• ACDF with Total En Bloc Resection of Uncinate in Foraminal Stenosis of the Cervical Spine: Comparison with Conventional ACDF

    Introduction: Foraminal stenosis is a major cause of radiculopathy. Most of the foraminal stenosis is due to hypertrophied uncinate process or osteophyte from uncovertebral joints.  To relieve the radiculopathy, ACDF is the most frequently performed procedure. No studies have been performed comparing ACDF with and without uncinate resection.  Purpose of this study was to find out any differences in clinical outcomes of ACDF depending on uncinate resection or not. Methods: 606 patients who underwent ACDF due to foraminal stenosis were included in this study.
  • Morbidity and Mortality Associated with Transoral Approaches to the Cervical Spine

    Introduction: Anterior approaches to the cervical spine can be an elegant and practical way to address anterior pathology. The transoral approach provides a direct access to C1, C2, and less commonly C3 without manipulation of critical structures, however, due to its rarity and unfamiliar anatomy, significant morbidity and mortality exist. The aim of this study was to analyze morbidity and mortality in patients undergoing transoral approaches to the cervical spine using a large national database.
  • The Profile of a Smoker and its Impact on Outcomes after Cervical Spine Surgery

    Objective: Smoking has been associated with worse self-reported outcomes in patients undergoing degenerative lumbar spine surgery. Current focus is on decreasing cost and complications while improving outcomes. This potentially can be accomplished by acting on modifiable preoperative patient characteristics such as smoking. However, the impact of smoking on outcomes following degenerative cervical spine surgery is poorly understood.  The aim of the study is to understand impact of smoking on patient reported outcomes after degenerative cervical spine surgery. Methods: A total of 473 patients enrolled in a prospective longitudinal registry undergoing degenerative cervical degenerative surgery over a period of one year were included in the study.
  • Missing Data May Invalidate Spine Surgery Database Studies

    Introduction: National databases are increasingly being used for research in spine surgery, as they offer significant power for analyses. However, these databases have significant limitations. One limitation that has received sparse mention in the literature is the prevalence of missing data. Studies using these databases often do not mention the percent of missing data for each variable used, and do not make note of how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database to illustrate how different treatments of missing data can significantly skew the results of spine studies.
  • Cervical Deformity Surgery does not Result in Acute Post-operative Dysphagia: Preliminary Results from a Prospective Cervical Deformity Study

    Introduction: Although dysphagia after cervical spine surgery has been described, prior studies have focused primarily on degenerative cases. We aimed to describe the incidence of dysphagia in patients undergoing surgery for cervical deformity. We hypothesized that posterior cervical deformity surgery would not result in post-operative dysphagia. Methods: This was a prospective cohort study seeking to enroll operative cervical deformity (CD) patients. The inclusion criteria were: cervical kyphosis (CK) >10°, cervical scoliosis (CS) >10°, C2-7 SVA > 4cm and/or chin-brow vertical angle (CBVA) > 25°.
  • Cervical Spine Fusion: 16-Year Trends in Epidemiology, Indications, and Bone Morphogenetic Protein Utilization by Surgical Approach

    Introduction: Studies analyzing nationwide databases have demonstrated progressive growth in the annual volume of cervical spine fusions. The explanation for increased adoption may be multi-factorial: advances in operative techniques, improvements in instrumentation systems, expanded indications, and improved peri-operative medical management have improved outcomes. The Food and Drug Administration’s (FDA) mid-2008 warning against the use of bone morphogenetic protein (BMP) in cervical spine fusion was another notable event.
  • Efficacy of a Short Plate with an Oblique Screw Trajectory for Anterior Cervical Plating: A Comparative Study with a Two-Year Minimum Follow-up

    Introduction: It has been reported that adjacent segment ossification development (ASOD) commonly occurs after anterior cervical arthrodesis. This study was conducted to compare the efficacy of the short plate and oblique screw trajectory with the traditional long plate and parallel screw trajectory by investigating the incidence of ASOD and graft subsidence. Materials/Methods: We retrospectively reviewed the patients who underwent single level anterior cervical discectomy and fusion (ACDF) with plate augmentation in our institute between June 2003 and August 2011.
  • Comparison of One- and Two-Level Treatment with Cervical Disc Arthroplasty or Anterior Cervical Discectomy and Fusion through Five-Year Follow-up

    Introduction: Anterior cervical discectomy and fusion (ACDF) has been a widely accepted procedure for years. There has been variation in reported results for two-level ACF. Cervical disc arthroplasty (CDA) has been gaining acceptance for single-level treatment and more data is becoming available for two-level. The purpose of this analysis was to compare the safety and effectiveness of one and two level treatment with CDA or anterior cervical discectomy and fusion (ACDF). Materials/Methods: A prospective, randomized, controlled trial in the U.S. compared CDA using Mobi-C© Cervical Disc Prosthesis and the ACDF control with allograft and anterior plate at one or two contiguous levels.