Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Spine 114 articles


Does Surgical Timing Influence Functional Recovery After Lumbar Discectomy? A Systematic Review

Andrew J. Schoenfeld MD, Christopher M. Bono MD

The impact of the duration of preoperative symptoms on outcomes after lumbar discectomy has not been sufficiently answered in a single study but is a potentially important clinical variable.

Does Less Invasive Spine Surgery Result in Increased Radiation Exposure? A Systematic Review

Elizabeth Yu MD, Safdar N. Khan MD

Radiation exposure to patients and spine surgeons during spine surgery is expected. The risks of radiation exposure include thyroid cancer, cataracts, and lymphoma. Although imaging techniques facilitate less invasive approaches and improve intraoperative accuracy, they may increase radiation exposure.

A 33-year-old Man With Low Back Pain

Dafang Zhang MD, Kathryn Hess BA, G. Petur Nielsen MD, Joseph H. Schwab MD

Minimally Invasive Versus Open Sacroiliac Joint Fusion: Are They Similarly Safe and Effective?

Charles G. T. Ledonio MD, David W. Polly MD, Marc F. Swiontkowski MD

The sacroiliac joint has been implicated as a source of chronic low back pain in 15% to 30% of patients. When nonsurgical approaches fail, sacroiliac joint fusion may be recommended. Advances in intraoperative image guidance have assisted minimally invasive surgical (MIS) techniques using ingrowth-coated fusion rods; however, how these techniques perform relative to open anterior fusion of the sacroiliac joint using plates and screws is not known.

Spontaneous Age-related Cervical Disc Degeneration in the Sand Rat

Helen E. Gruber PhD, Ryan Phillips BS, Jane A. Ingram BS, H. James Norton PhD, Edward N. Hanley MD

Disc space narrowing, osteophytes, and disc degeneration are common and increase with aging. Few animal models are appropriate for the study of spontaneous age-related cervical disc degeneration.

Complications Associated With the Initial Learning Curve of Minimally Invasive Spine Surgery: A Systematic Review

Joseph A. Sclafani MD, Choll W. Kim MD, PhD

There is an inherently difficult learning curve associated with minimally invasive surgical (MIS) approaches to spinal decompression and fusion. The association between complication rate and the learning curve remains unclear.

CT Provides Precise Size Assessment of Implanted Titanium Alloy Pedicle Screws

Michael J. Elliott MD, Joseph B. Slakey MD, CAPT, MC, USN

After performing instrumented spinal fusion with pedicle screws, postoperative imaging using CT to assess screw position may be necessary. Stainless steel implants produce significant metal artifact on CT, and the degree of distortion is at least partially dependent on the cross-sectional area of the implanted device. If the same effect occurs with titanium alloy implants, ability to precisely measure proximity of screws to adjacent structures may be adversely affected as screw size increases.

Do Epidural Injections Provide Short- and Long-term Relief for Lumbar Disc Herniation? A Systematic Review

Laxmaiah Manchikanti MD, Ramsin M. Benyamin MD, Frank J. E. Falco MD, Alan D. Kaye MD,PhD, Joshua A. Hirsch MD

As part of a comprehensive nonsurgical approach, epidural injections often are used in the management of lumbar disc herniation. Recent guidelines and systematic reviews have reached different conclusions about the efficacy of epidural injections in managing lumbar disc herniation.

Disc Space Preparation in Transforaminal Lumbar Interbody Fusion: A Comparison of Minimally Invasive and Open Approaches

Jeffrey A. Rihn MD, Sapan D. Gandhi BS, Patrick Sheehan BBA, Alexander R. Vaccaro MD, PhD, Alan S. Hilibrand MD, Todd J. Albert MD, David G. Anderson MD

Minimally invasive surgical (MIS) approaches to transforaminal lumbar interbody fusion (TLIF) have been developed as an alternative to the open approach. However, concerns remain regarding the adequacy of disc space preparation that can be achieved through a minimally invasive approach to TLIF.

Minimally Invasive Surgical Approaches in the Management of Tuberculosis of the Thoracic and Lumbar Spine

Nitin Garg MCh, MS, MRCS(Edin), Renuka Vohra DNB, DMRD

Spinal tuberculosis is the most common form of skeletal tuberculosis. Various approaches have been described for surgical management of spinal tuberculosis, but many entail wide exposures with attendant morbidity; whether minimally invasive surgical (MIS) approaches are suitable is unknown.