The Cannabinoid Pharmacology of Bone Healing: Developments in Fusion Medicine.

Cannabinoid use is rising among patients undergoing spinal fusion, yet its influence on bone healing is poorly defined. The endocannabinoid system (ECS)-through cannabinoid receptors 1 (CB1) and 2 (CB2)-modulates skeletal metabolism. We reviewed preclinical, mechanistic and clinical evidence to clarify how individual cannabinoids affect fracture repair and spinal arthrodesis.

Assessing Pain and Anxiety Impact in Smokers with Spine Fractures Managed Without Surgery: A Retrospective Cohort Study.

Smoking is known to impair fracture healing and worsen surgical outcomes, but its effect on psychological recovery in spine trauma patients remains unclear. The purpose of this study is to assess how smoking affects pain and anxiety in patients with spine fractures treated either conservatively or surgically. We conducted a retrospective analysis looking at spine fracture patients > 18 years old seen at a single institution between 11/2015 and 9/2019.

Body size and intracranial volume interact with the structure of the central nervous system: A multi-center in vivo neuroimaging study.

Clinical research emphasizes the implementation of rigorous and reproducible study designs that rely on between-group matching or controlling for sources of biological variation such as subject's sex and age. However, corrections for body size (i.e.

Monitoring morphometric drift in lifelong learning segmentation of the spinal cord.

Morphometric measures derived from spinal cord segmentations can serve as diagnostic and prognostic biomarkers in neurological diseases and injuries affecting the spinal cord. For instance, the spinal cord cross-sectional area can be used to monitor cord atrophy in multiple sclerosis and to characterize compression in degenerative cervical myelopathy. While robust, automatic segmentation methods to a wide variety of contrasts and pathologies have been developed over the past few years, whether their predictions are stable as the model is updated using new datasets has not been assessed.

Identification and Management of Neurologic Complications in Patients Undergoing Adult Spinal Deformity Surgery.

Study DesignNarrative Literature Review.ObjectiveTo provide a comprehensive literature review of neurologic complications in Adult Spinal Deformity (ASD) surgery in the pre-operative, peri-operative and post-operative periods.MethodsA broad review of the literature was conducted using the multiple databases including Pubmed, Embase, Scopus and the Cochrane library.

Blood Management and Conservation During Adult Spine Deformity Surgery.

Study DesignNarrative literature review.ObjectivesTo summarize the evidence for perioperative blood conservation for patients undergoing surgery for adult spine deformity.MethodsA systematic literature review with narrative analysis was conducted to describe the evidence for blood conservation strategies before, during and after surgery for adult spine deformity.

Perioperative Medical Complications in Adult Spine Deformity Surgery: Classification and Prevention Strategies.

Study DesignNarrative review.ObjectiveWe aimed to propose the classifications of, risk factors for, and prevention strategies for perioperative complications from previously published papers in adult spinal deformity (ASD) surgeries.MethodsA literature search was conducted in the PubMed/MEDLINE database to identify studies reporting perioperative complications of spinal deformity surgery, their classifications, risk factors, and prevention strategies.

A Systematic Review of Current Terminology for Conditions Preceding Degenerative Cervical Myelopathy: Evidence Synthesis to Inform an AO Spine Expert Opinion Statement.

Study DesignSystematic review.ObjectivesThe pre-symptomatic state of Degenerative Cervical Myelopathy (DCM), wherein degenerative changes and spinal cord compression are seen without clinical findings, is poorly understood and inconsistently categorised. Clear identification may elucidate the temporality of DCM development.

AO Spine Clinical Practice Recommendations for Diagnosis and Management of Degenerative Cervical Myelopathy: Evidence Based Decision Making - A Review of Cutting Edge Recent Literature Related to Degenerative Cervical Myelopathy.

Study DesignLiterature review of key topics related to degenerative cervical myelopathy (DCM) with critical appraisal and clinical recommendations.ObjectiveThis article summarizes several key current topics related to the management of DCM.MethodsRecent literature related to the management of DCM was reviewed.

Systematic Review of Peptide CAQK: Properties, Applications, and Outcomes.

Many central nervous system (CNS) disorders lack approved treatment options. Previous research demonstrated that peptide CAQK can bind to chondroitin sulfate proteoglycans (CSPGs) in the extracellular matrix of the CNS. In vivo studies have investigated CAQK conjugated to nanoparticles containing therapeutic agents with varying methodologies/outcomes.

Advanced MRI metrics improve the prediction of baseline disease severity for individuals with degenerative cervical myelopathy.

Background Context: Degenerative cervical myelopathy (DCM) is the most common form of atraumatic spinal cord injury globally. Degeneration of spinal discs, bony osteophyte growth and ligament pathology results in physical compression of the spinal cord contributing to damage of white matter tracts and grey matter cellular populations. This results in an insidious neurological and functional decline in patients which can lead to paralysis.

Interventions to Optimize Spinal Cord Perfusion in Patients With Acute Traumatic Spinal Cord Injury: An Updated Systematic Review.

Study Design: Systematic review update.

Objectives: Interventions that aim to optimize spinal cord perfusion are thought to play an important role in minimizing secondary ischemic damage and improving outcomes in patients with acute traumatic spinal cord injuries (SCIs). However, exactly how to optimize spinal cord perfusion and enhance neurologic recovery remains controversial.

Timing of Decompressive Surgery in Patients With Acute Spinal Cord Injury: Systematic Review Update.

Study Design: Systematic review and meta-analysis.

Objective: Surgical decompression is a cornerstone in the management of patients with traumatic spinal cord injury (SCI); however, the influence of the timing of surgery on neurological recovery after acute SCI remains controversial. This systematic review aims to summarize current evidence on the effectiveness, safety, and cost-effectiveness of early (≤24 hours) or late (>24 hours) surgery in patients with acute traumatic SCI for all levels of the spine.

An Update of a Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Role and Timing of Decompressive Surgery.

Study Design: Clinical practice guideline development.

Objectives: Acute spinal cord injury (SCI) can result in devastating motor, sensory, and autonomic impairment; loss of independence; and reduced quality of life. Preclinical evidence suggests that early decompression of the spinal cord may help to limit secondary injury, reduce damage to the neural tissue, and improve functional outcomes.

Degenerative Thoracic Myelopathy: A Scoping Review of Epidemiology, Genetics, and Pathogenesis.

Study Design: Literature Review.

Objective: Myelopathy affecting the thoracic spinal cord can arise secondary to several aetiologies which have similar presentation and management. Consequently, there are many uncertainties in this area, including optimal terminology and definitions.

Management of mild degenerative cervical myelopathy and asymptomatic spinal cord compression: an international survey.

Study Design: Cross-sectional survey.

Objective: Currently there is limited evidence and guidance on the management of mild degenerative cervical myelopathy (DCM) and asymptomatic spinal cord compression (ASCC). Anecdotal evidence suggest variance in clinical practice.

The Frequency of Symptoms in Patients With a Diagnosis of Degenerative Cervical Myelopathy: Results of a Scoping Review.

Study Design: Delayed diagnosis of degenerative cervical myelopathy (DCM) is associated with reduced quality of life and greater disability. Developing diagnostic criteria for DCM has been identified as a top research priority.

Objectives: This scoping review aims to address the following questions: What is the diagnostic accuracy and frequency of clinical symptoms in patients with DCM?

Methods: A scoping review was conducted using a database of all primary DCM studies published between 2005 and 2020.