AO
The June 2023
The April 2023
The April 2024
A retrospective review of patients with spinal growing rods in a single institution. Demographic data including age at first surgery, diagnosis, pre- and post-operative cobb angles from erect standardised radiographs were collected. The type of construct used i.e.
The August 2023
The February 2023
The October 2023
Prolonged length of stay (LOS) is a significant contributor to the variation in surgical health care costs and resource utilization after elective
Infections in
The December 2022
The December 2023
The February 2024
The June 2024
The August 2024
Background. Lateral lumbar
Purpose. Patients may present with concurrent symptomatic hip and
Adult
A stiff
Sarcopenia has been observed to be a predictor of mortality in international studies of patients with metastatic disease of the
Lower back pain (LBP) is a worldwide clinical problem and a prominent area for research. Numerous in vitro biomechanical studies on
Primary care physicians rely on radiology reports to confirm a scoliosis diagnosis and inform the need for
Aims. With resumption of elective
Introduction: With a life of over five years,
Aims. The aim of this study was to assess the accuracy of pedicle screw placement, as well as intraoperative factors, radiation exposure, and complication rates in adult patients with degenerative disorders of the thoracic and lumbar
Background. Surgical site infection following
Aim. To evaluate efficacy of a one stage posterior approach in decompression and eradication of infection in TB
Numerous prediction tools are available for estimating postoperative risk following
Surgical site infections (SSIs) after spinal fusion surgery increase healthcare costs, morbidity and mortality. Routine measures of obesity fail to consider site specific fat distribution. We aimed to assess the association between the
Abstract. Objectives. Spinal disorders such as back pain incur a substantial societal and economic burden. Unfortunately, there is lack of understanding and treatment of these disorders are further impeded by the inability to assess spinal forces in vivo. The aim of this project is to address this challenge by developing and testing a novel image-driven approach that will assess the forces in an individual's
Aims. The aim of this paper is to describe the impact of COVID-19 on
Abstract. Introduction. Back pain affects 80% of the population at some stage in their life with significant costs to society. Mechanisms and causes of pain have been investigated by studying the behaviour of functional spinal units (FSUs) subjected to displacement- or load control protocols in 6 degrees of freedom (DOF). Load control allows specimens to move physiologically in response to applied loads whereas displacement control constrains motion to individual axes. The displacement control system of the Bath University six-axis
Introduction and Aims: To evaluate open, minimal invasive
Introduction. The effect of spine-pelvis position and motion on hip arthroplasty function has been increasingly appreciated in the past several years. Some authors have stressed the importance of using precision technologies for component placement while others have advocated the use of dual mobility articulations or large bearings and lateralized liners in patients with fused lumbar
Adverse events (AEs) following
Background. Our current research aims to develop technologies to predict spinal loads in vivo using a combination of imaging and modelling methods. To ensure the project's success and inform future applications of the technology, we sought to understand the opinions and perspectives of patients and the public. Methods. A 90-minute public and patient involvement event was developed in collaboration with Exeter Science Centre and held on World
Abstract. Objective. This study assesses the prevalence of major and minor discordance between hip and
Abstract. Introduction. Specialist Spinal Services provide operative and non-operative management strategies for a variety of conditions ranging from simple pathologies to complex disabling conditions. The existing spinal hub and spoke model implemented in 2015 nationally across the NHS. We aim to assess the effectiveness and pitfalls of the Spinal hub and spoke model in this questionnaire-based study. Methods. We conducted a prospective questionnaire-based study in the Northwest England and attendees of the BOA conference in 2021. Questionnaires included from the hospitals with no local spinal services and those with on-site services were excluded. Questions specific to initial assessment, referrals process, MRI availability, and awareness of
This study aims to 1) determine reported cannabis use among patients waiting for thoracolumbar surgery and to 2) identify demographics and health differences between cannabis-users and non-cannabis users. This observational cohort study is a retrospective national multicenter review data from the Canadian
This study aims to 1) determine reported cannabis use among patients waiting for thoracolumbar surgery and to 2) identify demographics and health differences between cannabis-users and non-cannabis users. This observational cohort study is a retrospective national multicenter review data from the Canadian
Purpose. To question the reliability of Thoracic
We validated the North American
Objective: A patient-specific finite element model of the
Mental disorders in particular depression and anxiety have been reported to be prevalent among patients with spinal pathologies. Goal of the current study was to analyze the relationship of Zung pre- and post-op score to other PROs and length of stay. Secondary outcomes included revision surgery and post-operative infections. Data from the international multicenter prospective
Generally, it is considered to be safe in preventing iatrogenic instability if half of the facet joint is left intact during decompression surgeries. By removing half of the facets can we get adequate decompression of the nerve roots? Is there a difference at different levels in the lower lumbar spine? What is the inclination of the facet joint at each level and how does it affect the stability?. Retrospective study. We analysed 200 consecutive magnetic reasonance imaging (MRI) scans of the lumbosacral
En bloc resection for primary bone tumours and isolated metastasis are complex surgeries associated with a high rate of adverse events (AEs). The primary objective of this study was to explore the relationship between frailty/sarcopenia and major perioperative AEs following en bloc resection for primary bone tumours or isolated metastases of the
Introduction: As an example of possibilities of
Aims. The aim of this study was to systematically compare the safety and accuracy of robot-assisted (RA) technique with conventional freehand with/without fluoroscopy-assisted (CT) pedicle screw insertion for
Introduction and Objective. Over the past few years, a reorganization of the educational pathways has been promoted with the purpose of optimizing the acquisition of competences and their assessment, so as to reduce the risks to both health care professionals and end users. Virtual reality (VR) has been repeatedly tested, initially as a positive reinforcement for more traditional educational pathways and, more recently, as their potential substitute. The aim of this study was to demonstrate the potentiality of VR simulation training in
Introduction. The placement of a large interbody implant allows for a larger surface area for fusion, vis a vis, via retroperitoneal direct anterior, antero-lateral and lateral approaches. At the same time, spinal navigation facilitates a minimally invasive fixation for inserting posterior pedicle screws. We report on the first procedures in the United Kingdom performed by a single-surgeon at a single- centre using navigated robot-assisted
Abstract. OBJECTIVES. Bone health deterioration is a major public health issue. General guidelines for the limitation of bone loss prescribe a healthy lifestyle and a minimum level of physical activity. However, there is no specific recommendation regarding targeted activities that can effectively maintain lumbar
Aims. Patients may present with concurrent symptomatic osteoarthritis (OA) of the hip and degenerative disorders of the lumbar
The December 2015
Abstract. Objectives. to evaluate the efficacy and safety of topically applied tranexamic acid (TXA) in thoracolumbar spinal tuberculosis surgery, posterior approach. Methods. Thoracolumbar
Due to the presence of megakaryocytes, platelets and clotting factors, bone marrow aspirate (BMA) tends to coagulate. For the first time, starting from our previous studies on mesenchymal vertebral stem cells, it has been hypothesized that coagulated BMA represents a safe and effective autologous biological scaffold for bone regeneration in spinal surgery. The present research involved advanced preclinical in vitro models and the execution of a pilot clinical study. Evaluation of cell morphology, growth kinetics, immunophenotyping, clonogenicity, trilineage-differentiation, growth-factors and HOX and TALE gene expression were analyzed on clotted- and un-clotted human V-BMA. In parallel, a pilot clinical study on ten patients with degenerative
Aims. The aim of this study was to determine the differences in spinal imaging characteristics between subjects with or without lumbar developmental spinal stenosis (DSS) in a population-based cohort. Methods. This was a radiological analysis of 2,387 participants who underwent L1-S1 MRI. Means and ranges were calculated for age, sex, BMI, and MRI measurements. Anteroposterior (AP) vertebral canal diameters were used to differentiate those with DSS from controls. Other imaging parameters included vertebral body dimensions, spinal canal dimensions, disc degeneration scores, and facet joint orientation. Mann-Whitney U and chi-squared tests were conducted to search for measurement differences between those with DSS and controls. In order to identify possible associations between DSS and MRI parameters, those who were statistically significant in the univariate binary logistic regression were included in a multivariate stepwise logistic regression after adjusting for demographics. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported where appropriate. Results. Axial AP vertebral canal diameter (p < 0.001), interpedicular distance (p < 0.001), AP dural sac diameter (p < 0.001), lamina angle (p < 0.001), and sagittal mid-vertebral body height (p < 0.001) were significantly different between those identified as having DSS and controls. Narrower interpedicular distance (OR 0.745 (95% CI 0.618 to 0.900); p = 0.002) and AP dural sac diameter (OR 0.506 (95% CI 0.400 to 0.641); p < 0.001) were associated with DSS. Lamina angle (OR 1.127 (95% CI 1.045 to 1.214); p = 0.002) and right facet joint angulation (OR 0.022 (95% CI 0.002 to 0.247); p = 0.002) were also associated with DSS. No association was observed between disc parameters and DSS. Conclusion. From this large-scale cohort, the canal size is found to be independent of body stature. Other than spinal canal dimensions, abnormal orientations of lamina angle and facet joint angulation may also be a result of developmental variations, leading to increased likelihood of DSS. Other skeletal parameters are spared. There was no relationship between DSS and soft tissue changes of the
Frailty has been shown to be a risk predictor for peri-operative adverse events (AEs) in patients undergoing various type of
Twenty-one patients with rigid kyphosis treated by single stage
Introduction: Spinous process osteotomy (SPO) and multiple laminotomy can be used for multi-level lumbar decompression. We conducted an experimental study to compare the effects of these two methods on spinal kinetics. Method: Ten fresh calf
INTRODUCTION. Tibiofemoral contact at the base of the articular surface
Aims. Chronic low back pain due to degenerative disc disease is sometimes treated with fusion. We compared the outcome of three different fusion techniques in the Swedish
Aims. While previously underappreciated, factors related to the
Abstract. Aim. With resumption of elective
Introduction: Dural tears are one of the most frequent type of complication in posterior spinal fusion with little known about their predictors. Method: Prospective consecutive study with an evidence level 2++ of 42 patients in the international
Purpose and Background. Both overall
Symptomatic lumbar spinal stenosis is a common entity and increasing in prevalence. Limited evidence is available regarding patient reported outcomes comparing primary vs revision surgery for those undergoing lumbar decompression, with or without fusion. Evidence available suggest a lower rate of improvement in the revision group. The aim of this study was to assess patient reported outcomes in patients undergoing revision decompression, with or without fusion, when compared to primary surgery. Patient data was collected from the Canadian
Aims. The surgical treatment of tuberculosis (TB) of the
The April 2015
Aims. The British
The Bernese periacetabular osteotomy (PAO) is a well-established procedure in the management of symptomatic hip dysplasia. The associated Smith-Petersen exposure offers excellent visualization of the acetabulum and control of acetabular osteotomy and mobilization. The traditional exposure of the true pelvis involves osteotomy of the iliac wing in order to mobilize the sartorial and inguinal ligament insertion. However, full osteotomy of the iliac
Post-operative infection is a serious complication of
The June 2014
The August 2013
In multilevel posterior cervical instrumented fusions, extending the fusion across the cervico-thoracic junction at T1 or T2 (CTJ) has been associated with decreased rate of re-operation and pseudarthrosis but with longer surgical time and increased blood loss. The impact on patient reported outcomes (PROs) remains unclear. The primary objective was to determine whether extending the fusion through the CTJ influenced PROs at 3 and 12 months after surgery. Secondary objectives were to compare the number of patients reaching the minimally clinically important difference (MCID) for the PROs and mJOA, operative time duration, intra-operative blood loss (IOBL), length of stay (LOS), discharge disposition, adverse events (AEs), re-operation within 12 months of the surgery, and patient satisfaction. This is a retrospective analysis of prospectively collected data from a multicenter observational cohort study of patients with degenerative cervical myelopathy. Patients who underwent a posterior instrumented fusion of 4 levels of greater (between C2-T2) between January 2015 and October 2020 with 12 months follow-up were included. PROS (NDI, EQ5D, SF-12 PCS and MCS, NRS arm and neck pain) and mJOA were compared using ANCOVA, adjusted for baseline differences. Patient demographics, comorbidities and surgical details were abstracted. Percentafe of patient reaching MCID for these outcomes was compared using chi-square test. Operative duration, IOBL, AEs, re-operation, discharge disposittion, LOS and satisfaction were compared using chi-square test for categorical variables and independent samples t-tests for continuous variables. A total of 206 patients were included in this study (105 patients not crossing the CTJ and 101 crossing the CTJ). Patients who underwent a construct extending through the CTJ were more likely to be female and had worse baseline EQ5D and NDI scores (p> 0.05). When adjusted for baseline difference, there was no statistically significant difference between the two groups for the PROs and mJOA at 3 and 12 months. Surgical duration was longer (p 0.05). Satisfaction with the surgery was high in both groups but significantly different at 12 months (80% versus 72%, p= 0.042 for the group not crossing the CTJ and the group crossing the CTJ, respectively). The percentage of patients reaching MCID for the NDI score was 55% in the non-crossing group versus 69% in the group extending through the CTJ (p= 0.06). Up to 12 months after the surgery, there was no statistically significant differences in PROs between posterior construct extended to or not extended to the upper thoracic
The October 2013
Aim: To measure the quality of five major scientific meetings by assessing the publication rate of papers presented and recording their citation index. Material and Methods: Abstracts of podium presentations at the meetings of the Scoliosis Research Society, International Society for the Study of the Lumbar
Aim: To measure the quality of five major scientific meetings by assessing the publication rate of papers presented and recording their citation index. Material and Methods: Abstracts of podium presentations at the meetings of the Scoliosis Research Society, International Society for the Study of the Lumbar
The lordosis distribution index (LDI) describes distribution of lumbar lordosis, measured as the % of lower lumbar lordosis (L4-S1) compared to global lordosis (L1-S1) with normal value 50–50%. Maldistributed LDI is associated with higher revision in short lumbar fusions, 4 vertebrae1. We hypothesise maldistributed LDI is also associated with mechanical failure in longer fusions. Retrospective review of 29 consecutive ASD patients, aged 55+, undergoing long lumbar fusion, 4 levels, with >3-years follow-up. LDI, pelvic incidence (PI) and sagittal vertical axis (SVA) were measured on pre- and post-op whole
The August 2012
The dismal outcome of tuberculosis of the
Introduction. From 2004 to 2015, elective lumbar fusions increased by 62% in the US. The largest increases were for among age 65 or older (139% in volume) and scoliosis (187%) [1]. Age is a well known factor of osteoporosis. The load-sharing may exceed the pedicular screws constructs in aging
Purpose and Background:. Healthy adults with a curvy (lordotic) lumbar
The June 2012
Background. Finite element (FE) models have become a standard pre-clinical tool to study biomechanics of
Introduction. Functional deficits persist in a significant percentage of total hip arthroplasties (THA), leading to patient dissatisfaction. Spinal stenosis is a leading cause of chronic disability and lower extremity weakness. Although previous studies have evaluated the potential benefit of THA on back pain, none have reported the effects of
As an example of benchmarking in spinal surgery using