Hawkinsmoos0139

The mean age of the 38 patients (22 male and 16 female individuals) was 50.9 years (range, 21-71 y) at the time of surgery. The mean preoperative duration from disease onset was 14.9 months (range, 2-47 mo). GTR was achieved in 28 patients (74%) and STR in 10 (26%). The mean syrinx sizes preoperatively and at POM 1 and POM 12 were 7.5±2.3, 4.1±1.9, and 2.5±1.8 mm, respectively, with significant differences among the time points (P<0.01). The syrinx size shrunk over time after GTR and STR. The shrinkage rate was significantly higher in GTR cases (P<0.05) and in cases with the improvement of McCormick grade for neurological status after both GTR and STR (P<0.05).

These findings suggest that MRI can be used to evaluate the improvement of neurological status after surgery for spinal ependymoma.

These findings suggest that MRI can be used to evaluate the improvement of neurological status after surgery for spinal ependymoma.

Description of surgical technique and retrospective review.

To describe a novel surgical technique for multilevel lumbar fusion and describe early clinical results.

Patients with multilevel lumbar spinal stenosis and adult degenerative scoliosis often require multilevel interbody placement to achieve indirect decompression and lordosis. We describe a case series of patients treated with simultaneous lateral lumbar interbody fusion (LLIF) and anterior lumbar interbody fusion (ALIF) at L5-S1.

We retrospectively reviewed a consecutive series of patients treated for multilevel lumbar spinal stenosis with simultaneous ALIF and LLIF with at least 3-month follow-up. All patients received supplemental percutaneous bilateral pedicle screw placement as well. We measured on preoperative radiographs their lumbar lordosis, pelvic incidence, and L5-S1 lordosis. Intraoperative factors such as operative time, estimated blood loss, fluids provided, number of levels fused, and whether a trainee was present during the psurgery for treatment of lumbar degenerative conditions.

We have described our early positive results with simultaneous LLIF/ALIF surgery for treatment of lumbar degenerative conditions.

A retrospective cohort study.

To compare the postoperative opioid utilization rates and costs after anterior cervical discectomy and fusion (ACDF) procedures between groups of patients who were preoperative opioid users versus opioid naive.

Opioid medications are frequently prescribed after ACDF procedures. Given the current opioid epidemic, there is increased emphasis on early identification of patients at risk for prolonged postoperative opioid use.

Records from patients diagnosed with cervical stenosis who underwent a ≤3-level index ACDF surgery between 2007 and 2017 were collected from a large insurance database. International Classification of Diseases diagnosis/procedure codes, Current Procedural Terminology codes, and generic drug codes were used to search clinical records. Two cohorts were established a group of patients who utilized opioids preoperatively and a group of patients who were opioid naive at the time of surgery. The 1-year utilization and costs of postoperative therapies were docu Efforts should be made to avoid opioid use as a component of conservative management before surgery.

Level III.

Level III.

Retrospective review of prospectively collected single-institution database.

To analyze the clinical and radiographic outcomes of posterior thoracolumbar fusions using intraoperative computed tomography (CT)-guidance and stereotactic navigation in thoracolumbar spinal trauma.

Pedicle screw instrumentation is utilized for stabilization in thoracolumbar fusions. Suboptimal placement may lead to neurovascular complications, pseudarthrosis, postoperative pain, and the need for revision surgery. Image-guided spinal surgery is commonly used to improve accuracy, particularly for complex anatomy such as encountered with traumatic fractures.

We retrospectively identified 58 patients undergoing posterior thoracolumbar fusions using intraoperative CT and stereotactic navigation for traumatic fractures from 2010 to 2017 at a single institution. Pedicle screw accuracy, realignment, clinical outcomes, and ease of use were retrospectively reviewed. Accuracy was assessed on postplacement or postoperative CT. Breach ging as needed. CT-guidance maintains the benefit of reduced fluoroscopic exposure while improving accuracy of instrumentation and reducing reoperation for screw malposition.

Intraoperative CT-guidance and stereotactic navigation can overcome the difficulty associated with thoracolumbar trauma resulting in complex anatomy with malalignment and unpredictable trajectories. Intraoperative CT can be used with stereotactic guidance or for intraoperative verification of free-hand screw placement with repositioning as needed. CT-guidance maintains the benefit of reduced fluoroscopic exposure while improving accuracy of instrumentation and reducing reoperation for screw malposition.

Retrospective cohort study at a single institution.

To examine the effect of symptom duration on clinical outcomes after posterolateral lumbar fusion.

Nonoperative measures are generally exhausted before patients are indicated for surgical intervention, leaving patients with their symptomatology for varying lengths of time. Blasticidin S cost It is unclear at what point in time surgical intervention may become less efficacious at alleviating preoperative symptoms.

Consecutive patients who underwent primary elective open posterior lumbar spinal fusion at a single academic institution were included. Patient and operative characteristics were compared between symptom duration groups (group 1 <12 mo of pain, group 2 ≥12 mo of pain). Preoperative and final postoperative visual analog scale back/leg pain, and Oswestry Disability Index, were collected. Preoperative, immediate postoperative, and final radiographs were assessed to measure lumbar lordosis (LL), pelvic tilt (PT), pelvic incidence (PI), and the PI-LL difference was calculated.

In total, 167 patients were included in group 1, whereas 359 patients were included in group 2. Baseline demographics and operative characteristics were similar between the 2 groups. Both groups had similar changes in sagittal parameters and had no significant difference in rates of complication, reoperation, discharge to rehabilitation facility, or early adjacent segment degeneration. Both groups demonstrated similar improvement in clinical outcome measures.

Despite differences in symptom duration, patients who had pain for ≥12 months demonstrated similar improvement after posterolateral lumbar arthrodesis than those who had pain for <12 months. Extended effort of conservative treatments or delay of operative intervention does not appear to negatively impact the eventual outcome of surgery.

Level III.

Level III.