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Rani Nasser, Sanjay Yadla, Mitchell G. Maltenfort, James S. Harrop, D. Greg Anderson, Alexander R. Vaccaro, Ashwini D. Sharan, and John K. Ratliff

T he incidence of complications in spinal surgery remains unclear. Authors of previous reports have surmised that between 10 and 20% of patients undergoing surgical spinal procedures suffer adverse events or complications. 29 , 51 , 53 Most spinal literature consists of retrospective analyses that are assumed to underestimate the complication incidence. In the present study we assessed the different rates of complications reported in prospective and retrospective analyses of spine surgery complications through a systematic review of the spine surgery

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Alan H. Daniels, Roy Ruttiman, Adam E. M. Eltorai, J. Mason DePasse, Bielinsky A. Brea, and Mark A. Palumbo

M edical malpractice litigation increasingly affects the delivery and cost of health care. In 2014, malpractice payments totaled $3.9 billion in the United States. 18 , 20 The risk of malpractice encourages the defensive medicine practices of increased diagnostic testing, unnecessary referrals, and patient avoidance. 4 , 5 Neurosurgeons have the highest annual rate of malpractice claims of any medical specialty, with 19.1% of neurosurgeons facing a claim annually. 11 , 14 Spine surgery represents the majority of malpractice claims for neurosurgeons 9 and

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Kalil G. Abdullah, Edward C. Benzel, and Thomas E. Mroz

distinct questions regarding treatment efficacy. In SPORT, the investigators compared surgical versus conservative management for common spinal disorders, and the randomized, controlled trials published in 2009 examined the benefits of vertebroplasty versus a sham procedure in the treatment of osteoporotic fractures. These were notable trials because 1) Class I evidence had been lacking in the field of spine surgery and 2) the authors applied a prospective study design to answer important and common clinical questions. However, none of these studies was an example of CER

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Thiago S. Montenegro, Kevin Hines, Paul P. Partyka, and James Harrop

I n academic manuscripts, authors use references in publications as sources to validate and emphasize research points. Therefore, references lists serve writers, researchers, and readers as a vital source for confirmation of the accuracy of authors’ statements. The number of articles in the field of spine surgery has increased rapidly in the past years. 1 , 2 Due to the rapidity of publication, the accuracy of the information published is necessary to understand and to validate research findings. Unfortunately, reference errors in medical literature are common

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John Paul G. Kolcun, Won Hyung A. Ryu, and Vincent C. Traynelis

). This limitation is particularly relevant in spine surgery, where management decisions often hinge on subtle physical examination findings and an in-depth and more nuanced discussion with the patient than usually occurs in a TM setting. In addition, administrative and legal concerns such as inconsistent insurance coverage, liability in managing patients at a distance, and cross-state licensure remain major barriers for TM. For example, reimbursement policies have lagged behind technological advancement: as recently as 2016, only 29 states within the United States had

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Zachary A. Medress, Michael C. Jin, Austin Feng, Kunal Varshneya, and Anand Veeravagu

medical and surgical specialties listed, neurosurgeons had the highest percentage of practitioners receiving a claim each year at 19.1%. In this review, we discuss major medicolegal topics relating to malpractice in spine surgery, including tort reform, trends of malpractice claims related to spine surgery in the US, medicolegal considerations after catastrophic outcomes including spinal cord injury and death, and ethical considerations related to the disclosure of errors in spine surgery. Tort Reform and Spine Surgery Of particular significance to surgeons practicing

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M. Sami Walid and Joe Sam Robinson Jr.

H ealth care costs in the US have been rising linearly in the past decades, surpassing $2.5 trillion in 2009. 7 With increasing frequency of surgical spine procedures in an era of economic restraint, 2 health care providers ever more struggle to keep up with health care costs. Previous research has suggested that comorbidities may increase the hospitalization cost of patients who undergo spine surgery. 8–10 To study the prevalence of major comorbidities among patients undergoing expensive spine procedures and to examine their impact on hospital cost, we

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Adib A. Abla, Joseph C. Maroon, Richard Lochhead, Volker K. H. Sonntag, Adara Maroon, and Melvin Field

golf in the last 12 months. 6 Worldwide, this number is at least double and includes 10%–20% of the adult population. 15 Lower-back pain is often the first or second most common reason for patients to see a physician. Lower-back pain and its association with golf has been reported, 3 , 5 , 13 but the return to golf specifically after back or other spine surgery has not been studied. Cervical and lumbar surgeries, including fusion, are common procedures. In the 5-year period between 2002 and 2006, spine fusion procedures alone numbered 328,426 in 20% of community

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Marco V. Corniola, Bertrand Debono, Holger Joswig, Jean-Michel Lemée, and Enrico Tessitore

of fast-track lumbar fusion procedures 32 have been published. As in abdominal surgery, the use of minimally invasive spine surgery (MISS) 33 preceded the introduction of ERAS in spine surgery. The essential aspects of ERAS in spine surgery are reviewed in this paper. Special consideration was given to the risks and benefits for patients and caregivers, as well as to the medical and economical aspects. Methods We systematically and comprehensively reviewed the published literature on ERAS using the search function in MEDLINE (US National Library of Medicine), the

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Nicolas Dea, Anne Versteeg, Charles Fisher, Adrienne Kelly, Dennis Hartig, Michael Boyd, Scott Paquette, Brian K. Kwon, Marcel Dvorak, and John Street

al. reported on 942 consecutive patients admitted to a quaternary care referral center undergoing spinal surgery and found that 87% had at least one documented AE. 17 The patient population represented all admissions undergoing any type of spine surgery, either emergency or elective. Campbell et al. 3 prospectively studied 128 patients undergoing thoracic and/or lumbar spine surgery at the neurosurgical spine unit of a university hospital and documented AEs occurring within the first 30 days of the operative procedure. They found that 59.4% of the patients