Wrong-site Spine Surgery
Mark A. Palumbo, MD, Abstract Wrong-site spine surgery is an adverse event that has potentially devastating consequences for the patient as well as the surgeon. Despite substantial efforts to prevent wrong-site spine surgery, this complication continues to occur and has the potential for serious medical, personal, and legal repercussions. Although systems-based prevention methods are effective […]
Patient-reported Outcome Measures in Spine Surgery
John D. McCormick J Am Acad Orthop Surg February 2013 ; 21 Abstract The ultimate goals of intervention for spinal pathology are to improve the patients quality of life, restore function, and relieve pain. Traditional clinician-based assessments typically fall short of adequately addressing these important outcomes because these assessments are inherently biased and may not […]
Adjacent Segment Disease Following Cervical Spine Surgery
Samuel K. Cho, Abstract Cervical spine surgery is broadly divided into fusion and nonfusion procedures. Anterior cervical diskectomy and fusion (ACDF) is a common procedure, although adjacent segment disease following the surgery is an ongoing clinical concern. Adjacent segment cervical disease occurs in approximately 3% of patients per year, with an expected incidence of 25% […]
Bone Graft and Bone Graft Substitutes in Spine Surgery: Current Concepts and Controversies
Gregory Grabowski, Abstract Iliac crest bone graft has long been the standard adjunct used in spine fusion surgery. This graft provides osteogenic, osteoinductive, and osteoconductive elements that aid in creation of a fusion mass. However, morbidity associated with bone graft harvest has led surgeons to seek other potential adjuncts, including bone morphogenetic proteins, demineralized bone […]
Dropped Head Syndrome: Etiology and Management
Alok D. Sharan Abstract Dropped head syndrome (DHS) is characterized by severe weakness of the cervical paraspinal muscles that results in the passively correctable chin-on-chest deformity. DHS is most commonly associated with neuromuscular disorders. However, it is not always accompanied by electromyographic findings or noticeable changes on muscle biopsy. In such cases, the term isolated […]
Radiologic Assessment of Spinal Fusion
J Am Acad Orthop Surg November 2012 ; 20 Michael Derrick Selby Abstract Since surgical fusion of the spine was first described in 1911, multiple methods have been used to assess it. Although open surgical exploration remains the standard of care for determination of fusion, it is impractical in most clinical situations. Static radiographs have […]
The Spine-injured Patient: Initial Assessment and Emergency Treatment
J Am Acad Orthop Surg June 2012 vol. 20 no. 6 Rowan Schouten Abstract Failure to recognize spinal column or spinal cord injuries, or improper treatment of them, can have catastrophic and often irreversible neurologic consequences. Although the initial assessment is often shared with emergency care personnel, an orthopaedic surgeons perspective can elevate the priority […]
Radiographic Analysis of Spondylolisthesis and Sagittal Spinopelvic Deformity
J Am Acad Orthop Surg April 2012 Ying Li Abstract Traditional radiographic analysis of spondylolisthesis focuses on the regional sagittal deformity at the lumbosacral junction. Pelvic morphology has also been cited as an important factor that contributes to the development of high-grade spondylolisthesis. However, the importance of global sagittal balance of the spine and pelvis […]
Adult Scheuermann Kyphosis: Evaluation, Management, and New Developments
J Am Acad Orthop Surg February 2012 ; 20 Kirkham B. Wood Abstract Scheuermann kyphosis is a structural hyperkyphosis defined radiographically as anterior wedging of ≥5° of at least three consecutive vertebral bodies. Typically, the disease develops during adolescence but may not present until adulthood. The etiology remains unknown. Indications for management include progressive deformity, […]
Variations in Sacral Morphology and Implications for Iliosacral Screw Fixation
NULL Anna N. Miller JAAOS January 2012; 20 (1) Abstract Posterior pelvic percutaneous fixation following either closed or open reduction is a popular procedure. Knowledge of the posterior pelvic anatomy, its variations, and related imaging is critical to performing reproducibly safe surgery. The dysmorphic sacrum has several key characteristics. The upper portion of the sacrum […]