Sleep Physiology in Spine Disease: A Comparative Study of Cervical and Lumbar Patients.

Study Design: Prospective cohort study.

Objective: We aim to compare Fitbit-collected sleep metrics between patients with cervical and lumbar spine diseases and explore correlations between these metrics and patient-reported outcome measures (PROMs) and self-reported sleep.

Summary Of Background Data: Pain, fatigue, and postural problems often lead to sleep disturbances in patients with spine disease.

Randomized controlled trials comparing cervical disc arthroplasty and anterior cervical discectomy and fusion outcomes in degenerative spine disease: a systematic review and meta-analysis.

Objective: Anterior cervical discectomy and fusion (ACDF) is an established treatment for cervical degenerative disc disease; however, the procedure can cause loss of cervical spine range of motion and potentially accelerate adjacent segment degeneration. Cervical disc arthroplasty (CDA) seeks to preserve native motion of the cervical spine, which can theoretically reduce the incidence of adjacent level degeneration. The literature regarding the relative efficacy of ACDF versus CDA remains inconsistent.

Association between preoperative activity levels and postoperative complications in adult spinal deformity surgery.

Purpose: Adult spinal deformity (ASD) is a condition associated with significant pain, disability, and high complication rates after surgery, reaching 38-71%. These complications significantly impact recovery, which often takes over a year. Efforts to mitigate complications have focused on preoperative risk stratification using factors such as frailty and patient demographics.

Establishing objective markers of physical activity to identify early improvement after lumbar spine surgery.

Objective: Despite growing interest in using biometric measures as objective tools to monitor recovery after spine surgery, there is sparse guidance on appropriate thresholds to evaluate perioperative changes in these domains. The authors defined thresholds of activity and heart rate (HR) measures that mark improved early recovery and evaluated their association with longer-term surgical outcomes.

Methods: A prospective observational cohort study recruited patients undergoing elective surgery for lumbar degenerative spine disease at a single institution from February 2021 to June 2023.

Sex-Related Differences in Functional and Neurological Outcomes of Spinal Cord Injury.

Background And Objectives: Traumatic spinal cord injury (SCI) tends to occur in different demographics and with differing etiology between males and females. Sex-related differences may influence recovery, but there remains a lack of evidence on this subject. Our objective was to quantify the influence of sex on functional and neurological outcomes of SCI.

Association between concomitant traumatic brain injury and unfavorable 1-year outcomes in patients with traumatic spinal cord injury.

Objective: Traumatic spinal cord injury (tSCI) can cause lasting functional impairment. Concomitant traumatic brain injury (cTBI) is a common injury constellation, but the impact of tandem traumatic brain injury (TBI) and tSCI on long-term patient outcomes requires further study. The objective of this study was to compare outcomes among tSCI patients with and without TBI.

Multidomain postoperative recovery trajectories after lumbar and thoracolumbar spine surgery.

Background Context: Understanding early postoperative recovery is crucial for improving perioperative care and long-term outcomes. Traditional recovery assessments relying primarily on cross-sectional patient-reported measures may not fully capture the complexity of the recovery process.

Purpose: Our study evaluates early postoperative recovery using mobile health assessment and explores the relationship between early recovery patterns, multidomain recovery, and long-term outcomes.

Segmental and overall lumbar lordosis after single-level minimally invasive transforaminal lumbar interbody fusion: a systematic review and meta-analysis.

Objective: Because of heterogeneity in previous studies, the effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Given this evidence gap, the authors performed a systematic review and meta-analysis of studies reporting lordotic outcomes after single-level MI-TLIF. The authors also performed a meta-regression to identify preoperative factors associated with lordosis after surgery and assessed correlations between lordotic changes and patient-reported outcomes.

Utility of the psychache scale in patients undergoing surgery for degenerative lumbar disease: a prospective single-center study.

Purpose: This study aims to psychometrically validate the Psychache Scale (PAS) and investigate its prognostic value in predicting postoperative outcomes.

Methods: This is a prospective single-center study. Adults undergoing lumbar or thoracolumbar surgery were recruited.

The Role of Desflurane in the Functional Outcomes Among Spinal Cord Injury Patients Undergoing Upper Extremity Nerve Transfer Procedures.

Background and objective While several experimental studies have demonstrated the neuroprotective role of volatile anesthetics after spinal cord injury (SCI), the impact of volatile anesthetics on improving neurologic outcomes in spinal cord-injured patients is not known. Hence, this study aimed to examine the impact of volatile anesthetics on functional outcomes of chronic cervical SCI patients undergoing peripheral nerve transfer procedures. Methods We conducted a retrospective analysis involving adult patients with cervical SCI and upper extremity paralysis undergoing nerve transfer procedures between September 1, 2015, and January 31, 2019.

The Role of the Glymphatic System in Cervical Spondylotic Myelopathy: Insights From Advanced Imaging.

Study Design: Prospective cohort study.

Objective: To provide a primer of the glymphatic system, discuss its potential relevance in evaluating spinal diseases like cervical spondylotic myelopathy (CSM), and describe possible imaging markers of the glymphatic system derived from advanced diffusion-weighted imaging (dMRI), namely diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI).

Summary Of Background Data: The glymphatic system is a recently described physiological process that plays an integral role in macroscopic waste clearance in the CNS through cerebrospinal fluid (CSF)-interstitial fluid (ISF) exchange.

Defining Substantial Clinical Benefits of PROMIS Pain Interference and Physical Function in Patients Undergoing Lumbar and Thoracolumbar Spine Surgery.

Study Design: Prospective cohort study.

Objective: This study aims to define Substantial Clinical Benefit (SCB) thresholds for PROMIS physical function (PF) and pain interference (PI) in lumbar or thoracolumbar spine surgery population.

Summary Of Background Data: Patient-reported outcome measures (PROMs) are widely used in spine surgery to assess treatment efficacy.

Influence of Preoperative Depression on Cervical Spine Surgery Outcomes: A Systematic Review and Meta-Analysis.

Study DesignSystematic review and Meta-analysis.ObjectivesTo quantify the association of preoperative depression on patient reported outcome measures (PROMS) after cervical spine surgery.MethodsWe systematically searched PubMed, Cochrane, Embase, Scopus, PsychInfo, Web of Science, and ClinicalTrials.

Restoration of respiration in high cervical spinal cord injury via phrenic nerve reinnervation: illustrative case.

Background: Traumatic high cervical spinal cord injury (SCI) can result in a devastating loss of functional respiration, leaving patients permanently dependent on mechanical ventilation. Nerve transfer is a promising reinnervation strategy that has the potential to restore connectivity in paralyzed distal muscles. The spinal accessory nerve (SAN) remains functional in most cases after high cervical SCI and can serve as a donor to reinnervate the phrenic nerve (PN), thereby improving diaphragmatic function.

Spinal cord metrics derived from diffusion MRI: improvement in prognostication in cervical spondylotic myelopathy compared with conventional MRI.

Objective: A major shortcoming in optimizing care for patients with cervical spondylotic myelopathy (CSM) is the lack of robust quantitative imaging tools offered by conventional MRI. Advanced MRI modalities, such as diffusion MRI (dMRI), including diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI), may help address this limitation by providing granular evaluations of spinal cord microstructure.

Methods: Forty-seven patients with CSM underwent comprehensive clinical assessments and dMRI, followed by DTI and DBSI modeling.

Clinical prediction for surgical versus nonsurgical interventions in patients with vertebral osteomyelitis and discitis.

Background: Vertebral osteomyelitis and discitis (VOD), an infection of intervertebral discs, often requires spine surgical intervention and timely management to prevent adverse outcomes. Our study aims to develop a machine learning (ML) model to predict the indication for surgical intervention (during the same hospital stay) versus nonsurgical management in patients with VOD.

Methods: This retrospective study included adult patients (≥18 years) with VOD (ICD-10 diagnosis codes M46.

Diffusion MRI Metrics Characterize Postoperative Clinical Outcomes After Surgery for Cervical Spondylotic Myelopathy.

Background And Objectives: Advanced diffusion-weighted MRI (DWI) modeling, such as diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI), may help guide rehabilitation strategies after surgical decompression for cervical spondylotic myelopathy (CSM). Currently, however, postoperative DWI is difficult to interpret, owing to signal distortions from spinal instrumentation. Therefore, we examined the relationship between postoperative DTI/DBSI-extracted from the rostral C3 spinal level-and clinical outcome measures at 2-year follow-up after decompressive surgery for CSM.

Preoperative Mobile Health Data Improve Predictions of Recovery From Lumbar Spine Surgery.

Background And Objectives: Neurosurgeons and hospitals devote tremendous resources to improving recovery from lumbar spine surgery. Current efforts to predict surgical recovery rely on one-time patient report and health record information. However, longitudinal mobile health (mHealth) assessments integrating symptom dynamics from ecological momentary assessment (EMA) and wearable biometric data may capture important influences on recovery.

Implications of Preoperative Depression for Lumbar Spine Surgery Outcomes: A Systematic Review and Meta-Analysis.

Importance: Comorbid depression is common among patients with degenerative lumbar spine disease. Although a well-researched topic, the evidence of the role of depression in spine surgery outcomes remains inconclusive.

Objective: To investigate the association between preoperative depression and patient-reported outcome measures (PROMs) after lumbar spine surgery.

Impact of Upper Limb Motor Recovery on Functional Independence After Traumatic Low Cervical Spinal Cord Injury.

Cervical spinal cord injury (SCI) causes devastating loss of upper limb function and independence. Restoration of upper limb function can have a profound impact on independence and quality of life. In low-cervical SCI (level C5-C8), upper limb function can be restored via reinnervation strategies such as nerve transfer surgery.

Feasibility of postoperative diffusion-weighted imaging to assess representations of spinal cord microstructure in cervical spondylotic myelopathy.

Objective: Diffusion basis spectrum imaging (DBSI) has shown promise in evaluating cervical spinal cord structural changes in patients with cervical spondylotic myelopathy (CSM). DBSI may also be valuable in the postoperative setting by serially tracking spinal cord microstructural changes following decompressive cervical spine surgery. Currently, there is a paucity of studies investigating this topic, likely because of challenges in resolving signal distortions from spinal instrumentation.

Predictors of Postoperative Segmental and Overall Lumbar Lordosis in Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Consecutive Case Series.

Study Design: Retrospective Case-Series.

Objectives: Due to heterogeneity in previous studies, the effect of MI-TLIF on postoperative segmental lordosis (SL) and lumbar lordosis (LL) remains unclear. Therefore, we aim to identify radiographic factors associated with lordosis after surgery in a homogenous series of MI-TLIF patients.

Mechanomyography as a Surgical Adjunct for Treatment of Chronic Entrapment Neuropathy: A Case Series.

Background: Chronic entrapment neuropathy results in a clinical syndrome ranging from mild pain to debilitating atrophy. There remains a lack of objective metrics that quantify nerve dysfunction and guide surgical decision-making. Mechanomyography (MMG) reflects mechanical motor activity after stimulation of neuromuscular tissue and may indicate underlying nerve dysfunction.