Notes

Effect of decision for you to shipping and delivery period on perinatal benefits in the course of emergency cesarean transport in Ethiopia: A potential cohort study.
The incidence of 3- and 4-level lumbar arthrodesis is rising due to an aging population, and fusion rates affect clinical success in this population. Pulsed electromagnetic field (PEMF) stimulation is used as an adjunct to increase fusion rates following multilevel arthrodesis. The purpose of the study was to evaluate the fusion rates for subjects who underwent 3- and 4-level lumbar interbody arthrodesis following PEMF treatment.

In this retrospective, multicenter study, patient charts that listed 3- or 4-level lumbar arthrodesis with adjunctive use of a PEMF device were evaluated. Inclusion criteria included patients who were diagnosed with lumbar degenerative disease, spinal stenosis, and/or spondylolisthesis (grade 1 or 2). Ferrostatin-1 price A radiographic evaluation of fusion status was performed at 12 months by the treating physicians. Fusion rates were stratified by graft material, surgical interbody approach, and certain clinical risk factors for pseudoarthrosis.

A total of 55 patients were identified who had a 12-month follow-up. The radiographic fusion rate was 92.7% (51 patients) at 12 months. There were no significant differences in fusion rates for patients treated with allograft or autograft, for patients with different interbody approaches, or for those with or without certain clinical risk factors.

With modern fusion techniques and PEMF, the overall fusion rate was high following 3- and 4-level lumbar arthrodesis.

4.

PEMF may be a useful adjunct for treatment of patients with surgical risk factors, such as multilevel arthrodesis, and clinical risk factors.
PEMF may be a useful adjunct for treatment of patients with surgical risk factors, such as multilevel arthrodesis, and clinical risk factors.
Patient selection and analgesic techniques, such as the multimodal analgesic (MMA) protocol, aid in ambulatory surgical center (ASC) cervical spine surgery. The purpose of this case series is to characterize patients undergoing anterior cervical discectomy and fusion (ACDF) and total cervical disc replacement (CDR) in an ASC with an enhanced MMA protocol.

A prospectively maintained registry was retrospectively reviewed for cervical surgeries between May 2013 and August 2019. Inclusion criteria included ASC patients who underwent single-level or multilevel CDR or ACDF using an MMA protocol. Baseline, intraoperative, and postoperative characteristics were recorded, including length of stay, visual analog scale pain scores, neck disability index, complications, and narcotics administered.

A total of 178 patients met inclusion criteria with 125 single-level, 52 two-level, and 1 three-level procedure. Of those patients, 127 underwent ACDF and 51 underwent CDR. The longest procedure was 95 minutes and the meaes in appropriate patient populations.
Transitioning anterior cervical discectomy and fusions to the ASC requires an appropriate MMA protocol. Our findings reveal that an enhanced MMA protocol will help improve disability scores while keeping the likelihood of postoperative complications low. This supports the ASC setting for cervical spine procedures in appropriate patient populations.
Postoperative C5 palsy is a common complication following cervical decompression, occurring more frequently after posterior-based procedures. It has been theorized that this is the result of C5 nerve stretch resulting from spinal cord drift with these procedures. As such, it is thought to be less common after anterior cervical decompression and fusion (ACDF). However, no consensus has been reached on its true etiology. The purpose of this study is to assess the rate of C5 palsy following ACDF and to determine whether any radiographic or demographic parameters were predictive of its development.

Two hundred and twenty-six patients who received ACDF between September 2015 and September 2016 were reviewed, and 122 were included in the final analysis. Patient demographic, surgical, and radiographic data were analyzed, including preoperative and postoperative radiographic and motor examination results. The Mann-Whitney
test was used to compare continuous variables between independent groups, and Fisher's exact test was used to compare categorical variables between groups.

Seven patients developed a C5 palsy in the postoperative period, an incidence rate of 5.7%. Among the radiographic parameters evaluated, there were no statistically significant differences between the C5 palsy and nonpalsy groups. Additionally, there were no statistically significant differences in age, patient sex, or numbers of vertebral levels fused between groups.

Ultimately, we did not identify any statistically significant demographic or radiographic predictive factors for the development of C5 palsy following ACDF surgery.

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Cervical laminoplasty and laminectomy and fusion (LF) are posterior-based surgical techniques for the surgical treatment of cervical spondylotic myelopathy (CSM). Interestingly, the comparative amount of spinal cord drift obtained from these procedures has not been extensively described. The purpose of this study is to compare spinal cord drift between cervical laminoplasty and LF in patients with CSM.

The laminoplasty group consisted of 22 patients, and the LF group consisted of 44 patients. Preoperative and postoperative alignment was measured using the Cobb angle (C2-C7). Spinal cord position was measured on axial T2-magnetic resonance imaging of the cervical spine preoperatively and postoperatively. Spinal cord drift was quantified by subtracting preoperative values from postoperative values. Functional improvement was assessed using the modified Japanese Orthopaedic Association (mJOA) score.

Mean spinal cord drift was higher following LF compared to laminoplasty (2.70 vs 1.71 mm,
< .01). Using logistic regression analysis, there was no correlation between sagittal alignment and spinal cord drift. Both groups showed an improvement in mJOA scores postoperatively compared to their preoperative values (laminoplasty, +2.0,
= .012; LF, +2.4,
< .01). However, there was no difference in mJOA score improvement postoperatively between both groups (
= .482).

This study demonstrates that patients who had LF for CSM achieved more spinal cord drift postoperatively compared to those who had laminoplasty. However, the increased drift did not translate into superior functional outcome as measured by the mJOA score.

3.

Spinal cord drift following LF may differ from laminoplasty in patients undergoing surgery for CSM. This finding should be considered when assessing CSM patients for surgical intervention.
Spinal cord drift following LF may differ from laminoplasty in patients undergoing surgery for CSM. This finding should be considered when assessing CSM patients for surgical intervention.
A vertebral fracture in a patient with diffuse idiopathic skeletal hyperostosis (DISH) is unstable due to larger moment via the long lever arm of an ankylosed spine. Therefore, surgical treatment is commonly recommended to avoid complications of nonunion and paralysis. In this report, we present 3 cases of vertebral fractures related to DISH which were primarily forced to undertake conservative treatment because of medical comorbidities and advanced age. CASE 1 A 93-year-old woman suffered from T10 vertebral fracture by a ground-level fall on her back. A trunk cast for 6 weeks was followed by brace wear for 3 months with administration of daily teriparatide. link2 Then complete bone union was confirmed at 2 years after injury without back pain. CASE 2 An 84-year-old man suffered from T12 vertebral fracture by a fall on his back from a chair. A trunk cast for 12 weeks was followed by brace wear for 6 months with administration of daily teriparatide. Then acceptable bone union was confirmed at 1 year after the inju be one of the options in cases with high operative risk due to serious medical comorbidities.
Conservative treatment for vertebral fracture with DISH can be one of the options in cases with high operative risk due to serious medical comorbidities.
The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed to provide an easily administered patient-outcome questionnaire that was adaptable to a variety of medical and surgical subspecialties. Numerous authors have examined the effectiveness of PROMIS in various areas of spine surgery. Our goal was to systematically review PROMIS scores compared with legacy patient-reported outcomes measures (PROMs) in spinal surgery and spine pathology.

A systematic search of the PubMed, EMBASE, and Cochrane databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was performed, yielding 254 unique studies reporting on "PROMIS" in "spine." Each study was independently reviewed. A total of 16 studies were selected for inclusion.

The pooled sample size yielded a total of 4268 patients. In the cervical population, PROMIS physical function (PF; |r| = .47-.87, pain intensity (PIn; |r| = .61-.74), pain interference (PIf; |r| = .65-.88), and pain behIf, and PB demonstrated moderate to strong correlations with NDI, mJOA, ODI, SRS, and SF-12 measures in various populations of spine patients. All PROMIS domains had decreased time to completion and similar responsiveness compared with legacy measures.

2.

These results highlight the potential of PROMIS as a valid and reliable tool to assess patient-reported outcomes in spinal surgery patients and support more widespread use of PROMIS in spine.
These results highlight the potential of PROMIS as a valid and reliable tool to assess patient-reported outcomes in spinal surgery patients and support more widespread use of PROMIS in spine.
YouTube is a readily accessible, non-peer-reviewed video-based platform serving as a major source of online medical information presently. The aim of the current article is to analyze the comprehensiveness and reliability of the videos related to lumbar spinal fusion available on YouTube.

A YouTube search was conducted to analyze videos on lumbar spinal fusion using the search terms
,
, and
. Consequently, 107 videos met the inclusion criteria and were short-listed. Videos were analyzed for video information data, including views, likes and dislikes, views per day, likes per day and likes per view, and reliability and comprehensiveness scores.

Of the 107 videos included in the study, a majority (75.7%) were found to be
in comprehensiveness. There was no correlation found between video information data and reliability and comprehensiveness scores.

Patients browsing YouTube for additional medical information on lumbar spinal fusion will be presented with large volumes of poor-quality data with a majority of videos lacking important preoperative and postoperative information.

The current study provides both patients and physicians with an opportunity to understand the limitations of online content on lumbar spinal fusion available on YouTube. This knowledge about online medical information may further enhance the quality of patient-physician interaction and understanding.

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There is some controversy about which is the best approach, decompression technique and number of fixed levels in the surgical treatment for burst thoracolumbar fractures. Without a neurological injury, correcting thoracolumbar kyphosis and preventing mechanical failure should be the main concerns. The two-segment short fusion with screws at fractured vertebra by posterior approach was performed in 64 patients. Although a significant increase of postoperative kyphosis was observed, there were not clinical consequences, nor was there reintervention for mechanical failure.

Patients with unstable T11-L2 burst fractures and a two-level fusion including screws at the injured vertebra between 2000 and 2015 were included in the study. Demographic, clinical, and radiological variables were analyzed. Thoracolumbar, segmental, and vertebral kyphosis and anterior and posterior vertebral height were measured preoperatively, postoperatively, at one-year, and at the end of follow-up in the radiological study. link3 The statistical analysis consisted of a descriptive analysis, and we used the
test to compare the preoperative, postoperative, one-year, and end-of-follow-up radiographs to observe a thoracolumbar T10-L2 kyphosis increase.
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