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Background: The anatomic interplay and overlap between the cervical spine and the shoulder constitutes a challenge for shoulder and spine surgeons, as symptoms of spine and shoulder pathologies are often similar and may lead to entity misdiagnosis. Methods: PubMed, Cochrane, and Google Scholar (page 1-20) searches were updated to October 2023 in search of the qualified papers. Boolean Operators were used with a combination of the keywords “spine” OR “neck” And “Shoulder”. Furthermore, reference lists from papers were also searched to find literature. Results: It is of pivotal importance to conduct comprehensive preoperative clinical investigation to appropriately evaluate and assess the source of the pathology and the leading causes behind it. Certain markers can help guide surgeons towards etiologies, and these include areas of pain and physical exam findings with the arm squeeze test having the highest sensitivity and specificity for diagnosing cervical radiculopathy. As for the shoulder, despite its low sensitivity, the Yergason test had the highest specificity for diagnosing subacromial impingement. Local anesthetic injection can help as well in the diagnostic approach. Moreover, the interplay between these anatomic locations is not solely related to preoperative diagnosis. Studies have shown that previous surgery for cervical spine pathology may negatively affect the outcomes of shoulder procedures like arthroplasties. Conclusion: Shoulder and spine surgeons should be wary and vigilant of accurately diagnosing the etiology of the presenting symptoms to ensure proper management and optimize prognosis.

Background:. Lenke curve types can vary in their response to treatment. We explored potential differences in reoperation rates, causes, and risk factors among patients with different Lenke types who underwent posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Methods:. We studied a multicenter database of patients with AIS who underwent index PSF at ≤21 years of age and had a minimum 2-year follow-up. Baseline and surgical characteristics were collected. Reoperation rates, causes, and risk factors were analyzed by Lenke type. Results:. A total of 3,165 patients were included. The mean age was 14.6 years, and most patients were female (81%) and Caucasian (68%). The mean follow-up period was 4.4 years. A total of 138 patients (4.4%) underwent reoperation. The reoperation rate varied by Lenke type (p = 0.02): patients with type-5 curves had the highest reoperation rate (7.2%), and those with type-1 curves had the lowest (3.0%). The most common cause of reoperation was an instrumentation complication. The rate of reoperation due to an instrumentation complication varied by Lenke type (p < 0.01). Compared with patients with type-1 curves, those with type-5 curves had significantly higher rates of reoperation due to implant prominence (odds ratio [OR], 11.7; p = 0.03), loss of fixation (OR, 3.9; p = 0.01), or a broken rod (OR, 7.8; p = 0.02) and those with type-3 curves had a significantly higher rate of reoperation due to loss of fixation (OR, 4.37; p = 0.01). Independent risk factors for reoperation were a major curve magnitude of ≥60° in patients with type-5 curves (adjusted OR [aOR], 4.18; p = 0.04), a major curve correction of ≥40° in patients with type-5 curves (aOR, 3.6; p = 0.04), and a lowest instrumented vertebra (LIV) at or above L1 in patients with type-1 curves (aOR, 2.8; p = 0.02). Conclusions:. The reoperation rate for patients with AIS who underwent PSF varied by Lenke type. Patients with type-5 curves had the highest reoperation rate, whereas patients with type-1 curves had the lowest. Patients with Lenke type-5 curves had a higher rate of reoperation due to instrumentation complications. Level of Evidence:. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Background Acromioclavicular (AC) joint trauma is a frequent sports injury. Modified Weaver Dunn (MWD) is a commonly used technique to address this injury. However, tendinous grafts (Autogenous Palmaris Longus or Semitendinosus tendons) are increasingly being used due to the biologic weakness of MWD. Methods Three search was done until January 2024 with data extraction consisting of adverse events (infections and failures), Constant-Murley score, American Shoulder and Elbow Surgeons score, and postoperative coracoclavicular distance. Results Four studies were included in this metaanalysis. Tendinous graft was shown to have statistically better ASES and Constant-Murley scores. Furthermore, there were no difference in adverse events, and postoperative coracoclavicular distance. Conclusion The tendinous graft showed no differences in adverse events, and postoperative coracoclavicular distance when compared to modified Weaver Dunn. However, it showed higher postoperative ASES and Constant-Murley score without analysis of the minimal clinical important difference making the difference solely statistical. Level of evidence 3.