International Journal of Spine Surgery

BACKGROUND: Thoracolumbar burst fractures include a spectrum of treatment options ranging from conservative management to multilevel fusion with or without corpectomy. Given the variability of treatment options, consideration of radiographic outcomes with different treatment modalities should be a critical consideration in management. METHODS: A retrospective review was conducted evaluating all patients presenting with spine fractures over a 7-year period. Inclusion criteria were limited to adults with acute, traumatic burst fractures of the thoracolumbar joint levels T11-L2...

BACKGROUND: There remains a number of factors thought to be associated with survival in spinal metastatic disease, but evidence of these associations is lacking. In this study, we examined factors associated with survival among patients undergoing surgery for spinal metastatic disease. METHODS: We retrospectively examined 104 patients who underwent surgery for spinal metastatic disease at an academic medical center. Of those patients, 33 received local preoperative radiation (PR) and 71 had no PR (NPR)...

BACKGROUND: Assess correlation between preoperative cervical sagittal alignment (T1 slope [T1S] and C2-C7 cervical sagittal vertical axis [cSVA]) and postoperative cervical sagittal balance after posterior cervical laminoplasty. METHODS: Consecutive patients who underwent laminoplasty at a single institution with >6 weeks postoperative follow-up were divided into 4 groups based on preoperative cSVA and T1S (Group 1: cSVA <4 cm/T1S <20°; Group 2: cSVA ≥4 cm/T1S ≥20°; Group 3: cSVA <4 cm/T1S ≥20°; Group 4: cSVA <4 cm/T1S <20°)...

BACKGROUND: The purpose of this review is to provide a brief history of previous attempts at developing patient screening tools and to further examine the definitions of these psychological concepts, relevance to clinical outcomes, and implications for spine surgeons during preoperative patient assessments. METHODS: A literature review was performed by 2 independent researchers to identify original manuscripts related to spine surgery and novel psychological concepts...

BACKGROUND: Expandable cages are a recent development employed to reduce subsidence and improve fusion compared with static cages as they alleviate the need for repeated trialing or overdistraction of the disc space. This study aimed to compare the radiographic and clinical outcomes in patients undergoing lateral lumbar interbody fusion (LLIF) with either an expandable or static titanium cage. METHODS: This was a prospective study of 98 consecutive patients undergoing LLIF performed over a 2-year period, with the first 50 patients receiving static cages and the following 48 receiving expandable cages...

BACKGROUND: Operative approaches for far lateral disc herniation (FLDH) repair may be classified as open or minimally invasive. The present study aims to compare postoperative outcomes and resource utilization between patients undergoing open and endoscopic (one such minimally invasive approach) FLDH surgeries. METHODS: A total of 144 consecutive adult patients undergoing FLDH repair at a single, university health system over an 8-year period (2013-2020) were retrospectively reviewed...

BACKGROUND: Despite the known association between higher estimated blood loss (EBL) and suboptimal outcomes, the threshold of EBL that negatively impacts outcomes following elective spine surgery remains unknown. In an open 2- and 3-level posterolateral lumbar fusion, we sought to find a threshold of surgeon-reported EBL associated with length of stay (LOS), 30-day complications, and patient-reported outcomes (PROs). METHODS: A single-center, retrospective cohort study was performed for 2- and 3-level open posterolateral lumbar fusions between October 2010 and April 2021...

BACKGROUND: Juxtafacet cysts are located near or contiguous with the facet joints, and their occurrence is rare in the cervical spine. We report 4 cases of cervical juxtafacet cysts operated by microcervical foraminotomy (MCF) or a combination of MCF and laminoplasty. We simultaneously review previously reported cases in terms of location, clinical findings, and surgical technique. METHODS: Among the patients who underwent spine surgery at our hospital from 2015 to 2019, 4 had cervical juxtafacet cysts...

BACKGROUND: Transforaminal lumbar interbody fusion (TLIF) and posterolateral fusion (PLF) without an interbody device are two common approaches for single-level, open posterior fusion. Presently, it is unknown whether one of these operations leads to better outcomes. We sought to compare reoperation, complication, and readmission rates between TLIF and PLF for patients undergoing elective single-level, open, posterior lumbar fusion. METHODS: A single-center, retrospective cohort study utilizing prospectively collected data was performed...

BACKGROUND: Primary spinal epidural abscess (SEA) is a rare but serious pathology that may result in severe neurologic injury. While certain literature has identified medical risk factors for failure of conservative therapy, no current evidence has been published regarding socioeconomic risk factors associated with failure of medical therapy. METHODS: A retrospective review was conducted of patients presenting with SEA from primary spinal infections. Patients presenting with magnetic resonance imaging evidence of SEA treated conservatively in the absence of neurologic deficits were included...

BACKGROUND: Identify the external applicability of the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) risk calculator in the setting of adult spinal deformity (ASD) and subsets of patients based on deformity and frailty status. METHODS: ASD patients were isolated in our single-center database and analyzed for the shared predictive variables displayed in the NSQIP calculator. Patients were stratified by frailty (not frail <0...

BACKGROUND: Perioperative steroids have traditionally been administered during lumbar spine surgery in order to decrease local inflammation and prevent scar tissue formation, which can otherwise contribute to significant, long-lasting postoperative pain due to the formation of epidural fibrosis around lumbar nerve roots. However, the use of steroids in lumbar spine patients has raised concerns of postoperative wound complications caused by corticosteroid-induced immunomodulatory effects and changes in collagen synthesis...

BACKGROUND: Sacroiliac joint fusion (SIJF) has been established as an effective treatment for sacroiliac joint dysfunction. However, failure necessitating revision has been reported in up to 30% of cases. Little is known regarding outcomes of revision SIJF. METHODS: We retrospectively reviewed all revision SIJF at a single academic center between 2017 and 2020. Revision surgery was performed using the principles of joint decortication, bone grafting, compression, and rigid internal fixation...

BACKGROUND: Given the physical and economic burden of complications in spine surgery, reducing the prevalence of perioperative adverse events is a primary concern of both patients and health care professionals. This study aims to identify specific perioperative factors predictive of developing varying grades of postoperative complications in adult spinal deformity (ASD) patients, as assessed by the Clavien-Dindo complication classification (Cc) system. METHODS: Surgical ASD patients ≥18 years were identified in the American College of Surgeons' National Surgical Quality Improvement Program from 2005 to 2015...

No abstract text is available yet for this article.

BACKGROUND: Recombinant human bone morphogenetic protein-2 (rhBMP-2) combined with an activated collagen scaffold (Infuse; Medtronic, MN) has been used to facilitate lumbar intervertebral fusion; however, data regarding its efficacy are inconsistent. We aimed to assess the efficacy of rhBMP-2 when used in posterior lumbar interbody fusion (PLIF) by analyzing the rate of reoperation for nonunion and patient-reported outcome measures in a large retrospective case series. We also aimed to assess the impact of patient and surgical factors on rates of reoperation and determine frequency of complications...

No abstract text is available yet for this article.

BACKGROUND: The prone transpsoas (PTP) approach for lateral lumbar interbody fusion (LLIF) is a relatively novel technique. Currently, little is known about its associated complications and early patient-reported outcomes. The aim of this study was to investigate the effect of LLIF performed via the PTP approach on sagittal radiographic parameters, patient-reported outcome measures (PROMs), and rates of complications. METHODS: A retrospective review was performed of 82 consecutive patients who underwent LLIF via a PTP technique...

BACKGROUND: Posterior long-segment (LS) fixation, short-segment (SS) fixation, and short segment fixation with intermediate screws (SI) have shown good outcomes for the treatment of thoracolumbar burst fractures. However, limited data compared the biomechanical properties between LS fixation and SI. The purpose of this study was to compare the von Mises stresses on the pedicular screw system and bone between posterior LS fixation, SS fixation, and SI for the treatment of thoracolumbar burst fracture...

BACKGROUND: The present study aimed to assess the efficacy of a new haplo-paraspinal-muscle-preserving (HMP) laminoplasty technique in the treatment of cervical myelopathy. METHODS: The medical records of 68 patients diagnosed with multisegmental cervical myelopathy were retrospectively reviewed. Of these, 22 patients who underwent HMP laminoplasty were defined as the muscle-preserved group (MP), and 46 patients who underwent traditional open-door laminoplasty were enrolled and defined as the traditional open-door laminoplasty group (LP)...