Validated intraoperative bleeding severity scale (VIBe) for hemostasis assessment in lumbar spinal fusion: a prospective, randomized controlled trial.

Purpose: Intraoperative bleeding remains a major challenge in lumbar spine surgery, with conventional assessment methods lacking standardization. The Validated Intraoperative Bleeding Severity Scale (VIBe) is a structured five-grade tool developed to objectively assess bleeding severity across surgical fields. This study evaluated the clinical utility of VIBe in lumbar spinal fusion by comparing it with conventional bleeding metrics across various hemostatic strategies, including hypotensive anesthesia and local hemostatic agent use.

Impact of anti-osteoporosis medication on refracture prevention following osteoporotic vertebral fracture: a systematic review and meta-analysis.

Osteoporotic vertebral fractures (OVFs) increase mortality and impair patients' quality of life. Previous studies have focused on the effects of anti-osteoporosis drugs for primary fracture prevention; however, their role in secondary prevention remains insufficiently explored. Since refractures lead to more serious health issues and are strongly associated with prior fractures and low bone mineral density (BMD), effective treatment strategies for patients with existing OVFs are crucial.

Intracranial Embolism After a Dural Tear in Endoscopic Spine Surgery: A Case Report.

Case: An 87-year-old female patient with a history of lumbar fusion at L4-S1 presented with progressive stenosis at L2-3 and L3-4 and underwent biportal endoscopic decompression. Intraoperatively, a 0.7-cm dural tear was noted at L3-4.

Defining optimal postvoid residual volume thresholds for predicting delayed postoperative urinary retention in spinal surgery.

Background Context: Postoperative urinary retention (POUR) is a common complication following spinal surgery, increasing patient morbidity through prolonged hospital stays and urinary infections. Traditional diagnostic criteria, relying on two consecutives postvoid residual (PVR) volumes of 300 mL, may fail to predict delayed POUR in cases with initial PVR below this threshold.

Purpose: This study aims to establish refined PVR cut-off values that can predict delayed POUR in spinal surgery patients, incorporating stratified thresholds based on identified risk factors such as gender and age.

Postoperative Contralateral Facet Cyst after Endoscopic Unilateral Laminectomy for Bilateral Decompression: A Case Report.

Introduction: Endoscopic unilateral laminectomy for bilateral decompression (Endo-ULBD) is a minimally invasive, motion-preserving surgical technique designed to decompress neural elements while preserving the posterior spinal structures. Because it maintains spinal integrity, the risk of postoperative instability is generally lower than that of conventional decompression techniques. However, microinstability-related complications, such as facet cyst formation, can still occur and may lead to recurrent symptoms.

Lumbar spinal stenosis: current concept of management.

Lumbar spinal stenosis (LSS) is a common degenerative spinal condition where spinal canal narrowing causes symptoms such as neurogenic claudication, radiculopathy, and lower back pain. While non-operative and surgical approaches yield similar long-term outcomes, surgical intervention-particularly decompression-can provide earlier symptom relief, functional recovery, and fall prevention in selected patients with refractory symptoms. Recent advancements in surgical technologies and image guidance have brought about a paradigm shift in LSS management.

Infective Spondylitis in Adults: A Journey Through Diagnosis, Management, and Future Directions.

Infective spondylitis is a rare but potentially devastating spinal infection that requires timely diagnosis and appropriate treatment to prevent severe complications, including neurological deficits and spinal deformity. Despite advancements in diagnostic imaging, microbiological techniques, and antimicrobial therapies, clinical challenges persist because of the disease's insidious onset, varied etiologies, and increasing antimicrobial resistance. This review article provides a comprehensive analysis of the current literature on the epidemiology, pathophysiology, diagnostic approaches, and treatment strategies for infective spondylitis.

Biportal Endoscopic Decompression with Maximized Facet Joint Preservation for Central to Extraforaminal Lumbar Stenosis.

This is a retrospective study. We aimed to identify an optimal biportal endoscopic spine surgery (BESS) technique that maximizes facet joint preservation while achieving sufficient decompression for central to extraforaminal lumbar stenosis across all spinal levels. We retrospectively analyzed the data of 46 patients who underwent surgery and assessed clinical outcomes (visual analogue scale scores for pain; pregabalin usage) and radiological changes (using computed tomography/magnetic resonance imaging) in the spinal canal; intervertebral foramen area expansion; facet joint preservation; and degenerative change.

Antiosteoporosis medication in patients with posterior spine fusion: a systematic review and meta-analysis.

Background Context: Osteoporosis and osteopenia are common among patients undergoing posterior spine fusion surgery, presenting challenges such as pseudarthrosis, screw loosening, and poor patient outcomes. While pharmacological interventions are available, no consensus exists regarding the optimal perioperative treatment for these patients. Furthermore, the effectiveness of various treatment options in improving fusion rates and minimizing complications remains uncertain.

Bone resorption phenomenon following anterior-posterior combined cervical fusion surgery: is it a pathologic finding?

Purpose: Anterior vertebral bone resorption, commonly observed in cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF), has not been extensively studied in the context of APCF. This study aims to investigate the phenomenon of anterior vertebral bone resorption following APCF, its potential causes, and its clinical significance.

Methods: A retrospective analysis was performed on 177 patients (857 vertebral segments) who underwent multilevel APCF between April 2014 and April 2022.

The fate of cerebrospinal fluid after unrecognized incidental durotomy in cervical spine surgery.

Background Context: Cerebrospinal fluid (CSF) leakage due to incidental durotomy may not be recognized during cervical spine surgery. Thereafter large volume of CSF leakage may be found through inserted drainage.

Purpose: To examine the natural progress of large volume of CSF leakage after cervical spine surgery which were not managed by either revision surgery for dural repair or lumbar drainage.

Effective Biportal Endoscopic Spine Surgery Technique With Better Facet Joint Preserving for Lumbar Lateral Recess Stenosis.

Background: Biportal endoscopic spinal surgery (BESS) for the treatment of spinal stenosis provided favorable clinical outcomes in many studies. They reported that interlaminar BESS decompression achieved favorable effects in patients with central spinal stenosis. However, many patients still experienced radiating pain even after conventional interlaminar BESS decompression.

Impact of Distal Fusion Level on Sacroiliac Joint Degenerative Change Following Adolescent Idiopathic Scoliosis Surgery.

Purpose: To evaluate the relationship between distal fusion level in correction and fusion surgery for adolescent idiopathic scoliosis (AIS) and radiologic changes in the sacroiliac (SI) joint.

Materials And Methods: This retrospective cohort study evaluated patients who underwent correction and fusion for AIS between 2005 and 2017 with at least 5 years of follow-up. We categorized patients into two groups: Group 1 (distal fusion above L2, 74 patients) and Group 2 (distal fusion at L3 and below, 52 patients).

Effect of Preoperative Acupuncture and Epidural Steroid Injection on Early Postoperative Infection After Lumbar Spinal Fusion.

Background: Acupuncture and epidural steroid injection (ESI) are frequently performed in patients with degenerative lumbar disease. The purpose of this study was to explore preoperative acupuncture and ESI as risk factors for postoperative infection after elective lumbar fusion.

Methods: Patients >50 years of age who underwent spinal fusion due to degenerative lumbar disease from 2010 to 2019 were identified by diagnostic and procedural codes using a nationwide database.

Radiological Spinopelvic Parameters Can Be Risk Factors for Early Total Hip Replacement After Spine Fusion.

Background: Interest in the correlation between the spinopelvic complex and its radiographic parameters in early total hip arthroplasty has been increasing. This study investigated whether radiological spinopelvic parameters are risk factors for early total hip replacement (THR) within 1 year of spinal fusion surgery. The primary research question focused on identifying specific spinopelvic changes that may lead to early THR.

Effect of saline irrigation temperature difference on postoperative acute pain and hypothermia during biportal endoscopic spine surgery.

Background: Recently, enhanced recovery after surgery (ERAS) protocols have attracted attention; they emphasize on avoiding intraoperative hypothermia while performing lumbar fusion surgery. However, none of the studies have reported the protocol for determining the temperature of saline irrigation during biportal endoscopic spine surgery (BESS) procedure. This study evaluated the effectiveness of warm saline irrigation during BESS in acute postoperative pain and inflammatory reactions.

Risk Factors and Characteristics of In-Hospital Falls After Spine Surgery: A Retrospective, Single-Center Cohort Study in the Republic of Korea.

Background: Falls after orthopaedic surgery can cause serious injuries, which lengthen hospital stays and increase medical expenses. This has prompted hospitals to implement various fall-prevention protocols. The aims of this study were to determine the incidence of in-hospital falls after spine surgery, to analyze the overall risk factors, to discern factors that have a major influence on falls, and to evaluate the effectiveness of the fall-prevention protocol that we implemented.

Proximity Between Screw and Endplate of Upper Instrumented Vertebra Using a Cortical Bone Trajectory Screw can Increase Radiographic Adjacent Segment Degeneration Risks in Patients With Lumbar Spinal Stenosis.

Study Design: Retrospective observational study.

Objective: To determine the proximity between the screw and endplate of the upper instrumented vertebra (UIV) using a cortical bone trajectory (CBT) screw as a predictive factor for radiographic adjacent segment degeneration (ASD) in patients surgically treated with transforaminal lumbar interbody fusion (TLIF) with CBT screws (CBT-TLIF) with lumbar spinal stenosis.

Summary Of Background Data: The risk factors for radiographic ASD after CBT-TLIF remain unknown.

Association of Functional Gastrointestinal Disorders with Adolescent Idiopathic Scoliosis.

Numerous adolescents diagnosed with adolescent idiopathic scoliosis (AIS) often manifest symptoms indicative of functional gastrointestinal disorders (FGIDs). However, the precise connection between FGIDs and AIS remains unclear. The study involved adolescents drawn from sample datasets provided by the Korean Health Insurance Review and Assessment Service spanning from 2012 to 2016, with a median dataset size of 1,446,632 patients.

Anatomical considerations for nerve transfer in axillary nerve injury.

This study investigated the anatomical details of the axillary and radial nerves in 50 upper limbs from 29 adult formalin-embalmed cadavers, and ten fresh upper limbs. The focus was on understanding the course, division, and ramifications of these nerves to improve treatment of shoulder dysfunction caused by axillary nerve damage. The axillary nerve divided anteriorly and posteriorly before passing the quadrangular space in all specimens, with specific distances to the first ramifications.

Effectiveness of Toothbrushing Technique for Biofilm Removal and Postoperative Infection Control after Spinal Fusion Surgery: A Retrospective Study.

This retrospective study was designed to investigate the effectiveness of using a toothbrush, which is commonly used in our daily life, for biofilm removal and infection control in the treatment of spinal infections occurring after spinal fusion surgery. Currently, a biofilm is thought to form on the surface of the metal inserted during spine fusion surgery. We aim to determine the differences in clinical outcomes between using and not using a toothbrush to remove biofilm while performing conventional drainage, curettage, and debridement.