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Volume 31: Issue 3 (Sep 2019): Pages 299-455
in Journal of Neurosurgery: Spine
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In Brief
The authors investigated the segmental range of motion (ROM) after cervical disc arthroplasty (CDA) and compared postoperative outcomes for patients with less versus patients with more preoperative ROM. An important finding was that preoperative segmental mobility did not alter the clinical outcomes of CDA, and therefore CDA is a reasonable treatment for patients with less segmental mobility.
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In Brief
This study assessed long-term (10-year) outcomes of cervical disc arthroplasty (CDA), or the use of an artificial disc to replace a degenerated spinal disc, as an alternative to surgical fusion. Knowledge of long-term CDA outcomes is important for the patient and clinician decision-making process when considering cervical disc surgery options.
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In Brief
The authors describe the microsurgical removal of ossification of the posterior longitudinal ligament (OPLL) in the middle thoracic level via the transthoracic anterolateral approach without spinal fusion, including the surgical outcome and operative tips. This surgical method might be the logical and ideal procedure to treat thoracic myelopathy caused by OPLL on the concave side of the spinal cord.
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In Brief
This is the first report to examine whether intraoperative ultrasound can be used to identify paravertebral anatomy in real time and evaluate its usefulness for the safety of lateral lumbar spine surgery.
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In Brief
L5–S1 stand-alone anterior lumbar interbody fusion is a well-established technique to treat symptomatic degenerative disc disease but remains controversial to treat isthmic spondylolisthesis. This retrospective cohort study identified the presence of spondylolisthesis and high pelvic incidence as risk factors of instrumentation failure, which was statistically linked to pseudarthrosis.
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In Brief
The authors report on an FDA-approved total disc replacement clinical trial. This paper furthers the science for the treatment of lumbar degenerative disc disease by providing additional long-term evidence of the safety and effectiveness of lumbar disc arthroplasty.
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In Brief
The article analyzes the radiological changes across 3 different age groups of patients with lumbar spinal stenosis. The study attempts to better identify the possible role of age in degenerative lumbar spine disease.
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In Brief
The authors studied the impact of length of stay (LOS) on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores of lumbar spine surgery patients. Importantly, the data showed that a prolonged LOS decreases the likelihood of higher HCAHPS scores following lumbar surgery. With this knowledge, hospitals and providers can study factors affecting LOS and identify ways to improve the quality and efficiency of care for patients at risk for extended LOSs.
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In Brief
The authors demonstrate a method of quantifying global spinal alignment measured using distance (cranial sagittal vertical axis to the ankle) and angular (cranium-ankle-sacral angle) measures. They think that these novel parameters are better radiographic measures to predict clinical outcomes in adult spinal deformity surgery than the presently used standard radiographic parameters.
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In Brief
The authors examined paraspinal muscle size as an independent risk factor for proximal junctional kyphosis (PJK). They found that smaller paraspinal muscle size increases the risk for PJK, suggesting that the size of the paraspinal musculature should be considered when selecting an upper instrumented vertebra in patients undergoing lumbar fusion.
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In Brief
Predictors for quality of life (QOL) outcomes following kyphoplasty and vertebroplasty were identified. Despite a mean improvement in QOL following these procedures, certain patient populations seemed to benefit more than others. This study is important because identification of predictors of QOL outcomes will enable physicians to more accurately educate their patients as to the expected outcomes of these procedures.
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In Brief
The authors examined the utility of neuromonitoring during deformity correction surgery, specifically when performing a 3-column osteotomy. Improved understanding of how to interpret signal changes may improve patient outcomes.
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In Brief
The authors examined the factors influencing patient satisfaction following corrective surgery for adult spinal deformity. They identify the factors that are moderately to strongly associated with patient satisfaction to prevent low satisfaction after surgery.
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In Brief
Using a “head on kyphus” surgical concept, with correction of sagittal malalignment by positioning the patient’s head above the kyphotic deformity on the sagittal plane, the authors treated late-onset neurological deficits in patients with post-tuberculous kyphotic deformity. This simple surgical concept is important because it allows deformity correction that can lead to cosmetic and functional improvements rather than aggressive sagittal curve correction.
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In Brief
The potential role of microbial colonization in patients with clinical pedicle screw loosening but without signs of infection was evaluated using sonication. A high frequency of low-virulent microorganisms was detected by sonication as a potential cause for implant failure.
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In Brief
This study evaluates the impact of negative-pressure wound therapy on the incidence of surgical site infection in spine surgery, and determines the associated risks. The findings of this study demonstrate that negative-pressure wound therapy application in patients undergoing high-risk spine surgery is safe and reduces surgical site infection. These preliminary data strongly support a role for prophylactic negative-pressure wound therapy in spine surgery, although further research is required.
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In Brief
The authors looked at differences in biomechanical and alignment outcomes after performing minimally invasive transforaminal interbody fusions on cadavers with differing amounts of bone removal. If patients can have improved biomechanical and alignment outcomes with more bone removal, it may be worth the extra risk and time of performing more bone removal during minimally invasive transforaminal interbody fusions.