hayward II BS , Jonathan A. Harris MS , Jorge Gonzalez BS , Evan Thai BS , Jon Raso BS , Margaret R. Van Horn PhD , and Brandon S. Bucklen PhD
doi : 10.3171/2022.10.SPINE22351
The two most common revision options available for the management of loose pedicle screws are larger-diameter screws and cement augmentation into the vertebral body for secondary fixation.
Proximal junctional failure in primary thoracolumbar fusion/fixation to the sacrum/pelvis for adult symptomatic lumbar scoliosis: long-term follow-up of a prospective multicenter cohort of 160 patients
Bruno Lazaro MD , Juan Pablo Sardi MD , Justin S. Smith MD, PhD , Michael P. Kelly MD , Elizabeth L. Yanik PhD , Brian Dial MD , Jeffrey Hills MD , Munish C. Gupta MD , Christine R. Baldus RN, MHS , Chun Po Yen MD , Virginie Lafage PhD , Christopher P. Ames MD , Shay Bess MD , Frank Schwab MD , Christopher I. Shaffrey MD , and Keith H. Bridwell MD
doi : 10.3171/2022.9.SPINE22549
Proximal junctional failure (PJF) is a severe form of proximal junctional kyphosis. Previous reports on PJF have been limited by heterogeneous cohorts and relatively short follow-ups. The authors’ objectives herein were to identify risk factors for PJF and to assess its long-term incidence and revision rates in a homogeneous cohort.
Association of telomere length with risk of complications in adult spinal deformity surgery: a pilot study of 43 patients
Michael M. Safaee MD , Jue Lin PhD , Dana L. Smith MS , Marissa Fury BS , Justin K. Scheer MD , John F. Burke MD , Crystal Bravate PA-C , Dennis Lambert MA , and Christopher P. Ames MD
doi : 10.3171/2022.10.SPINE22605
Risk stratification is a critical element of surgical planning. Early tools were fairly crude, while newer instruments incorporate disease-specific elements and markers of frailty.
Use of the Global Alignment and Proportion score to predict postoperative health-related quality of life in adult spinal deformity surgery
Jichao Ye MD , Tsung-Cheng Yin MD , Sachin Gupta MD , Ali S. Farooqi BA , Wenbing Wan MD , Caglar Yilgor MD , Brenda A. Sides MA , and Munish C. Gupta MD
doi : 10.3171/2022.9.SPINE22809
The purpose of this study was to validate the Global Alignment and Proportion (GAP) score as a predictor of health-related quality of life (HRQOL) outcomes for patients undergoing adult spinal deformity (ASD) surgery.
Spinal deformity surgery in patients for whom blood transfusion is not an option: a single-center experience
Alexander J. Schupper MD , Margit Kaufman MD , Jay S. Reidler MD, MPH , Marc S. Arginteanu MD , Frank M. Moore MD , Alfred Steinberger MD , Omar N. Syed MD , Kevin C. Yao MD , and Yakov Gologorsky MD
doi : 10.3171/2022.11.SPINE221061
Spinal deformity surgery is associated with significant blood loss, often requiring the transfusion of blood and/or blood products. For patients declining blood or blood products, even in the face of life-threatening blood loss, spinal deformity surgery has been associated with high rates of morbidity and mortality
Development of new postoperative neck pain at 12 and 24 months after surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study
Brandon A. Sherrod MD , Giorgos D. Michalopoulos MD , Graham Mulvaney MD , Nitin Agarwal MD , Andrew K. Chan MD , Anthony L. Asher MD , Domagoj Coric MD , Michael S. Virk MD, PhD , Kai-Ming Fu MD , Kevin T. Foley MD , Paul Park MD , Cheerag D. Upadhyaya MD, MBA, MSc , John J. Knightly MD , Mark E. Shaffrey MD , Eric A. Potts MD , Christopher I. Shaffrey MD , Oren N. Gottfried MD , Khoi D. Than MD , Michael Y. Wang MD , Luis M. Tumialán MD , Dean Chou MD , Praveen V. Mummaneni MD, MBA , Mohamad Bydon MD , and Erica F. Bisson MD, MPH
doi : 10.3171/2022.9.SPINE22611
Patients who undergo surgery for cervical spondylotic myelopathy (CSM) will occasionally develop postoperative neck pain that was not present preoperatively, yet the incidence of this phenomenon is unclear. The authors aimed to elucidate patient and surgical factors associated with new-onset sustained pain after CSM surgery.
Anterior atlanto-occipital transarticular screw fixation: a biomechanical comparison with posterior fixation techniques
Panjie Xu MD , Zhiping Huang BSc , Hang Xiao MD , Junyu Lin MD, PhD , Qingan Zhu PhD , and Wei Ji MD, PhD
doi : 10.3171/2022.11.SPINE22564
Atlanto-occipital instability is commonly treated with posterior fixation. However, in patients with congenital or acquired factors, posterior fixation may not be possible. For these situations, a novel anterior atlanto-occipital transarticular screw (AATS) fixation technique has been introduced recently.
Multilevel cervical disc arthroplasty: a review of optimal surgical management and future directions
Tsung-Hsi Tu MD, PhD , Ching-Ying Wang MD , Yu-Chun Chen MD, PhD , and Jau-Ching Wu MD, PhD
doi : 10.3171/2022.11.SPINE22880
Cervical disc arthroplasty (CDA) has been recognized as a popular option for cervical radiculopathy or myelopathy caused by disc problems that require surgery. There have been prospective randomized controlled trials comparing CDA to anterior cervical discectomy and fusion (ACDF) for 1- and 2-level disc herniations.
Dysphagia after cervical spine surgery: a review of risk factors and preventative measures
Vincent J. Alentado MD , Erica F. Bisson MD, MPH , and Eric A. Potts MD
doi : 10.3171/2022.11.SPINE221247
Dysphagia is a regular occurrence after cervical spine surgery, and the development of dysphagia postoperatively is associated with worsened quality of life for patients. Despite the frequency and negative implications of this adverse outcome, there is no clear consensus for defining dysphagia within the spinal literature.
Selecting the lowest instrumented vertebra in a multilevel posterior cervical fusion across the cervicothoracic junction: a biomechanical investigation
Yaroslav Gelfand MD , Daniel Franco MD , Merritt D. Kinon MD , Rafael De la Garza Ramos MD , Reza Yassari MD, MS , Jonathan A. Harris MS , Samantha Flamand BS , Joshua P. McGuckin MS , Jorge L. Gonzalez BS , Jonathan M. Mahoney BS , and Brandon S. Bucklen PhD
doi : 10.3171/2022.10.SPINE22381
Posterior cervical fusion is a common surgical treatment for patients with myeloradiculopathy or regional deformity. Several studies have found increased stresses at the cervicothoracic junction (CTJ) and significantly higher revision surgery rates in multilevel cervical constructs that terminate at C7.
A novel scoring system concept for de novo spinal infection treatment, the Spinal Infection Treatment Evaluation Score (SITE Score): a proof-of-concept study
Jonathan Pluemer MD , Yevgeniy Freyvert MD , Nathan Pratt MD , Jerry E. Robinson MD , Jared A. Cooke DO , Zachary L. Tataryn MD , Clifford A. Pierre MD , Periklis Godolias MD , Sven Frieler MD , Alexander von Glinski MD , Emre Yilmaz MD , Zeyad A. Daher BS , Hamzah A. Al-Awadi MAMS , Mitchell H. Young BS , Rod J. Oskouian MD , and Jens R. Chapman MD
doi : 10.3171/2022.11.SPINE22719
De novo infections of the spine are an increasing healthcare problem. The decision for nonsurgical or surgical treatment is often made case by case on the basis of physician experience, specialty, or practice affiliation rather than evidence-based medicine.
Functional impact of multiple bleeding events in patients with conservatively treated spinal cavernous malformations
Laurèl Rauschenbach MD , Alejandro N. Santos MD , Hanah H. Gull MD , Christoph Rieß MD , Cornelius Deuschl MD , Börge Schmidt PhD , Marvin Darkwah Oppong MD , Oliver Gembruch MD , Neriman Özkan MD , Ramazan Jabbarli MD , Karsten H. Wrede MD , Ulrich Sure MD , and Philipp Dammann MD
doi : 10.3171/2022.10.SPINE22940
The aim of this study was to investigate the functional outcome in spinal cavernous malformation (SCM) patients with single or multiple intramedullary hemorrhagic events.
Letter to the Editor. Limitations of the Hospital Frailty Risk Score in metastatic spinal column tumor surgery
Kavelin Rumalla MD , Meic H. Schmidt MD, MBA , and Christian A. Bowers MD
Letter to the Editor. Interspinous process device clinical practice experience
John W. Gilbert MD , Brydon Christensen BS , and Sherri Matheny MHA
