Volume 32: Issue 2 (Feb 2020): Pages 155-333
in Journal of Neurosurgery: SpineImage from Tiwari et al. (pp 258–268).
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In Brief
This is the first study to investigate early cephalad adjacent segment degeneration following single-level posterior lumbar interbody fusion (PLIF) with cortical bone trajectory screw fixation for degenerative lumbar spondylolisthesis and to compare these results with those after single-level PLIF using traditional trajectory screw fixation for the same pathology.
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In Brief
The authors conducted an analysis of a prospective registry of patients who had undergone surgery for lumbar disc herniation. They determined whether late surgery is associated with worse outcomes and if there is a maximum time to surgery (waiting period) after which outcomes start to decline. It is vital to improve understanding of surgical timing and its influence on patient-reported outcomes. This knowledge is key to treatment planning, informed shared decision-making, and patient counseling.
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In Brief
The authors present a series of 11 patients with primary neck pain who underwent cervical spine fusion after a finding of facet osteoarthritis and a positive radionucleotide imaging study. Significant improvements in patient-reported neck pain and neck disability were found at 12-month follow-up. This case series represents the largest available to date and adds support to a growing body of evidence that suggests the usefulness of radionucleotide imaging for identification of a cervical facetogenic pain generator.
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In Brief
In a retrospective cohort study, the authors investigated the clinical and radiological differences between 3-level cer-vical disc arthroplasty (CDA) and 3-level anterior cervical discectomy and fusion (ACDF). The study is important because it demonstrated the effectiveness and efficacy of 3-level CDA, which, unlike ACDF, not only successfully preserved but also slightly increased the mobility at the 3 index levels.
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In Brief
The aim of this study was to use baseline demographic, clinical, and surgical factors to predict a poor overall outcome following cervical deformity (CD) corrective surgery. Identifying patient-specific factors that predict a poor outcome following CD surgery may help to improve patient outcomes.
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In Brief
The authors examined a 14-year series of patients who experienced C5 palsy following posterior cervical spine surgery. They investigated surgical and clinical predictors of the extent and timing of recovery following the onset of C5 palsy. They found that deltoid weakness at the time of C5 palsy diagnosis was the best predictor of both outcomes. The authors believe their results may be used by providers to help counsel and set expectations for patients suffering this complication.
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In Brief
The authors analyzed data from a series of patients who underwent surgery for thoracic ossification of the posterior longitudinal ligament (OPLL) and found that preoperative CT showed discontinuity between rostral and caudal ossified lesions in all but one of the patients. They compared measures of recovery in relationship to discontinuity or continuity of the OPLL at different postoperative time points and suggest that earlier postoperative development of continuity may be beneficial.
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In Brief
This study examines how surgeon experience affects perioperative complications and quality measures following thoracolumbar 3-column osteotomy (3CO) in adult spinal deformity. This study is important because it helps identify complications associated with 3CO early in a surgeon's career and helps understand when surgeons overcome the learning curve.
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In Brief
With new advances in minimally invasive surgery (MIS), the authors revised and updated the previously published MISDEF (minimally invasive spinal deformity surgery) algorithm. This updated algorithm was then validated. This is important because there is little consensus as to when MIS vs open surgery is appropriate. This algorithm provides a practical decision-making guide to practitioners.
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In Brief
The authors developed a novel prone positioning system able to cater to complex spine patients with advanced frailty and deformity, beyond the capacity of conventional prone positioning systems. This system allows surgery to be performed with the patient prone, eliminating the need for the sitting position, and moreover has marked benefits in terms of safety and economy.
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In Brief
Researchers from Johns Hopkins conducted a systematic review of operative and nonoperative management strategies for Scheuermann kyphosis. Correction and maintenance of correction were higher in the surgical intervention group than the bracing group. Of the surgical patients, there has been a recent trend toward the increased use of a posterior-only versus combined anterior-posterior approach. The posterior-only approach provides similar or superior correction compared to the anterior-posterior approach, along with a milder complication profile and identical maintenance of correction.
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In Brief
This study is one of the first retrospective reviews of an uncommonly used surgical procedure, T2 pedicle subtraction osteotomy, to treat cervicothoracic deformity.
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In Brief
This study aimed to determine if nerve transfer after long-term decentralization restores lower urinary tract function in canines. This study is important for patients who sustain spinal cord or cauda equina injuries that prioritize recovery of bladder function.
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In Brief
There is controversy about the role of scaffolds as an adjunctive therapy to mesenchymal stem cell (MSC) transplantation in spinal cord injury (SCI). The findings of this study showed that scaffolds + MSCs is more effective than scaffolds and MSCs alone in improving motor function following SCI in animal models, when used in the acute phase of injury.
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In Brief
Surgical site infection (SSI) remains a notable cause of postoperative morbidity and mortality with current operative techniques and antiseptic protocols, indicating a clear need for improved understanding and reduction of the risk factors. Over a 4-year period at a major institution, the authors determined the rate of deep SSI in 2252 consecutive patients. They demonstrated that male sex, coronary artery disease, and diabetes were associated with increased SSI, whereas the implementation of presurgical chlorhexidine showers reduced SSI.
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In Brief
Repair of spina bifida defects in utero does not benefit half of the children completely. This is typically due to incomplete closure of the defect. To improve on patient outcomes, a patch graft may be used. The authors found that patches made from cryopreserved human umbilical cords were superior in their healing properties to acellular dermal matrix patches. In summary, human umbilical cord patch repair of spina bifida defects may improve on patient outcomes.
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