Clinical Spine Surgery最新文献

{"title":"Establishment of Scoring to Predict Severe Complication After Pyogenic Spondylodiscitis Surgery.","authors":"Yuichiro Ukon, Shota Takenaka, Hiromasa Hirai, Tsuyoshi Sugiura, Yusuke Sakai, Takahito Fujimori, Masayuki Furuya, Yuya Kanie, Seiji Okada, Takashi Kaito","doi":"10.1097/BSD.0000000000001756","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001756","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study using prospective database.</p><p><strong>Objective: </strong>This study aimed to establish a risk-scoring system for predicting severe complications after pyogenic spondylodiscitis surgery.</p><p><strong>Summary of background data: </strong>Pyogenic spondylodiscitis surgery can cause severe complications.</p><p><strong>Methods: </strong>Grades III, IV, and V complications in the CD classification were defined as severe complications. A predictive scoring system for severe complications was developed using 7 risk factors identified from a cohort of 143 PS surgery patients from January 2013 to December 2017 described in a previous study. External validation used a separate cohort of 70 patients from 9 institutions identified from January 2018 to December 2021.</p><p><strong>Results: </strong>This first study proposed a risk predictive scoring system for severe complications [updated Charlson comorbidity index (≥3), 2; chronic pulmonary disease, 3; diabetes, 1; Gram-negative bacteria, 3; pyogenic osteoarthritis, 3; preoperative white blood count (≥1.0×104/μL), 2; preoperative platelet count (≤2.4×105/μL), 2]. The scoring system could well predict severe complications [area under the receiver operating curve (AUROC) value of 0.851]. There was classification into 3 risk groups: low-moderate risk (≤4), high risk (5 or 6), and very high risk (≥7), further simplified by the scoring system. Complication rates were 5.2% (low-moderate), 40.1% (high), and 84.2% (very high). In addition, external validation showed a very good AUROC value of 0.820.</p><p><strong>Conclusions: </strong>We developed a simple, externally validated scoring system for predicting severe complications after pyogenic spondylodiscitis surgery that will be helpful for clinicians involved in informed consent and intensive care unit management of high-risk patients.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Preoperative Physical Function Scores on Outcomes After Single-level Cervical Disc Replacement.","authors":"Timothy J Hartman, James W Nie, Eileen Zheng, Keith R MacGregor, Omolabake O Oyetayo, Kern Singh","doi":"10.1097/BSD.0000000000001746","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001746","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>We aim to determine the influence of preoperative Patient-Reported Outcome Measurement Information System Physical Function (PROMIS-PF) scores on perioperative and postoperative outcomes, the latter determined through patient-reported outcome measures (PROMs) and the degree of achievement rates of minimum clinically important difference (MCID) following single-level cervical disc replacement (CDR).</p><p><strong>Background: </strong>Several studies have examined the relationship between preoperative PROMIS-PF as a prognostic factor for postoperative outcomes. Few studies have examined this relationship as it applies to CDR.</p><p><strong>Methods: </strong>Patients undergoing single-level CDR with preoperative PROMIS-PF scores were identified retrospectively using a single-surgeon database. Patients undergoing surgery for infection/fracture/malignancy were excluded. Patients were divided by mean preoperative PROMIS-PF score: lower-functioning (PROMIS-PF <40) and higher-functioning (PROMIS-PF ≥40). Patient-Reported Outcomes Measurement Information System (PROMIS-PF), 12-item Short Form Physical Component Score (SF-12 PCS), Visual Acuity Scale (VAS) scores for neck and arm, and Neck Disability Index scores, collected at preoperative, 6-week, 12-week, 6-month, and 1-year time points.</p><p><strong>Results: </strong>Fifty-seven patients were included with 33 considered higher functioning. Operative times were increased in the higher-functioning group (P = 0.003). The lower-functioning cohort saw improvement in all 6-week/12-week/6-month PROMs. The higher-functioning cohort saw improvement in all PROMs except SF-12 PCS. Between groups, the higher-functioning cohort reported greater postoperative PROMIS-PF at multiple time points, preoperative SF-12 PCS, 12-week/preoperative VAS-neck, and preoperative VAS-arm (P ≤ 0.036, all). The lower-functioning group had greater preoperative/6-week Neck Disability Index (P ≤ 0.027, all) and had greater MCID achievement at 6-month SF-12 PCS/12-week VAS arm (P ≤ 0.026, all).</p><p><strong>Conclusion: </strong>Independent of preoperative function, both groups reported improvement in all outcomes except for SF-12 PCS in the higher-functioning cohort. Between groups, the higher-functioning cohort had significantly better outcomes; however, this significance was not seen past 12 weeks for any PROM. MCID achievement rates were significantly greater in the lower-functioning group in the SF-12 PCS and VAS arm. Patients with lower preoperative PROMIS-PF scores may experience greater rates of clinically noticeable improvements in function/arm pain postoperatively.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient Multimodal Pain Regimens Do Not Impact Hospital Length of Stay or Long-term Postoperative Opioid Use Following 1 and 2-Level Lumbar Fusion.","authors":"Michael Carter, Rajkishen Narayanan, Gregory Toci, Yunsoo Lee, Sebastian Fras, Emma Hammelef, Shiraz Mumtaz, Tasha Garayo, Mark Kurd, Ian David Kaye, Jose Canseco, Alan Hilibrand, Alexander Vaccaro, Christopher Kepler, Gregory Schroeder","doi":"10.1097/BSD.0000000000001753","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001753","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To determine hospital length of stay (LOS) and long-term opioid consumption among patients who received inpatient multimodal analgesia following lumbar spine surgery, as opposed to those who received opioids alone.</p><p><strong>Summary of background data: </strong>Opioids have long been the historical choice for managing postoperative pain. The use of multimodal analgesia has become more commonplace in recent years as it is thought to achieve similar levels of pain control while simultaneously diminishing opioid consumption and decreasing LOS.</p><p><strong>Materials and methods: </strong>Patients who underwent 1 or 2-level lumbar fusion from 2018 to 2019 were included. Patients who received opioids on an as-needed basis were propensity-matched to a cohort who received multimodal analgesia based on demographics, surgical approach, and levels fused. LOS was collected for each patient. One year preoperative to 2 postoperative opioid use was obtained from the Pennsylvania Prescription Drug Monitoring Program and included total prescriptions and total morphine milligram equivalents (MMEs). A subanalysis was also performed comparing preoperative, perioperative, and postoperative tramadol consumption during this time frame.</p><p><strong>Results: </strong>A total of 69 patients received an opioid-only pain regimen, while 207 patients received multimodal analgesia. Patients receiving a multimodal pain regimen consumed a higher daily tramadol MME but a comparable total in-hospital MME to patients in the opioid-only cohort. No statistically significant differences existed between cohorts with regards to LOS, preoperative, perioperative, and postoperative opioid consumption, though multimodal patients consumed more tramadol from 0 to 30 days postoperatively.</p><p><strong>Conclusions: </strong>Patients who received a multimodal pain regimen consumed comparable quantities of opioids to those who received opioids alone and did not have a longer LOS following 1 and 2-level lumbar fusion.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Preoperative T1 Slope is a Marker for Global Sagittal Malalignment.","authors":"Fares Ani, Ethan W Ayres, Diann Woo, Dennis Vasquez-Montes, Avery Brown, Haddy Alas, Edem J Abotsi, Cole Bortz, Katherine E Pierce, Tina Raman, Micheal L Smith, Yong H Kim, Aaron J Buckland, Themistocles S Protopsaltis","doi":"10.1097/BSD.0000000000001734","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001734","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To develop parameter thresholds obtainable from cervical radiographs that correlate with concomitant thoracolumbar malalignment.</p><p><strong>Summary of background data: </strong>T1 slope (T1S) is typically discussed in the context of cervical deformity and correlated with health-related quality of life outcomes. Prior research suggests that T1S is related to global alignment; however, a definition for \"high\" T1S has not been established. Most patients undergoing cervical surgery do not undergo full-spine imaging; therefore, obtaining a parameter associated with thoracolumbar malalignment from cervical radiographs would be beneficial.</p><p><strong>Methods: </strong>A database of preoperative adult spinal deformity (ASD) patients was analyzed. Measures obtained from standing lateral radiographs included T1S, thoracic kyphosis (TK), sagittal vertical axis (SVA), T1-pelvic angle (TPA), pelvic tilt (PT), and pelvic incidence minus lumbar lordosis (PI-LL). Decision tree analysis was then used to determine the T1S corresponding to published thresholds for high TK (40 degrees), SVA (40 mm), TPA (25 degrees), and PT (25 degrees). Alignment between high and normal T1S patients was compared.</p><p><strong>Results: </strong>Two hundred twenty-six preoperative patients were included (mean: 58±16 y 62%F). Larger T1S was correlated with greater SVA (r=0.365), TPA (r=0.302), TK (r=0.606), and PT (r=0.230) (all P<0.001). Decision tree analysis yielded a threshold of 30 degrees for high T1S, which 50% of patients had. Compared with patients with T1S <30 degrees, those with T1S >30 degrees had higher TK (41.5 vs. 25.8 degrees), SVA (78.7 vs. 33.7 mm), TPA (27.6 vs. 18.3 degrees), and PT (26.3 vs. 20.8 degrees), and PI-LL (18.2 vs. 11.7 degrees) (all P<0.05). Seventy-nine percent of patients with high T1S had high TK (T1S <30=13%), 69% had high SVA (T1S <30=38%), 66% had high TPA (T1S <30=37%), 60% had PT >25 degrees (T1S <30=42%), and 47% had PI-LL >20 degrees (T1S <30=34%) (all P<0.05).</p><p><strong>Conclusion: </strong>Higher T1S was associated with worse global alignment. T1S was most strongly associated with TK. A T1S=30 degrees corresponded to high TK, SVA, TPA, and PT thresholds. Therefore, surgeons should consider obtaining full-spine radiographs if a T1S >30 degrees is present on cervical imaging.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perseverance of Optimal Realignment is Associated With Improved Cost-utility in Adult Cervical Deformity Surgery.","authors":"Peter G Passias, Tyler K Williamson, Jordan Lebovic, Andrew Eck, Andrew J Schoenfeld, Claudia Bennett-Caso, Stephane Owusu-Sarpong, Heiko Koller, Lee Tan, Robert Eastlack, Thomas Buell, Renaud Lafage, Virginie Lafage","doi":"10.1097/BSD.0000000000001759","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001759","url":null,"abstract":"<p><strong>Background: </strong>Early-term complications may not predict long-term success after adult cervical deformity (ACD) correction.</p><p><strong>Objective: </strong>Evaluate whether optimal realignment results in similar rates of perioperative complications but achieves longer-term cost-utility.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>ACD patients with 2-year data included. Outcomes: distal junctional failure (DJF), good clinical outcome (GCO):[Meeting 2 of 3: (1) NDI>20 or meeting MCID, (2) mJOA≥14, (3)NRS-Neck improved≥2]. Ideal Outcome defined as GCO without DJF or reoperation. Patient groups were stratified by correction to 'Optimal radiographic outcome', defined by cSVA 9 (<40 mm) AND TS-CL (<15 deg) upon correction. Cost calculated by CMS.com definitions, and cost-per-QALY was calculated by converting NDI to SF-6D. Multivariable analysis controlling for age, baseline T1-slope, cSVA, disability, and frailty, was used to assess complication rates, clinical outcomes, and cost-utility based on meeting optimal radiographic outcome.</p><p><strong>Results: </strong>One hundred forty-six patients included: 52 optimal radiographic realignment (O) and 94 not optimal (NO). NO group presented with higher cSVA and T1-slope. Adjusted analysis showed O group suffered similar 90-day complications (P>0.8), but less DJK, DJF (0% vs. 18%; P<0.001) and reoperations (18% vs. 35%; P=0.02). Patients meeting optimal radiographic criteria more often met Ideal outcome [odds ratio: 2.2, (1.1-4.8); P=0.03]. Despite no differences in overall cost, O group saw greater clinical improvement, translating to a better cost-utility [mean difference: $91,000, ($49,000-$132,000); P<0.001].</p><p><strong>Conclusion: </strong>Despite similar perioperative courses, patients optimally realigned experienced less junctional failure, leading to better cost-utility compared with those sub-optimally realigned. Perioperative complication risk should not necessarily preclude optimal surgical intervention, and policy efforts might better focus on long-term outcome measures in adult cervical deformity surgery.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior Cervical Discectomy and Fusion Versus Cervical Corpectomy With Iliac Crest Graft and Fusion in Multilevel Degenerative Myelopathy: A Single Center Experience.","authors":"Claudio A Rivas Palacios, Mario M Barbosa, María A Escobar, Ezequiel Garcia-Ballestas, Camilo García, Salvador M Mattar, Salvador Mattar","doi":"10.1097/BSD.0000000000001754","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001754","url":null,"abstract":"<p><strong>Study design: </strong>Cohort retrospective study.</p><p><strong>Objective: </strong>We evaluated and compared the outcomes of anterior cervical discectomy with fusion (CDF) and anterior cervical corpectomy with iliac crest graft and fusion (CCF) in patients with ≥3 level degenerative cervical myelopathy (DCM).</p><p><strong>Background: </strong>Anterior and posterior approaches are widely employed in DCM when compressive elements predominate in the anterior or posterior spinal cord, respectively. Indications for each approach remain controversial in some contexts.</p><p><strong>Methods: </strong>Following the STROBE statement, a retrospective enrollment from records of patients who underwent anterior CDF and/or CCF between June 2015 and June 2022. Linear mixed models were applied to establish the effects of the type of surgery according to the follow-up time (mo).</p><p><strong>Results: </strong>In this study, 73 patients met the inclusion criteria, of which 21 (28.8%) were included in the CDF group and 52 (71.2%) in the CCF group. Twenty surgeries were performed at 3 cervical levels and 53 at 4 levels. There was an improvement in the NDI and VAS score, with an Odom mean of 1.63±0.67 at 12 months of follow-up, with no differences between CDF and CCF. In the CDF group, it was reported a greater C2-7 Cobb angle at the third month of follow-up. In the CCF group, the C2-7 Cobb angle had a negative correlation with the NDI and VAS scales, and a positive correlation with the mJOA scale. Intraoperative estimated blood loss (EBL), surgical time, and postoperative hospital stay were shorter in CDF. There were no differences between the 2 groups in medical complications and other radiologic findings.</p><p><strong>Conclusion: </strong>Surgery for multilevel DCM using an anterior approach with CDF or CCF showed good clinical outcomes without significant differences between the 2 groups, and equivalent results in medical complications and radiologic parameters. The CDF group had better perioperative results and shorter postoperative hospitalization time.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anesthesia and Pain Management for Scoliosis Surgery: A Narrative Review.","authors":"Małgorzata Reysner, Grzegorz Kowalski, Alicja Geisler-Wojciechowska, Tomasz Resyner, Katarzyna Wieczorowska-Tobis","doi":"10.1097/BSD.0000000000001758","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001758","url":null,"abstract":"<p><strong>Study design: </strong>This was a narrative review.</p><p><strong>Objective: </strong>The objective of this review was to summarize the current evidence and knowledge gaps regarding anesthesia and pain management for scoliosis surgery, including multimodal analgesia, and identify the best anesthetic approach to scoliosis surgery that ensures patient safety and pain relief even in the postoperative period, with minimal influence on SSEP monitoring.</p><p><strong>Summary of background data: </strong>Spinal surgeries and fusions for scoliosis are associated with high pain levels. Inadequate analgesia can cause patient dissatisfaction, delay recovery, and increase the risk of chronic pain. Despite serious side effects, opioids are the mainstay of pain medication after scoliosis surgery. However, increasing emphasis on minimizing opioids and accelerating recovery has increased the adoption of multimodal analgesic therapy.</p><p><strong>Materials and methods: </strong>The literature review was performed on standards of care, a pain management protocol, current therapeutic options, and innovative treatment options for patients undergoing scoliosis surgery. The literature was reviewed through 4 electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase.</p><p><strong>Results: </strong>The initial search yielded 994 articles. Forty-seven relevant articles were selected based on relevance, recentness, search quality, and citations. Ten studies described the influence of different methods of anesthesia on neuromonitoring. Twenty-one researchers studied the effect of analgesics and coanalgesics on pain relief protocol. Nine studies treated regional anesthesia and its influence on pain management.</p><p><strong>Conclusions: </strong>The most suitable anesthetic approach that does not disturb the neuromonitoring is obtained by combining total intravenous anesthesia (TIVA) with remifentanil and propofol with regional anesthesia, particularly erector spinae plane block (ESPB), as a part of a multimodal analgesia protocol.</p><p><strong>Level of evidence: </strong>Level II.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Recovery in Severe Adolescent Idiopathic Scoliosis (AIS) Patients With Cobb Angle ≥90 Degrees Undergoing Single-staged Posterior Spinal Fusion (PSF): Evaluating the Feasibility of Rapid Recovery Protocol (RRP).","authors":"Saturveithan Chandirasegaran, Chris Yin Wei Chan, Chee Kidd Chiu, Siti Mariam Mohamad, Mohd Shahnaz Hasan, Mun Keong Kwan","doi":"10.1097/BSD.0000000000001755","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001755","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objective: </strong>To assess the feasibility and outcome of rapid recovery protocol (RRP) in severe adolescent idiopathic scoliosis (AIS) patients with Cobb angle ≥90 degrees underwent single-staged posterior spinal fusion (PSF).</p><p><strong>Summary of background data: </strong>Corrective surgeries in severe AIS patients entail a higher risk of prolonged operation, excessive bleeding, extended hospital stay, and higher complication rates compared with non-severe AIS patients. Implementation of RRP among severe AIS patients has not been reported.</p><p><strong>Methods: </strong>Thirty-seven severe AIS patients who underwent single-staged PSF surgery from 2019 to 2022 were recruited. The RRP consisted of a preoperative regime and counselling, intraoperative strategies to reduce operation duration and blood loss and an accelerated postoperative rehabilitation pathway. Outcome measures were operative time, blood loss, postoperative pain scores, patient-controlled analgesia (PCA) morphine usage, length of hospital stay, and recovery milestones. Descriptive statistics were reported in mean (SD) for numerical data, whereas categorical data were presented in n (%).</p><p><strong>Results: </strong>The mean operation duration was 173.5±39.4 minutes, and the mean blood loss was 1064.6±473.3 mL. The average postoperative hospital stay was 3.2±0.6 days. Twelve hours post-operation pain score was 4.0±2.0 and reduced to 3.9±1.6 at 48 hours. 78.4% of patients discontinued their PCA at 48 hours. First liquid intake was at 6.3±8.5 hours, whereas solid food consumption was initiated at 23.4±14.2 hours. The urinary catheter was removed at 17.8±7.6 hours. Patients started ambulation at 24±12.7 hours, first passed flatus at 37.7±20.4 hours and had their first bowel movement at 122.1±41.7 hours. Three complications (8.1%) were reported, which included superficial surgical site infection, proximal wound stitch abscess and superficial thermal injury due to forced air-warming blanket.</p><p><strong>Conclusion: </strong>The implementation of the RRP after PSF in severe AIS patients was feasible and resulted in a short postoperative hospital stay of 3.2 days without increasing the risk of major complications, readmissions, and reoperations.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Risk of Intravenous Cement Leakage and Short-term Outcomes of Selective Cement-augmented Pedicle Screws: A Multicenter Retrospective Study.","authors":"Shinji Takahashi, Daisuke Sakai, Shota Ogasawara, Ryo Sasaki, Masato Uematsu, Takahiko Hyakumachi, Akihiko Hiyama, Hiroyuki Katoh, Hidetomi Terai, Akinobu Suzuki, Koji Tamai, Hiroaki Nakamura, Mitsuru Yagi","doi":"10.1097/BSD.0000000000001757","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001757","url":null,"abstract":"<p><strong>Study design: </strong>Multicenter retrospective cohort study.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of using cement-augmented pedicle screw (CAPS) fixation only for the cephalad and caudal vertebral bodies.</p><p><strong>Summary of background data: </strong>Pedicle screw fixation is less effective in patients with low-quality bone. Although CAPS fixation has shown promise in improving stability and reducing screw loosening in such cases, cement leakage can have serious consequences.</p><p><strong>Methods: </strong>This study included 65 patients who underwent spinal surgery using CAPS and were followed up for >3 months. Four CAPSs were used in each patient, and 254 CAPSs were included in the analysis.</p><p><strong>Results: </strong>Of the 65 patients, 36.9% showed intravenous cement leakage, and a low bone mineral density (BMD) was associated with a higher risk of cement leakage. The use of a CAPS on the right side was also potentially associated with a higher risk of leakage. However, the shape and location of the leaked cement remained stable over time. Screw loosening occurred in 3.5% of the CAPSs and was associated with a lower cement volume.</p><p><strong>Conclusion: </strong>Cement leakage was related to lower BMD. Using CAPS exclusively at the lower or upper instrumentation levels might minimize the risk of cement leakage in osteoporotic patients.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Altmetric Attention Scores in Evaluating the Influence of Spine Surgery Research.","authors":"Omar Tarawneh, Rajkishen Narayanan, Jonathan Dalton, Robert J Oris, Parker Brush, Olivia Opara, Delano Trenchfield, Yunsoo Lee, Amar Vadhera, Abbey Glover, Nathaniel Pineda, Pranav Jain, Andrew Kim, Mark F Kurd, Ian D Kaye, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder","doi":"10.1097/BSD.0000000000001751","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001751","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Objective: </strong>To analyze the annual trends in the most prevalent topics, journals, and geographic regions of the top 100 spine surgery articles, as determined by altmetric attention scores (AASs). We also describe the relationship between AAS and traditional article metrics.</p><p><strong>Background: </strong>The rapid growth of social media has transformed how medical literature is disseminated and perceived, including within the field of spine surgery. AAS is a metric that characterizes an article's reach and impact in various online sources.</p><p><strong>Materials and methods: </strong>We reviewed the Altmetric database to identify the top 100 spine surgery articles by AAS from 2015 to 2020 across 8 leading spine journals. Article topics, geographic origins, and publishing journals were analyzed. Correlation analyses were performed between AAS and traditional metrics.</p><p><strong>Results: </strong>Five hundred forty-one studies met the inclusion criteria. The majority were published in Spine (34.4%), TheSpine Journal (25.7%), European Spine Journal (15.0%), and Journal of Neurosurgery: Spine (14.2%). North America and Europe were the predominant regions of origin. The most common topics were injections (12.2%), diagnostics (11.8%), and complications (11.3%). A weak correlation was found between AAS and traditional metrics such as impact factor (Pearson coefficient = 0.041), total citations (0.051), and citations per year (0.048).</p><p><strong>Conclusions: </strong>Although AAS provides insights into the public and online engagement of articles, it shows only a weak correlation with traditional metrics. Therefore, AAS should be considered a complementary metric for gauging the impact of research. In the era of social media, authors should continue to promote their research to broaden readership, however further investigation into characterizing article impact is warranted.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}