Impact of signaling on interview invitations in the neurological surgery match process.

Objective: Neurosurgery remains one of the most competitive residency programs with an increasing application volume. Signaling was introduced to allow applicants to express interest in specific programs and streamline program director application review; however, there are limited data on how signaling affects interview invitations in neurosurgery. This study investigates the impact of signaling on interview invitation odds and subsequent residency program selection.

PTEN Mutations Associated with Increased Recurrence and Decreased Survival in Patients with Prostate Cancer Spinal Metastasis.

Introduction: Prostate cancer with spinal metastases (PCSM) is associated with high morbidity and mortality. The impact of biomarkers on the prognosis of spinal metastases, however, remains unclear.

Objective: This study explored associations between potential biomarkers, treatment modalities, survival, and neurological outcomes in PCSM patients.

Napsin A as a key prognostic biomarker in spinal metastases of lung cancer: implications for survival and neurological function.

Objective: Lung cancer's propensity for metastasizing to the spine significantly impacts morbidity and mortality. Understanding the impact of somatic mutations on the prognosis of these metastases is crucial for treatment development and optimization.

Methods: A retrospective analysis was performed on a neurosurgical cohort of 76 patients with lung cancer with spinal metastasis (LCSM) at a single comprehensive cancer center from 2013 to 2023.

Generating a Synthetic Lumbar CT from a Standard MRI Protocol.

Eliminating the need for a preoperative spine CT scan prior to spine surgery offers significant financial advantages, reduced radiation exposure, and a more streamlined workflow. This can be achieved by converting a standard-protocol MRI scan into a synthetic CT (sCT), which provides a precise representation of bone structures. The sCT is intended for use in the preoperative planning and navigation of spine surgeries, eliminating the need for an additional CT scan.

Duraplasty in acute spinal cord injury: a systematic review.

Background: Acute spinal cord injury (aSCI) can cause severe, lasting disabilities that may be fatal. Expansile duraplasty has been explored as a potential intervention aimed at alleviating spinal cord compression and enhancing neurological recovery in patients with aSCI.

Objective: This systematic review aimed to assess efficacy, safety, and clinical outcomes of expansile duraplasty in the management of aSCI.

A multi-analyte blood test for acute spinal cord injury.

BACKGROUNDRapid diagnosis to facilitate urgent intervention is critical for treatment of acute spinal cord injury (SCI). We hypothesized that a multi-analyte blood biomarker would support point-of-care SCI diagnosis, correlate with injury severity, and predict long-term neurologic outcomes.METHODSDroplet digital PCR (ddPCR) assays were designed to amplify differentially hypomethylated genomic loci in spinal cord tissue.

Synthesis and Preclinical Evaluation of a Novel Oxy133-Infused Biomimetic Bone Graft Using a Rat Model of Posterolateral Spinal Fusion.

Objective: To 1) create a novel tissue-engineered bone graft comprising the osteoinductive oxysterol Oxy133 and 2) compare the osteogenic capability of this novel bone graft with bone graft substitutes previously examined.

Methods: Oxy133 was homogeneously incorporated into a biomimetic (BioMim) bone graft substitute comprising extracellular matrix and calcium phosphates. Two iterations of the graft were created: one corresponding to an implant-dose of 2.

Augmented Reality Versus Freehand Spinopelvic Fixation in Spinal Deformity: A Case-Control Study.

Purpose: This study sought to compare screw placement accuracy and outcomes between freehand (FH) and AR-guided pelvic fixation. While pelvic fixation is a critical technique in spinal deformity surgery, S2-alar iliac (S2AI) screw placement poses challenges.

Methods: We conducted a case-control study of 50 consecutive patients who underwent spinopelvic fixation at a single institution.

Enabling Technologies in the Management of Cervical Spine Trauma.

Study Design: Narrative review.

Objective: The objective of this study is to explore and evaluate the role of novel technologies in enhancing the diagnosis, surgical precision, and rehabilitation of cervical spine trauma, and to discuss their potential impact on clinical outcomes.

Summary Of Background Data: Traumatic cervical spine injuries are challenging to manage due to their complex anatomy, the potential for long-term disability, and severe neurological deficits.

Pedicle screw placement in the cervical vertebrae using augmented reality-head mounted displays: a cadaveric proof-of-concept study.

Background: The accurate and safe positioning of cervical pedicle screws is crucial. While augmented reality (AR) use in spine surgery has previously demonstrated clinical utility in the thoracolumbar spine, its technical feasibility in the cervical spine remains less explored.

Purpose: The objective of this study was to assess the precision and safety of AR-assisted pedicle screw placement in the cervical spine.

Synthesis and evaluation of a novel vancomycin-infused, biomimetic bone graft using a rat model of spinal implant-associated infection.

Background: Postoperative infection is a complication of spinal fusion surgery resulting in increased patient morbidity. Strategies including intraoperative application of powdered vancomycin have been proposed to reduce the incidence of infection; however, such antimicrobial effects are short-lived.

Methods: Instrumentation of the L4-L5 vertebrae was performed mimicking pedicle screw and rod fixation in 30 rats.

External Validation of Predictive Models for Failed Medical Management of Spinal Epidural Abscess.

Objective: There is limited consensus regarding management of spinal epidural abscesses (SEAs), particularly in patients without neurologic deficits. Several models have been created to predict failure of medical management in patients with SEA. We evaluate the external validity of 5 predictive models in an independent cohort of patients with SEA.

Augmented Reality and Virtual Reality in Spine Surgery: A Comprehensive Review.

Augmented reality (AR) and virtual reality (VR) are powerful technologies with proven utility and tremendous potential. Spine surgery, in particular, may benefit from these developing technologies for resident training, preoperative education for patients, surgical planning and execution, and patient rehabilitation. In this review, the history, current applications, challenges, and future of AR/VR in spine surgery are examined.

Assessing the Accuracy of Spinal Instrumentation Using Augmented Reality (AR): A Systematic Review of the Literature and Meta-Analysis.

Technological advancements, particularly in the realm of augmented reality (AR), may facilitate more accurate and precise pedicle screw placement. AR integrates virtual data into the operator's real-world view, allowing for the visualization of patient-specific anatomy and navigated trajectories. We aimed to conduct a meta-analysis of the accuracy of pedicle screw placement using AR-based systems.

Reduction of cervicothoracic spondyloptosis in an ambulatory patient: when traction fails.

Introduction: Cervical spondyloptosis is a rare complication of high-energy trauma which often results in significant patient morbidity and mortality. The authors present a case of spondyloptosis of C7 over T1 with minimal radicular symptoms and otherwise complete spinal cord sparing. This case highlights the surgical challenges faced with cervical spondyloptosis and the techniques used when traction fails.

Augmented reality in spine surgery - past, present, and future.

Background Context: Augmented reality (AR) is increasingly recognized as a valuable tool in spine surgery. Here we provides an overview of the key developments and technological milestones that have laid the foundation for AR applications in this field. We also assess the quality of existing studies on AR systems in spine surgery and explore potential future applications.

Interventional approaches to symptomatic Tarlov cysts: a 15-year institutional experience.

Background: Tarlov cysts are perineural collections of cerebrospinal fluid most often affecting sacral nerve roots, which may cause back pain, extremity paresthesias and weakness, bladder/bowel dysfunction, and/or sexual dysfunction. The most effective treatment of symptomatic Tarlov cysts, with options including non-surgical management, cyst aspiration and injection of fibrin glue, cyst fenestration, and nerve root imbrication, is debated.

Methods: Retrospective chart review was conducted for 220 patients with Tarlov cysts seen at our institution between 2006 and 2021.

Patient Optimization for the Prevention of Proximal Junctional Kyphosis.

Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are well-recognized challenges of surgery for adult spinal deformity (ASD). Multiple risk factors have been identified for PJK/PJF, including osteoporosis, frailty, neurodegenerative disease, obesity, and smoking. Several surgical techniques to mitigate risk of PJK/PJF have been identified; however, patient optimization is also critical.

Contemporary Trends in Minimally Invasive Sacroiliac Joint Fusion Utilization in the Medicare Population by Specialty.

Background And Objectives: Sacroiliac (SI) joint dysfunction constitutes a leading cause of pain and disability. Although surgical arthrodesis is traditionally performed under open approaches, the past decade has seen a rise in minimally invasive surgical (MIS) techniques and new federally approved devices for MIS approaches. In addition to neurosurgeons and orthopedic surgeons, proceduralists from nonsurgical specialties are performing MIS procedures for SI pathology.

A novel rodent model of chronic spinal implant-associated infection.

Background Context: Bacterial infection of spinal instrumentation is a significant challenge in spinal fusion surgery. Although the intraoperative local application of powdered vancomycin is common practice for mitigating infection, the antimicrobial effects of this route of administration are short-lived. Therefore, novel antibiotic-loaded bone grafts as well as a reliable animal model to permit the testing of such therapies are needed to improve the efficacy of infection reduction practices in spinal fusion surgery.

In-Human Report of S2 Alar-Iliac Screw Placement Using Augmented Reality Assistance.

Background: S2 alar-iliac (S2AI) screws provide spinopelvic fixation with the advantages of minimized dissection, easier rod contouring, and decreased symptomatic screw-head prominence. However, placement of S2AI screws may be challenging because of the anatomy of the lumbosacral junction. Augmented reality is a nascent technology that may enhance placement of S2AI screws.