World Neurosurg
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This study examines patients with metastatic spinal disease undergoing non-total en bloc spondylectomy, focusing on revision surgery reasons and its effectiveness in treating spinal instability, neurological issues, and pain. ⋯ Long-segment fixation with radiotherapy may reduce revision surgery need and extend the time between surgeries. Hybrid or separation surgeries lower the likelihood of revision. Revision surgery can relieve pain and improve neurological function. Patients in the revision group have longer survival times.
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Patients with residual adolescent idiopathic scoliosis (AIS) and thoracolumbar/lumbar curves may present with progression after cessation of growth, with lateral translation as a major risk factor. Nonetheless, radiographic predictors and underlying mechanisms remain indefinite. This study aimed to determine these radiographic predictors and structural mechanisms in patients with residual AIS. ⋯ Facet joint instability, L4 tilt ≥20.5°, and L3 cranial vertebral bridging are predictive radiographic factors for L3 lateral translation in patients with residual AIS. Thus, patients exhibiting these characteristics require consistent follow-up or early surgical intervention before lateral translation occurs.
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To develop and validate a nomogram predicting the postoperative adding-on phenomenon in Lenke 1/2 adolescent idiopathic scoliosis patients, providing a quantitative tool for therapeutic benefit assessment and personalized risk prediction. ⋯ The model proved useful for predicting the occurrence of adding-on in Lenke 1/2 adolescent idiopathic scoliosis patients after surgery.
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Venous thromboembolism (VTE) is a serious postoperative adverse event after spine surgery. In patients with pain refractory to typical multimodal analgesia regimens after spine surgery, whom are often chronic opioid users, perioperative ketamine is an alternative analgesic that has grown in popularity. The aim of this study is to assess the risk of VTE in chronic opioid users undergoing spine surgery. ⋯ Our study found no association between chronic opioid use and VTE occurrence; however, we identified a significant association between ketamine infusion and VTE after spine surgery. Further studies should be conducted to identify the risks associated with ketamine and other newly implemented alternative analgesics.