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Christoph P. Hofstetter, Andrew R. James and Roger Härtl

interbody fusion cages augmented with a posterior construct. 2 , 5 The AxiaLIF procedure has been reported to be associated with a low risk of complications such as visceral, vascular, or sympathetic injury. 4 , 15 The rate of immediate operative complications of the first 5000 1- and 2-level AxiaLIF procedures was 1.08% (unpublished data). Known complications of spinal fusion surgery include bony nonunion and instrumentation failure and require revision surgery in 6%–36% of cases. 6 Revision surgeries tend to be associated with a poorer functional outcome than

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Lynn B. McGrath Jr., Karthik Madhavan, Lee Onn Chieng, Michael Y. Wang and Christoph P. Hofstetter

. 1 , 9 Moreover, up to 50% of patients have new or residual radiculopathy following fusion, due to pseudarthrosis, exacerbation of spondylolisthesis, and adjacent-segment disease. 9 Reoperation in this context often requires revision or extension of the instrumented fusion. The use of endoscopic techniques for spine surgeries is increasing. Endoscope-assisted lumbar discectomy was first described in 1997 by Foley et al., 7 and has since been established as a viable method of treating lumbar spinal stenosis. In addition, fully endoscopic foraminotomy has been

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Owoicho Adogwa, Scott L. Parker, David Shau, Stephen K. Mendelhall, Joseph Cheng, Oran Aaronson, Clinton J. Devin and Matthew J. McGirt

low-back and leg pain can be successfully managed medically, many require surgical management for pain that is refractory to medical treatments. 5 , 10 , 30 Accordingly, the rates of lumbar surgery for spinal pathology have increased by 220% over the past 2 decades, and the proportion of lumbar spine surgeries that involve fusion has similarly increased. 11 , 37 Lumbar pseudarthrosis is a potential complication of lumbar fusion and is associated with recurrent back pain and disability. In a large population-based, prospective review of revision following lumbar

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Prashant Chittiboina, Helena Pasieka, Ashish Sonig, Papireddy Bollam, Christina Notarianni, Brian K. Willis and Anil Nanda

needing permanent CSF shunts. 8 , 10 , 19 Cerebrospinal fluid shunts are prone to failures, including infections, obstructions, and migrations. 3 , 13 The economic costs of repeated shunt malfunctions are up to a billion dollars a year. 14 Authors have attempted to identify the factors leading to multiple shunt revisions in only a few studies. 4 , 16 , 18 To our knowledge, no study has investigated the predictors of multiple shunt failures in infants with posthemorrhagic hydrocephalus. We performed a retrospective analysis of patients presenting with posthemorrhagic

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Jonathan J. Stone, Corey T. Walker, Maxwell Jacobson, Valerie Phillips and Howard J. Silberstein

VP shunts. 3 , 13 , 16 These procedures cost our national health care system more than $1 billion each year. 13 , 16 The excessive costs predominantly arise from relatively high complication and revision rates. 5 Shunt failures result in the need for revision surgery, often requiring urgent management. 9 Causes of malfunction include valve failure, proximal or distal catheter obstruction, infection, distal catheter migration, shunt disconnection, or any combination of these problems. 11 , 15 One study estimated that approximately 41% of all shunting

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Shyamal C. Bir, Subhas Konar, Tanmoy Maiti, Anil Nanda and Bharat Guthikonda

cord stimulators are widely used and represent a potential alternative for the treatment of failed–back surgery syndrome (FBSS), complex regional pain syndrome, and radiculopathies refractory to conservative management. 6–8 Although SCSs are less invasive, safe, and efficient for the management of intractable pain, immediate and long-term complications after SCS implantation are not uncommon. 3 , 6 , 11 , 18 Any malfunction or nonfunction leads to revision or removal of the SCS, increasing the chances of additional surgery, prolonged hospital stay, and increased

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Varun Puvanesarajah, Francis H. Shen, Jourdan M. Cancienne, Wendy M. Novicoff, Amit Jain, Adam L. Shimer and Hamid Hassanzadeh

S urgical correction of adult spinal deformity (ASD) is a complex undertaking that ranks among the most morbid of orthopedic procedures. The challenges that arise from surgical management of this pathology have resulted in high complication rates, 3 , 4 , 34–36 particularly in elderly patients. 9 Specifically, revision rates often range from 8%–45% following primary spine fusion procedures, increasing with greater follow-up. 23 , 27 , 32 , 38 The elderly population is of particular interest given the rapidly rising need for care for this population

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Nicholas B. Rossi, Nickalus R. Khan, Tamekia L. Jones, Jacob Lepard, Joseph H. McAbee and Paul Klimo Jr.

H ydrocephalus remains the most common problem encountered by pediatric neurosurgeons. Although there is growing interest in the use of choroid plexus cauterization in conjunction with endoscopic third ventriculostomy, 33 ventricular shunting remains the predominant treatment. Surgeons continue to be frustrated by high revision rates, even with the availability of various valve types, intraoperative image guidance (i.e., ultrasound or electromagnetic stereotaxy), and antibiotic-impregnated shunt systems. 1 , 3 , 9 , 11 , 17 , 18 , 20 For example, a 2008

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Marc L. Schröder and Victor E. Staartjes

been established, the actual benefits for the patient in terms of surgical revision rates and clinical outcomes remain unknown. Little is currently known about the impact of robot-guided fusion, relative to alternative fusion techniques, on patient-reported outcomes (PROs) or on the revision rates for screw malposition. If a screw is inserted correctly, it is inconceivable that any significant change in outcome could be produced by simply changing the method of screw navigation. The clinical result of a fusion procedure depends on various factors, but the most

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Eric W. Sankey, C. Rory Goodwin, Ignacio Jusué-Torres, Benjamin D. Elder, Jamie Hoffberger, Jennifer Lu, Ari M. Blitz and Daniele Rigamonti

, regardless of ventriculostoma patency. Overall clinical outcome was evaluated by the clinical assessment reports of the treating neurosurgeon. In addition, post-ETV MMSE, TUG, and Tinetti scores were compared with preoperative values. Postoperative Evans’ index, ETV patency, and aqueductal and cisternal flow were assessed by high-resolution, gradient-echo MRI and phase-contrast imaging. Last follow-up included all visits after initial ETV or after subsequent revision surgery. Statistical Analysis Quantitative data are expressed as the median (interquartile range [IQR