Examining the Anatomy, Pathophysiology, and Clinical Presentation of Lower Extremity Neurologic Deficits: A Spine Surgeon's Guide to Foot Drop.

Foot drop is relatively common and can be a notable source of patient dissatisfaction and even potential litigation. For the spine surgeon evaluating such a patient, the natural inclination is to investigate a spinal etiology; however, foot drop can develop from a multitude of distinct insults along several locations, extending from the cerebral cortex to the leg musculature itself. In-depth understanding of the relevant anatomy implicated in foot drop, as well as the pathologies that may impede those structures, is paramount to expanding a surgeon's differential diagnosis.

Pilot Evaluation of the TissueStat-A Novel Device for Minimally Invasive Spine Surgery Fascial Closure.

Study Design: Pilot Evaluation Study.

Objective: To assess the ease-of-use and performance of TissueStat, a novel minimally invasive spine surgery (MIS) fascial closure device, compared with conventional suturing techniques.

Summary Of Background Data: Wound issues in spine surgery can be a major source of morbidity and decreased patient satisfaction.

Effect of Surgical Approach on Patient-reported Outcomes of Lumbar Fusion for Degenerative Spondylolisthesis: Should Grade Influence Approach?

Study Design: Retrospective cohort study.

Objective: The present study aims to compare outcomes for patients undergoing spinal fusion through PLDF and TLIF and determine whether specific radiographic characteristics, based upon both the CARDS and Meyerding classifications, might influence optimal fusion technique.

Summary Of Background Data: Despite the significant prevalence and high disease burden of degenerative spondylolisthesis (DS), consensus regarding surgical management is still lacking.

Type 2 Odontoid Fractures: Atlantodental Arthrosis as a Novel Risk Factor for Failure of Conservative Management.

Study Design: Retrospective case-control study.

Objective: The purpose of this study is to assess how the presence and grade of atlantodental arthrosis impact outcomes of nonoperatively managed type 2 odontoid fractures.

Summary Of Background Data: The nonoperative management of geriatric type 2 odontoid fractures requires consideration of all potential variables that may influence outcomes.

Fragility of Statistical Differences Between Surgical Approaches in Total Hip Arthroplasty.

Background: Total hip arthroplasty (THA) is a successful treatment for hip osteoarthritis, but the optimal surgical approach for this procedure is a topic of debate. This review uses fragility analysis to determine the statistical fragility of randomized controlled trials (RCTs) comparing the 3 most common surgical approaches for THA: direct anterior, direct lateral, and posterior.

Materials And Methods: A systematic review was conducted to identify RCTs comparing 2 of the 3 surgical approaches for THA.

Is the Atlantoaxial Level Overlooked in the Radiologic Interpretation of Cervical Magnetic Resonance Imaging?

Study Design: Retrospective analysis.

Objective: The purpose of this study is to quantify the rate at which the atlantoaxial level is omitted from official cervical magnetic resonance imaging (MRI) radiologic reports and to identify potential missed pathology, emphasizing the need for improved standardization of evaluation.

Summary Of Background Data: MRI is a readily utilized modality for evaluating the axial skeleton.

Impact of Chronic Preoperative Gabapentinoid Exposure on Surgical and Patient Reported Outcome Measures following Lumbar Fusion.

Study Design: Retrospective cohort.

Objective: To assess the relationship between long-term gabapentinoid use and outcomes after lumbar fusion.

Summary Of Background Data: Gabapentinoids, which include gabapentin and pregabalin, are commonly prescribed for radiculopathic pain.

The Fragility of Statistical Findings Regarding Hemiarthroplasty Versus Total Hip Arthroplasty for Displaced Femoral Neck Fractures.

There is debate over the treatment of displaced femoral neck fractures with either hemiarthroplasty or total hip arthroplasty. This study aimed to evaluate the fragility index (FI) of randomized controlled trials (RCTs) comparing these methods. We queried for these RCTs containing dichotomous outcomes, finding 11 RCTs with 63 dichotomous outcomes.

Hypermucoviscous presenting as sternocleidomastoid pyomyositis with subsequent lower extremity necrotising fasciitis.

Necrotising fasciitis (NF) is a severe, rapidly progressing infection of the muscular fascia and subcutaneous tissue. Monomicrobial NF from hypermucoviscous (hvKP-NF) is rare but highly virulent, most common in East Asia. This report reviews a unique case of hvKP-NF in a US male in his 40s with undiagnosed diabetes mellitus, presenting with severe sepsis, neck swelling and calf pain.

Impact of Antidepressant Use on Intraoperative Blood Loss and Transfusion Rates in Lumbar Fusion Surgery.

Objective: A quarter of spine surgery patients take antidepressants. Basic science research has suggested serotonergic antidepressants impair platelet function. This has been supported by only a small number of works in the setting of spine surgery.

Fix or Replace? Comparable Outcomes With Internal Fixation and Distal Femoral Replacement for Periprosthetic Fractures Above Total Knee Arthroplasty.

Background: The optimal treatment for periprosthetic fracture (PPfx) around total knee arthroplasty (TKA) remains a topic of debate. Due to its low incidence, comparative studies analyzing arthroplasty and fixation are lacking in the literature. The purpose of this study was to compare the outcomes of distal femoral replacement (DFR) and open reduction and internal fixation open reduction internal fixation (ORIF) for distal femur PPfx.

Analysis of Patients Who Undergo Index Arthroscopy With Biopsy but Not Implantation for Staged Chondrocyte Cell Transplantation.

Background: Autologous chondrocyte implantation (ACI) and matrix-induced autologous chondrocyte implantation (MACI) are 2-stage procedures requiring an index full-thickness cartilage biopsy. Only a portion of patients ultimately undergo second-stage ACI/MACI.

Purpose: To identify patients with articular cartilage defects who underwent arthroscopic debridement with biopsy for ACI/MACI and compare those who did with those who did not proceed with implantation within 2 years after biopsy.

Open Ankle Fractures in Older Individuals: A Multi-center Study.

The purpose of this study is to identify demographics, etiology, comorbidities, treatment, complications, and outcomes for older patients with open ankle fractures. Patients ≥60 years old who sustained an open ankle fracture between January 1, 2004 and March 31, 2014 at 6 Level 1 trauma centers were retrospectively reviewed. Univariate analysis using chi-squared or Student's t test was performed to identify associations between preoperative variables and 2 postoperative outcomes of interest: amputation and 1-year mortality.

Correlation of Radiographic Healing on Advanced Imaging in Young Adults and Adolescents With Symptomatic Spondylolysis Before and After Treatment: A Retrospective Study.

Study Design: Retrospective chart review.

Objective: To determine the effect of conservative measures on radiographic outcomes in those with isolated spondylolysis.

Summary Of Background Data: Spondylolysis is a common cause of low back pain in pediatric patients, affecting between 4.

Interpreting the Current Literature on Outcomes of Robotic-Assisted Versus Conventional Total Knee Arthroplasty Using Fragility Analysis: A Systematic Review and Cross-Sectional Study of Randomized Controlled Trials.

Background: Fragility analysis is a method of further characterizing outcomes in terms of the stability of statistical findings. This study assesses the statistical fragility of recent randomized controlled trials (RCTs) evaluating robotic-assisted versus conventional total knee arthroplasty (RA-TKA versus C-TKA).

Methods: We queried PubMed for RCTs comparing alignment, function, and outcomes between RA-TKA and C-TKA.

Factors Associated With Various Types of Industry Payments to Academic Spine Surgeons in the Open Payments Database.

Study Design: Retrospective cohort study.

Objective: The objective of this study was to investigate associations between spine surgeon characteristics and different types of industry payments.

Summary Of Background Data: Industry funding has played an important role in research and technological innovation within spine surgery, and industry payments supporting research have risen significantly in comparison to funding from other sources.

The severity of preoperative anemia escalates risk of poor short-term outcomes after lumbar spine fusion.

Objective: To evaluate how preoperative anemia severity affects 90-day outcomes of spinal fusion surgery.

Methods: A retrospective cohort study was conducted on adult lumbar fusion patients at a tertiary medical center. Patients were classified by World Health Organization anemia severity definitions for comparisons.

Severe thrombocytopaenia induced by systemic lupus erythematosus presenting as haemorrhagic oral bullae in a paediatric patient.

Systemic lupus erythematosus (SLE) is an autoimmune disease with varying dermatological findings. We review a unique presentation of SLE with a literature review. A previously healthy early adolescent female presented with painful, oral mucosal bullae filled with sanguineous fluid.

Opsoclonus myoclonus and ataxia syndrome with supraventricular tachycardia.

Pediatric opsoclonus-myoclonus and ataxia syndrome (OMAS) is a neurologic disorder characterized by disturbances in eye movement, muscle jerks, ataxia, sleep, and mood. In approximately 50% of cases, it is a paraneoplastic syndrome associated with a neuroblastoma. In the remaining cases, it is believed that the tumor is occult, has involuted, or there is a preceding immune-stimulating event.

Relationship Between Headache Characteristics and a Remote History of TBI in Veterans: A 10-Year Retrospective Chart Review.

Background And Objectives: The objective of this work was to examine the association between deployment-related traumatic brain injury (TBI) severity, frequency, and other injury characteristics with headache outcomes in veterans evaluated at a Veterans Administration (VA) polytrauma support clinic.

Methods: We conducted a retrospective chart review of 594 comprehensive TBI evaluations between 2011 and 2021. Diagnostic criteria were based on the Department of Defense/VA Consensus-Based Classification of Closed TBI.