News and Research for Spine Professionals

Assessing Lumbar Conditions in Elite Athletes

Study explores the common lumbar conditions affecting this elite athletic patient subgroup and how treatment impacts return to play.

Rates of Lumbar Radiofrequency Ablation on The Rise Despite Controversial Efficacy Data

Use of radiofrequency ablation to treat facet-mediated chronic low back pain is controversial. Large retrospective study examines trends in RFA use from 2007-2016.

How Cervical Myelopathy Led to Michael Collins’ Placement on Apollo 11

This story embodies the absolute best of the American spirit. One can only imagine the relentless, quiet frustration Astronaut Collins felt in watching someone else go to the moon in his place on Apollo 8. All the while, he never really knew if he would ever get another chance.

Robotic Guidance System for Cervical and Thoracolumbar Spinal Surgery

Study focused on predictive accuracy of surgical planning using a robotic guidance system in the placement of pedicle screws in cervical spine or thoracolumbar spine surgery.

Sleep Disorders Independently Linked to Higher Medical Costs in Low Back Pain

Study findings highlight importance of early detection and management of sleep disorders in patients with low back pain, including relationships between pain, disability and downstream healthcare utilization.

Standalone Lateral Lumbar Interbody Fusion Is Effective for Spinal Stenosis

The authors believe that standalone LLIF is a minimally invasive alternative to traditional anterior or posterior approaches in carefully selected patients.

Patient Reported Outcomes Predict Patient Satisfaction Up to 5 Years After Cervical Spine Surgery

Correlation of patient satisfaction and surgical outcomes years after anterior cervical surgery. Gregory D. Schroeder, MD remarks about key findings.

Meta-analysis Links Bisphosphonates to Atrial Fibrillation

“The results of our analysis (pooled data from randomized control trials and observational studies) suggest an increased risk of developing...

Patient Risk for Recurrent Herniation and Readmission by Annular Defect Size

Study results indicate intra-operative identification of annular defect size may allow spine surgeons to risk-stratify patients for recurrent disc herniation.

Insurance Status Linked to Quality of Care During Hospitalization for Primary Spinal Neoplasms

Insurance status was a significant predictor of experiencing adverse quality events during hospitalizations for primary spinal neoplasms in a recent retrospective cohort study.

Patient-Related Factors Predict Satisfaction With Spine Surgery

Patient satisfaction with elective spine surgery for degenerative diseases is influenced by whether they achieve ...

Patterns in Back Pain Over Time: Who Recovers and Who Persists?

Researchers analyzed data from a representative sample (n=12,782) of the Canadian population enrolled in the National Population Health Survey Results. Study results identified four distinct trajectories.

Factors Predict Which Patients Crossover to Surgery for Spondylolisthesis

Study identified factors in which patients with degenerative spondylolisthesis are likely to crossover to surgical treatment after initially being randomized to nonoperative care.

The Pros and Cons of Open Access Publishing

What’s the future for open access publishing? Could the elimination of subscription-based models without having systems in place to ensure independently vetted, high quality content lead to serious unintended consequences for the scientific literature?

Cervical Artificial Disc Replacement Outcomes at 5 to 10 Years

During ISASS19, Frank Phillips, MD, presented 5 to 10 year cervical artificial disc replacement outcomes; one of the most rigorously studied procedures to date in spine surgery.

Has the Affordable Care Act Improved Patients’ Health?

Researchers examined evidence from more than 40 studies to determine what impact insurance coverage has on health and mortality, if any.

Major Cost Drivers for Spine Surgery Identified

Researchers have identified the most important cost drivers in spinal surgery as well as considerable variability in both the management and costs of spinal surgery.

First Case of Spontaneous Spinal Cord Herniation Resolution Reported

The first case of spontaneous resolution of spinal cord herniation was reported in the September issue of the Journal of Neurosurgery. Resolution occurred during an approximately 1-year period.

Two-level Corpectomy and Three-level Discectomy Show Similar Outcomes for Cervical Spondylotic Myelopathy

Dr. Mummaneni and colleagues studied all patients who underwent 2-level anterior cervical corpectomy and fusion or 3-level anterior cervical discectomy and fusion in the treatment of cervical spondylotic myelopathy between 2006 and 2012.

Robotic-Assisted Surgery for Spinal Tumors Shows Low Complication Rate

No perioperative or postoperative complications were found among 9 consecutive patients who underwent robotic-assisted surgery for treatment of metastatic and primary spine tumors, according to study in the International Journal of Spine Surgery.

Implications of the Aging Population on Spine Surgery

With the global population undergoing an upward shift in its age structure, clinicians are required to manage a growing number of spinal disorders specific to the elderly.

Combined Robotic Navigation System for Screw Placement Shows Efficacy in Spinal Surgery

Malpositioning of screws in posterior lumbar spinal fusion can lead to neurologic and visceral injury, as well as biomechanical compromise. ISASS19 presentation reviews the efficacy of a novel robotic navigation system in a retrospective case series.

What Are the “Critical Elements” of Spine Surgeries?

Results of a consensus survey of spine surgeons “may be hard to digest,” stated lead author, Joseph Laratta, MD. Radiographic localization, decompression, instrumentation, and fusion were defined as critical elements for common spine procedures evaluated in a consensus survey of spine surgeons. Peer commentary by Lali Sekhon, MD.

Reprocessing of Pedicle Screws and Exposure in Sterile-Field Leads to Infection in Spinal Surgery

Coauthors discuss new research that avoiding reprocessing altogether and shielding pedicle screws intraoperatively with an impermeable guard can prevent or reduce the degree of contamination and resulting SSIs.

Improving Human Resources and Productivity in Orthopaedic and Spine Practices

How spine practices can plan for the everyday stress of caring for patients while at the same time improving productivity and profitability.

Pretreatment May Unlock the Regenerative Potential of Neural Stem Cells in Chronic Spinal Cord Injury

Pretreatment with the bacterial enzyme Chondroitinase ABC (ChABC) improves the regenerative outcome of neural stem cells in the chronically injured spinal cord.

Half of Patients Expect Physicians, Nurses to Protect Them Against Hospital Shootings

In an active hospital shooting situation, under what circumstances do you lock down doors and stay versus run and take patients with you?

Surgery Shows Measurable Benefits for Patients with Adult Spinal Deformity

This study is among the 10 winners of CNS’ inaugural Paper of the Year awards, which honor the best-in-class papers published in Neurosurgery.

Is Chiropractic Care Safe and Effective for Older Adults?

The updated recommendations include data from recently published randomized-controlled trials that provide additional support for the safety of spinal manipulative therapy in older adults.

Research Uncovers Mechanism of the BMP-2 Related Complications and Previously Unknown Source of Pluripotent Stem Cells

This study investigated how to make spine surgeries involving use of BMP-2 safer, so that potential nerve-related complications of BMP-2 can be avoided.

Surgery for Adult Spinal Deformity Improves Gait Patterns, but Limitations Remain

Surgical correction of adult spinal deformity was linked to improvements in gait patterns, but patients still show...

Patients Markedly Underestimate Radiation Exposure From Spinal Imaging

The radiation dose of computed tomography (CT) scans, and more than three-fourths of magnetic resonance imaging (MRI) was substantially underestimated by patients.

Yoga May Improve Functioning in Patients With Chronic Nonspecific Low Back Pain

Yoga may improve back-related function in patients with chronic nonspecific low back pain, according to a review of 12 randomized controlled studies.

Dreal High-Speed Shielded Curved Device May Speed Spinal Decompression and Preserve Vital Spinal Structures

The case series by Bernard et al involved 10 patients with cervical stenosis who underwent anterior cervical discectomy and fusion or cervical disc arthroplasty.

Durotomy in Malpractice Suits: What Spine Surgeons Need to Know

Malpractice and court rulings are explored in a retrospective study involving incidental durotomy and care that was delayed or improperly performed.

Optimal End Level for Long-Segment Cervical Fusion to the Thoracic Spine?

Extending posterior cervical fusions for degenerative spine conditions into the thoracic spine is associated with less risk for pseudarthrosis but significantly greater blood loss, tendency toward greater operating room time and length of hospital stay.

Can Opioids Still Be Prescribed Effectively and Safely in the Era of Federal Scrutiny?

A summary of "Opioid Use in an Era of Federal Scrutiny," presented by Carl W. Stopper, APN-C, during Spine Summit 2017.

Minimally Invasive Decompression Lowers Reoperation Rates

The study questions one of the long-held beliefs of many spine surgeons: When patients need surgery for lumbar spinal stenosis and spondylolisthesis, they will benefit most of a decompression and fusion procedure.

High-Frequency Spinal Cord Stimulation Manages Back and Leg Pain Better than Low-Frequency Counterpart

CNS 2017 Paper of the Year Award. Integral to securing regulatory approval of HF10 therapy and ensuring more people have access to treatment.

Porous PEEK Fusion Device Shows High Strength and Facilitates Bone Ingrowth

J. Kenneth Burkus, MD noted that a complication of standard PEEK-based implants relates to poor integration with the surrounding bone, producing a “PEEK-halo” effect.

Arthritis, Painkillers and Heart Health

Ten-year trial with osteoarthritis and rheumatoid arthritis patients had surprising findings about celecoxib, naproxen and ibuprofen.

Spinal Cord Stimulation for Chronic Pain: What Conditions and Which Patients?

Spinal cord stimulation is an ideal tool for the right patient, with proper patient selection being key to successful implementation.

Seven-Year cTDR Outcomes with Mobi-C® Shows Superior Efficacy to ACDF

7-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of two-level symptomatic degenerative disc disease.

Delays in Diagnosis of Vertebral Fractures Are Common in Patients With Spinal Ankylosing Disorders

Should you assume vertebral fracture in patients with spinal ankylosing disorders who present with pain following a fall?

8 Spine Technology and News Highlights July 2018

SpineUniverse highlights a blend of eight news briefs covering technology, clinical research, corporate updates, spine devices, surgical opinion, and more from July 2018.

John F. Kennedy’s Unsuccessful Back Surgeries and Chronic Back Pain

The authors uncovered information proving to be the tip of the iceberg revealing more about JFK's chronic back pain and possibly his death.

Is Lumbar Disc Replacement a Valuable Treatment for Degenerative Disc Disease?

The FDA approved total disc replacement as a treatment for lumbar degenerative disc disease. But how valuable is TDR compared to more established or traditional procedures?

Does Minimally Invasive Lumbar Fusion Benefit Patients Compared With Open Surgery?

Researchers collected data from an observational, prospective national registry of 2,036 patients to compare outcomes of MIS vs open spine surgery.

Review Examines the Role and Disparities of Rehabilitation After Lumbar Fusion

Starting physical therapy later and incorporating psychosocial elements have support according to a literature review published in the JNS: Spine.

Findings Point to Possible Major Therapeutic Intervention for Chronic Spinal Cord Injuries Via Stem Cell Injections

Injection of human neural stem cells distally, but not locally, to the site of chronic spinal cord injury lead to significant functional recovery in a rat model, researchers reported in the June issue of The Spine Journal.

Multifactorial Predictors of Work Status in Patients With Low Back Pain Identified

Simple questions that address the impact of an individual’s low back pain on home, play, and work life are critical to determining what is most important to the patient.

Pseudoathrosis Rates after ACDF Studied in Comprehensive Literature Review

The largest and most comprehensive literature review and meta-analysis of pseudoarthrosis rates after anterior cervical discectomy and fusion (ACDF) underscored significant variation in the definition of pseudoarthrosis.

Interspinous Spacer Relieves Painful Symptoms of Lumbar Spinal Stenosis Study Shows

The FDA-approved Superion interspinous spacer provided similar relief from symptoms of neurogenic claudication when compared to historical data from studies of decompressive laminectomy in the treatment of lumbar spinal stenosis.

Isthmic and Degenerative Lumbar Spondylolisthesis: Diagnosis and Treatment

"My goal with this presentation is to examine the history of this condition and show how far we have come, and how far we have to go,”

Synthetic Ceramic Bone Graft Substitutes

Brian Kwon, MD discussed what makes a synthetic bone graft substitute ideal during the North American Spine Foundation's biologics in spine care course.

Researchers Develop Thoracolumbar AOSpine Injury Score

Researchers have developed a data-driven, easy to use Thoracolumbar AOSpine Injury Score that will be used to develop a surgical algorithm to accompany the AOSpine Thoracolumbar Injury Classification System.

Preoperative MRSA Screening May Reduce Surgical Site Infections

Preoperative nasal swab MRSA screening may be helpful in reducing surgical site infections when used within a multimodal approach. This is according to a recent study published in Spine Deformity.

Findings Support Safety of Outpatient Anterior Cervical Discectomy and Fusion

Anterior cervical discectomy and fusion (ACDF) can safely be performed in the outpatient setting.

Great Job Candidate? Don't Be Too Quick to Extend the Offer

Using a multi-step approach to hiring will create a more organized and productive search.

Investigational Non-Opioid Analgesic NeuroRelease May Provide 2 Weeks of Postsurgical Pain Relief

A novel 14-day, non-opioid, postsurgical pain treatment known as NeuroRelease is being developed by PixarBio Corporation and is expected to be FDA approved in 2018, according to the company.

Ghost Attendance: How to Handle a Candidate who Lied about Their Education

A common practice for most candidates applying for jobs is to make their resumes more robust possibly by embellishing. What if the candidate never graduated or even attended a school they said they did? How to avoid difficult situations.

3D Printing With Synthetic Scaffolds

Researchers in China have used the concept of 3D printing for biomedical purposes, specifically fabrication of an artificial vertebral body.

Are Creating Job Descriptions Worth the Time and Effort?

A well-written job description serves a multitude of purposes and the better it’s written, the more useful it can be to define the roles of employees in your practice.

SpineUniverse Spine Surgeon Survey Results

In an effort to better understand challenges spine surgeons face, SpineUniverse developed several viewpoint questions.

Age, Procedure Type, and Magnitude of Systemic Disease Predict Length of Stay Following Open Lumbar Spine Surgery

Older age and widespread systemic disease were the only preoperative factors predictive of longer hospital stays following an elective open posterior lumbar spine surgery in a multivariate analysis reported in the June 1 issue of The Spine Journal.

Syndromes Mimic Nerve Entrapment of Peripheral Neuropathy

The challenge posed by differential diagnosis of peripheral neuropathy was the topic of a presentation given by Holly S. Gilmer, MD at the American Association of Neurological Surgeons 83rd Annual Scientific Meeting in Washington, DC.

Surgeon Surveys Provide Framework for Enhancing Perioperative Spine Care

Recent efforts have centered on perioperative interventions outside the operating room that might foster better outcomes more cost-effectively.

Surgical Approach Is a Risk Factor for Infection in Spinal Surgery

From our study, we found that the minimally invasive surgery (MIS) approach was associated with a lower ...

Two-fold Increased Risk for Unsatisfactory Spine Surgery Outcome Found in Workers’ Compensation Patients

Patients with workers’ compensation have a 2-fold increased risk of an unsatisfactory outcome compared to patients without workers’ compensation after spine surgery.

Spinal Cord Stimulation’s Place in the Pain Treatment Continuum and Advancements in Technology

Teatment paradigm for chronic pain is shifting, and spine surgeons should consider treatment with spinal cord stimulation earlier in the chronic pain treatment continuum.

Two-level Cervical Total Disc Replacement with Mobi-C® Shows Superior Efficacy to ACDF at 7 Years

Total disc replacement with the Mobi-C Cervical Disc demonstrated superior overall success compared to anterior cervical discectomy and fusion through 7 years in a prospective randomized study.

What Causes Osteoporosis in Greek Men?

Researchers aimed to determine the factors that are directly associated with bone mineral density, including BMD of the spine and hip, in Greek men.

Criteria for Fusion After Spinal Cord Tumor Surgery Described in Review Article

A recent literature review identified seven criteria for instrumented fusion after spinal cord tumor resection in adults. Overall, 8% of adults with spinal cord tumor surgery required fusion.

Results of a Large Single-center Retrospective Review of Cervical Disc Arthroplasty

The authors indicated this is largest non-sponsored, single-center study of cervical disc arthroplasty (CDA).

Meeting Highlights from the 31st Annual Meeting of the Section on Disorders of the Spine and Peripheral Nerves—Spine Summit 2015

Six prestigious international spine societies were represented during the Spine Summit 2015 program.

Traditional Open versus Mini-open Transpedicular Corpectomy in Thoracic Spinal Metastases

The outcomes of interest were operative time, estimated blood loss, complications, neurological status and long-term revision reoperation rates.

Infliximab Plus Naproxen Attains 70% Partial Remission in AS

Patients with Ankylosing Spondylitis (AS) who were given infliximab and naproxen achieved a 70.5% partial remission rate in a post hoc analysis of the Infliximab as First Line Therapy in Patients with Early Active Axial Spondyloarthritis Trial.

High-Dose Tranexamic Acid Reduces Blood Loss in Extensive Spine Surgery

Discover the findings of a study conducted in China treating patients with high doses of tranexamic acid (TXA).

FDA's Prescription Acetaminophen Recommendation

Limiting the amount of acetaminophen per dosage unit will reduce the risk of...

Is Osteoporosis of the Spine Common in Patients with COPD?

Researchers examined the progression of osteoporosis in patients who have chronic obstructive pulmonary disease (COPD).

Low-Dose Diclofenac Approved for Management of Osteoarthritis Pain

Low-dose submicron diclofenac (Zorvolex) was approved by the U.S. Food and Drug Administration for the management of osteoarthritis pain.

Satisfaction With Pain After Spine Surgery: What Residual Pain Level Do Spine Surgery Patients Find Acceptable?

“Studies in days gone by used pain scales only, but for various reasons over the years a more complex assessment of health-related quality of life has become popular”.

Early Physical Therapy for Low Back Pain Shows Modest Benefits

Low back pain is common among many Americans, and even as health care spending increases, so does the prevalence of poor outcomes associated with it.

Metastatic Epidural Spinal Cord Compression and Decompression Surgery Multicenter Study Results

Symptomatic metastatic epidural spinal cord compression (MESCC) is among the most debilitating complications of metastatic spine cancer.

Many Patients Lack Understanding of Spine Surgery Reimbursement

Patients who undergo spine surgery often overestimate the amount of reimbursement their surgeons receive for the procedures, according to a recent study in the The Spine Journal.

Polypharmacy Increased in Adults NHANES Survey Reports

Notably, several of the top 10 most commonly used drugs in 2011-2012 were medications used to treat factors associated with the cardiometabolic syndrome—including hypertension, diabetes, and dyslipidemia—or obesity.

Elderly Show Marked Increase in Rate of Surgery for Multilevel Spinal Curvature

Rates of surgery to correct multilevel spinal curvature in adults ages 60 and older increased by 108% between 2004 and 2011, exceeding the expected growth given the aging population.

Physician Burnout and Professional Dissatisfaction Linked to Electronic Health Records and Computerized Physician Order Entry

Use of electronic health records (EHRs) and computerized physician order entry (CPOE) may lead to lower physician satisfaction and higher rates of professional burnout.

Spinal Cord Stimulation Devices Can Pose Safety Concerns for Spine Surgery

Implantation of a spinal cord stimulation changes aspects of a patient’s structural anatomy that may pose challenges during spine surgery.

Triclosan-Coated Sutures May Reduce the Risk of Surgical Site Infection After Spinal Surgery

Use of triclosan-coated sutures instead of non-coated sutures was associated with a significantly lower incidence of surgical site infections in patients undergoing spinal surgery.

Modified Frailty Index Score Helps Stratify High-Surgical Risk Patients Undergoing ALIF

High score on a modified Frailty Index was an independent predictor of any complication and pulmonary complication in patients undergoing anterior lumbar interbody fusion.

Osteoporosis Risk in Long-term Osteosarcoma Survivors

A study examined the prevalence of osteoporosis in long-term osteosarcoma survivors and the factors that raise patients’ risk of developing osteoporosis.

FDA Issues New Warning for Reclast (Zoledronic Acid)

The FDA released a new warning label for the osteoporosis medication Reclast. This article reviews what practitioners should do before prescribing Reclast to osteoporosis patients.

6 Spine Societies Highlighted during Spine Summit 2015: AOSpine, ACSR, CSRS, ISASS, SRS, SMISS

Prestigious leaders in the spine field summarized the history of the six international spine societies represented at One Spine, One World.

Osteoporosis and Spinal Fracture Management Tool: Own the Bone®

The American Orthopaedic Association’s Own the Bone® tool helps hospitals, medical centers, and physician practices to develop their own Fracture Liaison Service (FLS).

Researchers Define Sets of Patient Experiences for Low Back Pain

Researchers have found that patients with low back pain typically follow distinct sets of patient experience.

Advice to Stay Active Markedly Increases Activity Level in Patients with Acute Severe Low Back Pain

All patients underwent extensive physical examination, X-ray, and magnetic resonance imaging to rule out disc herniation or spinal stenosis requiring surgery.

7 Year Outcome Comparing Cervical Disc Arthroplasty vs ACDF

This was a prospective study with 20 investigational sites comparing 265 historically-controlled ACDF patients in a prior cervical investigational device exemption study.

Nonopioid Medications and Acute Low Back Pain

During NASS 2017, Jerome Schofferman, MD, presented alternatives to opioids, which have shown little evidence for efficacy in acute low back pain or pose a high risk for adverse events.

Epidural Anesthesia via Catheter in Spine Surgery Effectively Reduces Postoperative Pain

The patient is comfortable and the injection allows for routine neurologic examinations. Many physicians are adopting this new technique.

Cervical Disc Replacement vs Anterior Cervical Discectomy and Fusion: Five-year Study Results Include Subsequent Spinal Surgeries

Patients with myelopathy or cervical radiculopathy may require surgical decompression that includes restoration of disc space and foraminal height.

Factors Affecting Medicare Diagnosis Related Group (DRG) Reimbursement for Minimally Invasive Deformity Spine Surgery

The study investigates the effect of Medicare DRG on reimbursement based on length of stay and medical comorbidity in MIS deformity surgery.

Adolescent Idiopathic Scoliosis: Are There Advantages of Surgical Correction During Adolescence?

Isador Lieberman, MD presented results of a retrospective study comparing the surgical outcome of idiopathic scoliosis patients who underwent corrective surgery as young adults with those who had surgery during adolescence.

Predictive Models in Risk Stratification Approach to Spinal Surgical Management

This article is a continuation of "Risk Stratification Approach to Spinal Surgical Management" presented by Sigurd H. Berven, MD.

Adolescent Idiopathic Scoliosis, Skeletal Maturity, Surgery—Study Statistical Analysis

The statistical analysis related to Surgery for Adolescent Idiopathic Scoliosis Patients After Skeletal Maturity: Now or Later? presented during the annual meeting of the American Association of Orthopaedic Surgeons is featured.

Clostridium difficile Infection Is Rare But Costly/Deadly Complication in Cervical Spine Surgery

The investigators used the 2002 to 2011 Nationwide Inpatient Sample (NIS) database to identify cases of C. difficile following cervical spine procedures for degenerative spine diagnoses.

Guidance on Medications for Fracture Healing Released by Expert Panel

The International Osteoporosis Foundation reviewed existing literature and voted on appropriateness of care for fracture healing.

Adjacent Level Disease: Can Cervical Arthroplasty Decrease the Risk?

At 7 years, patients treated with a single-level anterior cervical discectomy and fusion have three times the risk of needing surgery for adjacent segment disease compared to patients treated with total disc replacement.

Transpoas Approach to Lumbar Corpectomy Shows High Rate of Patient Satisfaction and Functional Outcomes

Patients with unstable burst fractures treated with anterior lumbar corpectomy and cage placement using a transpsoas approach and short-segment posterior instrumentation showed high rates of satisfaction with outcomes.

Laminectomy Plus Fusion and Laminoplasty Show Equivalent Efficacy in the Treatment of Degenerative Cervical Myelopathy

When deciding between laminectomy and fusion versus laminoplasty for an individual case, certain patient factors should be considered.

Do Multilevel Posterior Cervical Fusions Extended to T1 Reduce Revision Surgery Risk?

While extending cervical fusions into the thoracic spine is common practice, it remains a topic of ongoing debate.

Rates of Surgery for Spinal Deformity Increased Among Older Adults

The investigators used 2004-2011 data from the NIS to identify adults who underwent spinal fusion of 8 or more levels.

Is Surgery for Degenerative Cervical Myelopathy Cost Effective?

Data gathered may help guide clinical decision making and policy decisions regarding healthcare resource allocations used for treatment of degenerative cervical myelopathy.

Checklist Aims to Improve Flow, Reduce Risks During Minimally Invasive Lateral Interbody Fusion (MIS-LIF)

Researchers from the University of South Florida have developed a systematic approach to preoperative assessment and surgical technique.

Vertebroplasty Reduces Acute Pain Following Osteoporotic Vertebral Fractures in VAPOUR Study

The VAPOUR study included 120 patients with one or two osteoporotic vertebral fractures of less than 6 weeks’ duration and back pain of ≥7 out of 10 on the Numeric Rating Scale.

Changes in the Care of Head and Neck Injuries in Helmeted Student Athletes

The care of helmeted student athletes following a concussion and possible spine injury has changed over the past decade with new research and revised protocols included in this evolution.

Comorbidity Burden Associated With Poor Outcomes in Atlantoaxial Fusion

Age and comorbidity burden are associated with higher rates of postsurgical mortality and longer lengths of in-hospital stay after atlantoaxial fusion, according to findings from a large retrospective study.

Greater BMI Linked to Risk for Revision Procedures Following Lumbar Discectomy

Surgeons should consider a patient’s bone mass index (BMI) when evaluating them for lumbar surgery, due to the fact that "increased BMI is associated with increased risk of revision surgery, especially in the morbidly obese.

Cervical Total Disc Replacement With Mobi-C Is a Safe and Effective Alternative to Cervical Fusion, Long-Term Study Shows

“It is important for surgeons, non-surgeons, and patients to know that there is an alternative to cervical fusion with results that are at least as good and with lower rates of degeneration...

High Fat, High Sugar Diet Linked to Increased Fracture Risk

Vertebral fracture risk increased by chronic consumption of diet high in advanced glycation end-products (AGEs).

Quantitative MRI Shows High Sensitivity in Detecting Progression in Degenerative Cervical Myelopathy

Study compares methods to monitor for myelopathic progression in cases of degenerative cervical myelopathy, and provides a decision-making algorithm.

New Guidelines and App for Antiplatelet and Anticoagulant Therapy During Interventional Spine and Pain Procedures

Guidelines and app to clinical decision-making on when to stop antiplatelet and anticoagulant therapies in patients undergoing interventional spine and pain procedures to avoid serious bleeding, and when to restart the agents after the procedures.

At What Surgical Cost Does Transforaminal Lumbar Interbody Fusion Become Less Cost-Effective Than Posterolateral Fusion for Spondylolisthesis?

Study outcomes in JNS Spine suggest the cost of TLIF per QALYs vs PSF in the treatment of spondylolisthesis depends on factors, including the accuracy of cost assumptions.

Adult Native Vertebral Osteomyelitis Clinical Guideline

A summary of the Infectious Diseases Society of America’s (IDSA) recently published clinical practice guideline for treating native vertebral osteomyelitis, with commentary by Jeffrey Gudin, MD.

MRI Findings Not Helpful in Determining Herniated Disc-Related Sciatica Treatment

New research finds that MRI has no value in the decision making between early surgery and prolonged conservative care.

Paradigm Shift in Adult Spinal Deformity

The severity of sagittal plane deformity drives pain, disability, and surgical outcomes. This is according to a new paper from the Scoliosis Research Society recently published in Spine Deformity.

MIS for the Spine Improves Deformity with Fewer Intraoperative Complications and Lower Costs

Minimally invasive spine surgery improved deformity and is associated with fewer intraoperative complications and lower costs.

Managing Spine Patients With Diabetes: A Patient-Centric Approach

Carrie Diulus, MD discussed the unique challenges that diabetes poses for spine providers, including challenges with differential diagnosis, as well as medical, operative, and perioperative management.

How Can Spine Surgeons Protect Themselves in the Anti-Opioid Climate?

Mitchell F. Reiter, MD, discussed the current anti-opioid climate and its impact on spine care experts in the opening session to “The Opioid Predicament: Implications for Spine Physicians and Surgeons” during NASS 2017.

6 Spine Technology Highlights

During NASS 2017, SpineUniverse met with many industry leaders and randomly chose 6 to highlight in this snapshot.

Geographic Variations in Outcomes of Decompression Surgery for Degenerative Cervical Myelopathy

New findings show regional differences in demographics, causation, and surgical approaches for patients with degenerative cervical myelopathy, but similar efficacy worldwide.

Nonopioids for Chronic Pain Management

William Sullivan, MD, discussed nonopioid medication choices for the treatment of moderate to severe chronic pain, many options are those used to manage acute pain but with a couple of additions.

Generic Celecoxib Receives FDA Approval

FDA approves first versions of generic celecoxib and names two pharmaceutical companies who have received approval to market the drugs.

Can a Diet High in Processed Fat and Sugar Cause Disc Degeneration?

The role of advanced glycation endproducts (AGEs) and type 2 diabetes in the development of degenerative disc disease is the topic of this study.

Two-Level Cervical Artificial Disc Replacement Update

Building on one-level data supporting the efficacy of total disc replacement for cervical disc degeneration discussed at ISASS19, Domagoj Coric, MD, presented current evidence on two-level cervical disc replacement, which he said is “even more compelling.”

Reasons for Selecting ACDF Over Total Disc Replacement in Cervical Spine Surgery

Study outcomes revealed reasons for choosing anterior cervical discectomy and fusion (ACDF) over cervical total disc replacement in a consecutive series of patients undergoing cervical spine surgery.

Low Reoperation Rate After Cervical Total Disc Replacement With ProDisc-C

Large consecutive series study outcome over a 15-year period at a single institution of patients undergoing C-TDR with the ProDisc-C device showed a relatively low overall reoperation rate.

Cervical Total Disc Replacement and Routine Osteoporosis Screening

While osteoporosis is a contraindication for total disc replacement both in the lumbar and cervical spine, new findings suggest that routine DEXA scans may not be necessary for all cervical total disc replacement candidates.

Opioid Prescribing: The Hospitalist Perspective, A Qualitative Analysis

A study published recently in the Journal of Hospital Medicine reveals some surprising factors that influence hospitalists' attitudes toward opioid prescribing during hospitalization and at discharge.

Multimodal Pain Management Approaches in Neurosurgery

Neuromodulators and preemptive analgesia were presented by Sharad Rajpal, MD, during Spine Summit, the 33rd Annual Meeting of the Section on Disorders of the Spine and Peripheral Nerves.

SI Joint Fusion Shows High Success Rate Regardless of Level of Response to SI Joint Block

Patients who underwent sacroiliac joint fusion using the iFuse Implant System showed a high success rate regardless of their level of response to diagnostic SI joint block.

SI Joint Fusion Linked to Fewer Revision Surgeries Versus SI Joint Fixation

When a spine surgeon switched from SI joint fixation with screws to SI joint fusion using the iFuse Implant System® (SI-BONE, Inc), he found that fewer patients returned with continued SI joint pain and needing surgical revision.

Facilitating Greater Osseointegration Properties with a Deeply Porous Titanium Scaffold on PEEK

In the search to reduce fixation-related complications and infections associated with current interbody fusion cages, investigators have pursued various methods for integrating a titanium surface onto PEEK to promote osseointegration.

Navigating Health Insurance Coverage for Minimally Invasive SI Joint Surgery

Patients who underwent minimally invasive SI joint fusion with the iFuse Implant™ were 11 times less likely to be opioid users at their last visit.

Stepwise, Standardized Staged Protocol for Surgical Correction of Adult Spinal Deformity Improves Functional Outcomes

Results of a new stepwise, standardized approach to circumferential minimally invasive surgery (CMIS) for the correction of adult spinal deformity.

Number of Cervical Spine Surgeries Increased in the Last Decade

“I think the overall trends regarding the number of cervical spine procedures is increasing due to a multitude of factors".

NASS Releases Coverage Policy Recommendations on Intrathecal Drug Delivery Systems

The North American Spine Society released coverage policy recommendations on spinal intrathecal drug delivery systems for the treatment of nonmalignant pain and spasticity.

Risks Associated with Opioids after Spine Surgery

David W. Polly, Jr., MD presented Opioid-related Adverse Events with Lumbar Spine Surgery: Is the Risk Real? during the 31st Annual Meeting of the Section on Disorders of the Spine and Peripheral Nerves—Spine Summit 2015.

Modic Changes Associated with Greater Risk of Poor Outcome in Lower Back Pain

Patients with lower back pain who show Type 1 Modic changes may be at increased risk of experiencing poor treatment outcomes. This finding comes from a prospective study of 141 patients with lower back pain that was conducted in Denmark.

Clinical Prediction Model for Surgical Outcome in Cervical Spondylotic Myelopathy Found Valid

A clinical predictive rule can help surgeons determine whether an individual patient will benefit from spine surgery to treat cervical spondylotic myelopathy (CSM).

Preoperative Depression Is a Factor in Postoperative Improvement for Lumbar Spine Surgery

Findings come from a retrospective study of 919 surgical patients who were followed for at least 6 months after surgery.

Current and Prospective Management of Vertebral Compression Fractures and Osseous Spinal Metastases

New and prospective treatments for vertebral compression fractures.

Depression as a Predictor of Quality of Life Post Lumbar Spinal Stenosis Treatment

Nonoperative treatment included: Physical therapy and nonsteroidal anti-inflammatory drugs.

mobi-c, disc, replacement, TDR, anterior discectomy and fusion, ACDF, total

Although several TDR devices are on the market, few have been clinically evaluated for 2-level use.

Perspective on Training Future Spine Surgeons

A new residency pathway focused specifically on training future spine surgeons should be developed to meet the changing needs of modern spine surgery practice.

Naloxegol Shows Promise in Relieving Opioid-Induced Constipation

“This trial was unique in that it also identified and enrolled patients who had tried and failed other laxatives for their opioid-induced constipation prior to enrollment”.

Declining Rates of High-Dose Steroid Use for Acute Spinal Cord Injury

“It is a distressing commentary on our medico-legal system that despite the majority of surgeons who prescribe steroids...

Current Updates in Spinal Surgical Site Infections

While research on diagnosis, prevention, and treatment of spinal surgical site infections (SSIs) is rapidly emerging, there is little evidence to guide surgeons in the management of this complication.

Epidural Steroid Injections May Delay Surgery, But Only Minimally

The review article evaluated the findings from 26 studies to determine whether epidural steroid injections have a surgery-sparing effect on patients with back pain.

Medicare Payments for Spine Surgery Vary Across the Nation

This study examined the variation in episode payments from Medicare for surgery for three conditions, spinal stenosis, spondylolisthesis, and lumbar disc herniation.

Risk Stratification Approach to Spinal Surgical Management

Risk stratification is important in empowering informed choice regarding surgery, and in determining the appropriateness of surgical management in spinal deformity.

Preemptive Multimodal Analgesia Regimens Control Pain Following Spine Surgery

Emerging evidence also supports preemptive multimodal analgesia in controlling pain following spine surgery.

Robotic-Guided S2AI Screw Placement Offers Accurate and Efficient Sacropelvic Fixation

Robotic-guided S2-alar iliac (S2AI) screw placement was found to be accurate and efficient in sacropelvic fixation in a recent retrospective review.

NICE Guidance Supports Use of Minimally Invasive SI Joint Fusion for Chronic Sacroiliac Pain

The guidance is based on a review of effectiveness and safety data from clinical trials of minimally invasive SI joint fusion, and the only product used in the evaluation with an FDA clearance for SI joint fusion was iFuse.

Expandable Technology in Minimally Invasive TLIF

Findings from a prospective longitudinal study involving 25 patients who underwent MIS TLIF with an in situ expandable interbody device.

What Spine Specialists Need to Know About MACRA

MACRA was written to measure quality improvements in patient outcomes. Unfortunately, many of the measures proposed do not apply to specialists.

Use of Trinity Evolution Bone Matrix Shows High Success Rate in Single-Level Anterior Cervical Discectomy and Fusion

Seventy-five percent of the study participants were current or former smokers, diabetic, overweight, obese or extremely obese and considered to be at high risk for bone growth failure.

Artificial Disc Replacement: Lessons Learned From IDE Trial Outcomes

During ISASS19's artificial disc symposium, Dr. Jack Zigler discussed very "robust and reproducible" data for cervical and lumbar artificial disc replacement that included cost studies.

Visualized Endoscopic Transforaminal Technique Shows Efficacy in Foraminal Stenosis

Retrospective review of cases showed good to excellent 5-year outcomes in the majority of patients with foraminal spinal stenosis who underwent endoscopic transforaminal decompression using Yeung's technique.

Spinal Metastasis Surgery and Stereotactic Radiosurgery: Wound Healing and Complications

Stereotactic radiosurgery (SRS) for postoperative spinal tumor control was the focus of Dr. Yanamadala’s study.

Cervical Spondylotic Myelopathy: Pathophysiology and Biological Mechanisms

Information on the pathophysiology and biologic mechanisms of cervical spondylotic myelopathy—a common degenerative disease that results from spinal cord compression.

What Is the Rate of Lumbar Fusion Following Single-Level Discectomy?

The analysis was based on data from more than 13,500 patients who underwent discectomy between January 2007 and September 2014.

Spine Surgery Improves Physical Functioning and QOL in Mild Degenerative Cervical Myelopathy

The conundrum of improving physical function and quality of life issues in patients with mild degenerative cervical myelopathy is the focus in this large prospective cohort study.

The Changing Face of Spinal Cord Injury Trials

From studies on neuroprotective approaches to novel biologics, new discoveries are anticipated to translate into breakthroughs in this field.

Measures May Prevent Common Complications of Spinal Cord Injury

Researchers highlighted early measures that may prevent acute complications of spinal cord injury.

Riluzole May Protect Against Ischemia Reperfusion Injury During Spinal Decompression Surgery

Addition of the sodium glutamate antagonist riluzole when decompression surgery is undertaken results in better long-term improvements in forelimb function in cervical spondylotic myelopathy animal models than surgery alone.

The Future of Scientific Publications: The Effects of Open Access, Social Media, and Altmetrics

A panel of editors from leading spine journals convened to discuss the movement toward open access articles, new digital technologies, and if impact factor is an accurate measure for scientific journals.

Allograft Linked to Higher Fusion Rates Over Intervertebral Cages in ACDF

Review of 6,100 patients who underwent ACDF found the rate of nonunion was higher in cases using synthetic intervertebral cages than in cases using structural allograft raising the question when to choose cages over allograft.

Pseudarthrosis Found in Half of Patients With PEEK Implants for Anterior Cervical Discectomy and Fusion

Use of PEEK cages for ACDF was linked to a 5-fold increased incidence of pseudarthrosis compared with use of allograft materials, and a nearly 2-fold increase in the rate of subsequent revision surgery for pseudarthrosis, according to findings from a retrospective study presented at the 2018 AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves Annual Meeting.

Bundled Payments in Spine Surgery: Current Understanding and Future Directions

Efficacy of the bundled payment model has been demonstrated in total joint arthroplasty. However, concerns have been raised on whether bundled payments are appropriate for spine surgery.

Outpatient Transforaminal Endoscopic Decompression for Spinal Stenosis Linked to Cost Savings

Study outcomes provide reassurance to spine surgeons and payers that there is a real value proposition with outpatient endoscopic spine surgery, and the complication rate was lower than that for traditional microdiscectomy.

Predictors of Success With the iFuse Implant System Confirmed in Pooled Analysis

This pooled analysis marks publication of the 50th peer-reviewed study of the iFuse implant system, and confirms that minimally invasive SI joint fusion with iFuse significantly improves outcomes.

Increase in Lumbar Spine Bone Mineral Density in Infants Receiving Vitamin D

Is there an increase seen in lumbar spine bone mineral density in infants who receive a high dose of vitamin D daily ?

Using Age, Bone Mineral Density, and Spine Fracture Status to Predict Fracture Risk

Researchers found that the most predictive risk factors for incident fracture were age, bone mineral density, and spine fracture status.

Screening for Osteoporotic Vertebral Fractures: A Simple, Cost-effective Tool

Research was presented on a screening program for osteoporotic vertebral fractures (VF)—and how that program increases bisphosphonate prescriptions and eventually reduces the number of fractures.

Triple Herb Product Helps Prevent Osteoporosis in Spine and Hip

Researchers investigated the impact of a triple herb product in post-menopausal women with osteopenia.

Great Diversity Found in Outcome Domains Used in Adult Spinal Deformity Studies

New research shows “great diversity” in outcome domains and patient-reported outcome measures used in 144 studies on adult spinal deformity.

Volume-Outcome Benchmarks in Lumbar Spine Surgery

Volume-based benchmarks study for common lumbar spine surgeries received “The Spine Journal” Outstanding Paper: Value in Spine Care awarded at the North American Spine Society 2017 Annual Meeting.

ActivL Total Disc Replacement Device Found Noninferior to Conventional Devices

The activL total disc replacement device demonstrated noninferiority in overall trial success compared to conventional TDR devices in a prospective, multicenter, randomized, investigational device exemption trial.

Comparing Surgical Costs for Adult Spinal Deformity: Posterior-Only Versus Combination Anterior-Posterior

Researchers compared a posterior-only approach to a combination surgical anterior-posterior technique to determine which was most cost effective.

What’s a More Cost Effective Treatment for Cervical Radiculopathy: Epidural Injections or Surgery?

Results of a study comparing the cost effectiveness of epidural injections to anterior cervical discectomy and fusion (ACDF) in the treatment of cervical radiculopathy.

Ossification Shape May Predict Outcomes of Laminoplasty in the Treatment of Cervical Myelopathy

Read on to learn about an important predictor of poor surgical outcomes following laminoplasty.

Integrating Spinal Cord Stimulation into Surgical Practice

During the 31st Annual Meeting of the North American Spine Society, Dr. F. Todd Wetzel discussed use of spinal cord stimulation in the context of failed back surgery syndrome.

Adding Value to the Conservative Management of Degenerative Disc

Physicians who incorporate the biopsychosocial model can add value to the management and treatment of patients who have degenerative disc disease.

Infections in Spine Surgery: The Role of Occult Pathogens

Celeste Abjornson, MD, focused on occult, indolent infections that result from contamination or are innate. Environments created by adding hardware to the body may lead to biofilm development, which is another source of occult infection in spinal surgery.

Nanocoating Technology May Prevent Spinal Implant Infections Without Inhibiting Osseointegration

The paradigm shift in current understanding of the potential role of occult infection in aseptic loosening of spinal instrumentation has prompted research to focus on building an antimicrobial surface coating for spinal implants that offer minimal risk and maximum reward.

Study Shows Long-term Benefits of Osteoporosis Treatment

The beneficial effects of teriparatide injections to treat patients with primary osteoporosis may last up to 1 year following the completion of treatment, according to the results of a recent study published online.

Researchers Assess Re-formatted CT Scans for Previously Undetected Osteoporotic Vertebral Fractures

In a study focused on osteoporosis in the spine, researchers looked at vertebral fractures on computed tomography (CT) examinations of the chest or abdomen in older adults.

Three Factors May Predict Patients at Greatest Risk for Concomitant Epidural Abscesses

A single spinal epidural abscess is a serious condition that can be difficult to diagnose.

The Effectiveness of Bone Scan Imaging in Locating Vertebral Fractures

Researchers set out to understand the effectiveness of using bone scan imaging to gauge pain in patients with osteoporotic vertebral compression fractures.

Opioids for Chronic Pain: Putting Evidence Into Perspective

Excessive concerns over opioid abuse and safety may cause reluctance among physicians to prescribe these agents for chronic pain, or prescribe even small amounts for severe acute pain.

Preventing Spinal Implant Contamination in Spine Surgery

Is preventing spinal device-related infection a life-long battle? Bacteria are tougher to kill when they attach to the surface of a spinal implant, even before they form a biofilm.

Defining Spondylosis Beyond Age-related Spinal Degeneration

Seeking to develop a definition of spondylolosis instead of classifying it as one of "many degenerative spine diseases".

Decompression Surgery Indirectly Improves Glycemic Control in Patients with Diabetes and Lumbar Spinal Stenosis

This is the first study to show the effects of lumbar stenosis surgery on Diabetes Mellitus.

ISASS17 Spine Surgery Program Meeting Highlights

Meeting highlights from the 17th Annual Conference of the International Society for the Advancement of Spine Surgery (ISASS17).

3D-Printed PEEK Implants in Cervical Spondylotic Myelopathy

Early results from a study using patient-specific 3D-printed PEEK implants in the surgical treatment of cervical spondylotic myelopathy.

Adolescent Idiopathic Scoliosis, Skeletal Maturity, Surgery—Discussion, Conclusion

Surgical correction of the skeletally mature adolescent often evokes fear among family members to the possibility of complications.

Nonidiopathic Scoliosis Surgical Wound Closure Technique Findings

Wound infections following posterior spinal fusion in the treatment of nonidiopathic scoliosis are linked to high morbidity and costs. New findings suggest that use of a plastic multilayered closure technique can lower the infection rate.

Magnetic Kyphoplasty May Optimize Drug Delivery in Spinal Compression Fractures

Magnetic kyphoplasty as a new technique to accompany mainstay spinal compression fracture management lends advancement in predictive modeling and targeted drug delivery.

Cervical Disc Arthroplasty Found More Cost-Effective Than Anterior Cervical Discectomy for Disc Herniation

CDR appears to be more cost-effective than ACDF, according to findings presented at the AAOS 2018 Annual Meeting.

Managing Neurological Complications in Pediatric Spinal Deformity Surgery

Improving neurological outcomes in spinal deformity surgery include risk severity stratification, experience, intraoperative monitoring, and uniform response to neuromonitoring alerts.

Prevention and Management of Spine Injuries in Athletes

Safety of athletes who play contact sports requires an emergency action plan and emphasis on education about preventing and managing spinal cord injuries.

QOL Improvements of Scoliosis Surgery in Children With Cerebral Palsy Outweigh Risks

The benefit of scoliosis surgery to halt curve progression in children with cerebral palsy (CP) is a topic of ongoing debate. Study provides evidence that surgery for scoliosis in patients with CP provides a positive impact on QOL.

Multidisciplinary Algorithm Helps Patients With Spinal Metastases Live Longer

Multidisciplinary approach is essential to coordinate care for spinal metastases, which includes improved length and quality of life.

Staff and Office Factors May Negatively Affect Online Ratings for Spine Surgeons

Should spine surgeons ask patients if there were difficulties with the office appointment or surgical scheduling, and encourage patients to take an active role in billing prior to undergoing a surgical procedure in an attempt to provide more transparency for the patient?

Does Inflammatory Bowel Disease Complicate Lumbar Fusion Outcomes?

Inflammatory bowel disease is becoming increasingly more common among patients undergoing lumbar fusion, according to a retrospective, cross-sectional analysis of a nationwide database.

Porous PEEK May Have Better Impact Durability Over Titanium-Coated Device

Simulated cervical impaction testing showed fundamental differences in the response of porous versus titanium-coated PEEK devices, according to a recent study. Peer commentary by Khoi Than, MD.

Do Spinal Injections in the Treatment of Degenerative Disc Disease offer Value?

The 2015 Agency for Healthcare Research and Quality Assessment, although highly rigorous, may not be truly reflective of the entire evidence base regarding injections.

Treating Osteoporosis in Spine Surgery Patients

Study findings at a spine center reveal patients’ level of osteoporosis knowledge and experts weigh in on pre-operative osteoporosis treatment.

Enhanced Recovery After Surgery (ERAS) Protocol Reduces Opioid Use After Spinal Surgery

An enhanced recovery after surgery (ERAS) protocol for elective spine surgery and peripheral nerve surgery was associated with reduced opioid use at one month post-operatively.

Radiation-Free Surface Topography Is Highly Correlated With X-Ray Outcomes and Self-Image in Adolescent Idiopathic Scoliosis

Study explores scoliotic body shape distortions that are not depicted by x-rays routinely used to assess spinal curvature and improvements with corrective surgery.

Overcoming Barriers to Non-surgical Treatment for Lumbar Spinal Stenosis

Many patients with lumbar spinal stenosis are willing to comply with non-surgical treatment recommendations, including exercise, but face various barriers to treatment compliance, according to a qualitative study.

How to Improve Nursing Retention in Spine Practices

Nursing turnover rates are elevated in the United States, with estimates as high as 60% in some healthcare systems. Why nurses leave their jobs and solutions to improve nurse retention.

Physical Therapy for Cervical Radiculopathy Linked to Improved Post-surgical Outcomes

New findings suggest that physical therapy and epidural injections may have beneficial effects on post-surgical outcomes in patients with degenerative non-myelopathic cervical radiculopathy.

Effective Value-Based Initiatives for Complex Spine Surgery

Dr. Rajiv Sethi’s research lead to development of a spine safety improvement model that includes key factors needed at the individual, team, and organizational level to guide quality and safety improvement initiatives.

InFill Lumbar Fusion Systems Increase Bone Graft Volume Over Standard Prepacked Cages in Lumbar Interbody Fusion

The InFill Graft Delivery System can be used to “bulk up” a prepacked implant, or for a complete fill of the implant and disc space in-situ to maximize contact with the vertebral endplates.

Marked Variability in Diagnostic Interpretation of Lumbar Spine MRI Found

Magnetic resonance imaging (MRI) of a single patient’s lumbar spine at 10 different MRI centers showed marked variability in reported interpretive findings and a high prevalence of interpretive errors.

Diabetes and Chronic Kidney Disease Linked to Suboptimal Quality of Life Benefit After Lumbar Decompression

Patients with diabetes and chronic kidney disease do not experience expected improvements in quality of life following lumbar decompression in the treatment of lumbar degenerative disease.

Early Surgical Decompression Improves Outcomes From Spinal Cord Injuries

Early decompression should be considered as a treatment option for adults with traumatic spinal cord injuries, particularly in people with severe injury.

Assessing Mental Function, Pain, and Mobility in Men with Osteoporosis

How does osteoporosis affect the quality of life in males with the condition? Research in The Aging Male tackles this question.

Surgery for Lumbar Degenerative Disc Disease Increased by 2.4-fold in the Last Decade

Surgical treatment of lumbar/ lumbosacral degenerative disc disease increased by 2.4-fold between 2000 and 2009, according to data from a nationwide, population-based cohort published in the The Spine Journal.

Lumbar Herniated Discs: Diagnostic and Treatment Decision-Making

Richard Deyo, MD and Sohail Mirza, MD discuss the current research on lumbar herniated discs, including diagnostic pearls along with the most efficacious treatment options and guidelines.

Pre-Operative Depression Linked to Increased Opioid Use Following Lumbar Fusion

Delay lumbar spinal fusion until depression is treated? How does depression affect post-operative pain control?

Axial Spondyloarthritis: Are We Missing the Diagnosis?

Providers who treat back pain often lack a clear understanding of the presentation, diagnostic workup and treatment options for axial spondyloarthritis.

Women Are More Susceptible to Traumatic Lumbar Spine Injury Than Men

Gender differences in traumatic spine injuries include a higher rate of cervical spine fractures in men and a higher rate of thoracolumbar fractures in women.

Bundled Payments in Spine Surgery: Lessons Learned

While a majority of stakeholder groups are embracing the concept of bundles, physicians are not equally sold on the idea.

Neck Disability Index Scores of ≤7 Are Correlated with Patient Satisfaction Following Surgery for Degenerative Cervical Disc Disease

Findings from a study designed to correlate Neck Disability Index (NDI) score with patient satisfaction following anterior surgery for degenerative cervical disc disease.

Trends in Surgical Procedures Performed in Ambulatory Surgery Centers

Ambulatory surgery centers appear well-positioned to thrive in the continuing evolving health care industry, with industry experts forecasting strong industry growth in 2017.

Spine Surgery “Hype”? Robotics, Biologics, Navigation, Lasers

“Don’t Believe the Hype” was one of the popular symposiums held during the 17th Annual Meeting of the International Society for the Advancement of Spine Surgery (ISASS).

Depression Rates After Spine Surgery

Results from a large study evaluating risk for post-operative depression after spinal surgery suggest that psychosocial effects of major surgery on patients cannot be overstated.

Predictor of Return to Work after Lumbar Discectomy

The study focused on whether patients were working three months after surgery.

What Biopsychosocial Factors Increase Back Pain Risk?

Identifying people who are at the highest risk of developing back pain may open doors to research into targeted prevention strategies.

How Do Patients Choose a Spine Surgeon?

Many factors were evaluated and patients designated their preferences regarding six surgeon characteristics, including age, subspecialty, location, and appointment availability.

Patient Satisfaction Following Spine Surgery is Not Associated with Greater Opioid Use

“The take-home message from this study is that, certainly, communication of pain and the patient’s experience of pain are...

Which Patients Undergo Pre-Surgical Psychological Evaluation Before Spine Surgery?

How pre-surgical psychological evaluation may improve spine surgeons’ understanding of patients prior to intervention, allowing for better individualization of treatment based on both physiologic/biomechanical and psychosocial aspects of surgery.

ISASS Recommends Lumbar Decompression with Interlaminar Stabilization in Select Patients with Lumbar Spinal Stenosis

The International Society for the Advancement of Spine Surgery (ISASS) released a Policy Statement covering interlaminar stabilization in the treatment of lumbar spinal stenosis.

Mount Sinai Offers Onsite 3D Printing Services for Spine Clinicians and Researchers

Use of 3D printing in this case actually led to a change in the way the surgery was performed. “It was one of those sort of aha moments where we realized the potential power of 3D modeling used intra-operatively."

Volume Benchmarks for Common Lumbar Spine Surgeries Defined in Recent Study

Volume benchmarks for common lumbar spine surgeries were defined in a retrospective review published online ahead of print in The Spine Journal.

Advisory on rhBMP-2 in "The Spine Journal" Had a Greater Effect on Practice Than FDA Warning

New findings suggest the 2011 warnings in TSJ had a more profound impact on practice patterns in terms of decreasing rhBMP-2 use than the 2008 FDA warning.

Researchers Examine Optimal Vitamin D Dose for Osteoporosis

“Does a daily dose of 6,500 IU of vitamin D3 improve bone mineral density in the hip and spine when compared to a daily dose of 800 IU?”

Imaging Technology Improves Spinal Canal Tumor Detection

Scientists have developed a new computer system that works in conjunction with CT scans that improves detection of tumors in the spinal canal more clearly than ever. This latest technology was developed by doctors at the National Institutes of Health (NIH) Radiology and Imaging Sciences Department in Bethesda, Maryland.

How to Give Advice on Management of Low Back Pain

How do clinical trials that test advice for acute low back pain compare with practice guidelines in terms of content, method of delivery, and treatment regimens?

Spinal Fusions by Orthopaedic Surgeons Linked to Greater In-Hospital Complications in National Database

Patients undergoing PCDF who are operated on by orthopaedic surgeons are more likely to experience in-hospital complications than those operated on by neurosurgeons, according to data from a nationwide database. This discrepancy was not found among patients who underwent PCDF at a single institution where interdisciplinary collaboration via two-surgeon spinal surgery is common.

Preventing Glucocorticoid-Induced Vertebral Fractures

Case study reviews the mechanisms behind glucocorticoid-induced vertebral fractures as well as current recommendations for prevention and treatment.

What Comes First: Cervical or Lumbar Surgery for Tandem Spinal Stenosis?

This study provides additional support for treating the ‘proximal lesion’ first when the severity of stenosis symptoms is similar at the cervical spine and the lumbar spine, Choll Kim, MD, remarked.

Social Media for Doctors: How, When, and Why Physicians are Using Social Media

Facebook, Twitter, LinkedIn, Instagram, Snapchat—social media sites—not to mention marketing and patient outreach, can be overwhelming. Here’s how you and your practice can best utilize social media.

ACOs Not Linked to Improved Lumbar Spine Surgery Outcomes

Patients who underwent lumbar spine surgery at ACOs did not have improved 90-day post-surgical outcomes according to research published in The Spine Journal.

Early Physical Therapy For Musculoskeletal Pain Reduces Likelihood of Opioid Use

Use of physical therapy within 3 months of being diagnosed with musculoskeletal pain of the shoulder, neck, knee, or low back was link to a significantly lower likelihood of subsequent opioid use.

Pre-Operative Planning Reduces Complication Risk in Adult Spinal Deformity Surgery

Approximately 70% of patients undergoing adult spinal deformity surgery will develop perioperative or related complications. What is the best way to assess frailty in patients undergoing spine surgery?

Scoliosis Specific Exercise and Adolescent Idiopathic Scoliosis

In adolescents with idiopathic scoliosis, the goal of scoliosis specific exercise (SSE) treatment is prevention or reduction of curve progression, respiratory dysfunction, spinal pain, and improved appearance through postural correction.

Lumbar Spine Surgery Outcomes: Physiotherapy, Patient Mood and Behavior

Prolonged pain after surgery has been shown to be influenced by these factors: Patient selection, type of surgery performed, and whether or not there's a postoperative rehabilitation plan. Mood and patient behavior play a significant role in outcomes too.

Top 100 Most Frequently Cited Articles in Spine

Study provides a snapshot of the top 100 most frequently cited spine-related articles over the last 20 years and highlights the most common areas of concentration as well as gaps in the literature.

Paradigm Shift to Outpatient Spine Surgery Centers

Among the many changes ushered in by the Affordable Care Act is a focus on patient outcomes and the economics of health care in addition to clinical outcomes. Ambulatory surgery centers have evolved as one method to achieve these goals.

Lumbar Decompression Is Safe and Effective for Grade 1 Spondylolisthesis, Study Shows

Lumbar decompression is safe and effective for grade 1 spondylolisthesis-related spinal stenosis in patients with relative pre-operative stability, according to a retrospective review of prospectively collect data from a single center.

Cervical Excitatory Neurons Rescue Breathing After Spinal Cord Injury

Researchers discovered a novel neuronal circuit involving cervical excitatory interneurons that, when activated, rescue breathing after severe spinal cord injury.

Coflex Device Shows ‘Similar or Superior’ Efficacy to Fusion When Used With Decompression in 5-Year Study of Lumbar Spinal Stenosis

Decompression plus interlaminar stabilization with coflex® (Paradigm Spine, LLC) produced similar outcomes to decompression plus fusion with pedicle screws in the treatment of lumbar spinal stenosis.

Reimagining Spine Surgery Through Awake Spinal Fusion

NASS 2018 presentation on awake spinal fusions using spinal anesthesia in the outpatient setting, which led to improved outcomes and enhanced recovery time compared with performing these procedures under general anesthesia.

Marked Rise in Lumbar Fusion Rates Found in Past Decade

The rate of lumbar fusion performed in the United States increased by 32% between 2004 and 2015, with the largest increase found among patients aged 65 years and older.

Top 3 Device Manufacturers in the U.S. Spine Market

The total US spine market in 2017 was valued at over $7.7 billion USD. Of the many segments that make up this market, the MIS segment is among the fastest-growing. Of interest, the top 3 competitors in the overall market coincide with that of the MIS market, albeit in different orders.

9 Spine Technology and News Highlights August 2018

SpineUniverse highlights a blend of 9 news briefs covering spine industry corporate news, clinical research, 3D-printing advances and devices, and technical updates from August 2018.

Findings Support Vertebral Augmentation Over Non-surgical Management of Vertebral Compression Fracture

Strong support for vertebral augmentation over non-surgical management of vertebral compression fractures was found in a recent meta-analysis of 25 prospective studies.

Career Advancement Advice for Spine Professionals

As a spine professional, you have a much different experience in the job market compared to those in the business world. The focus isn’t merely on your technical skills.

Spine Technology News Highlights June 2018

Spine technology news highlights for June 18 include a novel investigational PEEK-on-ceramic cervical artificial disc, registration deadline and information about academic pain medicine programs and the NASS spine registry.

Factors May Predict Disc Degeneration Following Spinal Fusion for Adolescent Idiopathic Scoliosis

Lumbar disc degeneration following spinal fusion in the treatment of adolescent idiopathic scoliosis tends to occur in patients with greater L4 tilt angle and fewer mobile segments in the lower spine, according to a retrospective study.

Challenges of Spine Surgery in Patients With Osteoporosis

Management of spine surgery in patients with osteoporosis poses many challenges, given the additional complexity that poor-quality bone introduces to the surgical management.

Recombinant Bone Morphogenetic Protein Linked to Reduce Risk of Reoperation Following Spine Fusion for Adult Scoliosis

It is incumbent upon surgeons and researchers to provide clinical data for use of BMP in fusion surgery not only from large administrative databases, but also from single center studies.

Single-Level Instrumented Lumbar Interbody Fusion: The Impact of ASCs on Evidence-Based Medicine

Evidence-based medicine is the emerging trend in health care reform focused on making health care safer, less complicated, and more cost-effective.

Diabetes May Diminish QOL Improvement Following Lumbar Decompression

Diabetes was an independent predictor of diminished improvement in quality of life (QOL) after lumbar decompression surgery in a recent retrospective review.

Men With Osteoporosis Are At Increased Risk for Erectile Dysfunction

Men with osteoporosis should be evaluated for erectile dysfunction (ED), and men with ED should be screened for low bone mass density (osteoporosis), according to findings from a large nationwide study from Taiwan.

Do Sit-Stand Desks Have a Role in Spine Care?

Office workers who alternated between sitting and standing significantly increased the number of calories they burned without causing pain.

Instrument Assisted Soft Tissue Mobilization

The last 20 years have seen an explosion in the use of metal or hard plastic instruments to assess and treat soft-tissue injuries, such as in IASTM.

iMAS Technique Combines Open and Minimally Invasive Approaches for Treatment of Degenerative Spine Disorders

The intervertebral micro access surgery (iMAS) technique for transforaminal lumbar interbody fusion offers a novel approach for treatment of select degenerative lumbar disease processes. Learn more about this approach.

Elderly Women Report Worse Outcomes than Men Following Lumbar Discectomy, but Similar Satisfaction Rate

A review of the Swedish registry for spine surgery that looked at gender differences in over 1,000 elderly patients (age >65 years) who had a lumbar discectomy.

Higher Than Expected Rate of Reoperation Found Following Final Fusion in Early-Onset Scoliosis

Twenty percent of children with early-onset scoliosis who underwent growing-rod surgery required reoperation following final fusion. The higher than expected rate of reoperation has important implications for patient counseling.

Transsacral Fixation Is Linked to High Fusion Rate and Improved Quality of Life in Adult Scoliosis

Use of minimally invasive transsacral fixation resulted in fusion in nearly 90% of adults with scoliosis as well as improved health-related quality of life and a relatively low complication rate.

Adding Lateral Interbody Fusion to Open Surgery Improves Outcomes in Adult Spinal Deformity

Surgical correction of mild-to-moderate spinal deformity and sagittal imbalance is complex and often plagued by relatively high complication rates.

Addition of a Plasma-Sprayed Titanium Coated PEEK Interbody Implant to Anterior Lumbar Interbody Fusion Shows High Success Rate

The study involved 44 patients (48% male, mean age, 53 years) who received a PTC PEEK implant during single or multi-level anterior lumbar interbody fusion procedure.

Research Shows BMP Use in Pediatric Fusion Does Not Improve Revision Rates

First study to provide 10-year utilization and outcome data for rhBMP use in pediatric patients who underwent spinal arthrodesis. Jeffrey Wang, MD provides insightful commentary.

Epidural Steroid Injection Before Spine Surgery Linked to Postoperative Infection

The timing of lumbar epidural steroid injection (LESI) treatment before spinal fusion surgery may be an important risk factor for postoperative infection.

Clinical Massage Therapy “Real-World” Study Outcomes

In a first-of-its-kind study, clinical massage therapy was shown to produce "clinically meaningful improvement" for more than half of patients studied.

Music Therapy Decreases Pain After Spine Surgery

Music therapy, when combined with standard medical care, lowered pain perception in patients recovering from spinal fusion.

Global Recruitment Trends for Advanced Practice Providers in Spine Care

Nicola Hawkinson, DNP, RNFA, RN talked with SpineUniverse about trends in health care employment affecting spine practices today.

USC Launches Online Pain Medicine Programs

USC offers a Master of Science in Pain Medicine and a Certificate in Pain Medicine. Both online programs provide clinicians a comprehensive body of knowledge on pain and enable them to better treat pain in their patients.

Few Differences in Complication Rates Found Among Various Lumbar Microdiscectomy Techniques

A meta-analysis of complication rates from lumbar open microdiscectomy, microendoscopic discectomy (MED), and percutaneous microdiscectomy show few differences between the various techniques.

Is Vertebral Augmentation Beneficial for Compression Fractures in the Elderly?

Findings suggest that vertebral augmentation is efficacious for the treatment of compression fractures in elderly patients with osteoporosis, James S. Harrop, MD, told attendees at Spine Summit 2016.

iFuse Titanium Implant System Shows Efficacy and Safety in 2-Year Study

The introduction of minimally invasive alternatives to open SI joint fusion were met with skepticism early on; however, initial retrospective studies showed promise.

Osteoporotic Vertebral Fracture Risk in the Spine

Do homocysteine, vitamin B12, and folate impact the prevalence of asymptomatic osteoporotic vertebral fractures —specifically in the lumbar spine and proximal femur, in postmenopausal women?

Possible New Treatment for Type 1 Diabetes-induced Osteoporosis

Research published offers a possible new treatment for diabetes-induced osteoporosis.

Does Supplement to Prevent Osteoporosis Work in the Spine?

Researchers examined the effect on bone mineral density of a supplement that includes a combination of nutrients.

Is Anemia a Risk Factor for Osteoporosis in the Spine?

Researchers looked at the link between anemia and low bone mineral density—specifically in the spine and femur—in postmenopausal women living in Turkey.

Is Inflammatory Bowel Disease Linked to Osteoporosis?

A study set out to understand the relationship between osteoporosis and inflammatory bowel disease. Read the findings here.

Exploring the Link Between Poverty and Osteoporosis

A study in Clinical Endocrinology explored the associations between socioeconomic status and a person’s risk for osteoporosis, related fractures, and other health conditions.

A Comparison of Treatments for Osteoporotic Vertebral Compression Fractures

This study explored the clinical outcomes of patients with osteoporotic vertebral compression fractures who underwent different treatments for the condition.

Monthly Oral Ibandronate Boosts Bone Mineral Density in the Lumbar Spine

Is monthly ibandronate safe and effective when taken long-term?

Teriparatide Injections Can Improve Fusion Rates in Postmenopausal Women with Osteoporosis

A prospective trial was done to examine if teriparatide administration following instrumented lumbar posterolateral fusion would improve bone union in postmenopausal women with osteoporosis.

Formal Osteoporosis Screening Lowers Fracture Risk in Patients

A study was conducted to understand the effects of an osteoporosis screening program on patients’ fracture risk.

Predicting Osteoporotic Vertebral Compression Fractures in Women

What factors increase the risk of osteoporotic vertebral compression fractures in women who have reached menopause?

Epidural Steroid Injections and Osteoporotic Fracture Risk

Do epidural steroid injections (ESIs) play a role in a person’s risk of osteoporotic fractures?

What Are Optimal Screening Strategies for Treatment of Osteoporosis and Fractures of the Spine?

There were 202 frail women involved in the study. These women were 65 years old or older; their mean age was 85 years old.

Which Osteoporosis Medications Help Prevent Fractures in the Spine and Hip?

Researchers examined the efficacy of powerful antiresorptive agents that are currently available to help prevent fractures.

Does Inflammatory Bowel Disease Lead to Low Bone Mineral Density in the Lumbar Spine?

Researchers looked at whether inflammatory bowel disease could lead to osteoporosis in the lumbar spine, as well as other locations in the body.

Exploring the Association Between Osteoporosis and Psoriasis

Amidst controversy about the association between psoriasis and osteoporosis, their results demonstrate that both men and women with osteoporosis...

Osteoporosis in Patients with Parkinson’s Disease

What are the factors that influence the association between bone loss and Parkinson’s disease? A study in the Journal of Neurology explored this question.

Preventing Glucocorticoid-induced Osteoporosis in Men

Researchers examined bisphosphonates—specifically 2 osteoporosis medications and glucocorticoid-induced osteoporosis in men.

Low-molecular Weight Heparin New Warning Labels

Clinicians should carefully consider the timing of spinal catheter placement and removal in patients taking anticoagulant drugs.

Are Patients with Fibromyalgia at Risk for Osteoporosis of the Spine?

Patients with fibromyalgia typically have less sunlight exposure. The lack of exposure may put them at an increased risk of developing osteoporosis.

Monthly Minodronate Dose Safe and Effective for Osteoporosis

Researchers published a study on the safety and effectiveness of oral minodronate administered monthly.

How Effective Is High-impact Exercise on Osteoporosis?

How big of an impact does high-impact exercise have on bone health and osteoporosis?

The Concurrent Risks of Osteoporotic Fracture and Cardiovascular Disease

A study in the journal Bone set out to use risk factor algorithms to understand the association between osteoporosis risk factors and cardiovascular endpoints.

How Likely Are Women to Fracture a Bone While Taking Anti-osteoporosis Medications?

Researchers examined the characteristics of women who had a bone fracture—in the spine, wrist, or other location—after taking anti-osteoporosis medication.

Does Osteoporosis Influence Periodontitis Risk in Postmenopausal Women?

Is there an association between the low bone mineral density that occurs due to osteoporosis or osteopenia, and women’s risk of certain dental conditions?

Does Teen Pregnancy Lead to Osteoporosis?

Could teen pregnancy be a predictor of osteoporosis in postmenopausal women? Researchers explored this topic.

Can a Kale Supplement Boost Bone Mineral Density in the Spine?

Japanese researchers examined the effects kale supplementation has on bone mineral density (BMD) and bone metabolic markers in postmenopausal women.

Exercise at a Young Age May Prevent Later Osteoporosis

A study in the Asian Journal of Sports Medicine examines the effects of exercise and other interventions on low bone mass in young women.

Can Treatment Influence Osteoporotic Fracture Risk?

A study explored the characteristics that may cause patients taking alendronate to experience fractures.

How Lumbar Spine Degenerative Changes Affect BMD and Osteoporosis Diagnosis

Researchers looked at degenerative changes in the lumbar spine in elderly women using dual-energy x-ray absorptiometry (DXA).

Socioeconomic Status and Osteoporosis Risk

Is there an association between socioeconomic status, bone mineral density, and vertebral wedge deformities? A team led by researchers at the University of Melbourne in Australia explored this question.

Omega-3s and Exercise Have a Positive Effect on the Lumbar Spine

A study in Nutrition & Metabolism looked at how diet and exercise have a specific impact on osteoporosis in postmenopausal women.

FDA Warns Consumers of Pro ArthMax Dangers

The Food and Drug Administration (FDA) is advising consumers not to purchase or use Pro ArthMax, a product promoted and sold as a dietary supplement for joint, muscle and arthritic pain.

Women Report Better Outcomes After Surgery for Degenerative Lumbar Spondylolisthesis

Why women with degenerative lumbar spondylolisthesis are more likely to be satisfied with their surgical outcome.

Novel Scoring System Predicts Complications Post Spinal Fusion

A novel simple-to-use scoring system that can postoperatively predict which patients are at a higher risk for major complications from spinal fusion was published in The Spine Journal.

Spine-Related Disability: Understanding the Global Burden of Disease Studies

Understanding the global burden of spine-related disability was the focus of a recent presentation by Nicola V. Hawkinson, DNP, RN, RNFA at the 2nd Annual Spine 10 x 25 Summit.

Keys to Understanding Spine-Related Disability

Robert Barth, PhD, discusses three sets of key references he believes critical to changing our understanding of spine-related disability.

Role of Workers’ Compensation Data in Spinal Disability

Technology Update: Keith Rosenblum spoke about the unique role workers’ compensation data may play stemming from the rising tide of spinal disability costs worldwide.

Psychosocial Risk Factors for Extended Disability

Why do some people recover from an acute musculoskeletal injury, while others transition out of the acute injury phase in the opposite direction—toward chronic disability?

Innovative Biomarker Tool for Chronic Pain Assessment

The Neurophysiologic Pain Profile (NP3), combined with other standard technology and tools, provides unprecedented data that lets patients and physicians know what is necessary for each individual.

Abaloparatide Reduces Fracture Risk in Women with Osteoporosis

Daily injection of abaloparatide for 18 months significantly reduced the risk of new vertebral and nonvertebral fractures in postmenopausal women with osteoporosis at high risk of fracture.

Romosozumab Reduces Risk for New Vertebral Fractures in Postmenopausal Women with Osteoporosis

Results of the FRAME study involved 7,180 postmenopausal women with osteoporosis who were randomized to a monthly subcutaneous injection with either 210-mg romosozumab or placebo for 12 months.

Impact of Preoperative Fibrinogen Testing on Blood Loss in Adult Spinal Deformity Surgery

During large procedures, as bleeding continues, fibrinogen is one of the first factors consumed, and when depleted, excessive bleeding may occur.

Allogenic Blood Transfusions and Survival Following Surgery for Spinal Metastases

Researchers suggest that more liberal transfusion policies might be warranted for patients undergoing surgery for spinal metastasis.

Intracept Intraosseous Nerve Ablation System Reduces Pain and Disability in Chronic Axial Low Back Pain

Ablation of the intraosseous basivertebral nerve (BNV) is a recent FDA-approved treatment for axial chronic low back pain that does not respond to conservative care.

Adolescent Idiopathic Scoliosis Study, Skeletal Maturity and Surgical Considerations

An evaluation of differences in operative data and outcomes between patients with adolescent idiopathic scoliosis vs those with adult idiopathic scoliosis.

Benefits of Walking Sticks in Patients with Adult Degenerative Scoliosis

This study evaluated spatiotemporal relationships and kinematics of the lower extremities and spine during gait with walking sticks compared with a walker in 20 patients with scoliosis.

Why Perform Spinal Injections at All? Evidence is Weak

The audience discussion included the question, "If the patient is not a surgical candidate, would you and do you send that patient for pain management?"

Simple Tests for Lumbar Spondylolisthesis and Instability Show Efficacy

Despite the frequent occurrence of sponylolisthesis and lumbar instability in the United States, few physical examination findings have shown accuracy in detecting this condition.

Sex Life Question on Oswestry Disability Index is Accurately Answered by Most Patients with Chronic Low Back Pain

Anecdotal evidence suggests that the sex life-related question of the Oswestry Disability Index (ODI-8) may need to be altered because it is either inaccurately answered or limits patient participation in the survey.

Minimally Invasive Posterior or Transarticular Approach to Sacroiliac Joint Fusion?

Up to 20% of low back pain can be caused by one or both sacroiliac (SI) joints. Diagnosis of the SI joint as the pain generator can be challenging and requires...

Fibromyalgia Treated with Occipital Nerve Stimulation

The diagnosis, pathophysiology, and treatment of fibromyalgia were topics addressed at a Meeting of the American Association of Neurological Surgeons in Washington, DC.

Neuromodulation Holds Promise for Treatment of Non-Neurological and Neurological Conditions

The history of neuromodulation and outlook for the future were topics addressed.

Oral Steroids Provide Little Pain Relief Over Placebo in Acute Radiculopathy Due to Disc Herniation

“Each patient with acute radiculopathy (sciatica) will need to weigh the benefits and risks of taking a short course of oral steroids with their physician,”.

Nerve Root Involvement and Symptoms May Predict Treatment Success With McKenzie Method in Chronic Low Back Pain

The prospective cohort study involved 350 patients (age 18-60 years) with low back pain for more than 6 months who presented with centralization or peripheralization.

Bracing Plus Exercise to Promote Bone Mineral Growth Is Key to Managing Scoliosis in Adolescents

While brace treatment has been shown to slow down curve progression in adolescents with idiopathic scoliosis, physical activity—particularly in the form of weight-bearing activities—should also be prescribed to prevent bone mineral loss and promote bone mineral gain.

12 Sessions of Spinal Manipulation May Be Optimal for Chronic Low Back Pain

The study was designed to determine the optimal number of spinal manipulation sessions needed to give the most efficient care with the best outcomes.

Antibiotic Use in Childhood Linked to Increased Risk of Juvenile Idiopathic Arthritis

Antibiotics have a long and growing list of potential downsides, both short-term side effects and long-term risks. These risks need to be weighed against the potential benefits.

Race Impacts Severity of Adolescent Idiopathic Scoliosis and Likelihood of Surgery

"Hopefully, the findings of this study and other related investigations will lead to a better understanding among healthcare providers, in this case, scoliosis specialists".

MRI Equipment, Protocols, and Radiologists’ Expertise May Create Variability in Imaging Quality

An examination of the variability in quality of magnetic resonance imaging (MRIs) in the diagnosis of spine disorders.

Recommendations for Avoiding Position-Related Complications During Lumbar Surgery

New findings from a systematic review and meta-analysis suggest ways to avoid potentially severe complications associated with intraoperative positioning.

Do Occult Pathogens Play a Role in Failed Back Surgery?

Occult pathogens may play a role in chronic pain and failed fusion in instrumented spine surgery. The impact of this potential association is marked given the rising rates of instrumented spinal fusions in the past decade.

Opioid Focus: Federal Crisis Response, Education Versus Regulations and Legislation

The complexity of the opioid overdose problem is multifaceted and includes a poorly understood population, lack of provider education and an inordinate focus on pills and not the patient.

Nonopioid Multimodal Analgesia for Pre- and Post-Operative Spine Surgery

Multimodal analgesia, including use of nonopioid analgesia has emerged as a way to improve pain control following spine surgery and help limit the risk of opioid use.

Mobilization, Manipulation, and Clinical Massage Are Effective Treatments for Neck Pain

This study is an update on the landmark review performed in 2008 by the Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders.

Chêneau Brace Prevents Curve Progression and Improves Sagittal Parameters in Adolescent Idiopathic Scoliosis

Long-term use of the Chêneau brace in the treatment of adolescent idiopathic scoliosis may be associated with significant improvements in kyphosis, lordosis...

Acupuncture for Pediatric Back Pain

Study results show acupuncture could be a viable nonpharmacological option to improve back pain in pediatric patients.

Low Risk of Adjacent Segment Degeneration Found Following Lumbar Total Disc Replacement

“These findings finally verify the holy grail for those of us who have dedicated decades to disc replacement. We now have substantiated proof that this is correct,” stated Richard D. Guyer, MD.

Casting for Treatment of Early-Onset Scoliosis—Practice Pearls

Key points from the Scoliosis Research Society’s webinar on casting in treatment of early-onset scoliosis features commentary by faculty members.

Smoking Linked to Greater Blood Loss and Need for Transfusions in Spinal Surgery

Smoking is significantly associated with increased surgical blood loss and perioperative transfusions among patients undergoing lumbar spine surgery, according to a retrospective study,

Mesenchymal Stem Cell Allograft and ACDF Study Outcomes

Patients who received mesenchymal stem cell allografts during anterior cervical discectomy and fusion had lower fusion rates compared with a matched cohort of patients who received standard allografts.

Spine Biomechanics Laboratory Quantitates Functional Outcomes After Spine Surgery

The Spinal Biomechanics Laboratory is the first spine-related human movement biomechanics lab to be incorporated within a private practice spine center in the United States.

Osteoporosis Drug Significantly Reduced Fractures Compared to Traditional Treatment

Unlike previous romosozumab studies, this study showed the drug’s benefits beyond vertebral fractures, but cardiovascular risk puts FDA approval on hold.

Smokers With Cervical Disc Disease Have Increased Spine Surgery Rates

Are stronger pre-surgical smoking cessation programs needed? Zorica Buser, PhD, and Jeffrey C. Wang, MD, comment on the study findings.

Are Magnetically Controlled Growing Rods a Game Changer for Early-Onset Scoliosis?

The debate between magnetically controlled growing rods vs traditional growing rods continued at the Scoliosis Research Society's annual meeting.

Liberal Transfusions Linked to Increased Morbidity Following Spine Surgery

The impact of more liberal use of transfusions on patient outcomes in spine surgery was not investigated prior to this study.

Measuring Outcomes in the Treatment of Early Onset Scoliosis

Assessing outcomes in treatment of EOS entails more than just assessing the Cobb angle. At the 52nd Annual Meeting of the Scoliosis Research Society, presenters discussed options and outcomes.

ACA Brand Relaunch Aims to Set a Higher Standard for Chiropractic Care

Four key findings from the ACA’s Brand Study are revealed. David Herd, DC spoke with SpineUniverse about encouraging consistent, evidence-based care as part of the association’s goals.

What Factors Are Important to Patients When Deciding Between Minimally Invasive or Open Surgery for Posterior Lumbar Fusion?

Lead author, Dr. Hwee Weng Dennis Hey comments on this research study. Choll W. Kim, MD, offers his insight on the values of informed-consent.

AST-OPC1 Stem Cell Therapy May Offer New Hope for Spinal Cord Injury

Progress report: Rush University Medical Center are part of a multicenter phase 1/2a trial investigating the use of oligodendrocyte progenitor cells AST-OPCI for treatment of subacute cervical SCI.

Study Looks at the Effects of Teriparatide on Postmenopausal Women with Osteoporosis

The goal was to assess the effectiveness of a daily subcutaneous injection of teriparatide in postmenopausal women with osteoporosis.

Treatment Evaluation for Patients with Osteoporotic Vertebral Compression Fractures

The researchers set out to explore the efficacy of PV treatment in patients who were managing OVCFs following spinal fusion surgery for degenerative lumbar disease.

Alcohol’s Effect on Post-menopausal Bone Health

While it’s understood that moderate alcohol consumption is associated with higher bone mass in post-menopausal women, the actual mechanism that causes this is not understood.

Yoga Spinal Flexion Positions Can Cause Spinal Fractures in Osteoporotic Patients

Yoga is generally thought to be a “safe” exercise. However, some positions may not be advisable for people with low bone mass—either osteopenia or osteoporosis.

Short-term Aerobic Exercise with and without a Weighted Vest: What’s the Effect on Bone Metabolism?

There were 36 women in the study; all joined voluntarily and were sedentary and postmenopausal. The researchers randomly divided them into 3 groups.

Is Osteoporosis Associated with Poor Outcomes in Stroke Patients?

Learn whether researchers found osteoporosis linked to poor outcomes in stroke patients.

Does the Better Bones and Balance Program Help Prevent Bone Loss in the Hip and Spine?

US researchers evaluated Better Bones and Balance —a community-based exercise program to reduce fall and fracture risk—and its impact on bone health in a community setting.

Minimally Invasive Surgery for Adolescent Idiopathic Scoliosis Shows Same Efficacy as Open Approach with Less Transfusion Needs

The study is the first published case series comparing follow-up data from 7 patients with AIS who underwent MIS and 15 patients who underwent PSF.
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