Journal of Spine Surgery (Hong Kong)

BACKGROUND: Deep surgical site infections after spinal instrumentation represent a significant source of patient morbidity and poorer outcomes. Given lack of evidence or guidelines on the variety of procedural options in the management of deep spine surgical site infections, the purpose of this survey was to document and investigate the use of these techniques across Canada. METHODS: A 34-question survey evaluating surgical techniques for irrigation and debridement in postoperative thoracolumbar infection was distributed to Canadian adult spine surgeons...

BACKGROUND: The primary aim of our study is to assess the extent to which healthcare systems advertise their spine care programs as multidisciplinary and furthermore clarify whether these institutions accurately reflect this description in their online access to spine care. The secondary aim of our study is to determine what proportion of institutions enable patients to self-schedule appointments online and select providers. METHODS: Newsweek's 2021 list entitled "Best Hospitals 2021-United States" was utilized to obtain an extensive list of top-rated hospitals in the country...

BACKGROUND AND OBJECTIVE: Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been extensively studied in preclinical, animal, and human studies and has been used widely in spine fusion surgery. Evidence demonstrates that fusion rates with rhBMP-2 are similar to or higher than those achieved with autologous bone graft. However, there have been concerns regarding the cost, optimal dosage, and potential complications of rhBMP-2 use in spine surgery. The objective of this paper is to provide a current review of the available evidence regarding rhBMP-2 and other bone graft substitutes used for spinal surgery...

No abstract text is available yet for this article.

BACKGROUND: Disc-related sciatica is a frequent condition. Most cases of sciatica evolve favorably. Although several randomized controlled trials have reported that surgery is more effective than conservative management in the short-term, no significant differences in pain or functional disability have been reported in the longer term. As such, discounting complications requiring urgent intervention, surgery is generally only performed in patients in whom medical treatment has failed...

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has yielded far-reaching consequences for individual health systems as well as society. Although several studies have investigated epidemiological trends due to the pandemic-associated restrictions in patients requiring surgery for general surgical, trauma and orthopaedic aetiologies, there has been no assessment of the impact on spinal trauma and surgery in Australia. Thus, the aim of this study was to examine these changes at an Australian level one tertiary referral spinal cord injury (SCI) centre...

No abstract text is available yet for this article.

BACKGROUND: The United States has been facing a worsening opioid epidemic over the past two decades. The veteran population represents a large and vulnerable group with a higher burden of mental health comorbidities. The purpose of this study was to analyze the impact of lumbar spine surgery on postoperative opioid usage in the United States veteran population. METHODS: A retrospective cohort study was conducted using the Veterans Affairs Informatics and Computing Infrastructure database...

BACKGROUND: The optimal treatment of osteoporotic vertebral fractures is still a controversial and under discussion topic. Armed kyphoplasty with expansive intravertebral implants is an emerging procedure, which, in theory, it not only makes it possible to achieve instant analgesia, and to get stabilization gains of benefits of kyphoplasty and vertebroplasty, but also, allows for a more effective maintenance of the restored vertebral height. METHODS: A retrospective observational study is presented, in which 30 patients participated, including a total of 33 osteoporotic thoracolumbar compression burst vertebral fractures with involvement of one or both vertebral platforms and of more than one fifth of the posterior wall...

BACKGROUND: Spinal intradural (subdural and subarachnoid) hematoma following percutaneous kyphoplasty is an extremely rare complication. In this report, we describe a case of subarachnoid hemorrhage with delayed paralysis after kyphoplasty and review the literature on similar cases to describe the complications of kyphoplasty and vertebroplasty (VP). CASE DESCRIPTION: An 80-year-old man underwent percutaneous kyphoplasty at a local hospital an osteoporotic vertebral fracture (OVF) at the T12 and L1 level...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Background: Compare fusion at two independent timepoints (early and late) between 3D-printed titanium (Ti) and polyetheretherketone (PEEK) cages in patients undergoing standalone lateral lumbar interbody fusion (SA-LLIF). We hypothesized that 3D-printed Ti cages show higher fusion rates at an early timepoint compared to PEEK. Methods: A retrospective study of patients undergoing SA-LLIF with 3D-printed Ti cages and PEEK cages between 11/2016 and 01/2020 at a single academic institution was done...

BACKGROUND: Lumbar fusion (LF) is commonly performed to manage lumbar degenerative disc disease (LDDD) that has failed conservative measures. However, lumbar disc replacement (LDR) procedures are increasingly prevalent and designed to preserve motion in carefully selected patients. METHODS: A retrospective cohort study was performed using the National Inpatient Sample (NIS), queried from 2010 to 2019 to identify patients undergoing single and double-level LF or LDR with a diagnosis of LDDD using International Classification of Diseases (ICD) 9th (ICD-9) and 10th (ICD-10) revision diagnostic and procedure codes...

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Background: Despite its widespread use, definitive data demonstrating the efficacy of liposomal bupivacaine (LB) is limited especially in patients undergoing anterior cervical discectomy and fusion (ACDF). Therefore, this investigation examined whether ACDF patients who received intra-operative LB (LB cohort) exhibited decreased post-operative opioid use and lengths of hospital stay (LOS) compared to ACDF patients who did not receive intra-operative LB (controls). Methods: Eighty-two patients who underwent primary ACDF by a single surgeon from 2016 to 2019 were identified from an institutional database...

BACKGROUND: Crankshaft phenomenon secondary to posterior fusion for scoliotic deformity at a young age has become rare and its management can be very challenging. CASE DESCRIPTION: We report the case of an 11-year-old girl who has been complaining of a progressively increasing hump in her back with waist and shoulders asymmetry during the past 6 months. Three years prior to presentation, she underwent in another institution posterior correction fusion from T3 to L3 for a juvenile idiopathic scoliosis with a Cobb angle of 60°...

Background: C7 instrumentation during posterior cervicothoracic fusion can be challenging because it requires additional work of either placing side connectors to a single rod or placing two rods. Our clinical observations suggested that skipping instrumentation at C7 in a multi-level posterior cervicothoracic fusion will result in minimal intraoperative complications and decreased blood-loss while still maintaining sagittal balance parameters of cervical fusion. The objective of this study is to determine the clinical and radiographic outcomes of skipping C7 instrumentation compared to instrumenting the C7 vertebra in posterior cervicothoracic fusion...

No abstract text is available yet for this article.

No abstract text is available yet for this article.