Spine

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

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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...

PE
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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...

PA
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Early physical therapy provides a statistical but not a clinical improvement for acute axial back pain

November 2, 2015
Pain, Spine
By: 
Nathaniel P. Brooks, MD
Source: 
JAMA

Is physical therapy more beneficial than usual care in improving acute axial back pain?  Although this is not a common problem seen in neurosurgery or spine surgery clinics it is definitely a commonly asked question by our primary care colleagues....

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Steroid Use After Anterior Cervical Surgery Reduces Early Postoperative Dysphagia

August 31, 2015
Spine
By: 
H. Francis Farhadi, MD PhD
Source: 
Journal of Neurosurgery Reference

Steroid administration has been suggested as a possible treatment for post-operative dysphagia, which is a common early adverse event following anterior cervical surgery. Patients (N=112) were randomized in a 1:1 ratio to receive saline or dexamethasone with clinical and radiological...

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Two level cervical arthroplasty is as effective and safe as one level case

June 29, 2015
Spine
By: 
Yi Lu, MD PhD
Source: 
Spine

One level arthroplasty has been shown to be a safe alternative to one level anterior cervical diskectomy and fusion in selected patients with similarly excellent outcome. It has an added potential benefit of reducing the adjacent segment degeneration. Multi-level cervical...

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Surgical correction of adult spinal deformity improves back and leg pain

March 30, 2015
Spine
By: 
John S. Kuo, MD PhD
Source: 
Journal Neurosurgery Spine

Analysis of a prospectively collected, multi-center database of 421 adult spinal deformity (ASD) patients (235 surgical, 186 non-surgical patients) by the International Spine Study Group showed that surgical patients were 6.2 times more likely to experience improvement in back pain,...

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