Multirod Constructs in Spine Surgery.

➢ The use of multirod constructs (≥3 rods) in complex spine surgery has increased as its utility has been recognized over the past decade.➢ There are multiple different rod configurations that may be utilized on the basis of the desired supplemental rod function, with each type having its own advantages and clinical indications.➢ Literature has continued to demonstrate a reduced incidence of pseudarthrosis, rod fracture, and reoperation when comparing multirod constructs with traditional dual-rod constructs.

Investigating the epigenetic landscape of symptomatic disk degeneration: a case study.

Introduction: This study investigates the epigenetic landscape underlying painful intervertebral disk (IVD) degeneration in a single subject with a history of low back pain (LBP). Intervertebral disk degeneration is associated with LBP in some individuals; however, there is often a discrepancy between degeneration and pain. We hypothesize that DNA methylation, an epigenetic mechanism previously linked to discogenic LBP, is dysregulated in symptomatic vs asymptomatic IVDs.

Lumbar disc space height in relation to neural foraminal dimensions and patient characteristics: A morphometric analysis from L1-S1 using computed tomography.

Introduction: The normative relationship between lumbar intervertebral disc space height (DSH) and neuroforaminal dimensions (NFD) has yet to be defined.

Research Question: The purpose of this study was to investigate the relationship between lumbar DSH and NFD using computed tomography (CT), accounting for influences of patient demographic and anthropometric characteristics.

Materials And Methods: We analyzed CT imaging of 350 female and 350 male patients.

Minimally Invasive Hemilaminectomy in Baastrup Disease: A Case Report and Discussion of "Kissing Spine Disease".

Case: A patient presented with midline back pain radiating into the left lower extremity. Magnetic Resonance images revealed an abnormal midline dorsal structure described as a facet cyst. Rupture was attempted by spinal needle under fluoroscopic guidance.

Outcomes and Complications After Elective Thoracic and Lumbar Spinal Fusion in Elderly Patients: A Comparison of Methods to Predict Adverse Events.

Study DesignRetrospective study.ObjectivesThe current study compares the ability of the modified Frailty Index (mFI), the American Society of Anesthesiologists (ASA) classification, the modified Charleston Comorbidity Index (mCCI), the American College of Surgeons Surgical Risk Calculator (SRC), and the Fusion Risk Score (FRS) to predict perioperative outcomes.MethodsComorbidity indices were calculated for patients undergoing elective thoracic and lumbar spinal fusion at a single institution and assessed for their discriminative ability in predicting the desired outcomes using an area under the curve (AUC) analysis.

Are the Umbilicus and Iliac Crests Truly at the Level of L4 to L5? A Computed Tomography-Based Study of Surface Anatomy of the Anterior Lumbar Spine.

Background: This study aimed to determine whether the iliac crests are truly at the level of L4 to L5, accounting for patient demographic and anthropometric characteristics.

Methods: We measured the umbilicus and iliac crests relative to the lumbar spine using computed tomography of patients without spinal pathology, accounting for the influences of patient height, weight, body mass index (BMI), sex, race, and ethnicity.

Results: A total of 834 patients (391 men and 443 women) were reviewed.

Analysis of reasons for medical malpractice litigation due to spinal cord stimulator.

Study Design: Retrospective cohort study.

Introduction: Malpractice claims analysis is performed by several specialties to improve quality of patient care and to identify areas where physicians can improve their practice to mitigate the incidence of committing malpractice. The Food and Drug Administration has flagged over 80,000 injuries caused by spinal cord stimulator (SCS), making them the 3rd most flagged medical device.

Anatomic Parameters for Diagnosing Congenital Lumbar Stenosis Based on Computed Tomography of 1,000 Patients.

Introduction: Quantitative parameters for diagnosis of congenital lumbar stenosis (CLS) have yet to be universally accepted. This study establishes parameters for CLS using CT, assessing the influences of patient sex, race, ethnicity, and anthropometric characteristics.

Methods: Interpedicular distance (IPD), pedicle length, canal diameter, and canal area were measured using 1,000 patients between 18 and 35 years of age who were without spinal pathology.

Anterioposterior Views Coupled With Lateral Views Are the Best for the Intraoperative Radiographic Detection of Retained Surgical Sponges.

Introduction: A retained sponge after spine surgery can cause serious medical complications and medicolegal problems. Intraoperative radiographs are commonly used to detect it. This study evaluated intraoperative radiographs under routine clinical conditions that most spine surgeons experience to detect retained sponges.

The effect of thoraco-lumbo-sacral orthosis wear time and clinical risk factors on curve progression for individuals with adolescent idiopathic scoliosis.

Background Context: The effectiveness of bracing with a thoraco-lumbo-sacral orthosis (TLSO) for adolescent idiopathic scoliosis (AIS) has been studied extensively, with a growing body of evidence supporting TLSO use. In this study we examine the effect of wear time and other important causal factors affecting curve progression and develop a risk model that can be applied to individual patients and is based on important casual factors.

Purpose: Understand the impact of TLSO wear time and other risk factors in order to guide optimal treatment.

Development of Consensus-Based Best Practice Guidelines for the Perioperative and Postoperative Care of Pediatric Patients With Spinal Deformity and Programmable Implanted Devices.

Study Design: Modified Delphi consensus study.

Objective: To develop consensus-based best practices for the care of pediatric patients who have implanted programmable devices (IPDs) and require spinal deformity surgery.

Summary Of Background Data: Implanted programmable devices (IPDs) are often present in patients with neuromuscular or syndromic scoliosis who require spine surgery.

Correlations among MRI-based cervical and thoracic vertebral bone quality score, CT-based Hounsfield Unit score, and DEXA t-score in assessment of bone mineral density.

Background: Further optimization of the validated vertebral bone quality (VBQ) score using magnetic resonance imaging (MRI) may expand its clinical utility for bone mineral density (BMD) assessment. This study evaluated the correlations among cervical and thoracic VBQ scores, the validated Hounsfield Unit (HU) measured on computed tomography (CT), and dual-energy x-ray absorptiometry (DEXA) values.

Methods: We retrieved the medical and radiographic records of 165 patients who underwent synchronous MRI of the cervical and thoracic spine, as well as DEXA and CT imaging of the spine obtained within 1 year of each other between 2015 and 2022.

Morphometric analysis of cervical neuroforaminal dimensions from C2-T1 using computed tomography of 1,000 patients.

Background: Race and sex differences are not consistently reported in the literature. Fundamentally, anatomical differences of cervical neuroforaminal dimensions (CNFD) amongst these groups would be important to know.

Purpose: To establish normative radiographic morphometric measurements of CNFD and uncover the influence of patient sex, race, and ethnicity while also considering anthropometric characteristics.

Long-term reoperation rates following spinal fusion for neuromuscular scoliosis in nonambulatory patients with cerebral palsy.

Purpose: To describe the incidence of reoperation and factors contributing to surgical revision within a minimum of 10 years after spinal fusion for scoliosis in patients with nonambulatory cerebral palsy (CP).

Methods: We conducted a retrospective review of consecutive nonambulatory patients with CP who underwent primary spinal fusion at a single specialty care center with a minimum of 10 years from their index surgery (surgery dates 2001-2011). Causes of reoperation were classified as implant failure/pseudoarthrosis, surgical site infection (SSI), proximal junctional kyphosis, prominent/symptomatic implants, and implant removal.

Removal of Spinal Instrumentation Is Not Required to Successfully Treat Postoperative Wound Infections in Most Cases.

Introduction: Controversy exists regarding whether spinal implants need to be removed to treat postoperative deep wound infections (DWIs). This retrospective study aimed to determine whether the removal or retention of implants impacts the successful treatment of a DWI after spine surgery.

Methods: Postoperative spine surgery patients presenting with signs of infection who underwent irrigation and debridement (I&D) at Twin Cities Spine Surgeons at Abbott Northwestern Hospital, Minnesota, USA, were studied.

Analysis of reasons for medical malpractice litigation due to anterior cervical discectomy and fusion.

Background: Anterior cervical discectomy and fusions (ACDF) are among the most common cervical spine operations, with over 137,000 surgeries performed annually. Understanding reasons underlying malpractice pertaining to ACDF may inform physicians of practices to improve delivery of patient care and mitigate malpractice. The aim of our study was to analyze the causes and outcomes for lawsuits pertaining to ACDF.

Application of machine learning algorithms to predict 30-day hospital readmission following cement augmentation for osteoporotic vertebral compression fractures.

Objective: Osteoporosis is a common skeletal disease that greatly increases the risk of pathologic fractures and accounts for approximately 700,000 vertebral compression fractures (VCFs) annually in the United States. Cement augmentation procedures such as balloon kyphoplasty (KP) and percutaneous vertebroplasty (VP) have demonstrated efficacy in the treatment of VCFs, however, some studies report rates of readmission as high as 10.8% following such procedures.

Association Between Vertebral Bone Quality Score and Dual-Energy X-ray Absorptiometry for the Assessment of Bone Mineral Density in Adolescent Patients.

Background: The MRI-based vertebral bone quality (VBQ) score is an assessment tool for bone mineral density (BMD) that has been validated in adults against the clinical standard of dual-energy X-ray absorptiometry (DEXA). However, VBQ has yet to be validated against DEXA for use in adolescents. This study evaluated the associations between adolescent VBQ scores, DEXA Z-scores, and BMD values.

Adding Vertebral Bone Quality to the Fusion Risk Score: Does It Improve Predictions of Postoperative Complications?

Study Design: Retrospective review of prospectively collected data.

Objective: The current study evaluates whether the addition of the Vertebral Bone Quality (VBQ) score to the Fusion Risk Score (FRS) improves its ability to predict perioperative outcomes.

Summary Of Background Data: The FRS was developed to assess preoperative risk in patients undergoing thoracic and lumbar fusions.

The effects of gastrojejunostomy tube placement on pulmonary and gastrointestinal complications following spinal fusion for neuromuscular scoliosis.

To evaluate whether preoperative conversion from a gastrostomy tube (G-tube) to a gastrojejunostomy tube (GJ-tube) decreases short-term postoperative aspiration pneumonia and gastrointestinal complications in children with neuromuscular scoliosis. We conducted a retrospective chart review from January 2006 to October 2021 of pediatric patients who had neuromuscular scoliosis and were fed with a G-tube before spinal fusion. Eligible patients were divided into two groups based on whether they were converted to a GJ-tube preoperatively.

Oblique lateral interbody fusion at L5-S1: feasibility, surgical approach window, incision line, and influencing factors.

Purpose: The primary aim of this study was to describe the feasibility, surgical approach window (SAW), and incision line (IL) for oblique lateral interbody fusion at L5-S1 (OLIF51) using computed tomography (CT). A secondary aim was to identify associations among approach characteristics and demographic and anthropometric factors.

Methods: We performed a radiographic study of 50 male and 50 female subjects who received abdominal CT imaging.

Correlations among Cervical, Thoracic, and lumbar Hounsfield Unit measurements for assessment of bone mineral density.

Objective: Bone mineral density assessment using Hounsfield Unit (HU) currently depends upon the availability of computed tomography (CT) of the lumbar spine. The primary aim of this study was to evaluate the associations among HU measurements of the cervical (CHU), thoracic (THU), and lumbar (LHU) spine. The secondary aim of this study was to analyze the influence of patient demographic and anthropometric characteristics on HU measurements.

The Reoperation, Readmission, and Complication Rates at 30 Days Following Lumbar Decompression for Cauda Equina Syndrome.

Background and objective Cauda equina syndrome (CES) is considered a surgical emergency, and its primary treatment involves decompression of the nerve roots, typically in the form of discectomy or laminectomy. The primary aim of this study was to determine the complication, reoperation, and readmission rates within 30 days of surgical treatment of CES secondary to disc herniation by using the PearlDiver database (PearlDiver Technologies, Colorado Springs, CO). The secondary aim was to assess preoperative risk factors for a higher likelihood of complication occurrence within 30 days of surgery for CES.