Spine

STUDY DESIGN: This study was a retrospective propensity-matched study of patients receiving opioid sparing anesthesia (OSA) and those who did not receive an opioid sparing anesthesia regimen. OBJECTIVES: To determine whether patients undergoing spine fusion for deformity fared better with an OSA regimen than those not having an OSA regimen. SUMMARY OF BACKGROUND DATA: There has been a tremendous focus on opioid overuse. Accordingly, OSA regimens are being introduced to reduce narcotic use...

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: This study aims to assess the validity of the Thoracolumbar Injury Classification and Severity Score (TLICS) in patients ≤10 years-old. SUMMARY OF BACKGROUND DATA: TLICS is a validated measure developed to help facilitate clinical decision-making regarding thoracolumbar spinal trauma in adults. Studies examining the utility of TLICS in children skew towards older pediatric patients, where the spine's biomechanical properties are more similar to adults...

STUDY DESIGN: This was an observational study. OBJECTIVE: This study aims to explore sociodemographic and regional geographic variations in Lower back pain (LBP) incidence, prevalence, and burden in the United States (US from 2000-2019. SUMMARY OF BACKGROUND DATA: LBP is a major contributor to lost wages and disability in the US. As LBP is associated with increasing age and sedentary lifestyle, the incidence of LBP is expected to rise. Due to LBP's multifactorial causes, US epidemiological trends lack sufficient data...

STUDY DESIGN: Cross-sectional analysis of a prospectively enrolled cohort. OBJECTIVE: Determine the normative values of the T1 Pelvic Angle (TPA) and Lumbar Pelvic Angle (LPA) in an asymptomatic cohort of volunteers. SUMMARY OF BACKGROUND DATA: The TPA and LPA have been introduced as sagittal spino-pelvic parameters to guide correction of adult spinal deformity. Suggested values for these parameters were derived from linear regressions based on Oswestry Disability Index scores from adult spinal deformity patients...

STUDY DESIGN: Cost-effectiveness of two trial interventions for low back pain. OBJECTIVE: To investigate the incremental cost-effectiveness between risk-stratified and usual care for low back pain. SUMMARY OF BACKGROUND DATA: A recent trial compared risk-stratified care to usual care for patients with low back pain (LBP) in the US Military Health System. While the outcomes were no different between groups, risk-stratified care is purported to use fewer resources and therefore could be a more cost-effective intervention...

STUDY DESIGN: Retrospective study. OBJECTIVE: To compare the true cost between posterior cervical laminectomy and fusion and cervical laminoplasty using time driven activity-based costing methodology. SUMMARY OF BACKGROUND DATA: Cervical laminoplasty (LP) and posterior cervical laminectomy with fusion (LF) are effective procedures for treating cervical myelopathy. A comprehensive accounting of cost differences between LP versus LF is not available...

STUDY DESIGN: Retrospective analysis of a prospective multicenter Adult Spinal Deformity (ASD) registry. OBJECTIVE: Assess whether spinal alignment deteriorates post-surgery in absence of mechanical complications and evaluate the long-term outcomes of ASD surgery over a five-year period. SUMMARY OF BACKGROUND DATA: ASD is prevalent among older adults, leading to significant pain and disability. Surgical intervention, although increasingly popular, is associated with complications, high costs, and uncertain long-term outcomes beyond two years...

STUDY DESIGN: A retrospective review. OBJECTIVE: The purpose of this study is to trend PROMIS PF scores following lumbar fusion surgery, and to investigate how the presence of functional comorbidities affects PROMIS PF scores. Additionally, we compare trends in PROMIS PF scores to the Oswestry Disability Index (ODI) and to PROMIS Pain Interference (PI) scores. SUMMARY OF BACKGROUND DATA: National Institute of Health's (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) domain has been validated in spine surgery...

STUDY DESIGN: Retrospective study of a multicentric prospective database. OBJECTIVE: This study aimed at describing the relative contribution of vertebral bodies versus discs to lumbar lordosis, and its variation with age and pelvic incidence. SUMMARY OF BACKGROUND DATA: While studies sought to determine the physiological magnitude and distribution of lumbar lordosis, data regarding its anatomical composition is lacking. METHODS: This study included healthy volunteers with full-body stereoradiographs in free-standing position, without lumbosacral transitional vertebra or age under 18...

STUDY DESIGN: Retrospective study. OBJECTIVES: To validate the sagittal age-adjusted score (SAAS) in predicting proximal junctional kyphosis/failure (PJK/F) and good clinical outcomes following adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: SAAS is a relatively new assessment system that incorporates age-adjusted sagittal parameters of pelvic incidence (PI) - lumbar lordosis (LL), pelvic tilt (PT), and T1 pelvic angle (TPA) to predict the PJK/F...

STUDY DESIGN: Retrospective, observational study. OBJECTIVE: To evaluate the ability and value of metagenomic next-generation sequencing (mNGS) in detecting pathogens from spinal infections. BACKGROUND: The pathogenic diagnosis of primary spinal infection is challenging. The widespread application of mNGs in clinical practice makes it particularly useful in detecting rare, emerging, and atypical complex infectious diseases. METHODS: From January 2019 to December 2023, a retrospective collection of 120 samples was obtained from patients suspected of spinal infections and undergoing treatment...

No abstract text is available yet for this article.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Compare outcomes in patients undergoing one-level transforaminal lumbar interbody fusion (TLIF) at L4-S1. BACKGROUND: TLIF is frequently performed at L4-S1 to treat degenerative lumbar pathologies. However, the native alignment and biomechanics differ across L4-L5 and L5-S1, and there is limited data regarding comparative radiographic outcomes. METHODS: Patients who underwent one-level TLIF at L4-L5 or L5-S1 at a single academic institution were identified...

STUDY DESIGN: This was a single-center prospective clinical and radiographic analysis of pedicle screw instrumentation with Robotic-assisted navigation (RAN) and augmented reality (AR). OBJECTIVE: This study aimed to compare the accuracy of lumbosacral pedicle screw placement with RAN versus AR. SUMMARY OF BACKGROUND DATA: RAN and AR have demonstrated superior accuracy in lumbar pedicle screw placement compared to conventional free-hand techniques...

STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the risk factors for bony proximal junctional failure (B-PJF) and ligamentous PJF (L-PJF) separately after adult spinal deformity (ASD) surgery. SUMMARY OF BACKGROUND DATA: Despite numerous studies about the risk factors of PJF, it remains unclear whether same risk factors can be applied to both B-PJF and L-PJF. METHODS: Patients who underwent corrective surgery from low thoracic level (T9-T12) to pelvis with minimum follow-up duration of two years were included in this study...

No abstract text is available yet for this article.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate intensive postoperative nutritional supplementation on wound healing complications and outcomes after spinal fusion surgery. BACKGROUND: Poor nutritional status leads to inferior postoperative outcomes by increasing mortality and predisposing patients to infection and wound healing complications. While perioperative nutritional supplementation has shown promise in mitigating these risks, there is a paucity of literature regarding specific nutritional routines in spinal fusion surgery...

STUDY DESIGN: Retrospective, Multicenter. OBJECTIVE: Determine if posterior column osteotomies (PCO) at time of conversion from growth friendly instrumentation (GFI) to definitive fusion in early onset scoliosis (EOS) graduates impacts outcomes. SUMMARY OF BACKGROUND DATA: Increasing spinal rigidity following treatment of EOS with GFI can limit curve correction at time of conversion to definitive spinal fusion. PCO are often employed at the time of fusion to improve flexibility...

STUDY DESIGN: A genetic case-control study. OBJECTIVES: To investigate the association between AIS progression-associated SNPs reported by GWAS studies and the effectiveness of brace treatment. SUMMARY OF BACKGROUND DATA: Bracing is the most effective conservative method to treat adolescent idiopathic scoliosis (AIS). Several factors have been reported to be associated with bracing failure in AIS patients. Genetic markers associated with AIS have potential prognostic value...

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Compare outcomes in patients undergoing one-level or two-level anterior lumbar interbody fusion (ALIF) at L4-S1. BACKGROUND: Although ALIF may deliver restoration of lumbar lordosis and improvement in clinical outcomes, it also carries risk of complications including major vascular injury. Whether one-level and two-level ALIF offers similar outcomes is not known. METHODS: Adults who underwent one-level L4-L5 or L5-S1 ALIF and two-level L4-S1 ALIF at a single academic institution were identified...