Impact of multipoint pelvic fixation and multirod distal constructs on proximal junction biomechanics in cadaveric specimens.

Objective: Multipoint pelvic fixation with multirod constructs is increasingly used for long-segment deformity constructs to reduce rates of distal failure. However, more robust distal fixation may negatively impact proximal junction biomechanics, and this potential relationship has not been extensively studied.

Methods: Standard nondestructive flexibility tests (7.

Return-to-Sport Recommendations in Athletes Requiring Cervical Spine Surgery: A Modified Delphi Consensus Survey of Expert Opinion.

Study Design: Modified Delphi consensus survey.

Objective: To survey expert opinion on postoperative return-to-sport (RTS) decisions in athletes requiring cervical spine surgery.

Summary Of Background Data: Postoperative sport participation recommendations for athletes requiring cervical spine surgery are lacking, and management of these athletes remains challenging.

Low Posterior Electromyographic Threshold and Functional Outcomes After L4-5 Lateral Lumbar Interbody Fusion.

Background And Objectives: The transpsoas approach for lateral lumbar interbody fusion (LLIF) places the surgical retractor near the lumbar plexus, particularly at the L4-5 level. To mitigate risk to these nerves, surgeons rely on intraoperative neuromonitoring using stimulation to approximate the distance between the plexus and retractor. The aim of this study was to review a single-institution series of lateral-position LLIF procedures to determine whether the stimulation threshold was associated with plexus injury.

Clinical effect of occipitocervical and subaxial cervical fusion constructs on range of motion: comprehensive guide based on biomechanical cadaveric testing on 1009 motion segments.

Objective: Understanding the relative contribution of each cervical motion segment is vital for assessing the effect of fusion constructs on range of motion (ROM). Many spine surgeons are familiar with the work of Panjabi and White, from which these values have historically been cited. However, their data were obtained from a limited number of subjects, and methodological shortcomings have since been identified.

Defining cervical spondylotic myelopathy surgical endotypes using comorbidity clustering: a Quality Outcomes Database cervical spondylotic myelopathy study.

Objective: Coexisting medical conditions are increasingly prevalent in surgical populations. The impact of multiple comorbidities on patient-reported outcomes (PROs) and endotypes of frequently co-occurring conditions for cervical spondylotic myelopathy (CSM) remain unclear. This study explores whether CSM patients with multimorbidity have worse baseline and postoperative PROs and less functional improvement after surgery compared to those with few or no comorbidities.

Return-to-Sport Recommendations for Athletes With Cervical Spine Trauma: A Modified Delphi Consensus Survey of Expert Opinion.

Background And Objectives: Recommendations regarding return to sport (RTS) for athletes who have experienced cervical spine trauma are lacking, and management of these athletes remains challenging. The objective of this article was to perform a modified Delphi consensus survey of expert opinion on RTS in athletes who have suffered a traumatic injury to the cervical spine.

Methods: A cross-sectional, modified Delphi consensus survey examining RTS decisions in athletes with a history of a traumatic injury to the cervical spine was undertaken.

Return-to-Sport Recommendations for Athletes With Congenital Cervical Spine Pathology: A Modified Delphi Consensus Survey of Expert Opinion.

Background And Objectives: Recommendations guiding participation in sports for athletes with congenital cervical spine pathology are lacking, and management of these athletes remains challenging. Thus, the objective was to perform a modified Delphi consensus survey of expert opinion on return-to-sport (RTS) decisions in athletes with congenital cervical spine pathologies.

Methods: A cross-sectional, modified Delphi consensus survey investigating RTS decisions in athletes with various types of congenital cervical spine pathology was undertaken.

Management and outcomes for thoracic anterior spinal artery aneurysms: illustrative case.

Background: Anterior spinal artery (ASA) aneurysms are uncommon and difficult to diagnose due to their variable presentation and limited visibility with traditional imaging. They often present with severe back pain from rupture and spinal subarachnoid hemorrhage (SAH). There are few published studies and no established treatment recommendations.

Distal junctional failure following pelvic instrumentation in spinal fusion: a novel classification system.

Objective: While traditional literature in adult spinal deformity (ASD) examining mechanical complications has focused on proximal junctional kyphosis and failure, distal junctional failure (DJF) of constructs ending at the sacrum with or without spinopelvic fixation remains less explored. The current study sought to 1) propose a new DJF classification with a panel of experienced deformity surgeons, and 2) analyze intra- and interreliability of the novel classification.

Methods: A prior review study was completed that identified all types of distal complications for lumbosacral fusions.

A comparative study on the effect of age on Neck Disability Index improvement at 24 months after surgical intervention for cervical spondylotic myelopathy: a Quality Outcomes Database study.

Objective: Cervical spondylotic myelopathy (CSM) is often accompanied by neck pain, which, along with more recognized neurological deficits like motor and sensory changes, significantly impacts patients' quality of life. The authors examined whether age influences improvements in neck disability and related quality-of-life measures after surgery for CSM. Using the Neck Disability Index (NDI) as the primary outcome, they compared long-term outcomes at 24 months among patients aged ≥ 65, ≥75, and < 65 years, exploring the effects of surgical intervention on both pain-related disability and functional recovery in older adults.

Cervical disc replacement in athletes: a modified Delphi Consensus Survey of expert opinion.

Background Context: The safety and efficacy of cervical disc replacement (CDR) for spinal disorders in contact sport athletes is unclear. Current research is limited and highlights mixed results regarding return-to-sport (RTS) among athletes with CDR.

Purpose: We sought to perform a modified Delphi consensus survey of expert opinion on CDR in athletes.

Prediction of Postoperative Segmental Lordosis at L5 to S1 After Single-Level Anterior Lumbar Interbody Fusion.

Background: Anterior lumbar interbody fusion (ALIF) is used to improve spinopelvic alignment, most commonly by increasing segmental lordosis (SL) at L5 to S1. Achieving certain radiographic parameters is critical for good patient outcomes. However, the relationships between pre- and postoperative SL and interbody dimensions are inexact and have not been well studied.

Computed Tomography Assessment of Long-Term Fusion and Subsidence for Anterior Lumbar Interbody Fusion Performed at the Lumbosacral Junction.

Study Design: Retrospective cohort study.

Objective: To evaluate factors associated with long-term pseudoarthrosis and subsidence following L5-S1 anterior lumbar interbody fusion (ALIF).

Summary Of Background Data: Reported fusion rates for ALIF at the lumbosacral junction vary widely.

Impact of the day of the week on clinical outcomes following anterior cervical discectomy and fusion surgery.

Objective: Previous research suggests elective surgical procedures performed later in the week have worse outcomes. This study investigated whether the day of the week on which elective anterior cervical discectomy and fusion (ACDF) surgery was performed impacts clinical outcomes.

Methods: Using data from the Quality Outcomes Database, a nationwide, multicenter prospective registry, this study included patients undergoing elective ACDF for cervical spondylosis.

"Floating Island" Technique: Case Series of a Novel Technique for Surgical Management of Interdigitating Calcified Thoracic Disc Herniations.

Objective: The objective of this study was to describe the use of a novel approach, the "floating island" technique, to surgically address calcified thoracic disc herniation (cTDH) that interdigitates with adjacent dura and to report clinical and radiographic outcomes of patients.

Methods: A retrospective case series was conducted by examining the electronic medical records of consecutive patients who underwent thoracic discectomy from August 2017 to December 2022. Of 65 patients treated for thoracic disc herniation, 37 had cTDHs.

Management strategies for cervical schwannomas: a comprehensive review.

Objective: The authors' goal was to provide a comprehensive overview of the pathophysiology, clinical presentation, and management strategies of cervical schwannomas.

Methods: A thorough literature review of diagnostic imaging techniques, particularly MRI, was conducted to identify characteristic features of cervical schwannomas, such as avid Gd uptake and scalloping. Histological and immunohistochemical analyses, including stains for S100 and SOX10, were evaluated to confirm the diagnosis and differentiate schwannomas from other tumors, such as meningiomas and metastatic disease.

Urinary control in cervical myelopathy: does it improve postsurgery? A Quality Outcomes Database study.

Objective: Cervical spondylotic myelopathy (CSM) can be associated with urinary dysfunction, leading to an inability or marked difficulty with micturition. This study aimed to evaluate the urinary dysfunction, long-term prognosis, and recovery in patients with CSM following surgical intervention.

Methods: The CSM cases of the Quality Outcomes Database SpineCORe study group were analyzed.

Does smoking status affect baseline symptom severity and patient-reported outcomes and satisfaction in patients with cervical myelopathy at 24 months? A Quality Outcomes Database study.

Objective: It is not clear whether smoking impacts patient-reported outcomes (PROs) in patients with cervical spondylotic myelopathy (CSM). The aim of this study was to explore the impact of smoking status on baseline symptom severity and the rate of achieving satisfaction and the minimal clinically important differences (MCIDs) for PROs in patients with CSM.

Methods: This study was an analysis of the prospective Quality Outcomes Database CSM module.

Spinopelvic Fixation Using an Osseointegrative Implant: Analysis of Postmarket Surveillance to Determine the Failure Rate.

Background: Adult spinal deformities, affecting up to 60% of individuals older than 60 years, often require long segment fusions. Constructs spanning the lumbosacral junction commonly include pelvic fixation. Despite robust pelvic fixation, distal junctional failure, such as pseudoarthrosis, bone fracture, and instrumentation failure, occurs in 24%-34% of these cases.

T-Bar Angular Offset: A Novel Angle for Predicting Postoperative Coronal Balance Using Intraoperative Stitched Radiographs.

Background And Objectives: Accurate intraoperative assessment of coronal alignment is critical to achieving favorable clinical outcomes in adult spinal deformity surgery. However, surgical positioning creates challenges in predicting standing coronal alignment. Gravity-based plumblines require an upright posture and are not possible intraoperatively.

Anatomical Location of the Bowel in Different Surgical Positions: Implications for Lateral Access in Prone Single-Position Surgery.

Study Design: Radiographic analysis.

Objective: Evaluate the anatomical relationships of the bowel to the lateral surgical corridor and the spine in various surgical positions.

Summary Of Background Data: Retroperitoneal transpsoas lateral lumbar interbody fusion (LLIF) may be performed with patients in the prone position, allowing for lateral and posterior approaches to the spine without repositioning the patient.

Obesity and Clinical, Radiographic, and Surgical Outcomes After Minimally Invasive Single-Level Transforaminal versus Lateral Lumbar Interbody Fusion.

Objective: To determine the effect of obesity on clinical, radiographic, and surgical outcomes after lateral lumbar interbody fusion (LLIF) versus minimally invasive surgery (MIS) transforaminal lumbar interbody fusion (TLIF) and compare the effectiveness of LLIF versus MIS TLIF in treating obese patients.

Methods: A retrospective comparative analysis of patients who underwent single-level L4-5 LLIF or MIS TLIF over a 7-year period was performed. Spinopelvic parameters were compared based on preoperative and postoperative radiographs.

Patient-reported outcome trajectories the first 24 months after surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study.

Objective: Cervical spondylotic myelopathy (CSM) shows varying levels of improvement after surgical treatment. While some patients improve soon after surgery, others may take months to years to show any signs of improvement. The goal of this study was to evaluate postoperative improvement, patient-reported outcomes, and patient satisfaction up to 2 years after surgical treatment for CSM, which will help optimize the current treatment strategies and effectively manage patient expectations.

Optimization of 3D-printed titanium interbody cage design. Part 1: in vitro biomechanical study of subsidence.

Background Context: Cage subsidence is a complication of interbody fusion associated with poor clinical outcomes. 3D-printed titanium interbody cages allow for the alteration of features such as stiffness and porosity. However, the influence of these features on subsidence and their biological effects on fusion have not been rigorously evaluated.