Shifts in Diversity Along the Spine Surgery Training Pathway: Racial, Ethnic, and Gender Representation from Medical School to Fellowship.

Background Context: Racial and ethnic minorities are underrepresented among healthcare providers in the United States (US).

Purpose: This study analyzed the training pathway of underrepresented groups in spine surgery relative to earlier stages of training and the US population.

Study Design/setting: This was a cross-sectional analysis of medical students, orthopaedic surgery residents, and spine surgery fellows at accredited training programs (2014 to 2024).

Perceived Accuracy of Spine-Related Medical Advice From ChatGPT, TikTok, and the North American Spine Society Clinical Practice Guidelines.

Background: Patients increasingly turn to large language models (LLMs) and social media platforms for medical advice. The accuracy of these sources, particularly compared to peer-reviewed clinical practice guidelines, remains poorly characterized.

Materials And Methods: This cross-sectional study evaluated the perceived accuracy of spine-related medical advice generated by ChatGPT (ChatGPT (OpenAI, powered by GPT-4, San Francisco, CA, USA), TikTok (Los Angeles, CA, USA), and the North American Spine Society (NASS) clinical practice guidelines.

Clinical Efficiency and Radiation Safety of Fluoroscopy-Based 2D Intraoperative Computer Navigation in Biportal Spinal Endoscopy.

Background: Endoscopic spine surgery is a minimally invasive technique that can treat spinal conditions while resulting in less pain and faster recovery than alternative techniques. However, achieving precise navigation is challenging without significant radiation exposure and increased surgical times. Fluoroscopy-based 2-dimensional navigation (2DNAV) is an emerging technology that offers real-time navigation using intraoperative fluoroscopy.

Laminectomy with fusion for cervical spondylotic myelopathy is associated with higher early morbidity and risk of perioperative complications compared with laminectomy alone: a retrospective study in the United States.

Study Design: A retrospective cohort study.

Purpose: We present data assessing the differences in 30-day morbidity, mortality, and postoperative complications between the two surgical remedy options.

Overview Of Literature: The choice between decompression with fusion or decompression alone for the management of cervical spondylotic myelopathy (CSM) remains controversial.

Posterior Fixation and Fusion (PFF) versus Combined Anterior and Posterior Fixation and Fusion (CAPFF) for type B and C thoracolumbar spine injuries: a systematic review and meta-analysis.

Background: A literature review and meta-analysis were conducted on studies comparing posterior fixation and fusion (PFF) and combined anterior and posterior fixation and fusion (CAPFF) for type B and C thoracolumbar injuries to determine the superior technique.

Methods: A search of PubMed, Ovid Medline, Scopus, and the Cochrane Central Register was conducted from inception to September 2023. Randomized controlled trials and observational studies comparing PFF and CAPFF for B and C thoracolumbar injuries in adults were included.

National trends in postoperative complications for lumbar spinal fusion from 2009 to 2022.

Background: Although posterior lumbar fusions (PLFs) have risen in popularity due to minimally invasive techniques and favorable outcomes, complications still arise. Studies show relatively constant rates of postoperative complications from 2006 to 2016, but there are limited studies evaluating outcomes after 2016. Consequently, we aim to investigate trends in postoperative complications for PLFs from 2009 to 2022.

Decompression and fusion for lumbar degenerative spondylolisthesis is associated with higher early morbidity rates and risk of perioperative complications compared with decompression alone: a retrospective study in the United States.

Study Design: A retrospective cohort study.

Purpose: To assess differences in 30-day morbidity and mortality and postoperative complications between two surgical treatment options.

Overview Of Literature: The choice of decompression with fusion or decompression alone for the management of degenerative spondylolisthesis (DS) is controversial.

What is the learning curve for endoscopic spine surgery? A comprehensive systematic review.

Background Context: Endoscopic spine surgery (ESS) is rapidly emerging as a viable minimally invasive technique to successfully treat symptomatic degenerative spinal conditions. Widespread adoption has been limited in part due to the learning curve.

Purpose: To systematically review the learning curve for uniportal and biportal ESS and compare the 2 techniques.

Sex diversity in spine surgery fellowship training: analysis of recent trends and program characteristics associated with increased diversity.

Background Context: Sex diversity in the spine surgery workforce remains limited. Accelerated efforts to recruit more female trainees into spine surgery fellowship training may help promote diversity and inclusion in the emerging spine surgery workforce.

Purpose: This study assessed the representation of female trainees in spine surgery fellowship training and program factors associated with greater sex diversity among fellows.

Comparison of CT-Guided needle biopsy versus percutaneous endoscopic debridement and drainage in pathogen identification and pain outcomes for spondylodiscitis patients: A systematic review and literature review.

Introduction: Spondylodiscitis (SD) is an infection of the intervertebral disc with involvement of the adjacent vertebral bodies. Diagnostic tests with CT-guided biopsy only provide a positive yield in 14%-48% of cases. Percutaneous endoscopic debridement and drainage (PEDD) has recently shown promise in the treatment of spondylodiscitis.

Epidemiology and Management of Pediatric Fractures in Malawi.

Background: Pediatric fractures are common in Malawi, and surgical care, when needed, remains inaccessible to many. Understanding which children in Malawi receive surgery or nonsurgical treatment would help set priorities for trauma system development.

Methods: We used multivariate logistic regression to evaluate associations between surgical treatment and age, sex, school enrollment, injury mechanism, fracture type, open fracture, referral status, hospital of presentation, delayed presentation (≥2 days), healthcare provider, and inpatient vs outpatient treatment.

Does obesity and varying body mass index affect the clinical outcomes and safety of biportal endoscopic lumbar decompression? A comparative cohort study.

Background: Endoscopic spine surgery has recently grown in popularity due to the potential benefits of reduced pain and faster recovery time as compared to open surgery. Biportal spinal endoscopy has been successfully applied to lumbar disc herniations and lumbar spinal stenosis. Obesity is associated with increased risk of complications in spine surgery.

Cervical Spine Surgery Following COVID-19 Infection: When is it Safe to Proceed?

Study Design: Retrospective.

Objective: We utilized the NIH National COVID Cohort Collaborative (N3C) database to characterize the risk profile of patients undergoing spine surgery during multiple time windows following the COVID-19 infection.

Summary Of Background Data: While the impact of COVID-19 on various organ systems is well documented, there is limited knowledge regarding its effect on perioperative complications following spine surgery or the optimal timing of surgery after an infection.

Costs of revision operations for distal junctional kyphosis following thoracic posterior spinal fusion for adolescent idiopathic scoliosis.

Purpose: To assess direct costs and risks associated with revision operations for distal junctional kyphosis/failure (DJK) following thoracic posterior spinal instrumented fusions (TPSF) for adolescent idiopathic scoliosis (AIS).

Methods: Children who underwent TPSF for AIS by a single surgeon (2014-2020) were reviewed. Inclusion criteria were minimum follow-up of 2 years, thoracolumbar posterior instrumented fusion with a lower instrumented vertebra (LIV) cranial to L2.

The Socioeconomic consequences of femoral shaft fracture for patients in Malawi.

Background: Femoral shaft fractures are common in Malawi, with an annual incidence of 44 per 100,000 people. Inadequate treatment and delayed presentation often result in functional, biopsychosocial, and financial challenges for patients. The purpose of this study was to examine the socioeconomic consequences of femoral shaft fractures for patients in Malawi.

Combined Anterior Thoracic Vertebral Body Tethering and Posterior Lumbar Tethering Results in Quicker Return to Sport and Activity Compared to Posterior Spinal Instrumented Fusion in Patients with Adolescent Idiopathic Scoliosis.

Study Design: Retrospective comparative study.

Objective: To compare patient-reported physical activity between anterior thoracic vertebral body tethering and posterior lumbar spine tethering (ATVBT/PLST) and posterior spinal instrumentation and fusion (PSIF) with minimum 2 year follow-up.

Methods: Consecutive skeletally immature patients with idiopathic scoliosis and a thoracic and lumbar curve magnitude ≥40° who underwent either ATVBT/PLST or PSIF from 2015-2019 were included.

Avoiding Pitfalls in Adult Spinal Deformity.

To avoid the high rate of complications associated with the surgical management of adult spinal deformity, it is important to recognize and avoid three major pitfalls. The first is patient selection and determining which cases are appropriately indicated. The second is optimizing modifiable medical issues that can lead to a poor outcome, such as smoking, vitamin D deficiency, nutritional status, and poor bone quality.

Limited number of spine surgeons among recipients of National Institutes of Health grants awarded for degenerative spine disease research.

Objective: Surgeon scientists remain underrepresented among recipients of National Institutes of Health (NIH) grants despite their unique ability to perform translational research. This study elucidates the portfolio of NIH grants awarded for degenerative spine diseases and the role of spine surgeons in this portfolio.

Methods: The most common diagnoses and surgical procedures for degenerative spine diseases were queried on the NIH Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) database (2011-2021).

Erratum: Rates of readmission and reoperation after operative management of midshaft clavicle fractures in adolescents.

[This corrects the article on p. 1001 in vol. 12, PMID: 35036342.

Radiographic and perioperative outcomes following anterior thoracic vertebral body tethering and posterior lumbar spine tethering: a pilot series.

Background And Context:  In patients with adolescent idiopathic scoliosis (AIS) of main thoracic and lumbar spine regions, combined anterior thoracic vertebral body tethering and posterior lumbar spine tethering (ATVBT/PLST) is a novel non-fusion treatment option for growth modulation and conservation of motion.

Methods:  Fourteen patients with AIS who underwent ATVBT/PLST with at least 2-year follow-up were included. Primary outcomes included quality of life as assessed by SRS-22 instruments, radiographic analysis, and revision operations.

Anterior vertebral body tethering for adolescent idiopathic scoliosis associated with less early post-operative pain and shorter recovery compared with fusion.

Purpose: While posterior spinal instrumentation and fusion (PSIF) for severe adolescent idiopathic scoliosis (AIS) is the gold standard, anterior vertebral body tethering (AVBT) is becoming an alternative for select cases. Several studies have compared technical outcomes for these two procedures, but no studies have compared post-operative pain and recovery.

Methods: In this prospective cohort, we evaluated patients who underwent AVBT or PSIF for AIS for a period of 6 weeks after operation.

Perioperative Outcomes of Open Anterior Vertebral Body Tethering and Instrumented Posterior Spinal Fusion for Skeletally Immature Patients With Idiopathic Scoliosis.

Background: Correcting adolescent idiopathic scoliosis (AIS) without fusion can be achieved with anterior vertebral body tethering (AVBT). However, little is known about the perioperative outcomes, pain control, and clinical outcomes in patients undergoing AVBT compared with instrumented posterior spinal fusion (IPSF).

Methods: In this retrospective cohort study, we compared pediatric patients with AIS who underwent either AVBT or IPSF.