Clinical Spine Surgery最新文献

{"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}

{"title":"Validation of PROMIS-PI in a Lumbar Decompression Cohort Through Correlation to Established Pain and Disability Metrics.","authors":"Fatima N Anwar, Jacob C Wolf, Andrea M Roca, Alexandra C Loya, Srinath S Medakkar, Aayush Kaul, Vincent P Federico, Arash J Sayari, Gregory D Lopez, Kern Singh","doi":"10.1097/BSD.0000000000001717","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001717","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review.</p><p><strong>Objective: </strong>To validate using patient-reported outcome measurement information system-pain interference (PROMIS-PI) to assess outcomes in patients undergoing lumbar decompression surgery compared with well-established pain and disability measures.</p><p><strong>Summary of background data: </strong>PROMIS outcomes provide valuable information, but the PROMIS-PI measure has not been validated in lumbar decompression.</p><p><strong>Methods: </strong>Patient data from a single-surgeon registry were queried to identify patients undergoing elective, primary lumbar decompression for disc herniation. Exclusion criteria included records missing patient-reported outcome measures (PROMs). PROMs included: PROMIS-PI, visual analog scale (VAS)-back, VAS-leg, and Oswestry disability index (ODI). The association between PROMIS-PI and the other PROMs was determined at preoperative, 6-week, 12-week, 6-month, 1-year, and 2-year time points using the Pearson paired correlation tests. MCID achievement rates were determined for all PROMs and correlations were calculated between PROMIS-PI MCID achievement rates and achievement rates for VAS-B, VAS-L, and ODI.</p><p><strong>Results: </strong>A total of 102 patients were included. PROMIS-PI demonstrated a significant correlation to VAS-B at all periods (P<0.0048, all) with a magnitude of correlation (|r|) ranging from 0.535 to 0.907. PROMIS-PI demonstrated a significant correlation to VAS-L at all periods (P<0.0048, all) with a magnitude of correlation (|r|) ranging from 0.393 to 0.907. PROMIS-PI demonstrated a significant correlation to ODI (P<0.0010, all) with a magnitude of correlation (|r|) ranging from 0.664 to 0.925. There were moderate correlations between MCID achievement rates between PROMIS-PI and all other PROMs studied (P<0.0019, all) with correlation coefficients ranging from 0.367 to 0.406.</p><p><strong>Conclusion: </strong>PROMIS-PI demonstrated a significant correlation to VAS-back, VAS-L, and ODI metrics at preoperative and all postoperative follow-up periods. PROMIS-PI as a valid tool for the evaluation of patient-reported pain provides an additional metric that can guide pain management in patients undergoing spine surgery.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881433","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":"Comparing Patient-Reported Outcomes in Patients Undergoing Lumbar Fusion for Degenerative Spondylolisthesis With Predominant Back Pain Versus Predominant Leg Pain Symptoms.","authors":"Aayush Kaul, Jacob C Wolf, Fatima N Anwar, Andrea M Roca, Ishan Khosla, Alexandra C Loya, Srinath S Medakkar, Kevin C Jacob, Madhav R Patel, Hanna Pawlowski, Alexander W Parsons, Nisheka N Vanjani, Michael C Prabhu, Vincent P Federico, Arash J Sayari, Gregory D Lopez, Kern Singh","doi":"10.1097/BSD.0000000000001705","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001705","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review.</p><p><strong>Objective: </strong>This study aims to compare postoperative patient-reported outcome measures (PROMs) in predominant back pain (PBP) versus predominant leg pain (PLP) patients following lumbar fusion for degenerative spondylolisthesis (DS).</p><p><strong>Summary of background data: </strong>Prior studies comparing PROMs in patients undergoing lumbar fusion with PBP versus PLP symptoms have included heterogeneous spinal pathology and restricted analysis to posterior fusion techniques.</p><p><strong>Methods: </strong>Demographics, perioperative characteristics, complications, and PROMs from a retrospective single-surgeon database were collected for primary, elective, and single-level lumbar fusion for DS. Preoperative/postoperative PROMs included visual analog scale (VAS)-back/leg pain (VAS-BP/VAS-LP), Oswestry disability index (ODI), 12-Item Short Form Physical and Mental Composite Score (SF-12 PCS/MCS), and Patient-Reported Outcome Measurement Information System-Physical Function (PROMIS-PF). Preoperative VAS-BP>VAS-LP established the PBP cohort and VAS-LP>VAS-BP established the PLP cohort. The average follow-up was 23.4±2.8 months. Improvement in PROMs (ΔPROM) at 6 weeks (ΔPROM-6W) and final follow-up (ΔPROM-FF) were calculated. χ2 and the Student t test analyzed categorical and continuous variables, respectively. Postoperative PROMs, ΔPROMs, and MCID achievement rates were compared between groups with multivariate linear or logistic regression.</p><p><strong>Results: </strong>In total, 166 patients were selected with 108 in the PBP cohort. Both cohorts saw improvements in all PROM scores over time. The PBP cohort reported significantly greater ΔPROM-6W and ΔPROM-FF for VAS-BP (P<0.003). The PLP cohort reported greater ΔPROM-6W and ΔPROM-FF for VAS-LP and ΔPROM-FF for SF-12 PCS (P<0.014). MCID achievement rates for VAS-BP were higher in the PBP cohort, and VAS-LP MCID achievement rates were higher in the PLP cohort (P<0.015).</p><p><strong>Conclusion: </strong>Regardless of predominant pain location, patients-reported improvements in all PROs at the final follow-up. Patients with PLP-reported greater improvement in leg pain and physical function and patients with PBP-reported greater back pain improvement.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876361","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":"Local Anesthesia With 1% Lidocaine Versus General Anesthesia for Percutaneous Endoscopic Interlaminar Discectomy at L5/S1 Disc Herniation​​​: A Prospective Randomized Study.","authors":"Xin Wang, Junjie Shen, Zhiheng Chen, Bin Cai, Yuanyuan Chen, Guowang Zhang, Jianguang Xu, Xiaofeng Lian","doi":"10.1097/BSD.0000000000001743","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001743","url":null,"abstract":"<p><strong>Study design: </strong>A prospective randomized clinical trial.</p><p><strong>Objective: </strong>In this study, we compared local anesthesia with 1% lidocaine (LA) and general anesthesia (GA) utilized in PEID at L5/S1 disc herniation.</p><p><strong>Summary of background data: </strong>Given the anatomic characteristics of L5/S1 segment, interlaminar approach was preferred to perform endoscopic discectomy for L5/S1 disc herniation. Typically, general anesthesia was used for interlaminar approach. However, with general anesthesia, nerve damage during surgery due to being unable to monitor patient status is a main concerned for surgeons. As an alternative option, local anesthesia has been developed recently. But, the optimal type of anesthesia for PEID remains controversial.</p><p><strong>Methods: </strong>From March 2021 to March 2023, 103 consecutive patients with L5/S1 disc herniation who planned to undergo PEID in our unit were randomized to the LA group (n=53) or GA group (n=50). Both groups were followed up for at least 24 months. Surgical-related parameters, clinical outcomes, and complications were compared between the 2 groups.</p><p><strong>Results: </strong>The mean operative time and bed rest time were shorter in the LA group than in the GA group (both P<0.001). The estimated blood loss in the LA group was greater than that in the GA group (P<0.001). The cost of hospitalization in the LA group was significantly lower than that in the GA group (P<0.001). At every time point of follow-up, there was no significant difference between the 2 groups in terms of VAS, ODI, and modified MacNab criteria. The satisfaction surveys showed that more patients in the LA group would choose contrary anesthesia, including 6 patients who were administered extravenously injected sufentanil intraoperatively due to intensive pain. Postoperative neuropathic abnormalities were rarer in the LA group.</p><p><strong>Conclusions: </strong>Both local anesthesia using 1% lidocaine and general anesthesia are effective and safe for PEID at the L5/S1 segment. The use of local anesthesia is preferable due to its associated reductions in operative time, bed rest duration, and economic costs.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799652","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":"A Comprehensive Exploration of Digital Twinning in Spine Surgery.","authors":"Nija Lomax, Shreya Vinjamuri, Sthavir Vinjamuri, Daniel Franco, Gregory Schroeder, James Harrop","doi":"10.1097/BSD.0000000000001748","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001748","url":null,"abstract":"<p><p>One recent innovation in the health care landscape is the integration of Digital Twin (DT) in the field of spine surgery. DT, first used in 2002 is defined as the replication of physical entities in a virtual environment. It has emerged as a transformative tool for optimizing complex systems. In this review, we delve into the intersection of DT and spine surgery, exploring how this symbiotic relationship is reshaping precision medicine. By creating virtual replicas of the spine and its intricate neural networks, surgeons gain insights into personalized patient care, preoperative planning, and postoperative analysis. This exploration tackles the potential impact of DT on neurosurgical procedures, emphasizing its role in enhancing surgical precision, improving patient outcomes, and pushing the boundaries of innovation in modern health care.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766936","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 Impact of Proton Pump Inhibitor Use on Fusion Rates Following Single-level Anterior Cervical Discectomy and Fusion.","authors":"Yu Chang, Chih-Yuan Huang, Ming-Tsung Chuang, Kuan-Yu Chi, Junmin Song, Hong-Min Lin","doi":"10.1097/BSD.0000000000001749","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001749","url":null,"abstract":"<p><strong>Study design: </strong>Cohort study.</p><p><strong>Objective: </strong>This study explores how proton pump inhibitors (PPIs) affect fusion rates following anterior cervical discectomy and fusion (ACDF), using a large-scale data analysis.</p><p><strong>Background: </strong>ACDF is essential for treating cervical disc herniation leading to myelopathy and radiculopathy, involving disc removal and vertebral fusion, crucial for long-term stability and symptom relief. Notably, PPIs, which are commonly prescribed for acid-related disorders, have been linked to altered bone health and healing processes.</p><p><strong>Materials and methods: </strong>Utilizing the TriNetX network database spanning from 2008 to 2023, we identified patients undergoing single-level ACDF, classified into cohorts based on PPI usage following ACDF. A 1:1 propensity score matching was performed to balance demographics and comorbidities between the two groups. The study focused on the incidence of non-fusion, indicated by the International Classification of Disease-10 code M96.0, within 6 months to 2 years postoperatively.</p><p><strong>Results: </strong>The initial cohort comprised 1269 PPI users and 23,932 non-users, adjusted to 1266 per group after matching. Postmatching analysis indicated minimal differences in demographics and comorbidities between the cohorts. Our results showed that postoperative PPI users have a significantly higher risk of non-fusion following single-level ACDF surgery at 1 year (odds ratio: 1.35, 95% CI: 1.05-1.73) and 2 years (odds ratio: 1.42, 95% CI: 1.11-1.81) follow-up.</p><p><strong>Conclusions: </strong>Our study showed a significant link between postoperative PPI use and increased long-term pseudarthrosis risk after ACDF surgery. These findings suggest careful consideration of PPI use in these patients.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766189","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":"Timelines for Return to Different Sports Types After Eight Cervical Spine Fractures in Recreational and Elite Athletes: A Survey of the Association for Collaborative Spine Research.","authors":"Nicole J Hung, Robert Trigg McClellan, Wellington Hsu, Serena S Hu, Aaron J Clark, Alekos A Theologis","doi":"10.1097/BSD.0000000000001607","DOIUrl":"10.1097/BSD.0000000000001607","url":null,"abstract":"<p><strong>Study design: </strong>Prospective cross-sectional survey.</p><p><strong>Objective: </strong>To identify timelines for when athletes may be considered safe to return to varying athletic activities after sustaining cervical spine fractures.</p><p><strong>Background: </strong>While acute management and detection of cervical spine fractures have been areas of comprehensive investigation, insight into timelines for when athletes may return to different athletic activities after sustaining such fractures is limited.</p><p><strong>Methods: </strong>A web-based survey was administered to members of the Association for Collaborative Spine Research that consisted of surgeon demographic information and questions asking when athletes (recreational vs elite) with one of 8 cervical fractures would be allowed to return to play noncontact, contact, and collision sports treated nonoperatively or operatively. The third part queried whether the decision to return to sports was influenced by the type of fixation or the presence of radiculopathy.</p><p><strong>Results: </strong>Thirty-three responses were included for analysis. For all 8 cervical spine fractures treated nonoperatively and operatively, significantly longer times to return to sports for athletes playing contact or collision sports compared with recreational and elite athletes playing noncontact sports, respectively ( P < 0.05), were felt to be more appropriate. Comparing collision sports with contact sports for recreational and elite athletes, similar times for return to sports for nearly all fractures treated nonoperatively or operatively were noted. In the setting of associated radiculopathy, the most common responses for safe return to play were \"when only motor deficits resolve completely\" and \"when both motor and sensory deficits resolve completely.\"</p><p><strong>Conclusions: </strong>In this survey of spine surgeons from the Association for Collaborative Spine Research, reasonable timeframes for return to play for athletes with 8 different cervical spine fractures treated nonoperatively or operatively varied based on fracture subtype and level of sporting physicality.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"E404-E414"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293011","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":"Full Endoscopic Bilateral Discectomy at L5/S1 Level: Technical Note of a Unilateral Uniportal Interlaminar Circum-dural Approach.","authors":"Xinchun Liu","doi":"10.1097/BSD.0000000000001690","DOIUrl":"10.1097/BSD.0000000000001690","url":null,"abstract":"<p><strong>Study design: </strong>Technical report.</p><p><strong>Objective: </strong>This report aimed to describe a 3-step unilateral uniportal interlaminar circum-dural approach for entire spinal canal inspection and bilateral discectomy at L5/S1 level.</p><p><strong>Summary of background data: </strong>Treatment of lumbar disc herniation with bilateral symptoms at L5/S1 level is complicated in full endoscopic surgeries. Unilateral interlaminar approaches have been used for bilateral discectomy at L5/S1 level through a uniportal ventral dural approach or a biportal dorsal dural approach. Despite the reporting of successful clinical outcomes, inspection and manipulation of the entire spinal canal via a unilateral approach remain challenging.</p><p><strong>Methods: </strong>The 3-step inspection of the entire spinal canal includes the ipsilateral side, the midline, and the contralateral side. Two typical cases are provided to further demonstrate the technique. In case 1, bilateral symptoms were caused by bilateral multifocal herniations. In case 2, bilateral symptoms were caused by a huge midline herniation.</p><p><strong>Results: </strong>The surgical purposes were achieved as intended in both of the 2 cases. The herniations were successfully removed and the pain was relieved immediately after surgery.</p><p><strong>Conclusions: </strong>As indicated by the preliminary application, the present technique, integrating the advantages of both the ventral and the dorsal dural approaches, is probably an ideal choice for bilateral discectomy at L5/S1 level.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":" ","pages":"482-488"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139516","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}