Journal of Craniovertebral Junction and Spine最新文献

{"title":"Navigation-assisted occipitocervical fixation and decompression in a patient with polyostotic fibrous dysplasia.","authors":"Yoshitaka Nagashima, Yusuke Nishimura, Takashi Abe, Ryuta Saito","doi":"10.4103/jcvjs.jcvjs_104_24","DOIUrl":"10.4103/jcvjs.jcvjs_104_24","url":null,"abstract":"<p><p>Fibrous dysplasia (FD) is a rare skeletal disorder characterized by the replacement of normal bone with fibrous connective tissue, leading to abnormal bone formation. This case report details the successful treatment of a 61-year-old woman with FD at the craniovertebral junction (CVJ). The patient, who had a history of intracranial meningioma and had already been diagnosed with FD, experienced worsening gait disturbance and muscle weakness following a fall. Imaging studies revealed extensive polyostotic FD lesions in the skull and cervical spine, along with a C2 odontoid fracture causing spinal cord compression. The patient underwent occipitocervical fixation and decompression surgery. Intraoperative O-arm navigation was used to ensure accurate screw placement and effective decompression. This procedure allowed for proper positioning of the C2 and C3 pedicle screws, resection of the hyperplastic occipital bone and C1 posterior arch, and placement of the occipital plate with avoiding the cyst components. At a 2-year follow-up, there were no signs of screw loosening, and the patient showed marked clinical improvement. This case emphasizes the importance of tailored surgical strategies and the use of advanced navigational technologies in managing complex FD cases, particularly those involving the CVJ. It also highlights the challenges of treating polyostotic FD, where complete resection is often unfeasible. The successful outcome in this case supports the use of decompressive surgery combined with stabilization to relieve symptoms and prevent further complications.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"380-383"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographics in the context of health-care delivery for C1 and C2 fractures.","authors":"Lauren C Ladehoff, Kevin T Root, Marco Foreman, Jeffrey B Brown, Paul Bryce Webb, Michael J Diaz, Kamil Taneja, Karan Patel, Brandon Lucke-Wold, Robert P Wessel","doi":"10.4103/jcvjs.jcvjs_66_24","DOIUrl":"10.4103/jcvjs.jcvjs_66_24","url":null,"abstract":"<p><strong>Introduction: </strong>Atlas and axis fractures are the most severe cervical fractures which may result in complete paralysis or death. The purpose of the current study is to identify disparities regarding length of stay (LOS), mortality, and demographic factors in patients with the most serious cervical spine fractures utilizing a nationally representative database.</p><p><strong>Materials and methods: </strong>The Nationwide Emergency Department Sample was utilized to provide a representative sample for patients with a primary diagnosis of C1 or C2 fracture presenting to emergency departments in years from October 2015 to December 2019. A multivariable logistic regression model was used to estimate LOS for different patient demographics, including gender, race, and age.</p><p><strong>Results: </strong>A weighted sample of 7,262,791 patients presented to emergency rooms in the United States between 2015 and 2019. The mean age at admission was 76 years old, 52.6% of patients were female, and 83.0% identified as white. Patients between 45 and 65 and patients over 65 were significantly more likely to have an increased LOS. Women were less likely to have an increased LOS than men. Patients identifying as Black were significantly more likely to have increased LOS over white patients. In addition, patients who had an increased LOS were more likely to die in the hospital than patients with a shorter LOS.</p><p><strong>Conclusion: </strong>This study provides patient characteristics that help providers determine patient risk factors for increased hospital LOS and in-hospital mortality for those suffering from C1 and C2 fractures. Clinicians should be made aware of these disparities to allow equitable delivery of care.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"331-337"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catastrophic spontaneous spinal epidural hematoma following thrombolysis: An intersection of neurosurgical and cardiological challenges - An institutional experience.","authors":"Tushar V Soni, Shreyansh J Patel, Varshesh K Shah, Kavan M Joshipura","doi":"10.4103/jcvjs.jcvjs_62_24","DOIUrl":"10.4103/jcvjs.jcvjs_62_24","url":null,"abstract":"<p><p>Catastrophic spontaneous spinal epidural hematoma (SSEH) following thrombolysis poses a complex intersection of neurosurgical and cardiological challenges. This case report presents the institutional experience of a 66-year-old female who developed rapid-onset compressive myelopathy after thrombolysis for inferior wall myocardial infarction with injection streptokinase. SSEH, although rare, demands prompt recognition due to its potential for permanent neurologic injury and mortality. The discussion highlights the clinical significance, anatomical considerations, and multidisciplinary approach requisite for accurate diagnosis and effective management of SSEH. The conclusion underscores the necessity for clinicians, particularly cardiologists administering thrombolytic therapies, to consider SSEH in postthrombolysis patients presenting with neurological deficits.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"371-374"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do low-density screws influence pelvic incidence in adolescent idiopathic scoliosis correction?","authors":"Ahmed Maher Sultan, Walid El Nawawy, Mohammed Ahmad Dawood, Wael Tawfik Koptan, Yasser Elmiligui, Ahmed Samir Barakat, Khaled Ahmed Fawaz","doi":"10.4103/jcvjs.jcvjs_52_24","DOIUrl":"10.4103/jcvjs.jcvjs_52_24","url":null,"abstract":"<p><strong>Background: </strong>Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes.</p><p><strong>Patients and methods: </strong>This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10-16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30).</p><p><strong>Results: </strong>A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle.</p><p><strong>Conclusions: </strong>Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"315-320"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining autocorrection of concurrent cervical malalignment following thoracolumbar deformity surgery.","authors":"Anthony Yung, Oluwatobi Onafowokan, Ankita Das, Max R Fisher, Peter Gust Passias","doi":"10.4103/jcvjs.jcvjs_109_24","DOIUrl":"10.4103/jcvjs.jcvjs_109_24","url":null,"abstract":"<p><strong>Aims: </strong>The aim of the study was to assess preoperative radiographic parameters predictive of cervical deformity (CD) autocorrection in patients undergoing thoracolumbar deformity (ASD) surgery.</p><p><strong>Study design/setting: </strong>This was a retrospective cohort study.</p><p><strong>Methods: </strong>Inclusion criteria were operative ASD patients with complete baseline (BL) and 2-year radiographic data. Patients with cervical fusion during index surgery, revision involving cervical fusion, and those who developed proximal junctional kyphosis by 2-year postoperative were excluded from the study. If patients met CD criteria at BL but not at 6 weeks or 2 years postoperatively, they were considered autocorrected (AC).</p><p><strong>Statistical analysis used: </strong>Descriptive and univariate analysis, binominal logistic regression, and multivariable backward stepwise regression.</p><p><strong>Results: </strong>Two hundred and twenty ASD patients were included. 51.4% of patients had preoperative CD. By 6-week postoperative, 32.7% achieved AC. At 2 years, 24.8% of preoperative CD patients obtained AC. 2-year AC patients had lower BL sacral slope, lumbar lordosis (LL), T1 slope, cervical lordosis (CL), and C2-T3, and T2-T12 kyphosis (all P < 0.05). Patients with BL-unmatched Roussouly types are corrected postoperatively and are more likely to experience autocorrection at 1 year (45.2% vs. 19.0%; P = 0.042) and at 2 years (31% vs. 4.8%; P = 0.018). Multivariable analysis revealed that patients with BL-mismatched Roussouly types were corrected postoperatively and showed a significant increase in likelihood of AC at 1 year (odds ratio [OR]: 18.72; P = 0.029) and 2 years (OR: 8.5; P = 0.047). Similarly, BL LL (OR: 0.772; P = 0.003) and CL (OR: 0.829; P = 0.005) exhibited significant predictive value for autocorrection at 1 year and 2 years (OR: 0.927; P = 0.004 | OR: 0.942; P = 0.039; respectively).</p><p><strong>Conclusions: </strong>Autocorrection is more likely in patients with postoperatively corrected Roussouly types, those with lower BL cervical, and LL. Given these findings, it may not be necessary to routinely extend reconstruction into the cervical spine for ASD patients with similar characteristics to those in this study.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"347-352"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes after spinal surgery for metastatic breast cancer: A single-center analysis.","authors":"Nicole Iafigliola Gomes, Rômulo Augusto Andrade de Almeida, Andrei Fernandes Joaquim","doi":"10.4103/jcvjs.jcvjs_59_24","DOIUrl":"10.4103/jcvjs.jcvjs_59_24","url":null,"abstract":"<p><strong>Background: </strong>Advances in detection and breast cancer treatment lead to higher survival rates, with more patients living with spine metastases. Those surgeries are palliative; however, they can improve the quality of life (QOL).</p><p><strong>Objective: </strong>The aim of this study is to report pain and neurological function outcomes after surgery for spinal metastatic disease of breast cancer patients of a single institution. Complications were recorded.</p><p><strong>Materials and methods: </strong>A retrospective, single-center, single-arm study was performed. Consecutive patients who underwent spinal surgery were included. We analyzed demographic, surgical, histopathological, and clinical data.</p><p><strong>Results: </strong>Seventeen women were included. Three patients (17.6%) did not present pre- and postoperative pain (n = 3), 6 (35.3%) had pain in both situations, and 8 (47.1%) were pain-free postoperatively (P = 0.013). Ten (58.8%) patients had preoperative deficits: 3 (30%) did not improve and 7 (70%) improved after surgery. Six cases (35.2%) did not present preoperative deficits and did not get worse (n = 6). The Frankel classification after the following time showed that 11 patients (64.7%) remained stable after surgery and 5 patients (29.4%) got better. A single patient (5.6%) had deterioration of strength. Two patients (11.7%) had intraoperative complications.</p><p><strong>Conclusions: </strong>Pain was significantly improved by surgery, with also a possibly positive effect on functionality. Considering the low complication rates, surgery is still a useful tool in the management of spinal metastases in breast cancer patients and may be related to better QOL.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"284-289"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumbar offset distance: A simplified metric for evaluation of the lumbar spine alignment.","authors":"Kapil Shirodkar, Sai Niharika Gavvala, Sisith Ariyaratne, Nathan Jenko, Neha Nischal, Karthikeyan P Iyengar, Jwalant Mehta, Rajesh Botchu","doi":"10.4103/jcvjs.jcvjs_40_24","DOIUrl":"10.4103/jcvjs.jcvjs_40_24","url":null,"abstract":"<p><strong>Background: </strong>A healthy lower back is essential for optimal spinal function and overall wellness. Magnetic resonance imaging (MRI) has become the gold standard in assessing lumbar spine disease. This article aims to evaluate the precision and efficacy of the lumbar offset distance (LOD) as a novel MRI parameter designed to determine the lumbar spine alignment. normally measured as we compared it to a new parameter based on length.</p><p><strong>Materials and methods: </strong>Supine sagittal magnetic resonance images of 101 patients who underwent lumbar spine MRI scans were analyzed. We focused on L1-L5 lumbar lordosis angle (LLA) and LOD to assess lumbar spine alignment. Diagnostic cutoff values for LOD measurements were determined, and their diagnostic accuracies were evaluated.</p><p><strong>Results: </strong>The normal LLA in our dataset was 23°-45°, and the normal LOD was 5-15 mm. Using linear regression, the range of 6-14 mm correlates to the LLA range of 20°-45°, which would define the standard lumbar offset as normal between 6 and 14 mm. Hence, lumbar hypolordosis was defined as <6 mm, and lumbar hyperlordosis was defined as more than 14 mm. Our study showed a good correlation between the LOD and LLA and is particularly useful in identifying cases of normal lumbar lordosis, hypolordosis, and hyperlordosis.</p><p><strong>Conclusion: </strong>Linear measurements show good diagnostic accuracy of LOD in evaluating lumbar spinal alignment, including normal alignment, hypolordosis, and hyperlordosis.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"280-283"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between sagittal morphology of lower lumbar end plate and degenerative changes in patients with lumbar disc herniation.","authors":"Yang Yu, Chongqing Xu","doi":"10.4103/jcvjs.jcvjs_95_24","DOIUrl":"10.4103/jcvjs.jcvjs_95_24","url":null,"abstract":"<p><strong>Objective: </strong>As an important anatomic factor in the process of lumbar disc herniation (LDH), the correlation between end plate sagittal morphology and intervertebral disc degeneration (IDD) is unclear. Moreover, research on imaging data of lumbar end plate in patients with LDH is still insufficient. Our study aimed to observe the morphological change of the lower lumbar end plate (L3-S1) in patients with LDH on magnetic resonance imaging (MRI) and analyze its correlation with the degree of IDD.</p><p><strong>Materials and methods: </strong>A total of 116 patients were included in the study. Based on their MRI, we divided end plates into three types (concave, flat, and irregular), assigned intervertebral discs with Grade I-V given 1-5 points successively according to the Pfirrmann system, and determined whether there was Modic change of each end plate. The correlation between the morphology of the end plate and the degree of IDD was analyzed.</p><p><strong>Results: </strong>There was an excellent interobserver agreement for each item we analyzed (interclass correlation coefficient >0.75). Concave end plate appeared most frequently (187, 53.7%) and was mainly distributed in L3/4 and L4/5, whereas irregular end plate was the least common type (54, 15.5%) and mainly concentrated in L5/S1. The IDD degree of the corresponding disc increased gradually from concave (3.27 ± 0.81) to irregular end plates (4.25 ± 0.79) (P < 0.05). Irregular end plates were more likely to have Modic changes than concave and flat end plates (P < 0.05).</p><p><strong>Conclusion: </strong>The sagittal morphology of the lower lumbar end plate is related to modic changes and degree of IDD (based on the Pfirrmann grading system) in patients with LDH, and the concave end plate mostly reflects a lower degree of lumbar disc degeneration, which has substantial clinical significance.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"298-302"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic intracranial hypotension secondary to subarachnoid-pleural fistula after transthoracic surgery for the treatment of lateral thoracic meningocele.","authors":"Francesco Signorelli, Samuele Santi, Antonio Leone, Massimiliano Visocchi","doi":"10.4103/jcvjs.jcvjs_39_24","DOIUrl":"10.4103/jcvjs.jcvjs_39_24","url":null,"abstract":"<p><p>Subarachnoid-pleural fistula (SPF), a rare complication following transthoracic spinal surgery, results in the accumulation of cerebrospinal fluid (CSF) in the pleural space. Hindered spontaneous closure, attributed to negative pleural pressure, gives rise to CSF hypotension and subdural blood collections. Despite numerous reported cases, achieving consensus on management remains elusive. Treatment options encompass conservative measures, surgical repair, epidural blood patch, and diverse approaches such as multilayer dural closure or meningocele resection. Presented herein is a distinctive case following lateral thoracic meningocele surgery, where SPF-induced CSF hypotension found successful resolution through the innovative use of titanium hemostatic clips to occlude the meningocele. This novel approach, emphasizing the utility of titanium clips, deviates from conventional strategies. Surgical SPF exclusion, particularly leveraging titanium clips, emerges as a potential solution, effectively alleviating symptoms of CSF hypotension. The article also aims to present a personal experience, contributing an effective and alternative approach for the etiological treatment of thoracic meningocele.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"375-379"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of postoperative complications and outcomes following primary versus revision discectomy: A national database analysis.","authors":"Ryan Hoang, Junho Song, Justin Tiao, Sarah Trent, Alex Ngan, Timothy Hoang, Jun S Kim, Samuel K Cho, Andrew C Hecht, David Essig, Sohrab Virk, Austen D Katz","doi":"10.4103/jcvjs.jcvjs_97_24","DOIUrl":"10.4103/jcvjs.jcvjs_97_24","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lumbar microdiscectomy is a surgical procedure that is frequently used in the treatment of symptomatic lumbar herniation. Differences in outcomes following primary and revision lumbar microdiscectomy have been previously studied, with reports of comparably satisfactory results from the Spine Patient Outcomes Research Trial. In this study, we further investigate these outcomes, including length of stay, bleeding events, and durotomy. We hypothesized that length of stay, incidence of bleeding events, and dural tear would be greater in the revision cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The ACS-National Surgical Quality Improvement Program database was queried for patients undergoing single-level primary and revision lumbar microdiscectomy between 2019 and 2022. Eligibility for inclusion was determined by age &gt;18 years and current procedural terminology codes 63030 and 63042. Patients with preoperative sepsis or cancer were excluded. Length of stay, wound infection, bleeding events requiring transfusion, cerebrospinal fluid leak, dural tear, and neurological injury were compared between the cohorts. Multivariable Poisson regression adjusted for demographics and comorbidities, including age, sex, race, body mass index, diabetes, smoking, and hypertension, was used to determine if revision was predictive of complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 37,669 patients were included, of whom 3,635 (9.6%) required revision surgery. Patients in the revision cohort were older (54.25 ± 15.7 vs. 50.85 ± 16.0 years, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and had higher proportions of male (59.0% vs. 55.7%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and non-Hispanic White patients (82.0% vs. 77.4%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Length of stay (1.11 ± 2.5 vs. 1.58 ± 2.7, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) and rates of wound infection (2.1% vs. 1.4%, &lt;i&gt;P&lt;/i&gt; = 0.002) and bleeding events requiring transfusion (1.3% vs. 0.7%, &lt;i&gt;P&lt;/i&gt; &lt; 0.001) were greater in the revision cohort compared to primary patients. Differences in cerebrospinal fluid leak (0.2% vs. 0.1%, &lt;i&gt;P&lt;/i&gt; = 0.116), dural tear complication (0.01% vs. 0.01%, &lt;i&gt;P&lt;/i&gt; = 0.092), and neurological injury (0.008% vs. 0.006%, &lt;i&gt;P&lt;/i&gt; = 0.691) between the revision and primary cohorts were nonsignificant. Poisson log-linear regression adjusted for demographics and comorbidities demonstrated revision as a significant predictor for length of stay (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 462.95, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), wound infection (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 9.22, &lt;i&gt;P&lt;/i&gt; = 0.002), and bleeding events (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 9.74, &lt;i&gt;P&lt;/i&gt; = 0.002), while it was a nonsignificant predictor of cerebrospinal fluid leak (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 2.61, &lt;i&gt;P&lt;/i&gt; = 0.106), dural tear (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 2.37, &lt;i&gt;P&lt;/i&gt; = 0.123), and neurological injury (&lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; = 0.229, &lt;i&gt;P&lt;/i&gt; = 0.632).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Revision surgery was a significant predictor of increased length of stay, wound infection, and bleeding events requiring t","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 3","pages":"303-307"},"PeriodicalIF":1.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}