Sample MediSum Research Update

In a retrospective single-centre study of 119 patients (mean age 67.4) who underwent long posterior lumbosacral fusion (≥ five levels), 37.8% experienced rapid hip joint space narrowing (>0.5 mm/year). Patients with rapid progression had higher BMI, greater pelvic incidence, and higher postoperative sagittal vertical axis (SVA), and multivariate analysis found that a one-standard-deviation increase in postoperative SVA was independently associated with rapid joint space narrowing (OR 2.20, 95% CI 1.22–3.96; p = 0.009).

In a retrospective cohort of 191 single-level lumbar discectomy patients (91 endoscopic, 100 open), uniportal endoscopic discectomy was associated with lower short-term opioid use—fewer patients with persistent opioid use at 6 weeks (8.8% vs 21.0%; RR 0.47) and lower cumulative opioid consumption (MME 264.7 vs 340.5)—while rates of clinical outcomes (leg pain reduction, reoperation, durotomy, operative time) and opioid use beyond 6 weeks were similar between approaches.

Among 204 patients who underwent long-segment thoracolumbar fusion with pelvic fixation, patients were dichotomized by pelvic incidence (PI) around 55°; those with lower PI had higher rates of proximal junctional failure (PJF) than those with higher PI (21% vs 9%). Multivariate and Bayesian analyses identified lower PI, lower thoracic upper instrumented vertebra, and reoperation status as independent predictors of PJF.

In 161 patients undergoing single-position prone XLIF at lateral levels L2–5 (majority L4–5), transabdominal muscle action potential (TMAP) monitoring with an event-based protocol was used to detect intraoperative femoral nerve compromise. TMAP changes identified all four postoperative quadriceps weakness cases (100% sensitivity), with a 400–500 mA change emerging as a clinically significant threshold (specificity 83–90%), and injuries were temporally linked to specific steps (notably docking), implicating direct mechanical trauma rather than retractor time.

In a retrospective analysis of 3,311 adults undergoing open, instrumented multilevel posterior spine surgery, 35% had preoperative Staphylococcus aureus colonization and 2% developed postoperative S. aureus infections within 3 months. Preoperative colonization was associated with higher odds of superficial surgical-site infection (OR 1.7) and S. aureus bloodstream infection (OR 1.8), while prophylactic decolonization (chlorhexidine wash, intranasal mupirocin, or both) was associated with reduced odds of postoperative infection.