Predictors of Full-Time Spine Surgeon Faculty Position at a University Hospital.

Introduction: Although spine surgery careers are influenced by a multitude of professional and personal factors, predictors of career trajectories and future research effect may be identifiable at the spine fellow applicant stage. As such, this study aimed to (1) determine factors predictive of University Hospital [UH] employment and research contributions and (2) compare the application metrics identified as most important to an academic career by spine surgery program directors (PD) to those predictive of career environments from prior spine fellows applications.

Methods: All applications of individuals applying for spine fellowship training between 2017 and 2021 at an academic institution were reviewed.

Preoperative Radiographic Predictors of Subsequent Fusion After Lumbar Decompression Surgery.

Study Design: Retrospective cohort study.

Objective: The purpose of this study is to determine which demographic, surgical, and radiographic preoperative characteristics are most associated with the need for subsequent fusion after decompression lumbar spinal surgery.

Summary Of Background Data: There is a relatively high rate of the need for repeat decompression or fusion after an index decompression procedure for degenerative spine disease.

Construct length analysis of type B and C cervical and thoracolumbar fractures.

Objectives: The purpose of this study is to identify if construct length affects the rate of surgical complications and instrumentation revision following surgical fixation of subaxial and thoracolumbar Type B and C fractures. This study evaluates the effect of ankylosing spondylitis/diffuse idiopathic skeletal hyperostosis (AS/DISH) within this population on outcomes.

Methods: Retrospective review of 91 cervical and 89 thoracolumbar Type B and C fractures.

Circulating microRNAs May Be Predictive of Degenerative Cervical Myelopathy.

Study Design: Basic Science.

Objective: The objective of this study was to identify a unique serum profile of circulating miRNAs and inflammatory markers in patients with degenerative cervical myelopathy (DCM) compared with healthy controls (HC).

Summary Of Background Data: Currently, DCM is diagnosed with a combination of history, physical examination, and close correlation to advanced imaging.

The impact of robotic assistance for lumbar fusion surgery on 90-day surgical outcomes and 1-year revisions.

Objectives: To evaluate the (1) 90-day surgical outcomes and (2) 1-year revision rate of robotic versus nonrobotic lumbar fusion surgery.

Methods: Patients >18 years of age who underwent primary lumbar fusion surgery at our institution were identified and propensity-matched in a 1:1 fashion based on robotic assistance during surgery. Patient demographics, surgical characteristics, and surgical outcomes, including 90-day surgical complications and 1-year revisions, were collected.

PA and NP burnout in orthopedic surgery.

Objective: To quantify the burnout rate among physician associates/assistants (PAs) and NPs in a large orthopedic surgery practice affiliated with an academic institution.

Methods: The Maslach Burnout Inventory (MBI) and original research questions were given to all PAs and NPs in orthopedics at the facility. Burnout was defined as a high level of emotional exhaustion or depersonalization on the MBI subscale.

The Inhibitory Effect of NSAIDs and Opioids on Spinal Fusion: An Animal Model.

Study Design: Translational research.

Objective: To evaluate the relative effects of NSAIDs, opioids, and a combination of the two on spinal fusion inhibition in a rodent model.

Summary Of Background Data: Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are common postoperative analgesic agents.

Does physical therapy impact clinical outcomes after lumbar decompression surgery?

Objectives: The objectives of our study were to (1) determine if physical therapy (PT) impacts patient-reported outcomes (PROMs) after lumbar decompression surgery and (2) determine if PT impacts postsurgical readmissions or reoperations after lumbar decompression surgery.

Methods: Patients 18 years of age who underwent primary one- or two-level lumbar decompression at our institution were identified. Patient demographics, surgical characteristics, surgical outcomes (all-cause 90 days readmissions and 90 days surgical readmissions), and patient-reported outcomes (PROMs) were compared between the groups.

Cellular Bone Matrix in Spine Surgery - Are They Worth the Risk: A Systematic Review.

Study Design: Systematic Review.

Objective: To review the literature for complications and outcomes after the implantation of cellular bone matrix (CBM) during spine fusion.

Methods: The PubMed database was queried from inception to January 31, 2023 for any articles that discussed the role of and identified a specific CBM in spinal fusion procedures.

Radiographic and Patient-Reported Outcomes in Anteriorly Placed Transforaminal Lumbar Interbody Fusion Cage Versus Anterior Lumbar Interbody Fusion With Posterior Instrumentation.

Study Design: Retrospective cohort study.

Objective: To compare outcomes in anteriorly placed transforaminal lumbar interbody fusions (TLIFs) and anterior lumbar interbody fusions (ALIFs).

Summary Of Background Data: TLIF and ALIF are surgical techniques that have become more prevalent in recent years.

The Impact of Physical Therapy After Lumbar Fusion Surgery.

Study Design: Retrospective Cohort.

Objective: To determine if outcomes varied between patients based on physical therapy (PT) attendance after lumbar fusion surgery.

Summary Of Background Data: The literature has been mixed regarding the efficacy of postoperative PT to improve disability and back pain, as measured by patient-reported outcome measures.

The impact of demineralized bone matrix characteristics on pseudarthrosis and surgical outcomes after posterolateral lumbar decompression and fusion.

Objectives: The objectives of our study were to compare the fusion rates and surgical outcomes of lumbar fusion surgery based on the (1) type of demineralized bone matrix (DBM) carrier allograft, (2) the presence/absence of a carrier, and (3) the presence of bone fibers in DBM.

Methods: Patients >18 years of age who underwent single-level posterolateral decompression and fusion (PLDF) between L3 and L5 between 2014 and 2021 were retrospectively identified. We assessed bone grafts based on carrier type (no carrier, sodium hyaluronate carrier, and glycerol carrier) and the presence of bone fibers.

The Implication of Preoperative Central Stenosis on Patient-Reported Outcomes After Lumbar Decompression Surgery.

Objective: To assess the impact of central stenosis severity on patient-reported outcomes after lumbar decompression.

Methods: Patient diagnosis, demographics, and surgical characteristics were collected via query search and manual chart review of electronic medical records. The inclusion criteria were posterior lumbar decompressions from 2014-2020, with accessible magnetic resonance imaging reports.

Procedures employing interbody devices and multi-level fusion require target price adjustment to build a sustainable lumbar fusion bundled payment model.

Background Context: Bundled payment models require risk adjustment to ensure appropriate targets are set. While this may be standardized for many services, spine fusions demonstrate significant variability in approach, invasiveness, and use of implants, that may require further risk adjustment.

Purpose: To evaluate variability in costs of spinal fusion episodes in a private insurer bundle payment program and identify whether current procedural terminology (CPT) code modifications are necessary for sustainable implementation.

Implementation of a Private Payer Bundled Payment Model While Maintaining High-Value Lumbar Spinal Fusion.

Study Design: Retrospective single-institution cohort.

Objective: To evaluate the implementation of a commercial bundled payment model in patients undergoing lumbar spinal fusion.

Summary Of Background Data: BPCI-A caused significant losses for many physician practices, prompting private payers to establish their own bundled payment models.

Cellular Bone Matrix Leading to Disseminated Tuberculosis After Spinal Fusion: A Report of 2 Cases.

Case: Although implanted tuberculosis (TB) is rare, a single lot of cellular bone matrix was found to be infected with TB, leading to devastating outcomes. We present 2 cases referred to our institution because of instrumentation failure caused by TB inoculation of cellular bone matrix.

Conclusion: Irrespective of spinal region of implanted TB infection, excision of infected bone, extensive irrigation and debridement, and instrumented stabilization are of primary importance to ensure TB eradication and adequate stabilization.

Patient-specific Risk Factors Increase Episode of Care Costs After Lumbar Decompression.

Study Design: Retrospective cohort analysis.

Objective: To determine, which patient-specific risk factors increase total episode of care (EOC) costs in a population of Centers for Medicare and Medicaid Services beneficiaries undergoing lumbar decompression.

Summary Of Background Data: Lumbar decompression is an effective option for the treatment of central canal stenosis or radiculopathy in patients unresponsive to nonoperative management.

Predictors of Academic Productivity Among Spine Surgeons.

Introduction: The relationship between research productivity in training and future productivity as an attending spine surgeon is not well-established in the literature nor has the effect of geographic location of training institutions on future academic success been investigated. The aim of our study was to (1) summarize characteristics of academically productive spine surgeons, (2) assess predictors of long-term academic productivity, and (3) establish the effect of geographic location on long-term academic productivity.

Methods: A query was conducted of the 2021 to 2022 North American Spine Society Spine Fellowship Directory of all orthopaedic and neurosurgical spine fellowship selection committee members for each institution participating in the spine fellowship match.

Is disc height loss at 1 year predictive of pseudarthrosis and patient-reported outcome measures following anterior cervical discectomy and fusion with structural allograft?

Objective: The authors sought to determine if postoperative disc height loss is associated with pseudarthrosis following anterior cervical discectomy and fusion (ACDF). They also sought to determine if the amount of postoperative disc height loss is predictive of need for revision for pseudarthrosis, as well as the impact of postoperative disc height loss on patient-reported outcome measures (PROMs) following surgery.

Methods: The authors retrospectively identified patients aged > 18 years who underwent primary one- to three-level ACDF with allograft at a single institution with 1-year postoperative lateral and flexion-extension cervical spine radiographs.

Single-level Lumbar Fusion Versus Total Joint Arthroplasty: A Comparison of 1-year Outcomes.

Introduction: Primary hip and knee arthroplasty represent two of the most successful orthopaedic surgical interventions in the past century. Similarly, lumbar fusion (LF) remains a valuable, evidence-based option to relieve pain and disability related to spinal degenerative conditions. This study evaluates the relative improvements in 1-year health-related quality of life (HRQOL) measures among patients undergoing primary single-level LF, primary total hip arthroplasty (THA), and primary total knee arthroplasty (TKA).

An evaluation of patients with abdominal pain after lateral lumbar interbody fusion.

Context: Abdominal pain after surgery can occur for numerous reasons. Postoperative radiographs may be indicated to evaluate for ileus or other reasons for the pain. Whether outcomes are significantly different based on whether patients get radiographs following lateral lumbar interbody fusion (LLIF) are unclear.

Is Deep Vein Thrombosis Chemoprophylaxis Indicated After Spinal Irrigation and Débridement?

Objective: To identify risk factors for development of deep venous thrombosis (DVT) in patients undergoing spinal irrigation and débridement for an infection with subsequent peripherally inserted central catheter placement and to determine if chemoprophylaxis mitigates the risk of developing DVT.

Methods: Patients with spinal infection and peripherally inserted central catheter placement at an academic medical center between 2009 and 2020 were retrospectively identified. Patients were grouped based on whether they had postoperative DVT.

Soft Cervical Orthosis Use Does Not Improve Fusion Rates After One-Level and Two-Level Anterior Cervical Discectomy and Fusion.

Objective: To determine if postoperative soft cervical orthosis use affects arthrodesis rates on a per-level or construct basis after 1-level and 2-level anterior cervical discectomy and fusion (ACDF).

Methods: Electronic medical records were queried for 1-level and 2-level primary ACDF between 2016 and 2019 at a single academic center. Surgeons prescribed either a soft cervical orthosis or no orthosis.