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The current study has demonstrated that blended learning format, including online and F2F, is feasible and effective in training for a domain of spine surgery, pediatric deformity in this specific context.

The current study has demonstrated that blended learning format, including online and F2F, is feasible and effective in training for a domain of spine surgery, pediatric deformity in this specific context.

Longitudinal cohort study with 13-year follow-up.

To assess whether long-term disability is associated with baseline degenerative magnetic resonance imaging (MRI) findings in patients with low back pain (LBP).

In 2004-2005, patients aged 18 to 60 years with chronic LBP were enrolled in a randomized controlled trial and lumbar MRI was performed. Patients completed the Roland-Morris Disability Questionnaire (RMDQ) and the LBP Rating Scale, at baseline and 13 years after the MRI. Multivariate regression analysis was performed with 13-year RMDQ as the dependent variable and baseline disc degeneration (DD, Pfirrmann grade), Modic changes (MC), facet joint degeneration (FJD, Fujiwara grade) smoking status, body mass index, and self-reported weekly physical activity at leisure as independent variables.

Of 204 patients with baseline MRI, 170 (83%) were available for follow-up. Of these, 88 had Pfirrmann grade >III (52%), 67 had MC (39%) and 139 had Fujiwara grade >2 (82%) on at least 1 lumbar level. Only MC (β = -0.15,

= .031) and weekly physical activity at leisure (β = -0.51,

< .001) were significantly, negatively, associated with 13-year RMDQ-score (



= 0.31).

DD and FJD were not associated with long-term disability. Baseline MC and weekly physical activity at leisure were statistically significantly associated with less long-term disability.

DD and FJD were not associated with long-term disability. Baseline MC and weekly physical activity at leisure were statistically significantly associated with less long-term disability.

Cadaver study.

The retropharyngeal space's (RPS's) clinical relevance is apparent in anterior cervical spine surgery with respect to postoperative hematoma, which can cause life-threatening airway obstruction. This cadaver study aims to establish guidance toward a better understanding of the tolerance of the RPS to accommodate fluid accumulation.

Five fresh-frozen cadavers were dissected in the supine position. A digital manometer and a 20 Fr Foley catheter were inserted into the RPS via an anterolateral approach. While inflating the Foley catheter, the position of the esophagus/trachea was documented using fluoroscopy, and the retropharyngeal pressure was measured. We quantified the volume required to deviate the esophagus/trachea >1 cm from its original position using fluoroscopy. We also recorded the volume required to cause a visible change to the normal neck contour.

A mean volume of 12.5 mL (mean pressure 1.50 mm Hg) was needed to cause >1 cm of esophageal deviation. Tracheal deviation was encountered at a mean volume of 20.0 mL (mean pressure of 2.39 mm Hg). External visible clinical neck contour changes were apparent at a mean volume of 39 mL.

A relatively small volume of fluid in the RPS can cause the esophagus/trachea to radiographically deviate. The esophagus is the structure in the RPS to be most influenced by mass effect. The mean volume of fluid required to cause clinically identifiable changes to the normal neck contour was nearly double the volume required to cause 1 cm of esophageal/tracheal deviation in a cadaver model.

A relatively small volume of fluid in the RPS can cause the esophagus/trachea to radiographically deviate. The esophagus is the structure in the RPS to be most influenced by mass effect. The mean volume of fluid required to cause clinically identifiable changes to the normal neck contour was nearly double the volume required to cause 1 cm of esophageal/tracheal deviation in a cadaver model.

Retrospective cohort study.

To clinically evaluate saphenous nerve somatosensory-evoked potentials (SSEPs) as a reliable and predictable way to detect upper lumbar plexus injury intraoperatively during lateral lumbar trans-psoas interbody fusion (LLIF).

Saphenous nerve SSEPs were obtained by stimulation of inferior medial thigh with needle electrodes and recording from transcranial potentials. learn more The primary outcome was measured by testing reproducibility of SSEPs at baseline, changes during the procedure, and relevance to standard modalities. Significant SSEP changes were compared with actual postoperative nerve complications. The sensitivity and specificity of saphenous SSEPs to detect postoperative lumbar plexus nerve injury was calculated.

A total of 62 patients were included in the study. Reliable saphenous SSEPs were recorded on the LLIF approach side in 52/62 patients. Persistent saphenous SSEP reduction of amplitude of >50% in 6 cases was observed during expansion of the tubular retractor or during the procedure. Two of 6 patients postoperatively had femoral nerve sensory deficits, and 5 of 6 patients had mild femoral nerve motor weakness, all of which resolved at an average of 12 weeks postoperatively (range 2-24 weeks). One patient had saphenous SSEP changes but demonstrated intraoperative recovery and had no postoperative clinical deficits. Saphenous SSEPs demonstrated 52% to 100% sensitivity and 90% to 100% specificity for detecting postoperative femoral nerve complications.

Saphenous SSEPs can be used to detect electrophysiological changes to prevent femoral nerve injury during LLIF. Intraoperative SSEP recovery after amplitude reduction or loss may be a prognostic factor for final clinical outcome.

Saphenous SSEPs can be used to detect electrophysiological changes to prevent femoral nerve injury during LLIF. Intraoperative SSEP recovery after amplitude reduction or loss may be a prognostic factor for final clinical outcome.

A retrospective, comparative study.

To determine the radiological behavior of the lumbar curve in selective fusions in premenarchal girls with adolescent idiopathic scoliosis (Lenke 1 B/C).

A retrospective, comparative study was conducted. Selective fusion was performed in 21 patients younger than 18 years. The patients were divided into 2 groups group A, after menarche (n = 12) and group B, before menarche (n = 9). Angles (preoperative, and at 1 and 2 years postoperatively) of the fused thoracic curves and the corresponding lumbar curves were measured and compared. For statistical analysis, the

test was used with a significance level of

< .05.

Mean preoperative angle value of the proximal/main thoracic curve was 61° in group A and 57° in group B (

= .44), and 21° and 20°, respectively, in the first year postoperatively (

= .61). Mean preoperative angle value of the lumbar curve was 43° in group A and 42° in group B (

= .87), while at 1 year after surgery, this curve was 19° in both groups (

= 0.