• artificial intelligence
• complications
• logistic regression
• risk stratification
• spinal surgery
• standardized data registration

• Ankylosing spondylitis
• Anterior support
• Kyphosis deformity
• Posterior trans-intervertebral osteotomy

• Humans
• Spondylitis, Ankylosing/surgery
• Spondylitis, Ankylosing/complications
• Spondylitis, Ankylosing/diagnostic imaging
• Osteotomy/methods
• Kyphosis/surgery
• Kyphosis/etiology
• Kyphosis/diagnostic imaging
• Male
• Adult
• Female
• Middle Aged
• Treatment Outcome
• Follow-Up Studies

• CYFH202218 Beijing Chao-Yang Hospital, Capital Medical University

• Acute spinal fractures
• Ankylosing spondylitis
• Intraoperative navigation
• Post-operative outcomes
• Posterior spinal fusion

• Humans
• Spondylitis, Ankylosing/surgery
• Retrospective Studies
• Male
• Spinal Fusion/methods
• Female
• Aged
• Middle Aged
• Spinal Fractures/surgery
• Treatment Outcome
• Surgery, Computer-Assisted
• Fluoroscopy
• Tomography, X-Ray Computed
• Adult

• lumbosacral dissociation
• spinal fusion
• spine
• spondyloptosis
• traumatic

• Humans
• Adolescent
• Adult
• Aged
• Retrospective Studies
• Patient Readmission
• Cervical Vertebrae/surgery
• Spinal Fusion/adverse effects
• Diskectomy/adverse effects
• Postoperative Complications/epidemiology

• acute
• asia e
• fusion
• lumbosacral dissociation
• spine
• spondylolisthesis
• spondyloptosis
• surgical intervention
• trauma
• traumatic

• Old compression fracture
• cage
• kyphosis deformity
• thoracolumbar fracture
• trans-intervertebral space osteotomy

• Humans
• Fractures, Compression/surgery
• Retrospective Studies
• Blood Loss, Surgical
• Spinal Fractures/surgery
• Spinal Fractures/complications
• Thoracic Vertebrae/surgery
• Thoracic Vertebrae/injuries
• Lumbar Vertebrae/surgery
• Lumbar Vertebrae/injuries
• Treatment Outcome
• Kyphosis/surgery
• Kyphosis/complications
• Osteotomy/methods
• Fracture Fixation, Internal
• Musculoskeletal Abnormalities/complications

• critical care utilization
• intensive care unit
• orthopedic surgery
• step down unit
• surgical ICU

• Anterior thoracolumbar kyphorectomy
• hematoma
• hemothorax
• thoracolumbar kyphosis

This is a retrospective study.

To assess and compare the clinical outcomes of posterior unilateral limited laminectomy (ULL) or bilateral laminectomy (BL) debridement and bone grafting fusion combined with internal fixation among aged patients with single-segment thoracic and lumbar tuberculosis (SST/LTB).

We performed a retrospective study on aged patients (age > 65 years old) with SST/LTB from January 2010 to October 2018. We reviewed 36 aged patients who were treated with BL and 31 aged patients treated with ULL. All participants had undergone and finished a three-year follow-up. The outcomes were evaluated by the improvement of neurological function, correction Cobb angle, bone fusion time, and back pain, as well as operative time, blood loss, hospital stay, and postoperative complications.

The operative time, blood loss volume, and incidence of complications in group B were significantly less than those in group A (P < 0.01). The postoperative kyphotic angle in both groups was reduced significantly compared to the preoperative status (P < 0.01). The percentage of neurological improvement was 92.9% in group A and 90.9% in group B. All patients achieved solid bone fusion after surgery. At three-year follow-up, the angle loss in group B was significantly less than that in group A (P < 0.01); Furthermore, patients in group B had a lower average visual analog scale score of back pain and Oswestry Disability Index score than patients in group A (P < 0.05).

For aged patients with SST/LTB, ULL is a safer and more effective surgical treatment than BL.

• ACS-NSQIP database
• Anterior and lateral lumbar interbody fusion
• Difference-in-difference analysis
• Posterior and transforaminal lumbar interbody fusion
• Trends of lumbar interbody fusion

• Ghana
• complex spine deformity
• deformity
• pulmonary complication

• ACDF
• Charges
• Hospital size
• Length of stay
• Readmissions

• Analgesics, Opioid/administration & dosage
• Fascia/innervation
• Humans
• Lumbosacral Region/innervation
• Lumbosacral Region/surgery
• Morphine/administration & dosage
• Nerve Block/methods
• Pain Management/methods
• Pain Measurement/methods
• Pain, Postoperative/prevention & control
• Postoperative Nausea and Vomiting/diagnosis
• Postoperative Nausea and Vomiting/prevention & control
• Randomized Controlled Trials as Topic
• Spine/innervation
• Spine/surgery
• Surgical Wound/physiopathology
• Surgical Wound Infection/prevention & control
• Thorax/innervation
• Vomiting/diagnosis
• Vomiting/prevention & control

• combined anterior and posterior surgery (A-P)
• neurological deficit
• spinal fusion
• spine tuberculosis

• Elderly population
• Fenestrated augmented pedicle screws
• Osteoporosis
• PMMA
• Pulmonary embolism
• Spine surgery complication

• Aged
• Bone Cements/adverse effects
• Humans
• Lumbar Vertebrae/diagnostic imaging
• Lumbar Vertebrae/surgery
• Lung Injury
• Osteoporosis
• Pedicle Screws/adverse effects
• Polymethyl Methacrylate/adverse effects
• Prospective Studies
• Spinal Fusion/adverse effects

• anterior lumbar interbody fusion
• lateral lumbar interbody fusion
• simultaneous surgery
• minimally invasive spine surgery
• scoliosis
• deformity

• Adult
• Humans
• Lordosis/diagnostic imaging
• Lordosis/surgery
• Lumbar Vertebrae/diagnostic imaging
• Lumbar Vertebrae/surgery
• Lumbosacral Region
• Retrospective Studies
• Spinal Fusion
• Treatment Outcome

• UL1 TR002384 NCATS NIH HHS

Pott's disease is the most common granulomatous spine infection caused by tubercle bacilli and is a common site of osseous tuberculosis, accounting for 50–60% of cases. The delay in establishing diagnosis and management results in complications such as spinal cord compression and spinal deformity. The aim of this narrative review is to discuss the perioperative concerns in patients for spine surgery. The literature source for this review was obtained via PubMed, Medline, Google Scholar, Cochrane database of systematic reviews, and textbooks until December 2019. On the literature search, we could not retrieve any review article specifically discussing the perioperative concerns of spinal tuberculosis. Therefore, the aim of the present narrative review is to discuss the perioperative concerns of patients for spine surgery along with the specific concerns related to spinal tuberculosis.

• Anesthesia
• perioperative concerns
• spinal tuberculosis

We aimed to systematically review the literature to analyze the differences in posterior lumbar interbody fusion (PLIF), anterior lumbar interbody fusion (ALIF), and transforaminal lumbar interbody fusion (TLIF), focusing on the complications, risk factors, and fusion rate of each approach. Spinal fusion surgery is a well-established surgical procedure for a variety of indications, and different approaches developed. The various approaches and their advantages, as well as approach-related pathology and complications, are well investigated in spinal surgery. Focusing only on lumbosacral fusion, the comparative studies of different approaches remain fewer in numbers. We systematically reviewed the literature on the complications associated with lumbosacral interbody fusion. Only the PLIF, ALIF, or TLIF approaches and studies published within the last decade (2007–2017) were included. The exclusion criteria in this study were oblique lumbar interbody fusion, extreme lateral interbody fusion, more than one procedure per patient, and reported patient numbers less than 10. The outcome variables were indications, fusion rates, operation time, perioperative complications, and clinical outcome by means of Visual Analog Scale, Oswestry Disability Index, and Japanese Orthopaedic Association score. Five prospective, 17 retrospective, and two comparative studies that investigated the lumbosacral region were included. Mean fusion rates were 91,4%. ALIF showed a higher operation time, while PLIF resulted in greater blood loss. In all approaches, significant improvements in the clinical outcome were achieved, with ALIF showing slightly better results. Regarding complications, the ALIF technique showed the highest complication rates. Lumbosacral fusion surgery is a treatment to provide good results either through an approach for various indications as causes of lower back pain. For each surgical approach, advantages can be depicted. However, perioperative complications and risk factors are numerous and vary with ALIF, PLIF, and TLIF procedures, as well as with fusion rates.

• Anterior lumbar interbody fusion
• Complications
• L5/S1 fusion
• Posterior lumbar interbody fusion
• Risk factors
• Transforaminal lumbar interbody fusion

• anterior cervical discectomy and fusion (ACDF)
• cervical
• decompression
• degenerative
• degenerative disc disease
• disc
• discectomy
• fixation
• fusion
• neck pain

• ALIF = anterior lumbar interbody fusion
• ASA = American Society of Anesthesiologists
• CCI = Charlson Comorbidity Index
• EBL = estimated blood loss
• PSF = posterior spinal fusion
• UTI = urinary tract infection
• anterior approach
• circumferential fusion
• complications
• lumbar fusion

• Anterior lumbar interbody fusions
• Bundled payments
• Charlson Comorbidity Index
• Complications
• Elixhauser Comorbidity Index
• Outcomes
• Spine

To compare the efficacy, safety, and technical characteristics of anterior-only and posterior-only approach surgeries for the treatment of consecutive multisegment thoracic and lumbar tuberculosis.

Thirty-five patients who developed consecutive multisegment thoracic and lumbar tuberculosis from September 2012 to May 2016 were retrospectively analyzed. Group A was the posterior-only surgery group, and group B was the anterior-only surgery group. The data on the surgery, deformity correction, functional scores, and complications were compared between the two groups.

There was no significant difference in the operation time or blood loss between groups A and B (P > 0.05). The preoperative average Cobb angle of kyphosis in groups A and B were 36.2 ± 15.2° and 27.9 ± 7.7°, respectively, which significantly decreased to 4.9 ± 11.8° and 10.4 ± 5.6° after the operation, respectively (P < 0.05). At the final follow-up, the angles were 7.1 ± 10.5° and 14.6 ± 8.0°. The correction angle and correction rate in group A (31.3 ± 16.6°, 88.6 ± 43.6%) were greater than those in group B (17.5 ± 4.4°, 64.9 ± 14.0%) (P < 0.05). There was no significant difference in the loss angle between groups A and B (P > 0.05), but the loss rate in group B (24.0 ± 27.8%) was higher than that in group A (9.6 ± 10.2%) (P < 0.05). There was no significant difference in the incidence of complications between the two groups (P > 0.05).

The posterior-only and anterior-only approaches can lead to satisfactory clinical results in the treatment of patients with consecutive multisegment thoracic and lumbar tuberculosis. With posterior-only surgery, kyphosis can be better corrected, and the correction can be better maintained than with anterior-only surgery.

• Anterior-only approach
• Consecutive multisegment
• Deformity correction
• Kyphosis
• Posterior-only approach
• Spinal tuberculosis

With increasing prevalence of chronic diseases, multimorbid patients have become commonplace in the neurosurgical intensive care unit (neuro-ICU), offering unique management challenges. By reducing physiological reserve and interacting with one another, chronic comorbidities pose a greatly enhanced risk of major postoperative medical complications, especially cardiopulmonary complications, which ultimately exert a negative impact on neurosurgical outcomes. These premises underscore the importance of perioperative optimization, in turn requiring a thorough preoperative risk stratification, a basic understanding of a multimorbid patient’s deranged physiology and a proper appreciation of the potential of surgery, anesthesia and neurocritical care interventions to exacerbate comorbid pathophysiologies. This knowledge enables neurosurgeons, neuroanesthesiologists and neurointensivists to function with a heightened level of vigilance in the care of these high-risk patients and can inform the perioperative neuro-ICU management with individualized strategies able to minimize the risk of untoward outcomes. This review highlights potential pitfalls in the intra- and postoperative neuro-ICU period, describes common preoperative risk stratification tools and discusses tailored perioperative ICU management strategies in multimorbid neurosurgical patients, with a special focus on approaches geared toward the minimization of postoperative cardiopulmonary complications and unplanned reintubation.

• Cardiopulmonary complications
• Multimorbidity
• Neurocritical care
• Neurosurgery
• Perioperative complications
• Risk stratification

Lumbar spinal stenosis (LSS) is a degenerative spinal condition affecting nearly 50% of patients presenting with lower back pain. The goal of this review is to present and summarize the current data on how LSS presents in various populations, how it is diagnosed, and current therapeutic strategies. Properly understanding the prevalence, presentation, and treatment options for individuals suffering from LSS is critical to providing patients the best possible care.

The occurrence of LSS is associated with advanced age. In elderly patients, LSS can be challenging to identify due to the wide variety of presentation subtleties and common comorbidities such as degenerative disc disease. Recent developments in imaging techniques can be useful in accurately identifying the precise location of the spinal compression. Treatment options can range from conservative to surgical, with the latter being reserved for when patients have neurological compromise or conservative measures have failed. Once warranted, there are several surgical techniques at the physician’s disposal to best treat each individual case.

• Claudication
• Interspinous Spacer
• Spinal Stenosis

• ALIF = anterior lumbar interbody fusion
• APR-DRG = All Patient Refined Diagnosis-Related Groups
• ERAS = enhanced recovery after surgery
• HCUP = Healthcare Cost and Utilization Project
• ICD-9-CM = International Classification of Diseases, Ninth Edition, Clinical Modification
• LDD = lumbar disc degeneration
• LLIF = lateral transverse lumbar interbody fusion
• NIS = National (Nationwide) Inpatient Sample
• National Inpatient Sample
• OUD = opioid use disorder
• PLIF = posterior lumbar interbody fusion
• enhanced recovery
• lumbar disc degeneration
• opioid use disorders
• spine surgery

• Cervical myelopathy
• Decompression
• Fusion
• Morbidity
• National Inpatient Sample
• Outcomes
• Parkinson's disease

• elderly patients
• pulmonary complications
• risk factors
• vertebral compression fractures

The purpose of this study was to investigate the effect of the modified thoracolumbar interfascial plane block (TLIP) on postoperative analgesia and quality of recovery in patients undergoing lumbar disk surgery.

Ninety patients scheduled for lumbar disk surgery were divided into a control group (Group C) and a modified TLIP block group (Group T). Controlled analgesia was administered to both groups. Pain evaluation was performed at 30 min and at 1., 2., 4., 8.,12., and 24. hrs using a VAS scale, with patients at rest and duringand patients completed the QoR-40 quality of recovery inventory.

Fentanyl used during postoperative 24 hours was 742.5±220.3 mcg in Group C and 446.0±241.98 in Group T. Postoperative fentanyl consumption was statistically significantly lower in Group T (p<0.001) with a statistically significant intergroup difference. The patient’s pain, physical independence, physical comfort, psychological support, and emotional support were compared using the QoR-40 questionnaire survey. Significant differences in favor of Group T were observed (p<0.001, p=0.017, p=0.002, p=0.001 and p<0.001, respectively). Static and dynamic pain scores in Group C and Group T were recorded at 30 min and at 1, 2, 4, 8, 12, and 24^h. Mean static scores were statistically significantly different in favor of Group T with the exception of 8^th and 12^h assessments (p<0.05). Dynamic scores were statistically significantly different in favor of Group T at all time points (p<0.05).

Pain scores, opioid consumption and QoR-40 values after lumbar disk surgery were superior in the group undergoing TLIP. We think that the modified TLIP block may be an important method in terms of postoperative analgesia and patient recovery for lumbar spinal disk surgery.

• Fentanyl
• nerve block
• postoperative pain

• Bleeding disorder
• Complications
• PLF
• Polycythemia vera
• Posterior lumbar fusion
• Spine fusion
• Spine surgery

• Anterior combined with posterior approach
• Anterior-only approach
• Posterior-only approach
• Thoracolumbar tuberculosis

• Neurological disorders
• Neuroscience

• Abdomen
• Aged
• Compartment Syndromes/diagnostic imaging
• Compartment Syndromes/etiology
• Humans
• Male
• Postoperative Complications
• Spinal Fusion/adverse effects

laboratory research.

Through the increasing number of minimally invasive procedures in spinal fusion surgery, the complete removal of intervertebral disc (IVD) tissue has become more a challenge. Remaining IVD may interfere with the biological process of bone formation.

In order to establish whether complete removal of IVD tissue will improve or inhibit the fusion process, the effects of different concentrations of extracts of inflamed disc tissue on the mitochondrial activity of mesenchymal stem cells (MSCs), and the capacity to mineralize their extracellular matrix by osteoblasts and differentiated MSCs were tested in vitro.

A MTT assay was conducted to measure the mitochondrial activity of MSCs, and an Alizarin Red S staining quantification assay to measure the deposition of calcium by osteoblasts and differentiated, bone marrow-derived MSCs.

A significantly higher mitochondrial activity was shown in MSCs co-cultured with extracts of IVD tissue (10%, 50%, and 100%) compared with the control group after 48 hours of incubation, indicating that the IVD tissue extracts stimulated the mitochondrial activity of MSCs. This effect appeared to be inversely proportional to the concentration of IVD tissue extract. No significant differences in mineralization by human osteoblasts or differentiated MSCs were found between the samples incubated with IVD tissue extracts (3% and 33%) and the control samples.

Our findings indicate that remaining IVD tissue has more of a stimulating than inhibiting effect on the activity of MSCs. Even if inflammatory cytokines are produced, these do not result in a net inhibition of cellular activity or osteogenic differentiation of MSCs.

• Management
• Musculoskeletal Disorders
• Pain Medicine
• Spinal Pain
• Triage

• Complications
• NSQIP
• Surgical outcome
• Vertebral fracture

This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015.

This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach.

AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described.

We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds’ outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required.

The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds’ outcome analysis score at the latest follow-up revealed good-to-excellent outcomes in all patients.

ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.

• Andersson lesion
• Ankylosing spondylitis
• Posterior-only approach
• Pseudoarthrosis
• Spinal fractures

• NIS database
• lumbar spine surgery
• mortality incidence

• cervical fusion
• cervical surgery
• mortality

• HHI
• Health policy
• Hospital competition
• Lumbar fusion
• NIS
• Perioperative outcomes

• American Society of Anesthesiologists (ASA)
• Interbody fusion
• National Surgical Quality Improvement Program (NSQIP)
• anterior lateral interbody fusion (ALIF)
• posterior lateral interbody fusion (PLIF)
• transforaminal lateral interbody fusion (TLIF)

• Anterior column support
• Biomechanical
• Cervical
• Lateral mass screw
• Multilevel fracture
• Pedicle screw