Introduction Thoracolumbar vertebral body fractures are a common cause of spinal injury, where burst fractures account for up to 58% of all thoracolumbar fractures. These fractures can lead to pain and neurological deficit. In other cases, they may remain asymptomatic. The fracture itself may also lead to kyphotic deformity and spinal instability. When there is evidence of instability, kyphotic deformity, or even neurological deficit, surgical intervention…

Introduction Osteoporotic vertebral fracture is increasing in prevalence with our aging population. It has a reported incidence of 30% to 50% in those over the age of 50. This condition often affects postmenopausal women and can result spontaneously or following minor trauma. Osteoporotic fractures are suspected to total more than 3 million by 2025, which is an increase of 48%, surpassing a national burden of $25…

Introduction Transforaminal lumbar interbody interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) have become common procedures for the treatment of degenerative lumbar disease such as spondylolisthesis, scoliosis, and spondylosis leading to foraminal stenosis. Interbody cage placement is often used to increase fusion rate and stabilization of the instrumented segments. While this has shown to be advantageous to patient outcomes and fusion rates, migration of the…

Introduction Thoracic stenosis can lead to compression of the spinal cord as a result of spinal degeneration, hypertrophy of the facet and ligamentum flavum, ossification of the ligamentum flavum, and diffuse idiopathic skeletal hyperostosis, among others. These changes may be the result of degenerative changes or microinstability at the location of the stenosis. This can be especially true for stenosis due to adjacent segment disease from…

Introduction Low back pain is one of the leading causes of emergency visits in the United States, leading to billions of dollars in loss of productivity each year. Most Americans will experience back pain during their lifetime, and a majority of these are self-limiting and never require additional treatment. Others may improve with conservative management such as nonsteroidal antiinflammatory drugs and physical therapy, while others may…

Introduction Although first described in 1952 by Brian et al., cervical spondylotic myelopathy (CSM) continues to be a frequently misdiagnosed pathology. The insidious onset is often mistaken as part of the normal aging process, while patients often have progressive and debilitating neurological deficits. In fact, CSM is the leading cause of spinal cord–related disability in older adults. This results from degenerative changes of the cervical spine,…

Introduction Stenosis of the lumbar spine can occur at different areas of the lumbar spine. Stenosis of the lumbar spine is most common at L4-5 level but can also occur at L3-4, L2-3, L5-S1, and L1-2 in decreasing frequency. Stenosis can result from a number of causes such as hypertrophy of the ligamentum flavum. Ossification of the ligamentum flavum can also result in stenosis. Additionally, broad-based…

Introduction Pseudoarthrosis is a common complication following fusion operations. It can be found in both instrumented and noninstrumented fusions but more commonly occurs following noninstrumented fusion. Pseudoarthrosis is defined as symptomatic nonunion after 1 year of a fusion surgery. The symptoms can vary from mechanical back pain, radicular pain, or focal deformity due to construct failure. Pseudoarthrosis can also be identified radiographically in asymptomatic patients. Additionally,…

Introduction The cervical spine is composed of seven vertebrae. With the exception of the first cervical vertebrae, each vertebra has an associated nerve that exits the foramen above the named vertebrae. Additionally, the vertebral artery enters the foramen transversarium typically at the sixth cervical vertebrae and exits at C1 prior to entering the foramen magnum. Cervical radiculopathy is pain or sensorimotor deficit resulting from compression of…

Introduction Ossification of the posterior longitudinal ligament (OPLL) is one of many conditions classified as enthesopathies, which result from progressive inflammation of the tendons and ligaments of the spine followed by degeneration and calcification. Other examples of enthesopathies include ossification of the anterior longitudinal ligament, ossification of the ligamentum flavum, diffuse idiopathic skeletal hypertrophy, and ankylosing spondylitis. Since it was first recognized in 1838, there have…