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Marjorie C. Wang, Andrew M. Lozen, Purushottam W. Laud, Ann B. Nattinger and Erin E. Krebs

related to chronic postoperative opioid use after cervical spine surgery, we studied opioid use, patient-reported outcomes, and patient satisfaction with pain relief before surgery and up to 1 year after surgery. We included patients undergoing elective cervical spine surgery for degenerative conditions causing radiculopathy and myelopathy. Based on literature for lumbar spine surgery and chronic opioid use, we hypothesized that patients who used opioids before surgery would be more likely to be using chronic opioids 1 year after surgery compared to those who did not

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Zachary G. Ries, Steven D. Glassman, Ivan Vasilyev, Leanne Metcalfe and Leah Y. Carreon

L umbar degenerative disc disease (DDD) includes degenerative conditions of the lumbar spine, such as lumbar spinal stenosis, spondylolisthesis, and degenerative disc pathologies. Associated changes include varying degrees of canal stenosis, endplate sclerosis, osteophyte formation, facet hypertrophy, disc degeneration, and ligamentum flavum thickening. 7 Symptoms can include back and leg pain, neurogenic claudication, numbness, weakness, and gait abnormalities. 3 , 7 , 12 Radiographic workup of the degenerative lumbar spine includes plain radiographs, MRI

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Chang-Hyun Lee, Chun Kee Chung, Jee-Soo Jang, Sung-Min Kim, Dong-Kyu Chin, Jung-Kil Lee, Seung Hwan Yoon, Jae Taek Hong, Yoon Ha, Chi Heon Kim and Seung-Jae Hyun

L umbar lordosis (LL) is unique to the human spine; intact sagittal spinal alignment of the spine enables humans to walk upright with minimal effort. 38 Decreased LL and increased thoracolumbar and thoracic kyphosis (TK) are hallmarks of the aging human spine, and the prevalence of spinal deformity is increasing in the elderly population as people live longer. 16 , 43 Degenerative sagittal imbalance in the lumbar spine can refer to fixed sagittal imbalance, 7 , 8 lumbar degenerative kyphosis, 44 primary sagittal deformity, 47 or degenerative flat back. 28

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Kaisorn L. Chaichana, Mohamad Bydon, David R. Santiago-Dieppa, Lee Hwang, Gregory McLoughlin, Daniel M. Sciubba, Jean-Paul Wolinsky, Ali Bydon, Ziya L. Gokaslan and Timothy Witham

, 46 These previous studies confound the true incidence of infections for posterior lumbar instrumented fusion because they include patients with different pathological entities such as tumors and trauma, 6 , 36 patients who underwent nonlumbar procedures, 22 , 34 and patients who did not undergo instrumented fusion. 12 , 30 Therefore, it is difficult to interpret the risk of spinal infection for patients who are undergoing posterior lumbar fusion for degenerative spine disease, which is the most common type of fusion procedure. 9 , 35 The goals of this study

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Victor E. Staartjes, Marlies P. de Wispelaere and Marc L. Schröder

surgery. In particular, we are unaware of published ERAS evidence on anterior lumbar fusion procedures. Moreover, still little is known on the application of such protocols in specialized outpatient or short-stay settings. 24 , 25 This applies particularly to implementation of ERAS principles in a broad population of patients undergoing surgical procedures for degenerative spine conditions as seen clinically by neurosurgeons, as opposed to a group of patients all treated with the same single surgical procedure. Since the inception of the neurosurgical spine unit at

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Anna MacDowall, Martin Skeppholm, Lars Lindhagen, Yohan Robinson, Håkan Löfgren, Karl Michaëlsson and Claes Olerud

C ervical radiculopathy is characterized by radiating pain from the neck to the shoulder or arm and is typically the consequence of degenerative changes such as disc herniation and osteophyte formation, with lower cervical segments most frequently affected. 10 When treatment with pain medication and physiotherapy has failed there are several surgical treatment options available, the most common being anterior cervical decompression and fusion (ACDF). Artificial disc replacement (ADR) was invented to preserve motion at the index level, to prevent development of

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Borys V. Gvozdyev, Leah Y. Carreon, Christopher M. Graves, Stephanie A. Riley, Katlyn E. McGraw, R. Joseph Head, John R. Dimar II and Steven D. Glassman

P atient-reported outcome (PRO) measures are widely used to evaluate treatment outcomes following spine surgery for degenerative conditions. Consistent with an expanding patient-centered approach to care, PROs have in many ways replaced traditional outcome measures such as complication rates, physician assessments, and subjective patient satisfaction. 4 Two commonly used measures have demonstrated high validity combined with a reasonable response burden in evaluating patient-reported outcomes following spine surgery. 11 The Oswestry Disability Index (ODI) 6

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Myung Soo Youn, Jong Ki Shin, Tae Sik Goh, Seung Min Son and Jung Sub Lee

any spinal surgery, posttraumatic kyphosis, multilevel lumbar spinal stenosis exceeding 3 levels, and spinal deformities such as lumbar degenerative kyphosis were excluded. We classified 57 patients into two groups based on accompanying mild spondylolisthesis. Twenty-five patients had accompanying spondylolisthesis (group 2) and 32 patients did not (group 1). Of 57 patients, 5 in group 1 and 2 in group 2 were withdrawn from the study for reasons described in Fig. 1 . Of these 7 excluded patients, 2 in group 1 and 1 in group 2 did not satisfy the 2-year follow

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Yu Han, Jianguang Sun, Chenghan Luo, Shilei Huang, Liren Li, Xiang Ji, Xiaozong Duan, Zhenqing Wang and Guofu Pi

that range from 0% to 30.3%. 29 In this study, 20 (32.25%) of 62 patients in the PLIF and PDS groups had postoperative radiographic degenerative changes (9 [29.03%] of 31 in the PDS group; 11 [35.48%] of 31 in the PLIF group). Previous studies have documented a number of risk factors for ASD, such as age, multilevel fusion, BMI at admission, spinal sagittal alignment, and menopause. 14 , 21 , 23 , 24 A significant risk factor in determining ASD is preexisting degeneration at an adjacent level, including spinal stenosis and facet and disc degeneration. 15 Based on

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Anthony L. Asher, Clinton J. Devin, Kristin R. Archer, Silky Chotai, Scott L. Parker, Mohamad Bydon, Hui Nian, Frank E. Harrell Jr., Theodore Speroff, Robert S. Dittus, Sharon E. Philips, Christopher I. Shaffrey, Kevin T. Foley and Matthew J. McGirt

L ow -back pain associated with degenerative spine disease is the leading and most costly cause of work-related disability in the US. 42 , 45 , 60 , 66 , 67 Among those gainfully employed, approximately 26 million individuals report frequent low-back pain, and of that number 8% become disabled in any given year; this annual disability is responsible for 40% of all lost workdays. 20 , 26 , 30 This disability results in an estimated $30 billion in direct medical costs due to back-related health care resource utilization 42 , 63 and up to $20 billion annually in