Summary of Key Points Identification of predictors of readmission and reoperation is important to help address perioperative management and potentially both decrease readmissions and improve outcomes. The risk of spine instability, neural damage, and infection increases with revision surgery; and…
Summary of Key Points Implant wear remains a concern for arthroplasty devices, and with the increase in spinal disc arthroplasty it is essential to conduct comprehensive assessments of the implant mechanical integrity, bearing surface, and host tissue interactions, as well…
Summary of Key Points Postoperative spinal deformity manifests as an inability of the spine to maintain an adequate loadbearing capacity or withstand dynamic forces, which may occur because of iatrogenic reasons intraoperatively (decompression, instrumentation), pseudarthrosis, or the inevitable phenomenon of…
Summary of Key Points Soft tissue and vascular complications related to spinal surgery are usually predictable and vary depending on the region being operated upon. Cervical spine surgery–related soft tissue complications frequently include dysphagia, hoarseness, and vocal fold motion impairment.…
Summary of Key Points Posttraumatic and idiopathic syringomyelia represent a heterogenous group of neurological conditions characterized by fluid collections in the parenchyma of the spinal cord. Obtaining a detailed history and examining the entire neuraxis is required for effective treatment…
Summary of Key Points Syringomyelia is the formation of a fluid cavity within the spinal cord thought to result from a pathophysiological disruption of cerebrospinal fluid flow. Arachnoiditis is the scaring of the arachnoid and pia resulting from multiple etiologies,…
Summary of Key Points Arachnoiditis is a nonspecific inflammatory process of the arachnoid layer of the spinal cord or cauda equina. There are three stages in the progression of arachnoiditis, including inflammation, fibroblast proliferation, and collagen deposition. There are many…
Summary of Key Points Cerebrospinal fluid (CSF) fistulas and pseudomeningoceles are rare complications of spinal surgery. CSF fistulas usually develop shortly after surgery, resulting in increased postoperative morbidity, duration of hospitalization, and cost of care. Pseudomeningoceles develop more slowly and…
Summary of Key Points Neurological complications associated with spine surgery may result in a need for additional surgery, prolonged length of stay, and need for subsequent care (rehab, therapy, assistive devices). The spinal cord is at risk in any spine…
Summary of Key Points Although most surgeons understand the importance of sterile technique in preventing surgical site infections, other steps can be taken before, during, and after the procedure to reduce the risk. Thorough preoperative evaluation, including nasal Staphylococcus aureus…