Spine
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Observational Study
Spinal Cord Medial Safe Zone for C2 Pedicle Instrumentation: An MRI Measurement Analysis.
Retrospective observational study. ⋯ We demonstrated that around 20% of patients had C2 P-D distance <4 mm, but no patient had C2 P-SC distance <4 mm. Since a lateral misplacement can lead to a potentially fatal vertebral artery injury, medial screw trajectory is recommended for C2 pedicle instrumentation with consideration of these safety margins.Level of Evidence: 3.
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Histological, immunohistochemical, and suspension array analyses of cytokine expression in human cervical ossification of the posterior longitudinal ligament (OPLL). ⋯ Our findings suggest that specific changes in the cytokine profile during ossification promote osteoblast differentiation, thereby providing new insights into OPLL pathogenesis. Moreover, this work supports the development of a new therapeutic method for preventing OPLL progression by regulating the cytokine profiles.Level of Evidence: 3.
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Observational Study
Propensity-Matched Comparison of 90-Day Complications in Robotic-Assisted Versus Non-Robotic Assisted Lumbar Fusion.
Retrospective single center propensity-matched observational cohort study that included patients who underwent 1- to 3-level lumbar fusion surgery for degenerative conditions. ⋯ In propensity-matched cohorts, patients undergoing 1- to 3-level robotic-assisted posterior lumbar fusion for degenerative conditions did not have increased 90-day complication rate, and had a shorter length of stay compared with non-robotic-assisted patients. There findings differ from a prior administrative database study as the robotic-assisted group in the current study had 0% return to OR for malpositioned screws and 0.8% return to OR for infection.Level of Evidence: 2.
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Basic in vivo research. ⋯ This model was thought to be appropriate for analyzing the pathogenesis of C5P since our findings were comparable to the clinical course of C5P subsequent to posterior cervical decompression. Although a future study for clarifying histological and molecular alterations will be needed, tethering of the anterior rootlets due to posterior cord shift was suggested to be a probable mechanism causing C5P.Level of Evidence: 5.
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Prospective cohort study. ⋯ Preoperative DVT screening by US is advisable for patients with elevated d-dimer levels, lower extremities with MMT < grade 3, or DVT positivity. Postoperative US is advisable for patients with elevated SFMC levels on POD1.Level of Evidence: 3.