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The length of fixation was greater by 1 vertebral level in the Group Skipping than in the Group All, and the rate of revision surgery for pseudarthrosis was higher in the Group Skipping than in the Group All (

= .02). There was no statistically significant difference between the 2 groups in terms of the mean segmental lordotic angle or Barthel Index.

Skipping pedicle screw insertion for pyogenic spondylitis in posterior fixation led to an increased number of fixed vertebrae and may be a risk factor for revision surgery for pseudarthrosis.

4.

The insertion of short pedicle screws at the infected vertebra can prevent early treatment failure and increase the biomechanical stability of construct.

The insertion of short pedicle screws at the infected vertebra can prevent early treatment failure and increase the biomechanical stability of construct.

Renal cell carcinoma (RCC) is an aggressive malignant disease that frequently metastasizes to the spine. The main purpose of our study is to evaluate the influence of surgery as well as targeted therapy on the survival of patients with RCC metastases of the spine.

Retrospective cohort study. We identified 100 patients with spinal RCC metastases who were retrospectively reviewed for preoperative conditions, treatment, and survival. Metastasectomy was performed in 39 cases, and 61 patients underwent decompression procedures with stabilization. Only 26 patients had adjuvant targeted therapy (7 with metastasectomy, 19 with palliative decompression). Pain, neurological status, survival time (from operation to death or last follow up), and local progression-free survival were evaluated.

Neurological function recovery and reported significant pain relief were observed. There was no significant difference in overall survival for the patients with metastasectomy and palliative decompression (

= .750). Metastasectomy provided better local control of disease compared with decompression (

= .043). There was a statistically significant difference in overall survival for the patients who received targeted therapy (

= .012).

Metastasectomy is effective for local control of tumors. Targeted therapy can potentially prolong overall survival for patients with spinal RCC metastases.

3.

Our findings suggest that spinal metastasectomy is useful for local control of tumor growth but not for live expectancy. Effective systemic therapy is key role in stopping of disease progression.

Our findings suggest that spinal metastasectomy is useful for local control of tumor growth but not for live expectancy. Effective systemic therapy is key role in stopping of disease progression.

The transition of minimally invasive (MIS) spine surgery from the inpatient to outpatient setting has been aided by advances in multimodal analgesic (MMA) protocols. This clinical case series of patients demonstrates the feasibility of ambulatory MIS transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) procedures while using an enhanced MMA protocol.

Consecutive MIS TLIF or LLIF procedures with percutaneous pedicle screw fixation and direct decompression in the ambulatory setting were reviewed. The procedures were performed using an MMA protocol. The ambulatory surgery center (ASC) did not allow for observation of patients for periods of time greater than 23 hours. We recorded patient demographics, perioperative, and postoperative characteristics.

Fifty consecutive patients were identified from September 2016 to July 2019. Forty-one patients (82%) underwent MIS TLIF, and 9 patients underwent MIS LLIF (18.0%). All patients were discharged on the same day of surgery. Thimally invasive lumbar spine surgery to the ASC. Our findings indicate that MIS lumbar fusion spine surgery with an enhanced MMA protocol can lead to safe and timely ASC discharge while minimizing hospital admission.

A validated classification remains the key to an appropriate treatment algorithm of traumatic thoracolumbar fractures. Considering the development of many classifications, it is remarkable that consensus about treatment is still lacking. We conducted a systematic review to investigate which classification can be used best for treatment decision making in thoracolumbar fractures.

A comprehensive search was conducted using PubMed, Embase, CINAHL, and Cochrane using the following search terms classification (mesh), spinal fractures (mesh), and corresponding synonyms. All hits were viewed by 2 independent researchers. Papers were included if analyzing the reliability (kappa values) and clinical usefulness (specificity or sensitivity of an algorithm) of currently most used classifications (Magerl/AO, thoracolumbar injury classification and severity score [TLICS] or thoracolumbar injury severity score, and the new AO spine).

Twenty articles are included. The presented kappa values indicate moderate to substan

Without the appropriate treatment, the impact of traumatic thoracolumbar fractures can be devastating. Entinostat mouse Therefore it is important to achieve consensus in the treatment of thoracolumbar fractures.

Without the appropriate treatment, the impact of traumatic thoracolumbar fractures can be devastating. Therefore it is important to achieve consensus in the treatment of thoracolumbar fractures.

The aim of this study was to determine the contribution of individual vertebral body lordosis to lumbar lordosis and establish the relationship of vertebral body lordosis to the pelvic incidence (PI).

One-hundred and two computed tomography (CT) scans on patients free of radiographic disease were measured for PI and segmental lordosis of both bone and disc from L1 to sacrum. Correlative analysis and analysis of variance (ANOVA) were used to identify contribution from bone and disc to lordosis.

The mean total bony lordosis was 10.8° (SD 11.5°), mean total disc lordosis was 36.3° (SD 9.9°), and mean combined lordosis was 47.1° (SD 10.0°). The mean PI of the entire cohort was 49.2° (SD 9.3°). One-way ANOVA demonstrated a significant difference between the PI strata in total bony lordosis values with a mean difference of 14.0° between low and high PI cohorts (

< .001) and also mid- and high PI cohorts of 9.9° (

= .008). Overall, distal lordosis represented 80.8% of the total lordosis. In the proximal lumbar segments, the mean contribution from bone was -4.