Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Spine 114 articles


Is Surgery for Spine Metastasis Reasonable in Patients Older Than 60 Years?

Tangzhao Liang MD, PhD, Yong Wan MD, PhD, Xuenong Zou MD, PhD, Xinsheng Peng MD, PhD, Shaoyu Liu MD

Spinal metastases are common in patients older than 60 years with cancer. Because of the uncertainty of survival and the high incidence of fatal complications, however, chemotherapy and radiotherapy generally have been considered preferable and surgery a treatment of last resort for these patients. Further, the selection criteria indicating surgery and reliable prognostic factors for survival remain controversial.

Obesity Negatively Affects Spinal Surgery in Idiopathic Scoliosis

Christina K. Hardesty MD, Connie Poe-Kochert RN, CNP, Jochen P. Son-Hing MD, FRCSC, George H. Thompson MD

Are obese patients with idiopathic scoliosis undergoing spinal surgery at higher risk for perioperative complications? This is not clearly understood. One previous study showed a greater preoperative thoracic kyphosis but no increase in perioperative complications.

What is the Best Way to Apply the Spurling Test for Cervical Radiculopathy?

Yoram Anekstein MD, Ronen Blecher MD, Yossi Smorgick MD, Yigal Mirovsky MD

A diagnosis of cervical radiculopathy is based largely on clinical examination, including provocative testing. The most common maneuver was described in 1944 by Spurling and Scoville. Since then, several modifications of the original maneuver have been proposed to improve its value in the diagnosis of cervical radiculopathy.

Establishment of Parameters for Congenital Thoracic Stenosis: A Study of 700 Postmortem Specimens

Navkirat S. Bajwa BS, Jason O. Toy MD, Nicholas U. Ahn MD

Congenital thoracic stenosis (CTS) occurs when the bony anatomy of the canal is smaller than expected in the general population. The diagnosis currently is made based on the clinical impression from subjective radiographic studies, and the normal values for CTS have not been established.

L5 Pedicle Length Is Increased in Subjects With Spondylolysis: An Anatomic Study of 1072 Cadavers

Navkirat S. Bajwa BS, Jason O. Toy MD, Nicholas U. Ahn MD

In spondylolisthesis, it is believed that as L5 slips on S1, the pedicle may become elongated in response to the instability in an attempt to bridge the defect. Whether patients with spondylolysis, which is largely developmental, also develop elongation of the pedicles is unknown.

Is There Really No Benefit of Vertebroplasty for Osteoporotic Vertebral Fractures? A Meta-analysis

Ming-Min Shi MD, Xun-Zi Cai MD, Tiao Lin MD, Wei Wang MD, Shi-Gui Yan MD

Osteoporotic vertebral compressed fractures (VCFs) are the most common osteoporotic fractures. Although percutaneous vertebroplasty (PVP) reportedly relieves pain and improves function, a recent pooled analysis from two multicenter randomized controlled trials concluded the improvement in pain and disability treated with PVP was similar to those with sham surgery.

Prolonged Bed Rest as Adjuvant Therapy After Complex Reconstructive Spine Surgery

Rex A. W. Marco MD, Ryan M. Stuckey MD, Stephanie P. Holloway MHA

The benefits of postoperative mobilization include decreased incidence of pulmonary complications, pressure ulcers, and progression of deep vein thrombosis. However, the complexity of certain spinal reconstructions and the patient’s physiologic condition may preclude the possibility of early mobilization. Prolonged bed rest after spine surgery is controversial.

What Is the Prevalence of MRSA Colonization in Elective Spine Cases?

Antonia F. Chen MD, MBA, Srinivas Chivukula BS, Lloydine J. Jacobs MD, Matthew W. Tetreault BA, Joon Y. Lee MD

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing. However, the prevalence of MRSA colonization among patients undergoing spine surgery is unclear.

Spinal Cord Injury Resulting From Injury Missed on CT Scan: The Danger of Relying on CT Alone for Collar Removal

Gregory Gebauer MD, MS, Meredith Osterman MD, James Harrop MD, Alexander Vaccaro MD, PhD

Strict criteria have been used before removing cervical collars in patients with injuries who have midline pain or are unable to be reliably examined. This sometimes leads to prolonged immobilization in cervical collars or use of MRI to rule out injury. Several studies suggest a collar may be removed in the absence of fractures, dislocation, or pathologic subluxation on a cervical CT scan. This may avoid the morbidity of prolonged cervical immobilization or cost of advanced imaging study but risks devastating consequences from missing injuries.

Capacitive Coupling Reduces Instrumentation-related Infection in Rabbit Spines: A Pilot Study

Mohit Gilotra MD, Cullen Griffith MD, Jason Schiavone BA, Naren Nimmagadda BS, Jenna Noveau BS, Steven C. Ludwig MD

Postoperative spine infections cause considerable morbidity. Patients are subjected to long-term antibiotic regimens and may require further surgery. Delivery of electric current through instrumentation can detach biofilm, allowing better antibiotic penetration and assisting in eradicating infection.