Spine

Read the latest on spine-related findings and techniques in Neurosurgery Watch.

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Bupivacaine Field Block with Clonidine for Postoperative Pain Control in Posterior Spine Approaches: A Randomized Double-Blind Trial

August 2, 2018
Pain, Spine
By: 
Kelsey Hundley, MD
Erika Petersen, MD
Source: 
Neurosurgery

This double-blind study of 225 patients at a single center undergoing posterior cervical or lumbar surgery by the same surgeon demonstrated improved postoperative pain control when 150 ug clonidine was added to 20mL of bupivacaine for pre-incisional field block compared...

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Contralateral C7 Nerve Root Transfer Restores Hand Function After Cerebral Injury

March 1, 2018
Spine
By: 
Allan D. Levi, MD PhD
S. Shelby Burks, MD
Source: 
NEJM

CNS injury can lead to spastic upper extremity paralysis. Results of a prospective, randomized, single-blind controlled trial testing efficacy of nerve transfer with the contralateral C7 nerve root into the paralyzed limb in patients with central cerebral injury were reported...

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Long Term Results of Treating Thoracolumbar Burst Fractures With or Without Orthosis

September 27, 2017
Spine
By: 
H. Francis Farhadi, MD, PhD
Vibhu K. Viswanathan, MBBS
Source: 
Journal of Neurosurgery: Spine

External orthosis application for AO type 3 burst fractures in neurologically intact patients is considered a treatment option with unknown benefit. This study presents long-term follow-up results (mean 7.9 ± 1.1 years) on a subset of patients (n = 20...

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Outpatient ACDF costs less and is non-inferior to Inpatient ACDF

June 1, 2017
Spine
By: 
Jonathan Sherman, MD
Source: 
Neurosurgery

The cost of 1 and 2-level anterior cervical discectomy and fusion (ACDF) in inpatient (n = 46,996) and ambulatory settings (n = 3,315) were compared in a retrospective review of multiple State Inpatient and Ambulatory Databases. Outpatient ACDF was associated...

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VAPOUR - A Randomized-Controlled Study of Vertebroplasty for Acute Painful Osteoporotic Fractures

November 30, 2016
Spine
By: 
Justin Slavin, MD
Source: 
The Lancet (2016) 388: 1408-16

Two prior RCTs showed no benefit for vertebroplasty compared to non-surgical management of osteoporotic fractures up to 12 months after onset. The VAPOUR study is a randomized, placebo-controlled, double-blinded trial to assess effectiveness of vertebroplasty for acute fractures. 120 patients...

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Randomized trial of anterior cervical discectomy and fusion for radiculopathy

September 30, 2016
Spine
By: 
H. Francis Farhadi, MD PhD
Vibhu K. Viswanathan, MBBS
Source: 
Pubmed

Anterior cervical discectomy and fusion (ACDF) significantly enhances clinical outcomes at two years when compared to non-operative treatment for cervical radiculopathy. However, there is little evidence to suggest benefit beyond this period. In this Swedish multicenter randomized study, 5-8...

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Prospective Evaluation of Complication Rates Associated with Adult Spinal Deformity Surgery

August 1, 2016
Spine
By: 
H. Francis Farhadi, MD, PhD
Source: 
J Neurosurg Spine 25:1-14, 2016

Adult spinal deformity (ASD) surgery significantly improved quality of life compared to non-operative management at 2 years follow-up in a multicenter study. Researchers prospectively evaluated complication rates in 291 patients with a mean age of 56.2 years who achieved a...

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Outcomes of Operative and Nonoperative Treatment for Adult Spinal Deformity

June 30, 2016
Spine
By: 
Jonathan Sherman, MD
J. Bradley Elder, MD
Source: 
Neurosurgery

A prospective, multicenter, propensity-matched cohort assessment compared the outcomes of patients with at least a 2 year follow-up with adult spinal deformity (ASD) that were treated with operative versus non-operative measures (97 in each group).  The patients displayed at least...

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Randomized trials of lumbar fusion in addition to laminectomy for lumbar stenosis.

May 2, 2016
Spine
By: 
Justin Slavin, MD
Source: 
New England Journal of Medicine

Two randomized controlled studies were recently published that challenge the notion that instrumented fusion as an adjuvant to surgical decompression improves outcome when treating lumbar spinal stenosis. Forsth et al. randomized patients with symptomatic one and two-level lumbar stenosis with...

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Long-term outcomes after instrumented occipitocervical and atlantoaxial fusion in young children

February 8, 2016
Pediatrics, Spine
By: 
Brandon G. Rocque, MD MS
Source: 
Journal of Neurosurgery: Pediatrics

Craniocervical junction instability in children is a rare problem, and occipitocervical (O-C2) or atlantoaxial (AA) fusions are the commonly accepted treatments. One of the major theoretical risks is differential growth of the fused vertebrae relative to normal spine, possibly leading...

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