News and Research for Spine Professionals

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.

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.

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.

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.

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.

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...

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.

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.

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.

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.

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".

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.

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.

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.
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