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Background context Outpatient postoperative pain management in spine patients, specifically involving the use of opioids, demonstrates significant variability. Purpose Using preoperative risk factors and 30-day postoperative opioid prescribing patterns, we developed models for predicting long-term opioid use in patients after elective spine surgery. Study design/setting This retrospective cohort study utilizes inpatient, outpatient, and pharmaceutical data from MarketScan databases (Truven Health). Patient sample In all, 19,317 patients who were newly diagnosed with low back or lower extremity pain (LBP or LEP) between 2008 and 2015 and underwent thoracic or lumbar surgery within one year after diagnosis were enrolled. Some patients initiated opioids after diagnosis but all patients were opioid-naïve prior to the diagnosis. Crenolanib inhibitor Outcome measures Long-term opioid use was defined as filling ≥180 days of opioids within one year after surgery. Methods Using demographic variables, medical and psychiatric comorbidities,er of days with active opioid prescription between postoperative days 15-30 (OR 1.10; 95% CI 1.07-1.12), and number of dosage increases between postoperative day 15-30 (OR 1.71, 95% CI 1.41-2.08). The strongest negative predictors were number of dosage decreases in the 30-day postoperative period. Conclusions We evaluated several predictive models for postoperative long-term opioid use in a large cohort of patients with LBP or LEP who underwent surgery. A regression-based model with high sensitivity and AUC is provided online to screen patients for high risk of long-term opioid use based on preoperative risk factors and opioid prescription patterns in the first 30 days after surgery. It is hoped that this work will improve identification of patients at high risk of prolonged opioid use and enable early intervention and counseling.Background context Ossification of the posterior longitudinal ligament (OPLL) and ligamentum flavum (OLF) are not uncommon independent causes of thoracic myelopathy (TM); however, concomitant OPLL and OLF at the same segment is rare. The ideal surgical strategy remains controversial, and it is difficult for surgeons to balance sufficient neural decompression while simultaneously reducing the occurrence of postoperative neurological defect after circumferential decompression (CD). Aiming to solve this dilemma, we investigated a CD-based surgery using intraoperative ultrasound (IOU) assistance to evaluate spinal decompression sufficiency. Purpose The aims of this study are to evaluate the surgical outcomes and identify prognostic factors of one-stage posterior surgery with IOU assistance in patients with concomitant OPLL and OLF. Study design/setting Retrospective study of a single-center TM database with long-term follow-up. Patient sample Twenty-four patients with TM and concomitant OPLL and OLF. Outcome measisk factor for poor RR.Background context The development of bone loss (BL) at the operated level after cervical disc arthroplasty (CDA) has not been well recognized. The incidence of bone loss (BL) may be correlated with the prosthesis type. Currently, no study has reported the incidence of BL after CDA with the Prestige-LP disc, and this remains an active area of research. Purpose To determine the incidence of BL after Prestige-LP CDA and evaluate the impact of BL on clinical and radiological outcomes. Study design This is an observational study PATIENT SAMPLE A total of 396 patients were reviewed. Outcome measures The Japanese Orthopedics Association (JOA), Visual Analogue Scale (VAS), and Neck Disability Index (NDI) scores were evaluated. Cervical lordosis, disc angle, global and segmental range of motion (ROM), heterotopic ossification (HO), and BL were measured. Methods We retrospectively reviewed patients who underwent Prestige-LP disc from January 2008 to October 2018 at our institution. Clinical outcomes were evaluated usiowever, patients suffering from BL showed no deterioration of the clinical outcomes, more exceptional motion preservation at the arthroplasty level, and lower incidence with a lower grade of HO.Background Intraoperative three-dimensional (3D) computed tomography (CT) imaging has become increasingly popular in spine surgery. Previous spine surgeon radiation exposure research has focused largely on procedures using fluoroscopy, however, few studies have been performed on the subject since the introduction of the 3D imaging systems. As a result, concerns have re-emerged over surgeon radiation exposure and the effectiveness of operating room (OR) protocols for decreasing workplace radiation. Current radiation safety guidelines require surgeons wear full body protective lead while any type of radiation is being administered during surgery. As a result, local institutions do not allow for the use of free-standing lead shields for sole radiation protection in the operating room. However, there is no data available to demonstrate whether the additional personal lead is required, or if in fact the lead shield alone is sufficient. Purpose This study investigated the effectiveness of a free-standing lead shiel lead shielding. If surgeons stand behind lead shields in the OR, the annual number of 3D image-guided spinal procedures required to surpass exposure limits is 15,479 and 67,060 based on "worst case" and "average case" analyses, respectively. Conclusion Our study demonstrates standing behind intraoperative lead shields is very effective at decreasing radiation exposure to surgeons. Additionally, surgeon radiation doses behind lead shielding fall far below annual exposure limits. Surgeons should not need additional protective equipment when a lead shield is used.Background context Narcotic use amongst patients suffering from lumbar radiculopathy is common, but the clinical benefit of narcotics for lumbar radiculopathy is likely minimal. It is unknown what the impact of pre-operative use of narcotics has on outcomes related to lumbar microdiscectomy. Purpose Determine the impact that pre-operative opioid use has on post-operative outcomes after lumbar microdisectomy. Study design Retrospective analysis of a prospectively collected database PATIENT SAMPLE One hundred and twenty-six patients undergoing a microdiscectomy for a lumbar disc herniation. Outcome measures Patient-reported outcomes measurement information system mental health scores (PROMIS MHS), patient-reported outcomes measurement information system physical health scores (PROMIS PHS) and oswestry disability index (ODI), METHODS We analyzed a prospectively collected database of patients undergoing a lumbar microdiscectomy for pre-operative opioid use. We measured the severity of lumbar pathology on MRI based on degree of facet/disc degeneration and cross-sectional area (CSA) of the dural tube at the disc herniation.