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Editorial. Spinal laser interstitial thermal therapy: a great idea without a great application
Mark H. Bilsky and Yoshiya Yamada
doi : 10.3171/2020.7.SPINE201214
Volume 34: Issue 3.page range:351_353
Spinal laser interstitial thermal therapy: single-center experience and outcomes in the first 120 cases
Dhiego C. A. Bastos, Rafael A. Vega, Jeffrey I. Traylor, Amol J. Ghia, Jing Li, Marilou Oro, Andrew J. Bishop, Debra N. Yeboa, Behrang Amini, Vinodh A. Kumar, Ganesh Rao, Laurence D. Rhines, and Claudio E. Tatsui
doi : 10.3171/2020.7.SPINE20661
Volume 34: Issue 3.page range:354_363
The objective of this study was to present the results of a consecutive series of 120 cases treated with spinal laser interstitial thermal therapy (sLITT) to manage epidural spinal cord compression (ESCC) from metastatic tumors.
Predicting nonroutine discharge in patients undergoing surgery for vertebral column tumors
Jeff Ehresman, Zach Pennington, James Feghali, Andrew Schilling, Andrew Hersh, Bethany Hung, Daniel Lubelski, and Daniel M. Sciubba
doi : 10.3171/2020.6.SPINE201024
Volume 34: Issue 3.page range:364_373
More than 8000 patients are treated annually for vertebral column tumors, of whom roughly two-thirds will be discharged to an inpatient facility (nonroutine discharge). Nonroutine discharge is associated with increased care costs as well as delays in discharge and poorer patient outcomes. In this study, the authors sought to develop a prediction model of nonroutine discharge in the population of vertebral column tumor patients.
5-ALA fluorescence for intraoperative visualization of spinal ependymal tumors and identification of unexpected residual tumor tissue: experience in 31 patients
Matthias Millesi, Barbara Kiesel, Vanessa Mazanec, Lisa I. Wadiura, Adelheid W?hrer, Johannes Herta, Stefan Wolfsberger, Klaus Novak, Julia Furtner, Karl R?ssler, Engelbert Knosp, and Georg Widhalm
doi : 10.3171/2020.6.SPINE20506
Volume 34: Issue 3.page range:374_382
Gross-total resection (GTR) is the treatment of choice in the majority of patients suffering from spinal ependymal tumors. In such tumors, the extent of resection (EOR) is considered the key factor for tumor recurrence and thus patient prognosis. However, incomplete resection is not uncommon and leads to increased risk of tumor recurrence. One important cause of incomplete resection is insufficient intraoperative visualization of tumor tissue as well as residual tumor tissue. Therefore, the authors investigated the value of 5-aminolevulinic acid (5-ALA)–induced fluorescence in a series of spinal ependymal tumors for improved tumor visualization.
Predicting postoperative quality-of-life outcomes in patients with metastatic spine disease: who benefits?
James Feghali, Zach Pennington, Jeff Ehresman, Daniel Lubelski, Ethan Cottrill, A. Karim Ahmed, Andrew Schilling, and Daniel M. Sciubba
doi : 10.3171/2020.7.SPINE201136
Volume 34: Issue 3.page range:383_389
Symptomatic spinal metastasis occurs in around 10% of all cancer patients, 5%–10% of whom will require operative management. While postoperative survival has been extensively evaluated, postoperative health-related quality-of-life (HRQOL) outcomes have remained relatively understudied. Available tools that measure HRQOL are heterogeneous and may emphasize different aspects of HRQOL.
Long-term benefits of appropriately corrected sagittal alignment in reconstructive surgery for adult spinal deformity: evaluation of clinical outcomes and mechanical failures
Chong-Suh Lee, Jin-Sung Park, Yunjin Nam, Youn-Taek Choi, and Se-Jun Park
doi : 10.3171/2020.7.SPINE201108
Volume 34: Issue 3.page range:390_398
It has been well documented that optimal sagittal alignment is highly correlated with good clinical outcomes in adult spinal deformity (ASD) surgery. However, it remains to be determined whether the clinical benefit of appropriately corrected sagittal alignment can be maintained in the long term. Therefore, the aim of this study was to investigate whether appropriately corrected sagittal alignment continues to offer benefits over time with regard to clinical outcomes and mechanical failure.
Multicenter assessment of surgical outcomes in adult spinal deformity patients with severe global coronal malalignment: determination of target coronal realignment threshold
Thomas J. Buell, Justin S. Smith, Christopher I. Shaffrey, Han Jo Kim, Eric O. Klineberg, Virginie Lafage, Renaud Lafage, Themistocles S. Protopsaltis, Peter G. Passias, Gregory M. Mundis Jr., Robert K. Eastlack, Vedat Deviren, Michael P. Kelly, Alan H. Daniels, Jeffrey L. Gum, Alex Soroceanu, D. Kojo Hamilton, Munish C. Gupta, Douglas C. Burton, Richard A. Hostin, Khaled M. Kebaish, Robert A. Hart, Frank J. Schwab, Shay Bess, Christopher P. Ames, and the International Spine Study Group (ISSG)
doi : 10.3171/2020.7.SPINE20606
Volume 34: Issue 3.page range:399_412
The impact of global coronal malalignment (GCM; C7 plumb line–midsacral offset) on adult spinal deformity (ASD) treatment outcomes is unclear. Here, the authors’ primary objective was to assess surgical outcomes and complications in patients with severe GCM, with a secondary aim of investigating potential surgical target coronal thresholds for optimal outcomes.
Assessing the unique characteristics associated with surgical treatment of dystrophic lumbar scoliosis secondary to neurofibromatosis type 1: a single-center experience of more than 10 years
Song Li, Saihu Mao, Changzhi Du, Zezhang Zhu, Benlong Shi, Zhen Liu, Jun Qiao, and Yong Qiu
doi : 10.3171/2020.6.SPINE20898
Volume 34: Issue 3.page range:413_423
Dystrophic lumbar scoliosis secondary to neurofibromatosis type 1 (DLS-NF1) may present an atypical, unique curve pattern associated with a high incidence of coronal imbalance and regional kyphosis. Early surgical intervention is complicated and risky but necessary. The present study aimed to assess the unique characteristics associated with the surgical treatment of DLS-NF1.
C7 extension crosswise osteotomy: a novel osteotomy for correction of chin-on-chest deformity in a patient with ankylosing spondylitis
Andrzej Maciejczak, Andzelina Wolan-Nieroda, and Agnieszka Guzik
doi : 10.3171/2020.7.SPINE20258
Volume 34: Issue 3.page range:424_429
Extension crosswise osteotomy at C7 (C7 ECO) was developed for the correction of forward gaze in patients with chin-on-chest deformity due to ankylosing spondylitis. A modification of cervicothoracic extension osteoclasis (C/T EO), C7 ECO replaces osteoclasis of the anterior column with a crosswise cut of the C7 vertebral body to eliminate the risks of unintended dislocation of the cervical spine.
The impact of increasing interbody fusion levels at the fractional curve on lordosis, curve correction, and complications in adult patients with scoliosis
Dominic Amara, Praveen V. Mummaneni, Shane Burch, Vedat Deviren, Christopher P. Ames, Bobby Tay, Sigurd H. Berven, and Dean Chou
doi : 10.3171/2020.6.SPINE20256
Volume 34: Issue 3.page range:430_439
Radiculopathy from the fractional curve, usually from L3 to S1, can create severe disability. However, treatment methods of the curve vary. The authors evaluated the effect of adding more levels of interbody fusion during treatment of the fractional curve.
Long-term quality of life and work status after high-dose spinal cord stimulation in patients with failed back surgery syndrome: a secondary analysis of real-world data
Lisa Goudman, Ann De Smedt, Koen Putman, Maarten Moens, and the Discover Consortium
doi : 10.3171/2020.7.SPINE20764
Volume 34: Issue 3.page range:440_448
In recent years, the use of high-dose spinal cord stimulation (HD-SCS) as a treatment option for patients with failed back surgery syndrome (FBSS) has drastically increased. However, to the authors’ knowledge a thorough evaluation of health-related quality of life (HRQOL) and work status in these patients has not yet been performed. Moreover, it is unclear whether patients who are treated with HD-SCS can regain the same levels of HRQOL as the general population. Therefore, the aims of this study were to compare the HRQOL of patients who receive HD-SCS to HRQOL values in an age- and sex-adjusted population without FBSS and to evaluate work status in patients who are receiving HD-SCS
The association between patient rating of their spine surgeon and quality of postoperative outcome
Nicholas M. Rabah, Hammad A. Khan, Jay M. Levin, Robert D. Winkelman, Thomas E. Mroz, and Michael P. Steinmetz
doi : 10.3171/2020.7.SPINE20478
Volume 34: Issue 3.page range:449_455
The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey was developed by the Centers for Medicare and Medicaid Services as a result of their value-based purchasing initiative. It allows patients to rate their experience with their provider in the outpatient setting. This presents a unique situation in healthcare in which the patient experience drives the marketplace, and since its creation, providers have sought to improve patient satisfaction. Within the spine surgery setting, however, the question remains whether improved patient satisfaction correlates with improved outcomes.
Correlation of vertebral trabecular attenuation in Hounsfield units and the upper instrumented vertebra with proximal junctional failure after surgical treatment of degenerative lumbar disease
Qi Wang, Chi Wang, Xiaobo Zhang, Fanqi Hu, Wenhao Hu, Teng Li, Yan Wang, and Xuesong Zhang
doi : 10.3171/2020.7.SPINE20920
Volume 34: Issue 3.page range:456_463
The aim of this study was to investigate whether bone mineral density (BMD) measured in Hounsfield units (HUs) is correlated with proximal junctional failure (PJF).
Lumbar alignment and patient-reported outcomes after single-level transforaminal lumbar interbody fusion for degenerative lumbar spondylolisthesis with and without local coronal imbalance
Wei Pan, Jia-li Zhao, Jin Xu, Ming Zhang, Tao Fang, Jing Yan, Xin-hong Wang, and Quan Zhou
doi : 10.3171/2020.7.SPINE20703
Volume 34: Issue 3.page range:464-470
The purpose of this study was to compare the preoperative radiographic features of degenerative lumbar spondylolisthesis (DLS) with and without local coronal imbalance (LCI) and to investigate the surgical outcomes of transforaminal lumbar interbody fusion (TLIF) in the treatment of DLS with LCI at the spondylolisthesis level. DLS with scoliotic disc wedging and/or lateral listhesis at the same involved segment, as well as LCI, constitutes a distinct subgroup. However, previous studies concerning surgical outcomes focused mainly on sagittal profiles. There is a paucity of valid data regarding lumbar coronal alignment and patient-reported outcomes (PROs) after surgery in DLS with LCI.
Long-term radiographic outcomes of expandable versus static cages in transforaminal lumbar interbody fusion
Chih-Chang Chang, Dean Chou, Brenton Pennicooke, Joshua Rivera, Lee A. Tan, Sigurd Berven, and Praveen V. Mummaneni
doi : 10.3171/2020.6.SPINE191378
Volume 34: Issue 3.page range:471-480
Potential advantages of using expandable versus static cages during transforaminal lumbar interbody fusion (TLIF) are not fully established. The authors aimed to compare the long-term radiographic outcomes of expandable versus static TLIF cages.
Radiological predictors of recurrent lumbar disc herniation: a systematic review and meta-analysis
Michael Brooks, Ashraf Dower, Muhammad Fahmi Abdul Jalil, and Saeed Kohan
doi : 10.3171/2020.6.SPINE20598
Volume 34: Issue 3.page range:481_491
Lumbar discectomy for the management of lumbar radiculopathy is a commonly performed procedure with generally excellent patient outcomes. However, recurrent lumbar disc herniation (rLDH) remains one of the most common complications of the procedure, often necessitating repeat surgery. rLDH is known to be influenced by a variety of factors, and in this systematic review the authors aimed to explore the radiological predictors of recurrence.
Surgical results of nonambulatory patients caused by ossification of the posterior longitudinal ligaments in the thoracic spine: retrospective comparative study between posterior decompression and instrumented spinal fusion versus anterior decompression through a posterior approach
Toshimi Aizawa, Toshimitsu Eto, Ko Hashimoto, Haruo Kanno, Eiji Itoi, and Hiroshi Ozawa
doi : 10.3171/2020.7.SPINE20411
Volume 34: Issue 3.page range:492_497
Thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) remains one of the most difficult-to-treat disorders for spine surgeons. In Japan, approximately 75% of patients with this condition are treated using posterior decompression with instrumented spinal fusion (PDF). In contrast, anterior decompression is the most effective method for relieving spinal cord compression. The authors treated nonambulatory patients with thoracic OPLL by either PDF or by their technique using anterior decompression through a posterior approach. In this study the surgical results of these procedures are compared.
Primary treatment of atlantoaxial rotatory fixation in children: a multicenter, retrospective series of 125 cases
Takahiro Shimazaki, Kei Yamada, Kimiaki Sato, Kotaro Jimbo, Hidetomo Nakamura, Masafumi Goto, Tsunemasa Matsubara, Kenji Mizokami, Shoji Iwahashi, Takeharu Sasaki, and Naoto Shiba
doi : 10.3171/2020.7.SPINE20183
Volume 34: Issue 3.page range:498-505
The primary treatment for atlantoaxial rotatory fixation (AARF) remains controversial. The aim of this study was to investigate the primary treatment for AARF and create an algorithm for primary treatment.
Spinal pathologies and management strategies associated with cervical angina (pseudoangina): a systematic review
Nolan J. Brown, Shane Shahrestani, Brian V. Lien, Seth C. Ransom, Ali R. Tafreshi, Ryan Chase Ransom, and Ronald Sahyouni
doi : 10.3171/2020.7.SPINE20866
Volume 34: Issue 3.page range:506_513
Cervical angina, or pseudoangina pectoris, is a noncardiac syndrome of chest pain that often mimics angina pectoris but is a disease of the spine. Diagnosis of cervical angina can be difficult and is often overlooked, although once identified, it can be successfully managed through conservative therapies and/or a variety of surgical interventions. Ultimately, cervical angina is an important component of the list of differential diagnoses in noncardiac chest pain. In the present study, the authors report the first comprehensive systematic review of the range of cervical and thoracic pathologies associated with cervical angina, as well as the different treatment methods used to manage this condition.
Neurosurgical versus endovascular treatment of spinal dural arteriovenous fistulas: a multicenter study of 195 patients
Keisuke Takai, Toshiki Endo, Takao Yasuhara, Toshitaka Seki, Kei Watanabe, Yuki Tanaka, Ryu Kurokawa, Hideaki Kanaya, Fumiaki Honda, Takashi Itabashi, Osamu Ishikawa, Hidetoshi Murata, Takahiro Tanaka, Yusuke Nishimura, Kaoru Eguchi, Toshihiro Takami, Yusuke Watanabe, Takeo Nishida, Masafumi Hiramatsu, Tatsuya Ohtonari, Satoshi Yamaguchi, Takafumi Mitsuhara, Seishi Matsui, Hisaaki Uchikado, Gohsuke Hattori, Hitoshi Yamahata, and Makoto Taniguchi
doi : 10.3171/2020.6.SPINE20309
Volume 34: Issue 3.page range:514_521
The purpose of the present study was to compare the treatment success rates of primary neurosurgical and endovascular treatments in patients with spinal dural arteriovenous fistulas (dAVFs).
Microsurgical anatomy and treatment of dural defects in spontaneous spinal cerebrospinal fluid leaks
Ako Matsuhashi, Keisuke Takai, and Makoto Taniguchi
doi : 10.3171/2020.6.SPINE20487
Volume 34: Issue 3.page range:522_530
Spontaneous spinal CSF leaks are caused by abnormalities of the spinal dura mater. Although most cases are treated conservatively or with an epidural blood patch, some intractable cases require neurosurgical treatment. However, previous reports are limited to a small number of cases. Preoperative detection and localization of spinal dural defects are difficult, and surgical repair of these defects is technically challenging. The authors present the anatomical characteristics of dural defects and surgical techniques in treating spontaneous CSF leaks.
Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative
Paul Park, Victor Chang, Hsueh-Han Yeh, Jason M. Schwalb, David R. Nerenz, Lonni R. Schultz, Muwaffak M. Abdulhak, Richard Easton, Miguelangelo Perez-Cruet, Osama N. Kashlan, Mark E. Oppenlander, Nicholas J. Szerlip, Kevin N. Swong, and Ilyas S. Aleem
doi : 10.3171/2020.7.SPINE20729
Volume 34: Issue 3.page range:531_536
In 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.
“Houston, we have a problem”: the difficulty of measuring outcomes in spinal surgery
Gregory W. Basil, Annelise C. Sprau, Zoher Ghogawala, Jang W. Yoon, and Michael Y. Wang
doi : 10.3171/2020.8.SPINE201279
Volume 34: Issue 3.page range:537_539
