6%) patients. There were no cases of total flap loss and no major donor site complications recorded.Folded MI-VRAM flap is a reliable method for reconstruction of complex maxillectomy and midfacial defects. It provides multiple independent skin islands with excellent plasticity and abundant volume of tissue for restoration of facial contours.

This was a national database study.

The objective of this study was to assess the impact of prior bariatric surgery (BS) on altering 90-day postoperative outcomes following elective anterior cervical discectomy and fusions (ACDFs).

Though obesity has previously been shown to be linked with adverse outcomes following elective spine surgical procedures, the effectiveness of weight-loss strategies such as BS has not been explored.

The PearlDiver program was used to query the 2007-2013 100% Medicare Standard Analytical Files (SAF100) for patients undergoing an elective ACDF. The study cohort was divided into 2 groups-(1) obese ACDF patients (body mass index ≥35 kg/m) receiving a BS procedure within 2 years before an ACDF and (2) obese ACDF patients (body mass index ≥35 kg/m) without a known history of a BS procedure within the last 2 years. Multivariate regression analyses were used to assess the impact of a BS procedure on postoperative outcomes following ACDF while adjusting for age, sex, region, and Elixhauser Comorbidity Index.

A total of 411 ACDF patients underwent BS within the 2 years before an ACDF. Multivariate analysis showed that undergoing BS before an elective ACDF was associated with a significantly reduced risk of pulmonary complications [odds ratio (OR)=0.53; P=0.002], cardiac complications (OR=0.69; P=0.012), sepsis (OR=0.69; P=0.035), renal complications (OR=0.54; P=0.044), and 90-day readmissions (OR=0.53; P=0.015).

Surgery-induced weight loss before an ACDF in obese patients is associated with reduced 90-day complication and readmission rates. Orthopaedic and bariatric surgeons should counsel obese patients on the benefits of BS following ACDFs.

Surgery-induced weight loss before an ACDF in obese patients is associated with reduced 90-day complication and readmission rates. Orthopaedic and bariatric surgeons should counsel obese patients on the benefits of BS following ACDFs.

This was a prospective cohort study.

The aim was to explores whether fear-avoidance is associated with altered gait patterns in cervical spinal myelopathy (CSM) patients.

Fear-avoidance is associated with activity restriction and emotional distress in chronic pain patients and with poorer spine surgery outcomes. In adults with spinal deformity, fear and avoidance correlates with gait pattern disruptions. Afuresertib supplier Patients having CSM also display distorted gait.

Ninety CSM patients completed the Tampa Scale for Kinesiophobia (TSK) questionnaire, and the Fear-avoidance Beliefs Questionnaire (FABQ). Each patient performed a series of gait trials. Pearson’s product correlation analysis was used to determine the relationship between the self-reported fear of movement measures and the objective gait biomechanical data.

The TSK total score was correlated with walking speed (P=0.003), cadence (P=0.012), stride (P=0.010) and step (P=0.036) time, and stride (P=0.018) and step (P=0.035) length. The FABQ physical dimens a framework for further investigation of the relationship between psychosocial factors and objectively measured function in patients with CSM. This study demonstrates a strong correlation between fear and avoidance of movement, as measured with the TSK and FABQ and multiple biomechanical gait parameters, as measured with gait analysis. The current results may imply that fear and avoidance may compound and worsen functional deficits arising from CSM, and strongly suggest that fear and avoidance beliefs should be included as a component of presurgical diagnostic process for CSM patients.

This was a retrospective consecutive cohort analysis.

This study aimed to examine the association between commonly prescribed medications and outcomes following posterior lumbar spine surgery.

Postoperative complications and prolonged length of stay significantly increase costs following posterior lumbar spine surgery and worsen patient outcomes. To control costs and complications, providers should focus on modifiable risk factors, such as preoperative medications. Antihypertensive and anticholinergic drugs are among the most commonly prescribed medications but can carry significant risks in the perioperative period.

This study was a retrospective cohort analysis of patients undergoing posterior lumbar spine surgery from January 2014 through December 2015 at a large tertiary care center. The variable selection followed by multivariable logistic and negative binomial regressions were performed. An α threshold of 0.0056 was used for significance after correction for multiple comparisons. A secondary analysis was performed to evaluate confounding or effect modifying variables.

This study included 1577 patients. Postoperative urinary retention risk was increased in patients taking loop diuretics. Acute kidney injury risk was increased for patients on nondihydropyridine calcium-channel blockers. Surgical site infection risk was increased for patients on aldosterone receptor blockers. Urinary tract infection risk was increased for patients on anticholinergics for urinary incontinence. Length of stay was decreased for patients on angiotensin II antagonists and angiotensin-converting enzyme inhibitors.

A care path should be established in the perioperative period for patients who are deemed to be at higher risk due to medication status to either modify medications or improve postoperative monitoring.

Level III.

Level III.

A retrospective comparative study.

The present study aims to compare the surgical outcomes between bilateral partial laminectomy (BPL) and posterior lumbar interbody fusion (PLIF) in patients with mild degree of slippage.

To date, there have not been established surgical procedures for patients with mild degree of slippage. Moreover, sufficient studies that have compared surgical outcomes between BPL and PLIF are very few.

In this retrospective study, the authors enrolled 202 consecutive patients with degenerative spondylolisthesis with slippage at L3 or L4 of >3% who underwent spine surgery between 2005 and 2015. Patients were grouped into those who underwent single-segment PLIF (n=106) and those who underwent BPL (n=51). To adjust for potential confounders, the inverse probability of treatment weighting based on the propensity score was used. Surgical outcomes were compared between the BPL and PLIF groups. The threshold age for the final recovery rate of >70% was evaluated using receiver operating characteristic curve analyses to assess the limit of age to achieve good outcomes.