7 spine studies to know

Spine

From long-term disc replacement outcomes to outpatient spine case volume, here are six key spine studies Becker's reported about since May 6.

1. Weight loss and diabetes medication semaglutide has been linked to a significantly greater risk for repeat operations in patients with diabetes who require lumbar surgery. The risk of an additional procedure was higher among patients who took semaglutide over long periods of time. While spine and orthopedic surgeons have considered the effect of semaglutides on patient care, this is the first study providing evidence of spine surgery effects. The report is based on a study led by researchers at the University of Illinois Chicago.

2. A matched analysis published in the June issue of Spine found experienced neurosurgeons and orthopedic spine surgeons had similar outcomes after transforaminal lumbar interbody fusions. Researchers analyzed patient records between 2010 and 2022 to identify patients with lumbar spinal or spondylolisthesis who had one- to three-level TLIF procedures. There were no differences in all-cause surgical complications, but neurosurgeons saw a higher rate of all-cause medical complications.

3. Minimally invasive sacroiliac joint fusion is associated with increased opioid usage, according to a study published in the June 15 edition of Spine. Researchers used an insurance claims database to evaluate 4,666 patients who had minimally invasive SI joint fusion. They found patients tended to fill opioid prescriptions one year postoperatively at a higher rate than those who had other common spine procedures. Chronic users filled the highest opiate dosages in the 30-days after surgery.

4. Spinal decompression on its own is more cost-effective than the procedure combined with spinal fusion in patients with lumbar stenosis with associated degenerative spondylolisthesis, according to a study in the June 15 issue of Spine. The study found the incremental costs and utility of decompression and fusion relative to only decompression were $12,778 and 0.00529 aggregated quality adjusted life years. Corresponding incremental cost-effectiveness ratio of $2,416,281 exceeded the willingness to pay threshold of $100,000.

5. Researchers at Washington University in St. Louis developed a machine learning method to better predict recovery from lumbar spine surgery. Their findings, published in Proceedings of the ACM, showed that a "Multi-Modal Multi-Task Learning" method could make a predicted change for patients' postoperative pain interference and physical function scores. 

6. A study published in the June 2024 issue of The Spine Journal found cervical disc implant design can affect the patient's range of motion postoperatively. Researchers analyzed flexion-extension range of motion histograms from 1,173 patients in single-level disc replacement clinical trials for seven implants. Implants with built-in stiffness from its nucleus-annulus design saw the highest proportion of implanted segments in the physiological mobility range. Sixty-five of the discs with the two mobile-core implant designs saw a range of motion of 17 degrees or more. 

7. Researchers from the Pediatric Emergency Care Applied Research Network found that a clinical prediction rule can be used to identify neck injuries in children and reduce the need for imaging. The new model incorporates nine risk factors identified in physical exams, according to a June 6 news release from PECARN. Of the 22,000 study participants, 0.2% without any of the risk factors had a clinically significant cervical spine injury, meaning that children can be safely evaluated without imaging. The findings were published June 4 in The Lancet Child & Adolescent Health.

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