Total Hip Arthroplasty versus Education and Exercise: A Secondary Analysis of Propensity Matched Data Comparing Outcomes Across Hip Osteoarthritis Symptom Severity.

Background: Using propensity-matched data, we have previously shown that total hip arthroplasty (THA) provides superior outcomes to an education and exercise (Edu + Ex) program in patients who have hip osteoarthritis (OA), overall. This study investigated whether treatment effects of Edu + Ex versus THA differ across patients who have varying degrees of hip OA symptom severity.

Methods: This was a secondary analysis of propensity-matched patients who had hip OA who underwent THA or an Edu + Ex program (1:1 match ratio).

Composite RAI, Malnutrition, and Anemia Model Superiorly Predicts 30-Day Morbidity and Mortality After Surgery for Adult Spinal Deformity.

This study examines the composite influence of frailty, malnutrition, and anemia on postoperative outcomes for patients with adult spinal deformity (ASD). In this retrospective cohort study using the 2011-2022 NSQIP database, we utilized CPT and ICD codes to identify ASD patients who underwent PSF. Subjects were stratified based on frailty status.

Direct oral anticoagulants versus Vitamin K antagonists for left ventricular thrombus management.

Background: This study compared the rates of intracranial hemorrhage (ICH), ischemic stroke, transient ischemic attack (TIA), and major bleeding events between patients receiving direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs) for left ventricular thrombus (LVT) management.

Methods: In this retrospective analysis of claims data, 3152 patients receiving treatment for LVT were identified. Two cohorts were exactly matched on age, sex, and pertinent comorbidities.

Neurosurgical Techniques for Chronic Pain in Adult Cancer Survivors.

Background: Chronic pain is a prevalent and often undertreated issue for adult cancer survivors, lasting well beyond the completion of curative treatment or during prolonged maintenance therapy. Historically, pain management in this population has followed strategies similar to those used for active cancer pain - primarily systemic opioids - despite the long-term risks of functional decline, endocrine disruption, and misuse during periods of survivorship that may span decades.

Summary: This review examines the evolving role of neuromodulatory and functional neurosurgical interventions for chronic pain in adult cancer survivors.

The Impact of Social Determinants of Health on Morbidity and Mortality Outcomes in Patients With Intracerebral Hemorrhage: Nationwide Study.

Background And Objectives: Understanding the impact of social determinants of health (SDoH) on clinical outcomes in conditions such as intracerebral hemorrhage (ICH) is crucial for enhancing patient management and improving health policy. The aim of this study was to assess the impact of SDoH on the prognosis and clinical outcomes of patients with ICH.

Methods: This retrospective study used the MARINER165 national administrative database, encompassing medical and surgical claims from January 2010 to October 2022.

A national study of neurosurgical residency competency development.

Objective: The aim of this study was to evaluate milestone progression across 6 Accreditation Council for Graduate Medical Education (ACGME) core competencies and 20 subcompetencies among neurosurgery residents, focusing on the attainment of level 4 proficiency by the final postgraduate year (PGY 7), and to identify patterns of co-occurring deficiencies.

Methods: A retrospective cohort analysis was conducted using national ACGME Milestone data from 2478 neurosurgery residents across 120 programs in the United States, covering 2018 to June 2022 evaluations. Semiannual milestone scores were analyzed using mean, standard deviation, median, and interquartile range.

Comparing morbidity and mortality in adult patients with acute traumatic cervical spinal cord injury in 2013-2017 and 2018-2022: a retrospective 10-year national trend analysis.

Objectives: While considerable attention has been dedicated to quality improvement in spine surgery, few studies have evaluated progress in spinal cord injury (SCI) outcomes. This study aimed to assess whether morbidity and mortality trends have improved for acute cervical SCI patients in the last decade.

Methods: The American College of Surgeons Trauma Quality Programs database was retrospectively queried and outcomes for adult patients with acute cervical SCI were compared between two 5-year groups: 2013-2017 and 2018-2022.

Impact of preoperative nutritional status on morbidity and mortality in geriatric patients undergoing spine surgery: Role of geriatric nutritional risk index.

Background: Malnutrition is a risk factor for poor surgical outcomes amongst the elderly. However, the association between malnutrition and outcomes in geriatric patients undergoing spine surgery has been understudied. The aim of this study was to assess associations between malnutrition and 30-day morbidity and mortality in geriatric patients undergoing spine surgery.

The safety and feasibility of anticoagulant resumption following middle meningeal artery embolization in patients with subacute subdural hematomas.

BackgroundManaging antithrombotic therapy (AT), including anticoagulants and antiplatelet agents, in patients with subacute or chronic subdural hematomas (SDHs) poses a considerable challenge, balancing the risk of hemorrhagic expansion against the potential for thromboembolic events. Middle meningeal artery (MMA) embolization presents a therapeutic opportunity to stabilize SDHs. Without clear guidelines, the decision to resume AT after embolization is fraught with uncertainties.

An Appraisal of the Quality of Development and Reporting of Predictive Models in Spine Surgery.

Study DesignLiterature review.ObjectiveThe Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD) statement was developed to improve the generalizability of predictive models. This study systematically evaluated the quality of predictive models related to spine procedures and assessed their compliance with the TRIPOD guidelines.

The impact of semaglutide use for weight loss on transforaminal lumbar interbody fusion outcomes.

Introduction: While glucagon-like peptides 1 receptor agonists (GLP-1RAs) grow in popularity, their potential for presurgical weight optimization in spine surgery remains unclear. We examined the influence of semaglutide prescription on one- to three-level transforaminal lumbar interbody fusion (TLIF) outcomes.

Methods: Retrospective analysis of obese, non-diabetic patients was conducted from 2018 to 2022.

Multifunctional moxifloxacin and essential oil loaded sodium alginate/thiolated karaya gum hydrogel dressings for improved wound healing.

Numerous efforts have been done to develop wound dressings for effective wound treatment, remains a considerable challenge. The aim of current research work was to prepare multifunctional sodium alginate/thiolated karaya gum hydrogel dressings containing moxifloxacin in combination with artemesia/cedarwood essential oil. Thiolation of karaya gum was achieved by esterification reaction with 3 mercapto-propionic acid and synthesis of blended sodium alginate and thiolated karaya gum hydrogel films without (S/TK) and with moxifloxacin and artemesia/cedarwood oil (S/TK.

Impact of preoperative nutritional status on morbidity and mortality in elderly patients undergoing spine surgery for metastatic spinal tumors: a role for the Geriatric Nutritional Risk Index.

Objective: The Geriatric Nutritional Risk Index (GNRI) is commonly used to assess malnutrition risk in elderly patients, but its impact on spine surgery for metastatic spinal tumors is not well understood. This study aimed to evaluate the associations between preoperative nutritional status, as measured by the GNRI, and postoperative morbidity and mortality in elderly patients undergoing spine surgery for metastatic spinal tumors.

Methods: A retrospective cohort study was performed using the 2011-2022 National Surgical Quality Improvement Program database of the American College of Surgeons.

Assessing Morbidity and Mortality in Adult Patients With Acute Traumatic Cervical Spinal Cord Injury Using a Modified Risk Analysis Index.

Background And Objectives: The Risk Analysis Index (RAI) is a comprehensive assessment of frailty for predicting neurosurgical outcomes. The aim of this study was to assess whether frailty, measured by a modified RAI (mRAI), was an independent predictor of adverse events (AEs), nonroutine discharge (NRD), and in-hospital mortality for patients with acute cervical spinal cord injuries (SCIs).

Methods: A retrospective cohort study was performed using the American College of Surgeons Trauma Quality Programs database.

Myxopapillary ependymoma with a knotted filum terminale: illustrative case.

Background: A 32-year-old male with no previous significant medical history presented to the authors' clinic with a 7-week history of severe low back pain. The patient was evaluated with MRI, which revealed a large intradural spherical enhancing mass behind the L1 vertebral body. He was subsequently treated with a left L1-2 hemilaminectomy and excision of the tumor.

Isolated Testicular Metastasis From Prostate Cancer: A Rare Presentation 15 Years Posttreatment.

Testicular metastases from prostate cancer (PCa) are exceedingly rare and are typically accompanied by other metastatic sites. We present the case of an 82-year-old male patient who developed isolated testicular metastasis 15 years after undergoing radiotherapy and androgen deprivation therapy (ADT) for localized PCa. The patient presented with a palpable left testicular mass, which was confirmed to be a metastatic prostate adenocarcinoma by histopathological and immunohistochemical analyses.

Altius electrical nerve stimulation for post-amputation pain treatment: a comprehensive review.

Post-amputation pain (PAP), which includes both residual limb and phantom limb pain, affects up to 85% of amputees and severely impairs quality of life, mobility, and psychological well-being while incurring substantial healthcare costs. Conventional treatments - pharmacotherapy and neuromodulation techniques such as spinal cord stimulation and peripheral nerve stimulation - often provide inadequate relief and are associated with adverse effects like opioid dependence and systemic toxicity. The Altius High-Frequency Nerve Block System is an innovative therapeutic approach that delivers high-frequency alternating current (HFAC) directly to peripheral nerves, inducing a reversible conduction block without paresthesia.

Deep learning-based clustering for endotyping and post-arthroplasty response classification using knee osteoarthritis multiomic data.

Objectives: Primary knee osteoarthritis (KOA) is a heterogeneous disease with clinical and molecular contributors. Biofluids contain microRNAs and metabolites that can be measured by omic technologies. Multimodal deep learning is adept at uncovering complex relationships within multidomain data.

Cell and transcriptomic diversity of infrapatellar fat pad during knee osteoarthritis.

Objectives: In this study, we employ a multiomic approach to identify major cell types and subsets, and their transcriptomic profiles within the infrapatellar fat pad (IFP), and to determine differences in the IFP based on knee osteoarthritis (KOA), sex and obesity status.

Methods: Single-nucleus RNA sequencing of 82 924 nuclei from 21 IFPs (n=6 healthy control and n=15 KOA donors), spatial transcriptomics and bioinformatic analyses were used to identify contributions of the IFP to KOA. We mapped cell subclusters from other white adipose tissues using publicly available literature.

Spontaneous Calyceal Rupture Due to a 3-mm Obstructing Ureteric Stone: A Case Report.

Spontaneous rupture of the renal collecting system due to an obstructing ureteric stone is a rare, but significant complication. We present the case of a 27-year-old woman who presented with sudden, severe abdominal pain initially suspected to be of gynecological origin. Further investigation revealed a 3-mm obstructing stone at the vesicoureteric junction causing calyceal rupture.

Association of malnutrition with surgical outcomes after spine surgery for spinal epidural abscess.

Background: Malnutrition is a predictor of poor surgical outcomes, but its specific effects in spinal epidural abscess (SEA) are understudied. This study aims to assess the association between nutritional status and post-operative outcomes.

Methods: We conducted a retrospective cohort study using the 2011-2022 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database to identify adult SEA patients who underwent spinal surgery.

Racial/Ethnic Associations With Morbidity and Mortality in Adults With Acute Traumatic Cervical Spinal Cord Injury.

Study Design: Retrospective cohort study.

Objective: This study aimed to investigate the association of race with morbidity and mortality in acute cervical spinal cord injury (cSCI) patients.

Background: Racial disparities in spine surgery are associated with adverse outcomes, however, the impact of race on cSCI is understudied.

Comparative Efficacy of Ventriculosubgaleal Shunt Versus Ventricular Reservoir in Achieving Shunt Independence for Infants With Posthemorrhagic Hydrocephalus by 6 Months.

Background And Objectives: Low-birth weight, premature infants often have severe intraventricular hemorrhage (IVH), which can result in posthemorrhagic hydrocephalus (PHH), sometimes requiring cerebrospinal fluid diversion. Initial temporizing management of PHH includes placement of a ventriculosubgaleal shunt (VSGS) or ventricular access device (VAD). Studies have found similar permanent shunt conversion rates between VSGS and VAD but were limited by sample scope and size.

Impact of patient age on morbidity and mortality in adults with acute traumatic cervical spinal cord injury: An ACS trauma quality programs database study.

Background: This study aimed to examine associations between age and outcomes in acute cervical SCI (cSCI) patients.

Methods: We conducted a retrospective cohort study using the American College of Surgeons Trauma Quality Programs database to compare outcomes for acute cSCI patients stratified by age: 18-44, 45-65, and > 65 years. Patient demographics, comorbidities, injury type, treatment modality, AEs, and length of stay (LOS) were assessed.