Browsing by Author "Sankey, Eric W"
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Item Open Access Biomechanics, evaluation, and management of subaxial cervical spine injuries: A comprehensive review of the literature.(Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 2021-01) Wang, Timothy Y; Mehta, Vikram A; Dalton, Tara; Sankey, Eric W; Rory Goodwin, C; Karikari, Isaac O; Shaffrey, Christopher I; Than, Khoi D; Abd-El-Barr, Muhammad MStudy design
Literature review.Objectives
It has been reported that 2.4-3.7% of all blunt trauma victims suffer some element of cervical spine fracture, with the majority of these patients suffering from C3-7 (subaxial) involvement. With the improvement of first-response to trauma in the community, there are an increasing number of patients who survive their initial trauma and thus arrive at the hospital in need of further evaluation, stabilization, and management of these injuries.Methods
A comprehensive literature review compiled all relevant data on the biomechanics, imaging, evaluation, and medical and surgical management strategies for subaxial cervical spine fractures.Results
After review of the current literature on subaxial cervical spine biomechanics, imaging characteristics, evaluation strategies and surgical and orthopedic management techniques, the authors created a comprehensive review and protocol for management of subaxial cervical spine fractures.Conclusions
The subaxial cervical spine is biomechanically and anatomically unique from the remainder of the spinal axis. Evaluation of subaxial cervical spine injuries is nuanced, and improper management of these injuries can lead to significant patient morbidity and even death. This provides a comprehensive review combining anatomy, imaging characteristics, evaluation strategies, and surgical and orthopedic management principles for subaxial cervical spine fractures.Item Open Access Importance of Spinal Alignment in Primary and Metastatic Spine Tumors.(World neurosurgery, 2019-12) Sankey, Eric W; Park, Christine; Howell, Elizabeth P; Pennington, Zach; Abd-El-Barr, Muhammad; Karikari, Isaac O; Shaffrey, Christopher I; Gokaslan, Ziya L; Sciubba, Daniel; Goodwin, C RorySpinal alignment, particularly with respect to spinopelvic parameters, is highly correlated with morbidity and health-related quality-of-life outcomes. Although the importance of spinal alignment has been emphasized in the deformity literature, spinopelvic parameters have not been considered in the context of spine oncology. Because the aim of oncologic spine surgery is mostly palliative, consideration of spinopelvic parameters could improve postoperative outcomes in both the primary and metastatic tumor population by taking overall vertebral stability into account. This review highlights the relevance of focal and global spinal alignment, particularly related to spinopelvic parameters, in the treatment of spine tumors.Item Open Access Preoperative optimization for patients undergoing elective spine surgery.(Clinical neurology and neurosurgery, 2021-01-14) Wang, Timothy Y; Price, Meghan; Mehta, Vikram A; Bergin, Stephen M; Sankey, Eric W; Foster, Norah; Erickson, Melissa; Gupta, Dhanesh K; Gottfried, Oren N; Karikari, Isaac O; Than, Khoi D; Goodwin, C Rory; Shaffrey, Christopher I; Abd-El-Barr, Muhammad MItem Open Access Single-position prone transpsoas fusion for the treatment of lumbar adjacent segment disease: early experience of twenty-four cases across three tertiary medical centers.(European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022-09) Wang, Timothy Y; Mehta, Vikram A; Sankey, Eric W; Shaffrey, Christopher I; Than, Khoi D; Taylor, William R; Pollina, John; Pimenta, Luiz; Abd-El-Barr, Muhammad MPurpose
Prone transpsoas fusion (PTP) is a minimally invasive technique that maximizes the benefit of lateral access interbody surgery and the prone positioning for surgically significant adjacent segment disease. The authors describe the feasibility, reproducibility and radiographic efficacy of PTP when performed for cases of lumbar ASD.Methods
Adult patients undergoing PTP for treatment of lumbar ASD at three institutions were retrospectively enrolled. Demographic information was recorded, as was operative data such as adjacent segment levels, operative time, blood loss, laterality of approach, open versus percutaneous pedicle screw instrumentation and need for primary decompression. Radiographic measurements including segmental and global lumbar lordosis, pelvic incidence, pelvic tilt, sacral slope and sagittal vertical axis were recorded both pre- and immediately post-operatively.Results
Twenty-four patients met criteria for inclusion. Average age was 60.4 ± 10.4 years and average BMI was 31.6 ± 5.0 kg/m2. Total operative time was 204.7 ± 83.3 min with blood loss of 187.9 ± 211 mL. Twenty-one patients had pedicle screw instrumentation exchanged percutaneously and 3 patients had open pedicle screw exchange. Two patients suffered pulmonary embolism that was treated medically with no long-term sequelae. One patient had transient lumbar radicular pain and all patients were discharged home with an average length of stay of 3.0 days (range 1-6). Radiographically, global lumbar lordosis improved by an average of 10.3 ± 9.0 degrees, segmental lordosis by 10.1 ± 13.3 degrees and sagittal vertical axis by 3.2 ± 3.2 cm.Conclusion
Single-position prone transpsoas lumbar interbody fusion is a clinically reproducible minimally invasive technique that can effectively treat lumbar adjacent segment disease.Item Open Access The Impact of Instrumentation and Implant Surface Technology on Cervical and Thoracolumbar Fusion.(Operative neurosurgery (Hagerstown, Md.), 2021-06) Wang, Timothy Y; Mehta, Vikram A; Sankey, Eric W; Shaffrey, Christopher I; Abd-El-Barr, Muhammad M; Than, Khoi DSpinal fusion has undergone significant evolution and improvement over the past 50 yr. Historically, spine fusion was noninstrumented and arthrodesis was based entirely on autograft. Improved understanding of spinal anatomy and materials science ushered in a new era of spinal fusion equipped with screw-based technologies and various interbody devices. Osteobiologics is another important realm of spine fusion, and the evolution of various osteobiologics has perhaps undergone the most change within the past 20 yr. A new element to spinal instrumentation has recently gained traction-namely, surface technology. New data suggest that surface treatments play an increasingly well-recognized role in inducing osteogenesis and successful fusion. Until now, however, there has yet to be a unified resource summarizing the existing data and a lack of consensus exists on superior technology. Here, authors provide an in-depth review on surface technology and its impact on spinal arthrodesis.Item Open Access The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States.(Neurosurgical focus, 2020-11) Sankey, Eric W; Mehta, Vikram A; Wang, Timothy Y; Than, Tracey T; Goodwin, C Rory; Karikari, Isaac O; Shaffrey, Christopher I; Abd-El-Barr, Muhammad M; Than, Khoi DSpine surgery has been disproportionately impacted by medical liability and malpractice litigation, with the majority of claims and payouts related to procedural error. One common area for the potential avoidance of malpractice claims and subsequent payouts involves misplaced pedicle and/or lateral mass instrumentation. However, the medicolegal impact of misplaced screws on spine surgery has not been directly reported in the literature. The authors of the current study aimed to describe this impact in the United States, as well as to suggest a potential method for mitigating the problem.This retrospective analysis of 68 closed medicolegal cases related to misplaced screws in spine surgery showed that neurosurgeons and orthopedic spine surgeons were equally named as the defendant (n = 32 and 31, respectively), and cases were most commonly due to misplaced lumbar pedicle screws (n = 41, 60.3%). Litigation resulted in average payouts of $1,204,422 ± $753,832 between 1995 and 2019, when adjusted for inflation. The median time to case closure was 56.3 (35.2-67.2) months when ruled in favor of the plaintiff (i.e., patient) compared to 61.5 (51.4-77.2) months for defendant (surgeon) verdicts (p = 0.117).