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The role of sagittal pelvic morphology in the development of adult degenerative scoliosis.

Eur Spine J 2021 Jul 22. Epub 2021 Jul 22.

Department of Orthopaedic Surgery, G05.228, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.

Purpose: Pelvic morphology dictates the alignment and biomechanics of the spine. Recent observations in different types of adolescent idiopathic scoliosis indicate that individual pelvic morphology is related to the spinal levels in which scoliosis develops: primary lumbar adolescent scoliosis is associated with a higher pelvic incidence (PI) than thoracic scoliosis and non-scoliotic controls. We hypothesize that adult degenerative scoliosis (ADS) of the lumbar spine follows the same mechanical principles and is associated with a high PI. Read More

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Same Day Surgical Intervention Dramatically Minimizes Complication Occurrence and Optimizes Perioperative Outcomes for Central Cord Syndrome.

Clin Spine Surg 2021 Jul 21. Epub 2021 Jul 21.

Department of Orthopaedics, NYU Langone Orthopedic Hospital, New York, NY Department of Pediatric Neurosurgery, UT Southwestern Medical Center, Dallas, TX Department of Neurologic Surgery, University of Michigan, Ann Arbor, MI Department of Orthopaedic Surgery, University of Calgary, Calgary, AB, Canada Department of Neurological Surgery Montefiore Medical Center/Albert Einstein College of Medicine Bronx, NY Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD Deparment of Orthopedic Surgery, SUNY Downstate, New York, NY.

Study Design: This was a retrospective cohort study.

Objective: The aim of this study was to investigate associations between time to surgical intervention and outcomes for central cord syndrome (CCS) patients.

Background: As surgery is increasingly recommended for patients with neurological deterioration CCS, it is important to investigate the relationship between time to surgery and outcomes. Read More

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Evaluating the results of long tubular bone distraction with an advanced rod monolateral external fixator for achondroplasia.

Sci Rep 2021 Jul 19;11(1):14727. Epub 2021 Jul 19.

Department of Pediatrician Surgery, NSC Astana Medical University, Nur-Sultan, Kazakhstan.

The work aimed to evaluate the effectiveness of the developed distraction system based on the rod external monolateral fixation mechanisms by comparing it with the classical technique of long tubular bones distraction based on the circular multi-axial system. The study included patients with a genetically confirmed diagnosis of achondroplasia. The experimental group consisted of 14 patients who underwent surgical limb lengthening by the rod monolateral external fixator with a distraction system developed by the authors. Read More

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Metastatic renal cell carcinoma to the spine: outcomes and morbidity. Single center experience.

World Neurosurg 2021 Jul 16. Epub 2021 Jul 16.

Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, 52242, USA. Electronic address:

Introduction: Renal cell carcinoma with metastases to the spine (RCCMS) requires a multidisciplinary approach. We reviewed our institutional experience with RCCMS patients undergoing spinal surgery in order to identify factors that may affect clinical outcomes, survival, and complications.

Methods: Patients with RCCMS who underwent operative intervention from 2007-2020 were reviewed retrospectively. Read More

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Protocol for Testing Yoga to Reduce Post-Lumbar Spine Surgery Pain: A Methodology Article.

Int J Yoga Therap 2021 Jul 19. Epub 2021 Jul 19.

Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center, Kansas City.

Currently, acute postoperative pain during hospitalization is primarily managed by medications, and patients must adhere to restrictive postoperative precautions for 3 months following lumbar spine surgeries. Yoga can be an alternative approach to assist in acute and subacute postoperative pain management, anxiety, and return to function. The purpose of the present work was to develop and test the feasibility and explore the effectiveness of a tailored yoga program, delivered in-person during the hospital stay and electronically after hospital discharge, as a potential new avenue for postoperative care. Read More

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Blockage of Drp1 phosphorylation at Ser579 protects neurons against Aβ‑induced degeneration.

Mol Med Rep 2021 Sep 19;24(3). Epub 2021 Jul 19.

Institute of Geriatrics, Affiliated People's Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China.

Alzheimer's disease (AD), one of the most common types of chronic neurodegenerative diseases, is pathologically characterized by the formation of amyloid β (Aβ) peptide‑containing plaques and neurofibrillary tangles. Among Aβ peptides, Aβ induces neuronal toxicity and neurodegeneration. In our previous studies, Cdk5 was found to regulate Aβ‑induced mitochondrial fission via the phosphorylation of dynamin‑related protein 1 (Drp1) at Ser579. Read More

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September 2021

Feasibility of anterior pedicle screw fixation in lumbosacral spine: a radiographic and cadaveric study.

Ann Transl Med 2021 Jun;9(12):968

Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.

Background: The anterior pedicle screw (APS) technique for L5 and S1 is crucial for proper anterior lumbar interbody fusion (ALIF). This study aimed to determine the projection, screw trajectory angle, and bone screw passageway length (BSPL), as well as the screw insertion regularity and the operating area within which it is safe to perform insertion.

Methods: Forty patients with low back pain, all of whom had lumbar computed tomography scans available, was included in this retrospective analysis. Read More

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Short term outcomes associated with patients requiring blood transfusion following elective laminectomy and fusion for lumbar stenosis: A propensity-matched analysis.

J Clin Neurosci 2021 Aug 10;90:184-190. Epub 2021 Jun 10.

Department of Neurosurgery, Rhode Island Hospital, Providence, RI, United States.

Perioperative blood transfusion has been associated with poor outcomes but the impacts of transfusion after fusion for lumbar stenosis have not been well-described. We assessed this effect in a large cohort of patients from 2012 to 2018 in the National Surgical Quality Improvement Program (NSQIP). We evaluated baseline characteristics including demographics, comorbidities, hematocrit, and operative characteristics. Read More

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Enhanced recovery after surgery pathway reduces the length of hospital stay without additional complications in lumbar disc herniation treated by percutaneous endoscopic transforaminal discectomy.

J Orthop Surg Res 2021 Jul 17;16(1):461. Epub 2021 Jul 17.

Department of Orthopaedic Surgery, Minhang Hospital, Fudan University, 170 Xin Song Road, Shanghai, People's Republic of China.

Background: Enhanced recovery after surgery (ERAS) pathway in spine surgery is increasingly popular which can reduce the length of hospital stay (LOS). However, there are few studies on the safety and effectiveness of ERAS pathway in the treatment of single-level lumbar disc herniation (LDH) by percutaneous endoscopic transforaminal discectomy (PETD). The aim of this study was to investigate whether ERAS can reduce LOS of patients with single segment LDH treated by PETD. Read More

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Morphometric analysis of cervical vertebrae in some marine and land mammals.

Anat Histol Embryol 2021 Jul 17. Epub 2021 Jul 17.

Phuket Marine Biological Center, Phuket, Thailand.

Bones or skeletal remains can be used to answer a number of questions related to species, sex, age or cause of death. However, studies involving vertebrae have been limited as most were performed on skulls or long bones. Here, we have stated the hypothesis that the morphometry of cervical vertebrae can be used for species identification and body size estimation among marine and land mammals. Read More

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Does minimally invasive spine surgery improve outcomes in the obese population? A retrospective review of 1442 degenerative lumbar spine surgeries.

J Neurosurg Spine 2021 Jul 16:1-11. Epub 2021 Jul 16.

2Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC; and.

Objective: The effect of obesity on outcomes in minimally invasive surgery (MIS) approaches to posterior lumbar surgery is not well characterized. The authors aimed to determine if there was a difference in operative variables and complication rates in obese patients who underwent MIS versus open approaches in posterior spinal surgery, as well as between obese and nonobese patients undergoing MIS approaches.

Methods: A retrospective review of all consecutive patients who underwent posterior lumbar surgery from 2013 to 2016 at a single institution was performed. Read More

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Osteological development of a small and fast metamorphic frog, Microhyla fissipes (Anura, Neobatrachia, Microhylidae).

J Anat 2021 Jul 15. Epub 2021 Jul 15.

CAS Key Laboratory of Mountain Ecological Restoration and Bioresource Utilization & Ecological Restoration Biodiversity Conservation Key Laboratory of Sichuan Province, Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu, China.

Describing osteological development is of great importance for understanding vertebrate phenotypic variations, form-functional transitions and ecological adaptations. Anurans exhibit dramatic changes in their morphology, habitat preferences, diet and behaviour between the tadpole and frog stages. However, the anatomical details of their cranial and postcranial development have not been extensively studied, especially in Microhylidae. Read More

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Percutaneous Endoscopic Interlaminar Discectomy with Modified Sensation-Motion Separation Anesthesia for Beginning Surgeons in the Treatment of L5-S1 Disc Herniation.

J Pain Res 2021 8;14:2039-2048. Epub 2021 Jul 8.

Department of Spine Surgery, Affiliated Hospital of Qingdao University, Qing'dao, Shandong Province, 266000, People's Republic of China.

Purpose: To compare the clinical effects of local anesthesia (LA), general anesthesia (GA) and modified sensation-motion separation anesthesia (MA) in percutaneous endoscopic interlaminar discectomy (PEID) in the treatment of L5/S1 lumbar disc herniation (LDH) for the purpose of guiding junior surgeons.

Methods: Eighty-four patients with L5/S1 LDH underwent PEID using three anesthesia methods. Patients in the LA (26), GA (29) and MA (29) groups received a follow-up examination retrospectively. Read More

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Effect of Surgical Setting on Cost and Hospital Reported Outcomes for Single-Level Anterior Cervical Discectomy and Fusion.

Int J Spine Surg 2021 Jul 15. Epub 2021 Jul 15.

Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.

Background: Hospitals seek to reduce costs and improve patient outcomes by decreasing length of stay (LOS), 30-day all-cause readmissions, and preventable complications. We evaluated hospital-reported outcome measures for elective single-level anterior cervical discectomy and fusions (ACDFs) between tertiary (TH) and community hospitals (CH) to determine location-based differences in complications, LOS, and overall costs.

Methods: Patients undergoing elective single-level ACDF in a 1-year period were retrospectively reviewed from a physician-driven database from a single medical system consisting of 1 TH and 4 CHs. Read More

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Understanding the Aorta-Spine Relation in Idiopathic Scoliosis: Value of Noncontrast CT-Derived Curved Coronal Reformats and 3D Volume Images.

Int J Spine Surg 2021 Jul 15. Epub 2021 Jul 15.

Department of Diagnostic and Interventional Radiology, Mansoura University, Faculty of Medicine, Mansoura, Egypt.

Background: Investigating axial position and longitudinal bending of the aorta in relation to spine curvature in adolescent idiopathic scoliosis patients could help surgeons in planning of spine surgeries.

Methods: Noncontrast computed tomography (CT) scans of 27 consecutive patients with adolescent idiopathic scoliosis (19 right and 8 left curves) and 16 control subjects were retrospectively reviewed. Using semiautomated software, centerline was drawn along the descending aorta, and curved reformat was generated. Read More

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The Effect of Esophageal Temperature Probes on Postoperative Dysphagia Following Primary Anterior Cervical Discectomy and Fusion: A Randomized Prospective Study.

Int J Spine Surg 2021 Jul 15. Epub 2021 Jul 15.

Department of Orthopaedic Surgery, George Washington University, Washington, DC.

Background: The anterior approach to the cervical spine is associated with postoperative dysphagia. It is difficult to predict which patients are most at risk for dysphagia. The objective of this study was to determine if placing an esophageal temperature probe preoperatively would affect the severity and length of postoperative dysphagia. Read More

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Botox Injections in Paraspinal Muscles Result in Low Maximal Specific Force and Shortening Velocity in Fast but not Slow Skinned Muscle Fibres.

Spine (Phila Pa 1976) 2021 Jul 7. Epub 2021 Jul 7.

Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada Korea Institute of Industrial Technology, Ansan, Gyeonggi, Republic of Korea Biomechanics Laboratory, School of Sports, Federal University of Santa Catarina, SC, Brazil.

Study Design: Basic science, experimental animal study.

Objective: To determine the effects of BTX-A injections on the mechanical properties of skinned muscle fibres (cells) of rabbit paraspinal muscles.

Summary Of Background Data: Botulinum toxin type A (BTX-A) has been widely used in the treatment of disorders of muscle hyperactivity, such as spasticity, dystonia, and back pain. Read More

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Dipeptidyl peptidase 4 contributes to Alzheimer's disease-like defects in a mouse model and is increased in sporadic Alzheimer's disease brains.

J Biol Chem 2021 Jul 12:100963. Epub 2021 Jul 12.

Université Côte d'Azur, INSERM, CNRS, IPMC, team labeled "Laboratory of Excellence (LABEX) Distalz", 660 route des Lucioles, 06560, Sophia-Antipolis, Valbonne, France. Electronic address:

The amyloid cascade hypothesis, which proposes a prominent role for full-length amyloid β peptides in Alzheimer's disease is currently being questioned. In addition to full-length amyloid β peptide, several N-terminally truncated fragments of amyloid β peptide could well contribute to Alzheimer's disease setting and/or progression. Among them, pyroGlu3-amyloid β peptide appears to be one of the main components of early anatomical lesions in Alzheimer's disease-affected brains. Read More

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Thoracic paravertebral nerve catheter reduces postoperative opioid use for vertebral body tethering patients.

Spine Deform 2021 Jul 15. Epub 2021 Jul 15.

Department of Orthopedic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, USA.

Purpose: Vertebral body tethering is increasingly being performed, yet postoperative pain management has not yet been optimized. We sought to determine whether the addition of a thoracic paravertebral block in addition to a standard multimodal postoperative pain management program could provide greater pain relief, reduced analgesic requirement, and reduced length of stay.

Methods: Patients who underwent VBT at a single tertiary referral center were retrospectively reviewed. Read More

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Use of a Standardized Perioperative Care Path for Adolescent Idiopathic Scoliosis Leads to Decreased Complications and Readmissions.

Clin Spine Surg 2021 Jul 14. Epub 2021 Jul 14.

Department of Neurosurgery, Cleveland Clinic Cleveland Clinic, Lerner College of Medicine Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH.

Study Design: Retrospective review of patients ages 10-18 who underwent posterior fusion for adolescent idiopathic scoliosis (AIS) at a single institution from 2014 to 2019.

Objective: The aim was to evaluate a standardized Care Path to determine its effects on perioperative outcomes in patients undergoing spinal fusion for AIS.

Summary Of Background Data: AIS is the most common pediatric spinal deformity and thousands of posterior fusions are performed annually. Read More

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Influence of microbiological diagnosis on the clinical course of spondylodiscitis.

Infection 2021 Jul 12. Epub 2021 Jul 12.

Division of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.

Purpose: This study sought to recognize differences in clinical disease manifestations of spondylodiscitis depending on the causative bacterial species.

Methods: We performed an evaluation of all spondylodiscitis cases in our clinic from 2013-2018. 211 patients were included, in whom a causative bacterial pathogen was identified in 80. Read More

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A deep learning approach to automatically quantify lower extremity alignment in children.

Andy Tsai

Skeletal Radiol 2021 Jul 13. Epub 2021 Jul 13.

Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.

Objective: To develop and validate a convolutional neural network (CNN) capable of predicting the anatomical landmarks used to calculate the hip-knee-ankle angles (HKAAs) from radiographs and thereby quantify lower extremity alignments in children.

Materials And Methods: A search of the image archive at a large children's hospital was conducted to identify full-length lower extremity radiographs performed in children (≤ 18 years old) for the indication of lower extremity alignment (7/2019-10/2019). A radiologist manually labeled each radiograph's six requisite anatomical landmarks used to measure HKAAs (bilateral centers of the femoral head, tibial spine, and tibial plafond) and defined the resultant labels as ground truth. Read More

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Computed tomography evaluation of proposed implant corridors in canine thoracic vertebrae.

Vet Surg 2021 Jul 12. Epub 2021 Jul 12.

Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA.

Objective: Identify acceptable implant corridors in the normal canine thoracic vertebrae (T) from T1 to T9.

Study Design: Retrospective study.

Sample Population: Computed tomographic (CT) studies of normal canine thoracic spines (n = 39). Read More

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Acta Ortop Bras 2021 Mar-Apr;29(2):97-100

Universidade de São Paulo, Ribeirão Preto School of Medicine, Department of Orthopedics and Anesthesiology, Ribeirão Preto, SP, Brazil.

Objective: To evaluate the reproducibility of a S2-alar iliac (S2AI) screw parameters measurement method by inter and intraobserver reliability.

Methods: Cross-sectional study, considering computed tomography exams. Morphometric analysis was performed by multiplanar reconstructions. Read More

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Understanding the effect of window length and overlap for assessing sEMG in dynamic fatiguing contractions: A non-linear dimensionality reduction and clustering.

J Biomech 2021 Jun 29;125:110598. Epub 2021 Jun 29.

Laboratory of Neuromechanics, Universidade Federal do Pampa, Uruguaiana, Brazil. Electronic address:

The Short-Time Fourier transform (STFT) is a helpful tool to identify muscle fatigue with clinical and sports applications. However, the choice of STFT parameters may affect the estimation of myoelectrical manifestations of fatigue. Here, we determine the effect of window length and overlap selections on the frequency slope and the coefficient of variation from EMG spectrum features in fatiguing contractions. Read More

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Efficacy and Safety of a Thrombin-Containing Collagen-based Haemostatic Agent in Spinal Surgery: A Randomized Clinical Trial.

World Neurosurg 2021 Jul 8. Epub 2021 Jul 8.

Department of Neurosurgery, Spine and Spinal Cord Institute, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea. Electronic address:

Objective: When common haemostatic methods, such as suturing, cautery, and compression, fail to arrest bleeding during surgery, various local haemostatic agents are used. We aimed to evaluate the haemostatic efficacy and safety of CollaStat® (Dalim Tissen Co. Ltd. Read More

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Diagnostic Value of Various Morphological Features of Horizontal and Vertical Laminar Fractures for Posterior Ligamentous Complex Injury of the Thoracolumbar Spine as Defined by Magnetic Resonance Imaging.

World Neurosurg 2021 Jul 7. Epub 2021 Jul 7.

Department of Neurosurgery, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.

Objective: To determine diagnostic value of morphological features of horizontal laminar fracture (HLF) and vertical laminar fracture (VLF) for diagnosis of posterior ligamentous complex (PLC) injury.

Methods: This retrospective review comprised 271 consecutive patients with acute thoracolumbar fractures presenting to a Level 1 trauma center between January 2014 and January 2021. Two reviewers evaluated computed tomography and magnetic resonance imaging. Read More

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Economic Burden of Hospitalizations Associated with Opioid Dependence Among Patients Undergoing Spinal Fusion.

World Neurosurg 2021 Jul;151:e738-e746

Mayo Clinic Neuro-Informatics Laboratory, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address:

Background: The current study seeks to examine the association between chronic opioid use and postoperative outcomes for patients undergoing anterior cervical discectomy and fusion (ACDF) and posterior lumbar fusion (PLF).

Methods: The National Inpatient Sample was queried for patients with and without chronic opioid use undergoing ACDF or PLF for degenerative disc disease between 2012 and 2015 using ICD-9 diagnosis and procedure codes. Multivariable conditional logistic regression was performed to assess the association between chronic opioid use and length of stay (LOS), nonhome discharge, and hospital charge. Read More

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Thoracolumbar Interfascial Plane Block Results in Opioid-Free Postoperative Recovery After Percutaneous/Endoscopic Transforaminal Lumbar Interbody Fusion Surgery.

World Neurosurg 2021 Jul 6. Epub 2021 Jul 6.

Morgenstern Institute of Spine, Centro Médico Quirón Teknon, Barcelona, Spain.

Objective: To evaluate efficacy in reducing postoperative pain and opioid analgesia of a novel interdisciplinary strategy combining preoperative thoracolumbar interfascial plane (TLIP) block and percutaneous/endoscopic transforaminal lumbar interbody fusion surgery and to determine time to first postoperative ambulation and hospital length of stay.

Methods: In this retrospective review, 42 patients who underwent elective single-level percutaneous/endoscopic transforaminal lumbar interbody fusion surgery between 2015 and 2021 were divided into 2 groups: TLIP group with 17 patients who underwent TLIP block and non-TLIP group with 25 patients. Both groups received the same postoperative analgesia with morphine as patient-controlled rescue medication. Read More

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How Much Benefit Can Patients Acquire from Enhanced Recovery After Surgery Protocols with Percutaneous Endoscopic Lumbar Interbody Fusion?

Int J Gen Med 2021 2;14:3125-3132. Epub 2021 Jul 2.

Department of Orthopedics, The Second Affiliated Xinqiao Hospital of Army Military Medical University, Chongqing, People's Republic of China.

Purpose: We aimed to explore the role of enhanced recovery after surgery (ERAS) in patients who underwent percutaneous endoscopic lumbar interbody fusion (PELIF).

Patients And Methods: We performed a retrospective, observational, cohort study on 91 patients who underwent PELIF for degenerative disc disease. The primary outcomes were postoperative opioid consumption, hospital length of stay (LOS), and hospital cost. Read More

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