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Background and objective: Comparative effectiveness research plays a vital role in health care delivery. Specialty training is one of these variables; surgeons who are trained in different specialties may have different outcomes performing the same procedure. The objective of this study was to investigate the impact of spine surgeon specialty (neurosurgery vs orthopedic surgery) on early perioperative outcome measures of elective posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Methods: This is a retrospective, 1:4 propensity score-matched cohort study. 5520 AIS patients were reviewed from ACS-NSQIP pediatric database. Propensity score matching was utilized. Results: Patients operated on by orthopedic surgeons were more likely to have shorter operation time (263 min vs 285 min), shorter total hospital stay (95 h vs 118 h), lower rate of return to operating room within the same admission (1.2% vs 3.8%), lower discharge rates after postoperative day 4 (23.8% vs 30.9%), and lower unplanned readmission rate (1.6% vs 4.1%), (p < 0.05). On the other hand, patients operated on by neurosurgeons had lower perioperative blood transfusion rate (62.1% vs 69.8%), (p < 0.05). Other outcome measures and mortality rates were not significantly different between the two cohorts. Conclusions: This retrospective study found significant differences in early perioperative outcomes of patients undergoing PSF for AIS by neurosurgeons and orthopedic surgeons. Further studies are recommended to corroborate this finding which may trigger changes in the educational curriculum for neurosurgery residents. [ABSTRACT FROM AUTHOR]

Purpose: Bone marrow aspirate has been successfully used alongside a variety of grafting materials to clinically augment spinal fusion. However, little is known about the fate of these transplanted cells. Herein, we develop a novel murine model for the in vivo monitoring of implanted bone marrow cells (BMCs) following spinal fusion.Methods: A clinical-grade scaffold was implanted into immune-intact mice undergoing spinal fusion with or without freshly isolated BMCs from either transgenic mice which constitutively express the firefly luciferase gene or syngeneic controls. The in vivo survival, distribution and proliferation of these luciferase-expressing cells was monitored via bioluminescence imaging over a period of 8 weeks and confirmed via immunohistochemistry. MicroCT imaging was performed 8 weeks to assess fusion.Results: Bioluminescence imaging indicated transplanted cell survival and proliferation over the first 2 weeks, followed by a decrease in cell numbers, with transplanted cell survival still evident at the end of the study. New bone formation and increased fusion mass volume were observed in mice implanted with cell-seeded scaffolds.Conclusions: By enabling the tracking of transplanted bone marrow-derived cells during spinal fusion in vivo, this mouse model will be integral to developing a deeper understanding of the biological processes underlying spinal fusion in future studies. These slides can be retrieved under Electronic Supplementary Material. [ABSTRACT FROM AUTHOR]

Introduction: Spinal high-grade gliomas (S-HGGs) is an extremely rare entity in the literature, with only sporadic cases reported. We aim to characterize prognostic factors for post-treatment survival using the SEER database.Methods: We examined all patients with gliomas located in the spinal cord. WHO-grade was first determined by site-specific factor-1 (WHO-grade), then supplemented by direct review of ICD-O-3 histology. Only grades 3 and 4 were included in this study. Multivariable Cox regression analysis was performed.Results: A total of 158 high-grade spinal cord gliomas were included. Mean age at diagnosis was 36.88 years with 52.8% male. Median survival of all patients was 20 months. A stepwise Akaike information criterion was performed for multivariable Cox regression, with forced inclusion of surgery extent and postoperative radiation therapy (RT). The final model selection added tumor size in addition to these two variables. Tumor size was not related to survival in our study. The extend of surgery had no significant impact on survival of patients, whereas postoperative RT is associated with prolonged survival (HR = 0.55, CI [0.33, 0.93], p = 0.026).Conclusion: S-HGGs are rare tumors with aggressive course of disease. We have found that overall median survival of S-HGGs is poor at 24 months, and no demographic or tumor-related factors have been confirmed. Extend of surgery is not associated with improved survival after adjusting for postoperative RT. Postoperative RT is the only factor in our study associated with prolonged survival in S-HGGs. [ABSTRACT FROM AUTHOR]