Carbon Footprint of Minimally Invasive and Open Microdiscectomy: Emerging Implications.

Study DesignRetrospective cohort study.ObjectiveTo quantify and compare the carbon footprint (CF) of open and MIS microdiscectomy.MethodsThe study included 161 patients undergoing primary 1 level open or minimally invasive surgery (MIS) for lumbar disc herniation between 2018 and 2022.

Contemporary decision-making factors leading to cervical disc replacement vs. fusion for the treatment of single-level degenerative cervical radiculopathy or myelopathy: survey opinions from members of the Society of Minimally Invasive Spine Surgeon and Cervical Spine Research Society.

Background: Degenerative cervical radiculopathy and myelopathy are frequently encountered pathologies in spine surgery. Cervical disc replacement (CDR) offers a motion-preserving alternative to conventional anterior cervical discectomy and fusion (ACDF). Presently, there is limited consensus on which variables impact the decision to perform fusion vs.

Current use and Complications Associated with Bone Morphogenetic Protein in Spine Fusion Surgery: A Review of 9809 Patients.

Study Design: Retrospective review of electronic health records system.

Objective: To compare the indications and complication rates between rhBMP-2 and non-rhBMP-2 use in spine fusion at a high-volume tertiary orthopedic institution.

Summary Of Background Data: Bone morphogenetic proteins are growth factors that play a critical role in bone development and proliferation.

Incidence and Prediction of Postoperative Urinary Retention Following Lumbar Decompression.

Background: Postoperative urinary retention (POUR), a common complication after spine surgery, can contribute to longer hospital stays, urinary tract infection, pain, and morbidity. This study aimed to determine the incidence of POUR in patients who underwent lumbar decompression and to construct a predictive model for preoperatively identifying high-risk patients.

Methods: This was a retrospective review of patients undergoing primary lumbar decompression from 2017 to 2023.

Outcomes of primary versus revision TLIF following decompression alone in degenerative spondylolisthesis: a retrospective propensity score matched study.

Background: Degenerative grade 1 spondylolisthesis is associated with lumbar instability, typically addressed with decompression and fusion to prevent iatrogenic instability. The SLIP trial indicated that decompression-only patients benefit significantly from early reoperation for instability. Yet, it's unclear how these revision patients' outcomes compare to those undergoing primary fusion.

Erector Spinae Plane Block is Associated with Earlier Discontinuation of Opioids and Return-to-Work Following Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Study Design/setting: Retrospective review of prospectively collected data.

Objective: To assess the impact of erector spinae plane (ESP) blocks on recovery kinetics and patient-reported outcomes (PROMs) following minimally invasive transforaminal lumbar interbody fusion (MI-TLIF).

Summary Of Background Data: ESP block continues to emerge as a safe and effective regional anesthetic technique and has been shown to reduce immediate postoperative pain and opioid requirements, although its impact on patient recovery and outcomes farther out postoperatively remains unclear.

High Modified 5 Factor Frailty Index is Associated With Worse PROMs and Decreased Return to Activities After 1 or 2 Level MI-TLIF.

Study DesignRetrospective cohort study.ObjectiveFrailty is defined as a state of minimal "physiologic reserve." The modified 5 factor frailty index (mFI-5) is a recently proposed metric for assessing frailty and has been previously studied as a predictor of morbidity and mortality.

Impact of pedicle screw accuracy on clinical outcomes after 1- or 2-level minimally invasive transforaminal lumbar interbody fusion.

Objective: When creating minimally invasive spine fusion constructs, accurate pedicle screw fixation is essential for biomechanical strength and avoiding complications arising from delicate surrounding structures. As research continues to analyze how to improve accuracy, long-term patient outcomes based on screw accuracy remain understudied. The objective of this study was to analyze long-term patient outcomes based on screw accuracy.

Influence of coronal lumbar Cobb angle and surgical level on short-segment lumbar surgery outcomes in degenerative scoliosis.

Purpose: This study investigates the relationship between surgical levels and coronal deformity to identify risk factors for failing to achieve a minimal clinically important difference (MCID) in the Oswestry Disability Index (ODI) following short-segment isolated decompression or fusion surgery in patients with degenerative scoliosis (DS) and concurrent lumbar canal stenosis (LCS), without severe sagittal deformity malalignment.

Methods: Patients with degenerative scoliosis who underwent 1- or 2-level lumbar isolated decompression or fusion surgery were included. Surgical level was labeled as "Cobb-related" when decompression or surgical levels spanned or were between end vertebrae, and "outside" when the operative levels did not include the end vertebrae.

Short-segment fusion versus isolated decompression in lumbar spinal canal stenosis patients with Cobb angles over 20°.

Background Context: Lumbar decompression and short-segment lumbar fusion are standard procedures for short-segment lumbar canal stenosis, even in patients with moderate Cobb angles. Adult degenerative scoliosis is diagnosed at a threshold of 10°, and patients with coronal Cobb angles over 30° are recommended for long fusion due to global spinal deformity. However, there is a lack of research on clinical outcomes in patients with moderate coronal deformity, such as Cobb angles between 20° and 30°.

Early NRS Leg and Back Thresholds Predict Clinical Recovery After MIS Transforaminal Lumbar Interbody Fusion for Degenerative Spine Disease.

Study Design: This retrospective study included patients who underwent primary one-level minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar spine conditions.

Objective: To identify early predictors of failing to achieve the Oswestry Disability Index (ODI) minimum clinically important difference (MCID) 1 year post-surgery.

Background: Early identification of patients at risk of failing to achieve ODI-MCID is crucial for early intervention and improved postoperative counseling.

Discrepancy between global- and disease-specific outcome measures following lumbar spine surgery.

Objective: The aim of this study was to assess the correlation between patient-perceived changes in health and commonly utilized patient-reported outcome measures (PROMs) in lumbar spine surgery.

Methods: This was a retrospective review of prospectively collected data on consecutive patients who underwent lumbar microdiscectomy, lumbar decompression, or lumbar fusion at a single academic institution from 2017 to 2023. Correlation between the global rating of change (GRC) questionnaire, a 5-item Likert scale (much better, slightly better, about the same, slightly worse, and much worse), and PROMs (Oswestry Disability Index, visual analog scale for back and leg pain, 12-Item Short Form Health Survey Physical Component Summary and Mental Component Summary, and PROMIS physical function) was assessed using Spearman's rank correlation coefficients.

Level-specific comparison of 3D navigated and robotic arm-guided screw placement: an accuracy assessment of 1210 pedicle screws in lumbar surgery.

Background Context: Robotic spine surgery, utilizing 3D imaging and robotic arms, has been shown to improve the accuracy of pedicle screw placement compared to conventional methods, although its superiority remains under debate. There are few studies evaluating the accuracy of 3D navigated versus robotic-guided screw placement across lumbar levels, addressing anatomical challenges to refine surgical strategies and patient safety.

Purpose: This study aims to investigate the pedicle screw placement accuracy between 3D navigation and robotic arm-guided systems across distinct lumbar levels.

Preoperative Physical Therapy is Associated With Decreased Length of Stay and Improved Postoperative Mobility in Patients With Sarcopenia Undergoing Adult Spinal Deformity Surgery.

Study Design: Retrospective cohort study.

Objective: To determine the relationship between preoperative physical therapy (PT) and postoperative mobility, adverse events (AEs), and length of stay (LOS) among patients with low normalized total psoas area (NTPA) undergoing adult spinal deformity (ASD) surgery.

Background: Sarcopenia, as defined by low NTPA, has been shown to predict poor perioperative outcomes of ASD surgery.

Morbidly Obese Patients Have Similar Clinical Outcomes and Recovery Kinetics After Minimally Invasive Decompression.

Study Design: Retrospective cohort.

Objective: To study the impact of class 2/3 obesity (body mass index, BMI ≥35) on outcomes following minimally invasive decompression.

Summary Of Background Data: No previous study has analyzed the impact of class 2/3 obesity on outcomes following minimally invasive decompression.

Practical Answers to Frequently Asked Questions in Anterior Cervical Spine Surgery for Degenerative Conditions.

Introduction: Surgical counseling enables shared decision making and optimal outcomes by improving patients' understanding about their pathologies, surgical options, and expected outcomes. Here, we aimed to provide practical answers to frequently asked questions (FAQs) from patients undergoing an anterior cervical diskectomy and fusion (ACDF) or cervical disk replacement (CDR) for the treatment of degenerative conditions.

Methods: Patients who underwent primary one-level or two-level ACDF or CDR for the treatment of degenerative conditions with a minimum of 1-year follow-up were included.

Temporal Trends of Improvement After Minimally Invasive Transforaminal Lumbar Interbody Fusion.

Study Design: Retrospective review of prospectively collected data.

Objective: To analyze temporal trends in improvement after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).

Summary Of Background Data: Although several studies have shown that patients improve significantly after MIS TLIF, evidence regarding the temporal trends in improvement is still largely lacking.

Limited Improvement With Minimally Invasive Lumbar Decompression Alone for Degenerative Scoliosis With Cobb Angle Over 20°: The Impact of Decompression Location.

Study Design: Retrospective review of a prospectively collected multisurgeon registry.

Objective: To evaluate the outcomes of minimally invasive (MI) decompression in patients with severe degenerative scoliosis (DS) and identify factors associated with poorer outcomes.

Summary Of Background Context: MI decompression has gained widespread acceptance as a treatment option for patients with lumbar canal stenosis and DS.

The Impact of Posterior Intervertebral Osteophytes on Patient-Reported Outcome Measures After L5-S1 Anterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion.

Study Design: Retrospective cohort study.

Objective: (1) To develop a reliable grading system to assess the severity of posterior intervertebral osteophytes and (2) to investigate the impact of posterior intervertebral osteophytes on clinical outcomes after L5-S1 decompression and fusion through anterior lumbar interbody fusion (ALIF) and minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF).

Background: There is limited evidence regarding the clinical implications of posterior lumbar vertebral body osteophytes for ALIF and MIS-TLIF surgeries and there are no established grading systems that define the severity of these posterior lumbar intervertebral osteophytes.

Age-dependent acquisition of pathogenicity by SARS-CoV-2 Omicron BA.5.

Pathology studies of SARS-CoV-2 Omicron variants of concern (VOC) are challenged by the lack of pathogenic animal models. While Omicron BA.1 and BA.