Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Spine 112 articles


Nonoperative versus Operative Treatment for Thoracolumbar Burst Fractures Without Neurologic Deficit: A Meta-analysis

Sonali R. Gnanenthiran MBBS, Sam Adie BSc(Med), MBBS, MSpMed MPH, Ian A. Harris MBBS, MMed(Clin Epid), PhD, FRACS(Orth)

Decision-making regarding nonoperative versus operative treatment of patients with thoracolumbar burst fractures in the absence of neurologic deficits is controversial. Lack of evidence-based practice may result in patients being treated inappropriately and being exposed to unnecessary adverse consequences.

Value-based Care in the Management of Spinal Disorders: A Systematic Review of Cost-utility Analysis

Santoshi S. Indrakanti BS, Michael H. Weber MD, Steven K. Takemoto PhD, Serena S. Hu MD, David Polly MD, Sigurd H. Berven MD

Spinal disorders are a major cause of disability and compromise in health-related quality of life. The direct and indirect costs of treating spinal disorders are estimated at more than $100 billion per year. With limited resources, the cost-utility of interventions is important for allocating resources.

Complications of the Lateral Transpsoas Approach for Lumbar Interbody Arthrodesis: A Case Series and Literature Review

D’Mitri A. Sofianos MD, Michael R. Briseño MD, Joshua Abrams DO, Alpesh A. Patel MD

The lateral transpsoas approach to the lumbar spine was developed to eliminate the need for an anterior-approach surgeon and retraction of the great vessels and has the potential for shorter operative times. However, the reported complications associated with this approach vary.

Improvement in Reflux Gastroesophagitis in a Patient with Spinal Muscular Atrophy after Surgical Correction of Kyphoscoliosis: A Case Report

Jae Hyuk Yang MD, Niraj Sharad Kasat MD, Seung Woo Suh MD, PhD, Seung Young Kim MD, PhD

Scoliosis, a three-dimensional deformity, has secondary effects on the gastrointestinal system. Reflux gastroesophagitis with hiatus hernia in patients with scoliosis is difficult to manage. We present a patient in whom primary correction of a spinal deformity was associated with resolution of symptoms of reflux.

Cauda Equina Syndrome After a TLIF Resulting From Postoperative Expansion of a Hydrogel Dural Sealant

Brian J. Neuman MD, Kristen Radcliff MD, Jeffery Rihn MD

DuraSeal(Coviden, Waltham, MA, USA), a hydrogel sealant, is primarily used as an adjunct to a dural repair. Its use has also been described to seal off an annulotomy after a transforaminal lumbar interbody fusion when recombinant human bone morphogenetic protein-2 (rhBMP-2) is used. This aids in the reduction of postoperative radiculitis caused by rhBMP-2. However, as a result of its hydrophilic properties, DuraSealhas the potential to swell, which could lead to compression of the thecal sac.

Superiority of the Bryan® Disc Prosthesis for Cervical Myelopathy: A Randomized Study with 3-year Followup

Lei Cheng MD, PhD, Lin Nie MD, Mu Li MD, Yong Huo MD, Xin Pan MD

The current standard of care for cervical myopathy is anterior discectomy and fusion (ACDF). Although well tolerated in the short term, this treatment might ultimately result in progressive degeneration of adjacent motion segments. Artificial disc arthroplasty offers the theoretical advantage of preservation of motion at the operative level with consequent stress reduction at adjacent levels.

Case Report: Cauda Equina Syndrome Associated With an Interspinous Device

Worawat Limthongkul MD, Wicharn Yingsakmongkol MD

Although postoperative spinal epidural hematoma (SEH) is not uncommon, hematomas that require surgery are rare. Cauda equina syndrome (CES) may be associated with postoperative SEH. In these cases, early recognition and emergency decompression can prevent further damage and better neurologic recovery.

Odontoid Fractures With Neurologic Deficit Have Higher Mortality and Morbidity

Amar Patel BS, Harvey E. Smith MD, Kris Radcliff MD, Navin Yadlapalli BS, Alexander R. Vaccaro MD, PhD

Type II odontoid fractures are reportedly increasing in incidence and occur primarily in the elderly. Neurologic deficits (ND) at presentation add to the morbidity of these fractures; however, reports are limited as a result of small case series. It is unclear what specific complications are associated with ND and whether these result in increased incidence of mortality.

Convex Instrumented Hemiepiphysiodesis with Concave Distraction: A Preliminary Report

Ahmet Alanay MD, Ozgur Dede MD, Muharrem Yazici MD

The convex growth arrest (CGA) procedure has been well accepted for treatment of congenital scoliosis as it is a simpler procedure with successful results. However, unpredictability of curve behavior, slow and usually inadequate correction, and necessity of anterior surgery for completeness of the epiphysiodesis are its shortcomings.

Cervical Spine Surgery: An Historical Perspective

Vincenzo Denaro MD, Alberto Di Martino MD, PhD

Continued innovation in surgery requires a knowledge and understanding of historical advances with a recognition of successes and failures.