JOURNAL OF NEUROSURGERY-SPINE

A validation defense of the PROMIS-10 in anterior cervical spine surgery
Tippins NP, Foreit AM, Potts EA and Alentado VJ
The Patient-Reported Outcomes Measurement Information System Global Health-10 (PROMIS-10) has not been validated for use in anterior cervical spine surgery (ACSS). The PROMIS-10 distinctly measures global physical health (GPH) and global mental health (GMH) domains, setting it apart from other patient-reported outcome measures (PROMs). This study aimed to validate the PROMIS-10 and identify minimum clinically important differences (MCIDs) in PROMIS-10 GPH and GMH scores in ACSS.
Cage migration in multilevel stand-alone lateral lumbar interbody fusion: incidence and clinical correlations
Lee JJ, Giraldo JP, Eghrari NB, Lee KE, Abbatematteo JM, Williams GP, Turner JD and Uribe JS
The objective of this study was to investigate the incidence and postoperative clinical outcomes of lateral interbody cage migration (LCM) in patients undergoing multilevel stand-alone lateral lumbar interbody fusion (LLIF) compared with an aged-matched cohort undergoing LLIF with posterior pedicle screw instrumentation.
Reassessing the minimal clinically important differences of patient-reported outcomes in cervical myelopathy: a patient-centered approach from the Canadian Spine Outcomes and Research Network
Lozano CS, Shakil H, Evaniew N, Dea N, Malhotra AK, Davis AM, Paquet J, Weber MH, Phan P, Rodrigues Fernandes R, Attabib N, Cadotte DW, Christie SD, Small CA, Wang Z, Nataraj A, Fisher C, Rampersaud YR, Bailey CS, Glennie RA, McIntosh G and Wilson JR
The objective of this study was to determine minimal clinically important difference (MCID) values for patient-reported outcomes (PROs) including the 12-Item Short-Form Health Survey (SF-12) Physical Component Summary (PCS), SF-12 Mental Component Summary (MCS), and Neck Disability Index (NDI) in patients with degenerative cervical myelopathy (DCM) undergoing surgery, and to assess whether MCID values vary by baseline disease severity.
Impact of discharge to subacute rehabilitation or home with health services on prolonged length of stay and increased inpatient expense following elective surgery for cervical spondylotic myelopathy: a propensity score-matched Quality Outcomes Database study
Howell HJ, Khan FA, Mummaneni PV, Shlobin NA, Chou D, DiGiorgio AM, Bydon M, Bisson EF, Shaffrey CI, Gottfried ON, Asher AL, Coric D, Potts EA, Foley KT, Wang MY, Fu KM, Virk MS, Knightly JJ, Meyer SA, Park P, Upadhyaya CD, Yen CP, Uribe JS, Tumialán LM, Turner JD, Haid RW and Chan AK
Surgery for cervical spondylotic myelopathy (CSM) is becoming increasingly common and costly. Using propensity score matching to rigorously control for demographic, clinical, and surgical confounders, the authors provide the most refined assessment yet of the impact of discharge to subacute rehabilitation (SAR) or home with health services on excess length of stay (LOS) and inpatient expense following surgery for CSM.
Impact of postoperative C5 palsy on quality of life in patients with cervical ossification of the posterior longitudinal ligament: a prospective study
Segi N, Nakashima H, Imagama S, Egawa S, Sakai K, Kusano K, Tsutsui S, Hirai T, Matsukura Y, Wada K, Katsumi K, Koda M, Kimura A, Furuya T, Maki S, Nagoshi N, Nishida N, Nagamoto Y, Oshima Y, Ito S, Endo T, Mori K, Nakajima H, Murata K, Miyagi M, Kaito T, Yamada K, Banno T, Kato S, Ohba T, Takahata M, Moridaira H, Otsuki B, Katoh H, Kanno H, Taneichi H, Kawaguchi Y, Takeshita K, Nakamura M, Yamazaki M and Yoshii T
The impact of C5 palsy on quality of life (QOL) and its relationship with recovery and overall well-being remain poorly understood. In this study, the authors aimed to examine the effects of postoperative C5 palsy on upper extremity function and QOL in patients undergoing cervical ossification of the posterior longitudinal ligament (C-OPLL) surgery, using both objective clinical assessments and patient-reported outcome measures (PROMs). Additionally, this study aimed to explore the correlation between residual C5 palsy and QOL over a 2-year period.
Effect of early mobilization on 30-day wound complications following sacral amputation for en bloc tumor resection
Sadagopan NS, Chaliparambil RK, Du R, Sriram N, Jain R, Benato A, Prasad D, Cach G, Alghoul MS, Ellis MF, Jordan SW, Ko JH, Galiano RD, Dumanian GA and Wolinsky JP
Sacral amputations for en bloc resection of malignant spinal tumors are associated with significant morbidity, especially wound complications, and require complex plastic surgery reconstructions to achieve wound closure. In this study, the authors investigate wound healing related to early postoperative mobilization (≤ 3 days of bed rest) compared with delayed postoperative mobilization (> 3 days of bed rest). The primary outcome was 30-day postoperative wound complications.
Are there distinct patterns of clinical deficits in cervical deformity? A discriminant analysis of health-related quality of life measures
Finoco M, Sivaganesan A, Lafage R, Passias PG, Klineberg EO, Mundis GM, Protopsaltis TS, Shaffrey CI, Bess S, Kim HJ, Ames CP, Schwab FJ, Smith JS and Lafage V
While health-related quality of life (HRQOL) measures have been extensively quantified in cervical deformity (CD), this clinical dimension has not yet been fully integrated into understanding CD radiographic subtypes prior to surgery. The aim of this study was to identify distinct patterns of HRQOL deficits among patients with CD by focusing on clinical scores and to examine the association of these patterns with radiographic morphotypes of CD.
Erratum. Editorial. Paraspinal musculature and bone quality: the answer to the mode of proximal junctional kyphosis
Shasby G
Effects of glucagon-like peptide-1 agonist therapy on vertebral bone mineral density as measured by CT-based Hounsfield units
Martini ML, Hamouda AM, Pennington Z, Rechberger JS, Mikula AL, Lakomkin N, Perez J, Flanigan P, Sebastian A, Freedman B, Helgeson MD, Nassr A, Krauss WE, Clarke MJ, Fogelson JL, Kennel K and Elder BD
Glucagon-like peptide-1 (GLP-1) agonists are established therapeutics for weight loss that are increasingly used for BMI optimization prior to spine surgery. However, emerging evidence has suggested that GLP-1 agonists might reduce bone mineral density (BMD), increasing the risk of postoperative biomechanical complications. CT-based Hounsfield units (HUs) have gained popularity as a method for measuring spinal BMD. The aim of this study was to evaluate the effects of GLP-1 agonist-induced weight loss on spinal BMD as measured by opportunistic CT-based HUs.
Age as a predictor of patient-reported outcomes in anterior cervical discectomy and fusion: analysis of the Michigan Spine Surgery Improvement Collaborative
Beladi RN, Lawless MH, Tong D, Li C, Claus CF, Carr DA, Houseman CM, Kelkar PS, Richards B, Abdulhak MM, Aleem IS, Khalil JG, Perez-Cruet MJ, Easton R, Nerenz DR, Kazemi NJ, Taliaferro K, Hu J, Chang V and Soo TM
Older patients are increasingly undergoing anterior cervical discectomy and fusion (ACDF). Although studies have examined complication rates in older patients, the correlation between age and achieving specific patient-reported outcomes (PROs) is lacking. The authors sought to determine whether older patients undergoing ACDF are independently associated with lower odds of achieving minimal clinically important difference (MCID) for pain and physical function.
Letter to the Editor. Geriatric Nutritional Risk Index as a preoperative tool in spine tumor surgery
Tanaka T and Matsuno A
Outcomes following stereotactic body radiation therapy specific to spinal metastases with paraspinal disease extension: does volume matter?
Ong WL, Zeng KL, Moore-Palhares D, Soliman H, Myrehaug S, Detsky J, Chen H, Ruschin M, Atenafu EG, Larouche J, Witiw CD, Jabehdar Maralani P, Sahgal A and Tseng CL
Paraspinal involvement has been consistently reported as a negative predictor of local control following stereotactic body radiation therapy (SBRT) for spinal metastases. The aim of this study was to investigate the characteristics of paraspinal disease and determine the impact on outcomes.
Association between inpatient kyphoplasty and vertebroplasty and improved short-term outcomes following acute thoracolumbar compression fractures: a nationwide study
McIntyre MK, Chen H, Gandhi D, Malhotra A, Liu J and Colasurdo M
Vertebral compression fractures (VCFs) are associated with significant pain and disability. The current standard of care is expectant medical management; however, there is emerging data encouraging the use of early kyphoplasty or vertebroplasty. The goal of this nationwide study was to investigate the outcomes of patients with acute thoracolumbar VCF who undergo very early (inpatient) kyphoplasty compared with those managed medically.
Factors associated with long-term deterioration in back pain after surgical treatment for low-grade lumbar spondylolisthesis at 2 and 5 years: an evaluation from the Quality Outcomes Database spondylolisthesis data
Croft AJ, Glassman SD, Adams SW, Djurasovic M, Chan AK, Bisson EF, Bydon M, Foley KT, Shaffrey CI, Potts EA, Coric D, Knightly JJ, Park P, Wang MY, Fu KM, Slotkin JR, Asher AL, Virk MS, Chou D, Haid RW, Mummaneni PV and Carreon LY
Symptomatic, low-grade spondylolisthesis is usually well treated by surgical intervention. While some patients obtain less than optimal improvement, low-grade spondylolisthesis deteriorates in a few patients. The purpose of this study was to investigate what factors predict deterioration in back pain scores after surgical treatment of low-grade spondylolisthesis.
Do all patients with adult scoliosis need instrumented fusion from T10 to the pelvis?
Chou D, Chan AK, Joiner EF, Tan LA, Berven SH, Park P and Mummaneni PV
In this review article, the authors describe the thought process, alternatives, and approaches to adult spinal deformity. Although fusion of the entire major curve of scoliosis is certainly reasonable and necessary in certain cases, the authors discuss conditions in which shorter constructs may be considered. They also discuss when it is important to fuse both the major and fractional curves and when shorter constructs are not ideal. Factors that favor choosing an upper instrumented vertebral level in the upper thoracic, lower thoracic, or lumbar spine are discussed. Case examples are presented, and decision-making considerations are discussed.
Markers of preoperative depression and anxiety as predictors of increased short-term healthcare utilization after lumbar fusion surgery
Karsalia R, Xu E, Malhotra RD, Gor A, Arena JD, Kost J, McClintock SD, Yoon J, Ozturk AK, Judy B, Marcotte P, Shin JH, Schuster J and Malhotra NR
Depression and anxiety affect 10%-20% of the population, are leading causes of nonfatal disease, and are underdiagnosed globally. Mental health can play a significant role in surgical outcomes, including treatment of degenerative spinal conditions. Understanding the relationships between mental health and spinal surgery outcomes is critical for optimizing perioperative care.
Presenting symptoms and outcomes of cervical and thoracic ependymomas compared to conus and filum ependymomas
Ruchika F, Ahmed AK, Al-Mistarehi AH, Xia Y, Rajasekaran J, Derin E, Bettegowda C, Sciubba DM, Lo SL, Bydon A, Witham T, Theodore N, Jallo G, Redmond KJ, Kleinberg LR and Lubelski D
Prior studies on spinal ependymoma typically group patients based on tumor pathology, often combining myxopapillary ependymomas and other ependymoma subtypes into a single cohort. This study aimed to evaluate differences in patient presentation and long-term functional outcomes between cervical/thoracic and conus/filum ependymomas. The authors hypothesized that these variations are location specific and warrant further stratification.
Unraveling the cause of microspurs in spontaneous intracranial hypotension type 1: discogenic origin or calcified Hofmann's ligament?
Nasiri D, Maragkou T, Dislich B, Häni L, Goldberg J, Piechowiak EI, Dobrocky T, Beck J, Raabe A and Schär RT
Spontaneous intracranial hypotension (SIH) with a ventral CSF leak (type 1) is believed to be caused by discogenic microspurs. Recently, this hypothesis was questioned, in which Hofmann's ligament, a fibrous connective tissue between the dura and posterior longitudinal ligament, was claimed to be the cause of a spinal dural tear. The primary objective of this study was to determine whether SIH type 1 lesions arise from a discogenic source or from fibrotic tissue.
A natural history of penetrating ballistic spinal column injury: a single-center continuous case series
Ditzel RM, Kolcun JPG, Chiu L, Raksin PB and Towner JE
The aim of this study was to characterize patient demographics, injury characteristics, clinical management, and inpatient hospital course of victims of gunshot wounds (GSWs) to the spine to describe a "natural history" of disease following this injury.
Enhanced recovery after surgery clinical pathway in oblique lumbar interbody fusion: overcoming postoperative pain to improve compliance and recovery. A prospective randomized noninferiority trial
Kim JH, Kim M, You DW, Park H, Hwang SH, Rhee JM, Lee CH, Chung CK, Choi Y and Kim CH
Enhanced recovery after surgery (ERAS) has demonstrated benefits across various surgical specialties. However, a significant research-practice gap remains, with fewer than half of spine surgeons incorporating ERAS principles into daily practice. A key barrier to ERAS implementation in spine surgery is postoperative compliance, as patients often express concerns about worsening pain. To address these challenges, the authors developed a standardized, delivery-focused ERAS clinical pathway (CP) for oblique lumbar interbody fusion (OLIF). This study prospectively evaluated whether ERAS-CP can improve postoperative compliance without compromising pain control compared with conventional ERAS.
Spinal oligodendroglioma: a > 70-year systematic review of current literature
Balasubramanian K, Kharbat AF, Yurtluk MD, Call-Orellana F, Sankarappan K, Downes A, Passias P, Hwang S, Agarwal N, Rajendran S, Shakir HJ, Burke JF, Jea A, Graffeo CS and Janjua MB
Primary spinal oligodendrogliomas (sODGs) are an exceptionally rare subset of oligodendrogliomas (ODGs). As such, there is a limited understanding of their natural history, optimal treatment approaches, and long-term outcomes. This systematic review aimed to better characterize the presentation and management of sODGs.