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Cervical Spine Alignment in Helmeted Skiers and Snowboarders With Suspected Head and Neck Injuries: Comparison of Lateral C-spine Radiographs Before and After Helmet Removal and Implications for Ski Patrol Transport.

OBJECTIVE: Current protocols for spine immobilization of the injured skier/snowboarder have not been scientifically validated. Observing changes in spine alignment during common rescue scenarios will help strengthen recommendations for rescue guidelines. METHODS: Twenty-eight healthy volunteers (18 men, 10 women) age 47±17 (range 20-73) (mean ±SD with range) underwent a mock rescue in which candidate patrollers completing an Outdoor Emergency Care course performed spine immobilization and back boarding in 3 scenarios: 1) Ski helmet on, no c-collar; 2) helmet on, with c-collar; and 3) helmet r…

Spine MRI Diverticular Patterns Predict CSF-Venous Fistula Location: A 100-Patient Study.

BACKGROUND AND PURPOSE: CSF-venous fistulas (CVFs) are an increasingly recognized cause of spontaneous intracranial hypotension and require invasive myelography for localization. Whether spine MRI can noninvasively predict CVF origin remains unclear. The purpose of our study was to determine if spine MRI features, particularly the size and location of spinal meningeal diverticula, are predictive of the CVF location identified on myelography. MATERIALS AND METHODS: Retrospective review was conducted of 100 patients with a CVF confirmed on decubitus CT myelography who underwent preprocedural sp…

Plasma NGAL-detected kidney injury following paediatric spine surgery: role of intraoperative hypotension.

BACKGROUND: Post-operative acute kidney injury (AKI) remains a major complication in paediatric surgery. Serum creatinine is an insensitive marker, that increases only after significant impairment. Neutrophil gelatinase-associated lipocalin (NGAL) has emerged as an early biomarker capable of detecting tubular injury before functional decline. This study aimed to determine the incidence of clinical AKI and subclinical AKI in paediatric spine surgery using plasma NGAL levels and to evaluate the associations of intraoperative hypotension with kidney injury. METHODS: In this prospective single-ce…

Real-time phase-dependent occupational radiation exposure analysis in full-endoscopic spine surgery.

Full-endoscopic spine surgery performed under local anesthesia offers clinical advantages, particularly for elderly patients. However, its reliance on fluoroscopy raises concerns about occupational radiation exposure. Although several studies have evaluated cumulative radiation dose, real-time data identifying specific high-risk phases of surgery remain limited. This study aimed to clarify phase-dependent scatter radiation patterns and identify targets for effective protection. We analyzed real-time personal dose equivalent, Hp(10), measured over the protective apron (over-apron Hp(10)) in 28 …

Validation of a modular low-fidelity training model for biportal endoscopic spine surgery.

OBJECTIVE: Spinal endoscopy is associated with a steep learning curve, in part owing to its limited depth perception, which increases the ne … hat are relevant to, and potentially transferable to, a simulated procedure representing endoscopic spine surgery.

Выявляется высокий уровень использования медицинских услуг после операции на шейном позвоночнике с использованием комплексных методов прогнозирования.

Расходы на медицинское обслуживание пациентов с хроническими заболеваниями позвоночника и пациентов, проходящих хирургическую операцию, продолжают расти заметными темпами. Таким образом, выявление пациентов, подверженных риску в плане более широкого использования послеоперационного медицинского обслуживания, имеет решающее значение для оптимизации результатов медицинского обслуживания и распределения ресурсов. Цель нашего исследования заключается в использовании целого ряда предоперабельных характеристик пациентов, включая всеобъемлющую медицинскую, хирургическую и социальную историю, для разр

Совпадение в аннотации оригинала
IntroductionHealthcare expenditures among patients with chronic spinal conditions and those undergoing surgery continue to grow at a notable … g (ML) models capable of granular prediction of postoperative healthcare utilization among cervical spine fusion patients.Materials and methodsA cohort of anterior cervical decompression and fusion and posterior cervical decompression and fusion surgeries was queried from a tertiary academic medical center from 2002 to 2022. Patient and operative charac …

From Spine to Limbs: Imaging Insights and Clinical Correlation in Caudal Regression Syndrome.

Caudal regression syndrome (CRS) refers to a spectrum of congenital structural defects of the caudal region. We present a case of caudal reg … with flat buttocks and hard swelling over the lower lumbar region were found. On x-ray lumbosacral spine both view, low-positioned L5 vertebra fused with a rudimentary S1 vertebra on the right with the absence of the rest of the sacral pieces and coccyx, broad spinous process of L5 were seen. Vertical talus, absent navicular bones and adducted forefeet …

Evaluating reasoning-tuned large language models for clinical decision-making in spine surgery.

PURPOSE: Most clinical evaluations of large language models assess factual recall rather than the multi-step reasoning behind operative plans. Reasoning-tuned models, post-trained to generate explicit intermediate reasoning before answering, may better approximate surgical decision-making. We compared two such models from different development ecosystems, OpenAI o1 and DeepSeek R1, on complex spine cases. METHODS: Ten synthetic vignettes spanning deformity, degenerative, urgent, and cervical pathology were analysed; an eleventh was excluded owing to a survey error. Both models received identi…

Bridging the Gender Pay Gap: Medicare Procedure Volume and Reimbursement Among Spine Surgeons.

BACKGROUND: Gender differences in physician compensation have been described in various medical specialties, although little is known about reimbursement patterns among spine surgeons. We sought to determine whether any differences exist in procedural volume, claims, and Medicare reimbursement between male and female spine surgeons performing fusion procedures. MATERIALS AND METHODS: This was a retrospective analysis of the Medicare Provider Utilization and Payment Public Use File (2017-2022). Spine surgeons performing fusion procedures were identified and stratified by sex. Procedural volume…

National Medicare trends in navigation-assisted spine surgery: A temporal and geographic analysis.

BACKGROUND: Although initially utilized for pedicle screw placement, indications for navigation assistance in spine surgery have expanded over the past several years. While existing studies have evaluated safety, efficacy, and outcomes from navigation assistance, national reimbursement, and utilization patterns remain poorly characterized. This study aims to quantify temporal, geographic, and provider-level trends in navigation-assisted spine surgery among Medicare beneficiaries. MATERIALS AND METHODS: The Medicare Part B National Summary Data Files were queried for national utilization and r…

Diabetes as a significant risk factor for postoperative dysphagia following cervical spine surgery.

OBJECTIVE: This study investigated the relationship between diabetes and the incidence of postoperative dysphagia following cervical spine surgery (CSS). METHODS: A prospectively collected multi-institutional quality registry was retrospectively reviewed. Patients who underwent CSS were categorized on the basis of diabetes status, and correlations with preoperative and postoperative Eating Assessment Tool-10 (EAT-10) dysphagia questionnaire scores were assessed. Mixed-effects logistic regressions were performed to examine the impact of preoperative diabetes on postoperative dysphagia. RESULT…

Impact of perioperative dexamethasone on postoperative complications in diabetic patients undergoing spine surgery.

BACKGROUND: Dexamethasone is commonly used perioperatively for analgesic and antiemetic benefit, however, the risk of postoperative hyperglycemia is concerning, particularly among diabetic patients undergoing spine surgery, where extensive tissue exposure and hardware implantation may increase risk of wound complications. The influence of baseline glycemic control and surgical approach on dexamethasone-associated risk remains poorly characterized. METHODS: A retrospective cohort study using the TriNetX United States Collaborative Network, a nationally representative database comprised of over…

[High-energy thoracic and lumbar spine fractures at Landspítali 2003-2022 (25 years)].

INTRODUCTION: To investigate the epidemiology of high-energy thoracic and lumbar spine fractures at Landspítali and evaluate their treatment and associated injuries using international injury classification systems. MATERIALS AND METHODS: Medical records were reviewed with regard to age, sex, nationality, length of hospital stay, mechanism of injury, associated injuries, treatment, neurological injury, seasonality, and injury location. Imaging studies were used for diagnosis and for classification of fractures according to the AO injury classification system. RESULTS: A total of 424 individu…

Drain versus no drain after intradural spine surgery: a 10-year multicenter study.

OBJECTIVES: A postoperative drain is commonly used after intradural spine surgery to prevent hematoma formation, but it may lead to other complications. We aimed to investigate the efficacy and safety of postoperative drain use after intradural spine surgery. METHODS: Patients who underwent intradural spine surgery at three tertiary neurosurgical centers from January 2015 to December 2024 were retrospectively analyzed. Data collected included preoperative (demographics, comorbidities, symptoms), intraoperative (pathology, details of surgery, use of drain, duration and type of drain [active or…

High Psychosocial Impact of Complications, Suboptimal Coping Strategies, and Burnout among Spine Surgeons.

BACKGROUND CONTEXT: Complications in spine surgery are unavoidable. Apart from the patients' suffering, complications can profoundly affect surgeons' emotional well-being. Though medical literature discusses extensively about handling the medical aspect of complications, the real psychological impact of complications on spine surgeons is less discussed. PURPOSE: To evaluate the emotional burden of complications, psychological impact, coping strategies, and burnout among spine surgeons. STUDY DESIGN: Cross-sectional survey-based study PATIENT SAMPLE: 50 practicing spine surgeons METHODS: An a…

Opioid Use Following Spine Surgery: Strategies for a Multimodal Approach To Pain Management.

Chronic back pain is highly prevalent and closely associated with opioid misuse, particularly in patients undergoing spine surgery. Optimizing opioid prescribing practices and advancing alternative treatment modalities is critical to reduce opioid-related morbidity and mortality.  RECENT FINDINGS: Despite their well-documented risks-including misuse, adverse effects, and detrimental impacts on postsurgical outcomes-opioids remain the most commonly prescribed analgesics for back pain. Spine surgery, meanwhile, is frequently followed by intense postoperative pain due to central sensitization, wh…

Accelerated Spine Magnetic Resonance Imaging: Techniques and Practical Implementation for Routine Clinical Imaging.

ABSTRACT: Spine magnetic resonance imaging is among the most frequently performed examinations in clinical radiology and places substantial demands on workflow efficiency and image quality. Over the past 20 years, acquisition times have been markedly reduced through a combination of optimized sequence parameters, advanced acceleration techniques, and modern image reconstruction methods. ABSTRACT: This article provides an overview of contemporary strategies for accelerating two-dimensional spine magnetic resonance imaging, with a focus on techniques that are robust and feasible in routine clin…

Passive surgical correction of rigid adult spine deformities to normative alignment and balance.

Realizing an age-adjusted correction in adult spine deformities (ASD) is demanding. We focus on rigid ASD patients requiring three-column osteotomies (TCO) and analyze the capability to obtain a normative alignment. Additionally, we introduce a new age-adjusted alignment parameter: the C7-SA norm. We retrospectively included 26 patients (68.2 ± 1.6 years) with rigid ASD who underwent lumbar TCO for deformity correction. All patients were positioned on a ProAxis table (Mizuho OSI, USA) with the shoulders, hips and ankles aligned for passive correction without bending the surgical table. The mea…