Cervical deformity correction: comparison of neurological, radiographic, and patient-reported outcome measures by three-column osteotomy level.

Objective: The purpose of this study was to evaluate whether level selection for a three-column osteotomy (3CO) impacts cervical deformity correction outcomes, including neurological, radiographic, and patient-reported outcomes.

Methods: A retrospective review was performed of patients who underwent a cervical or upper thoracic 3CO for cervical deformity correction by the senior author from 2008 to 2024. Collected outcome measures included neurological outcomes, mechanical complication rates, spinopelvic alignment, and patient-reported outcomes.

Optimizing Rod Configuration Across Lumbar Pedicle Subtraction Osteotomy Site: Evolution of a High-Volume Deformity Practice.

Background And Objectives: Three-column osteotomy (3CO) is a powerful corrective technique in adult spinal deformity. Unfortunately, they carry high complication rates including mechanical complications (MC) of rod fracture and pseudoarthrosis. Owing to the rapidly aging population, this intervention will only increase in use.

Sarcopenia prevalence and relationship to frailty by measurement method in patients with adult spinal deformity.

Objective: There is no consensus on how to diagnose sarcopenia in patients with spine disorders, limiting one's understanding of the relationship among sarcopenia, frailty, and surgical outcomes. The authors characterized the baseline prevalence of sarcopenia in patients with adult spinal deformity (ASD) according to previously established methods. They then examined the intersection between sarcopenia and frailty.

Risk factors for distal junctional failure following three-column osteotomy for cervical deformity correction.

Objective: The purpose of this study was to determine risk factors for distal junctional failure (DJF) following three-column osteotomy (3CO) for the correction of cervical deformity.

Methods: A retrospective review was performed of patients who underwent a cervical or upper thoracic 3CO for cervical deformity correction by the senior author from 2008 to 2023. The main outcome of interest was DJF, defined as revision surgery with extension of the distal end of the fusion construct.

Single-Position Prone Transpsoas Lateral Interbody Fusion at L4-L5: Technical Pearls.

Single-position prone transpsoas (PTP) lateral interbody fusion has been proposed as an alternative to lateral lumbar interbody fusion performed in the lateral decubitus position. The advantages to this single-position technique include facilitating segmental lordosis, obviating the need for repositioning for posterior instrumentation, and providing access for posterior decompression. Although PTP lateral interbody fusion can be a powerful and efficient technique, adopting and navigating this approach is challenging.

Obesity and Clinical, Radiographic, and Surgical Outcomes After Minimally Invasive Single-Level Transforaminal versus Lateral Lumbar Interbody Fusion.

Objective: To determine the effect of obesity on clinical, radiographic, and surgical outcomes after lateral lumbar interbody fusion (LLIF) versus minimally invasive surgery (MIS) transforaminal lumbar interbody fusion (TLIF) and compare the effectiveness of LLIF versus MIS TLIF in treating obese patients.

Methods: A retrospective comparative analysis of patients who underwent single-level L4-5 LLIF or MIS TLIF over a 7-year period was performed. Spinopelvic parameters were compared based on preoperative and postoperative radiographs.

Prone Lateral Transpsoas Approach to the Spine: A Technical Guide for Mastery.

Background: The single-position prone transpsoas (PTP) lateral interbody fusion represents an alternative approach to the traditional lateral lumbar interbody fusion (LLIF) typically performed with the patient in the lateral decubitus position. Advantages of PTP surgery include improved segmental lordosis, single-position surgery, and ease of performing posterior techniques as needed. However, the learning curve of PTP is distinct from that of traditional LLIF surgery performed with the patient in the lateral decubitus position.

Enhancing the Technical Pearls for L5-S1 Anterior Lumbar Interbody Fusion in Patients with Body Mass Index More Than 30: Clinical and Radiographic Outcomes at 1-Year Follow-Up.

Background: Performing anterior lumbar interbody fusion (ALIF) in patients with a body mass index (BMI) >30 presents surgical challenges. To overcome those challenges, a modified procedure is described.

Methods: This study retrospectively reviewed patients with a BMI >30 who underwent the modified L5-S1 ALIF procedure from August 2017 to September 2023.

A retrospective analysis of 513 patients undergoing pedicle subtraction osteotomy for adult spinal deformity by a single surgical team: are elderly patients at an elevated risk for complications?

Objective: This study aimed to assess whether elderly patients (aged ≥ 70 years) face an elevated risk of complications following pedicle subtraction osteotomy (PSO) for adult spinal deformity (ASD) compared with younger patients (< 70 years) and to evaluate if clinical and radiological outcomes differ between these age groups.

Methods: A retrospective analysis of 513 patients undergoing PSO for ASD by a single surgical team between January 2006 and January 2023 was conducted. Patients were categorized by age (≥ 70 years and < 70 years).

Superior Laryngeal Nerve Palsy After Anterior Cervical Diskectomy and Fusion: A Case Report and Cadaveric Description.

Background And Importance: Superior laryngeal nerve (SLN) injury after high cervical dissection can result in changes in vocal pitch due to cricothyroid denervation and dysphagia with aspiration risk because of decreased sensation of the supraglottic larynx.

Clinical Presentation: We describe a 69-year-old singer with cervical spondylotic myelopathy who underwent elective C3/4 and C4/5 anterior cervical diskectomy and fusion. Postoperatively, the patient reported changes in his voice, most noticeable with higher registers.

Bone grafting and biologics for spinal fusion in the pediatric population: current understanding and future perspective.

Pediatric spinal fusions have been associated with nonunion rates of approximately 25%, putting patients at risk for neurological complications while simultaneously incurring significant costs for revision surgery. In an effort to decrease nonunion rates, various bone grafts and biologics have been developed to increase osseous formation and arthrosis. The current gold-standard bone graft is autologous bone taken from the iliac crest or ribs, but this procedure is associated with significant morbidity and postoperative pain due to an additional graft harvesting procedure.

"July Effect" Revisited: July Surgeries at Residency Training Programs are Associated with Equivalent Long-term Clinical Outcomes Following Lumbar Spondylolisthesis Surgery.

Study Design: Retrospective analysis of a prospective registry.

Objective: We utilized the Quality Outcomes Database (QOD) registry to investigate the "July Effect" at QOD spondylolisthesis module sites with residency trainees.

Summary Of Background Data: There is a paucity of investigation on the long-term outcomes following surgeries involving new trainees utilizing high-quality, prospectively collected data.

Evaluating the Clinical Utility and Cost of Imaging Strategies in Adults with Newly Diagnosed Primary Intradural Spinal Tumors.

Objective: In patients with new primary intradural spinal tumors, the best screening strategy for additional central nervous system (CNS) lesions is unclear. The goal of this study was to document the rate of additional CNS tumors in these patients.

Methods: Adults with primary intradural spinal tumors were retrospectively reviewed.

The effect of anterior lumbar interbody fusion staging order on perioperative complications in circumferential lumbar fusions performed within the same hospital admission.

Objective: Anterior lumbar interbody fusion (ALIF) is a powerful technique that provides wide access to the disc space and allows for large lordotic grafts. When used with posterior spinal fusion (PSF), the procedures are often staged within the same hospital admission. There are limited data on the perioperative risk profile of ALIF-first versus PSF-first circumferential fusions performed within the same hospital admission.

Oblique Lumbar Interbody Fusion With Stereotactic Navigation: Technical Note.

Study Design: Surgical technical note.

Objectives: Describe the preoperative evaluation, approach, and technical considerations for an oblique lumbar interbody fusion using neuronavigation.

Methods: A thorough review of previous technical and anatomic descriptions for pre- and transpsoas interbody techniques was performed and incorporated into the technical considerations warranting discussion for a navigated oblique lateral interbody fusion.

Immediate Voice and Swallowing Complaints Following Revision Anterior Cervical Spine Surgery.

Objective: To report on the incidence of dysphagia, dysphonia, and acute vocal fold motion impairment (VFMI) following revision anterior cervical spine surgery, as well as to identify risk factors associated with acute VFMI in the immediate postoperative period.

Study Design: Retrospective cohort study.

Setting: Tertiary care center.

Ommaya Reservoir Insertion: A Technical Note.

Ommaya reservoir insertion is an elective neurosurgical procedure to deliver repeated intraventricular therapy, but placement can be complicated by malposition of the catheter, clogging, infection or poor postoperative cosmesis. Here, we describe the technique used by the senior author for accurate placement including preassembly of the reservoir and catheter, and recessing of the reservoir so that others may consider the technique for their practice. Results in a consecutive series of 27 Ommaya placements were reviewed.

The impact of obesity on perioperative complications in patients undergoing anterior lumbar interbody fusion.

Objective: Anterior approaches to the lumbar spine provide wide exposure that facilitates placement of large grafts with high fusion rates. There are limited data on the effects of obesity on perioperative complications.

Methods: Data from consecutive patients undergoing anterior lumbar interbody fusion (ALIF) from 2007 to 2016 at a single academic center were analyzed.

Association between plasma GFAP concentrations and MRI abnormalities in patients with CT-negative traumatic brain injury in the TRACK-TBI cohort: a prospective multicentre study.

Background: After traumatic brain injury (TBI), plasma concentration of glial fibrillary acidic protein (GFAP) correlates with intracranial injury visible on CT scan. Some patients with suspected TBI with normal CT findings show pathology on MRI. We assessed the discriminative ability of GFAP to identify MRI abnormalities in patients with normal CT findings.

Glioblastoma-Derived IL6 Induces Immunosuppressive Peripheral Myeloid Cell PD-L1 and Promotes Tumor Growth.

Purpose: Upregulation of programmed death-ligand 1 (PD-L1) on circulating and tumor-infiltrating myeloid cells is a critical component of GBM-mediated immunosuppression that has been associated with diminished response to vaccine immunotherapy and poor survival. Although GBM-derived soluble factors have been implicated in myeloid PD-L1 expression, the identity of such factors has remained unknown. This study aimed to identify factors responsible for myeloid PD-L1 upregulation as potential targets for immune modulation.

Impact of Cochlear Dose on Hearing Preservation following Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy for the Treatment of Vestibular Schwannoma.

 The objective of this study was to examine the effect of cochlear dose on hearing preservation in stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) for vestibular schwannoma (VS).  This is a retrospective case-control study.  This study was completed at the Ronald Reagan UCLA Medical Center, a university-affiliated tertiary care center.

Evolution of the Minimally Invasive Spinal Deformity Surgery Algorithm: An Evidence-Based Approach to Surgical Strategies for Deformity Correction.

Minimally invasive surgery (MIS) is an alternative to open surgery for adult spinal deformity correction. However, not all patients are ideal candidates for MIS correction. The minimally invasive spinal deformity surgery algorithm is a systematic and reproducible decision-making framework for surgeons to identify patients appropriate for deformity correction by MIS techniques.

The immune checkpoint protein PD-L1 induces and maintains regulatory T cells in glioblastoma.

Glioblastoma (GBM) promotes immunosuppression through upregulation of PD-L1 and regulatory T cell (Treg) expansion, but the association of these suppressive factors has not been well elucidated. Here, we investigate a role of PD-L1 in expanding Tregs and the value of targeting the PD-1 receptor to inhibit Treg expansion. Quantitative RNA sequencing data from The Cancer Genome Atlas were evaluated for an association between CD274 and FOXP3 transcript expressions and impact of FOXP3 on clinical outcomes.

Sellar plasmacytomas masquerading as pituitary adenomas: A systematic review.

Given the rarity of intracranial plasmacytomas, these lesions are frequently misdiagnosed as pituitary adenomas. We report on the distinguishing characteristics of sellar plasmacytomas from cases in the literature and our experience. A literature search was conducted to collect all documented cases of a plasmacytoma originating in the sellar region.