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Purpose The purpose of this study is to perform a citation analysis on the most frequently cited articles in the topic of cervical spine surgery and report on the top most cited publication in this topic. Methods We used the Thomson Reuters Web of Science to search citations of all articles from to relevant to cervical spine surgery and ranked them according to the number of citations. The most cited articles that matched the search criteria were further analyzed by number of citations, first author, journal, year of publication, country and institution of origin.

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Results The top cited articles in the topic of cervical spine surgery were published from The number of citations ranged from times for the th paper to times for the top paper. The decade of saw the most publications.

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Investigators from America authored the most papers and The University of California contributed the most publications. Cervical spine fusion was the most common topic published with 36 papers, followed by surgical technique and trauma. Conclusion This article identifies the most cited articles in cervical spine surgery. It has provided insight to the history and development in cervical spine surgery and many of which have shaped the way we practice today.

The top classic papers in lumbar spine surgery. Bibliometric review of the literature.

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To analyze and quantify the most frequently cited papers in lumbar spine surgery and to measure their impact on the entire lumbar spine literature. Lumbar spine surgery is a dynamic and complex field. Basic science and clinical research remain paramount in understanding and advancing the field. While new literature is published at increasing rates, few studies make long-lasting impacts.

The Thomson Reuters Web of Knowledge was searched for citations of all papers relevant to lumbar spine surgery. The number of citations, authorship, year of publication, journal of publication, country of publication, and institution were recorded for each paper. The most cited paper was found to be the classic paper from by Boden et al that described magnetic resonance imaging findings in individuals without back pain, sciatica, and neurogenic claudication showing that spinal stenosis and herniated discs can be incidentally found when scanning patients.

The second most cited study similarly showed that asymptomatic patients who underwent lumbar spine magnetic resonance imaging frequently had lumbar pathology. The third most cited paper was the publication of Fairbank and Pynsent reviewing the Oswestry Disability Index, the outcome-measure questionnaire most commonly used to evaluate low back pain.


This report identifies the top papers in lumbar spine surgery and acknowledges those individuals who have contributed the most to the advancement of the study of the lumbar spine and the body of knowledge used to guide evidence-based clinical decision making in lumbar spine surgery today. Multilevel spine fusion surgery for adult deformity correction is associated with significant blood loss and coagulopathy. Tranexamic acid reduces blood loss in high-risk surgery , but the efficacy of a low-dose regimen is unknown. The primary outcome was the total volume of red blood cells transfused intraoperatively.

Thirty-one patients received tranexamic acid, and 30 patients received placebo. Patient demographics, risk of major transfusion, preoperative hemoglobin, and surgical risk of the 2 groups were similar. There was a significant decrease in total volume of red blood cells transfused placebo group median mL vs.

The decrease in packed red blood cell transfusion did not reach statistical significance placebo group median mL vs. Our results support the use of low-dose tranexamic acid during complex multilevel spine fusion surgery to decrease total red blood cell transfusion. All rights reserved. Philosophy and concepts of modern spine surgery. The main goal of improving pain and neurological deficit in the practice of spine surgery is changing for a more ambitious goal, namely to improve the overall quality of life and the future of patients through three major actions 1 preserving the vertebral anatomical structures; 2 preserving the paravertebral anatomical structures; and 3 preserving the functionality of the segment.

Thus, three new concepts have emerged a minimal surgery ; b minimal access surgery ; and c motion preservation surgery. These concepts are covered in a new term, minimally invasive spine surgery MISS The term "MISS" is not about one or several particular surgical techniques, but a new way of thinking, a new philosophy. Although the development of minimally invasive spine surgery is recent, its application includes all spine segments and almost all the existing conditions, including deformities. In most cases, the only evidence one can find in the literature is the lack of evidence Resnick D Spine SS Only then, with a.

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Return to golf after spine surgery. The objective of this study is to provide data from surveys sent to spine surgeons. Of spine surgeons surveyed, responded Responses were tallied for lumbar laminectomy, lumbar microdiscectomy, lumbar fusion, and anterior cervical discectomy with fusion. The results showed a statistically significant increase in the recommended time to resume golf after lumbar fusion than after cervical fusion in all patients p spine surgery depends on many variables, including the general well-being of patients in terms of pain control and comfort when golfing.

This survey serves as a guide that can assist medical practitioners in telling patients the average times recommended by surgeons across North America regarding return to golf after spine surgery. A multicentered retrospective case series.

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To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine. Patients who underwent cervical spine surgery between January 1, , and December 31, , at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified.

Substantial variation between institutions was noted, with 11 sites reporting no epidural hematomas, and 1 site reporting an incidence of 0. All patients initially presented with a neurologic deficit. Additionally, the patients who experienced a postoperative epidural hematoma did not experience any significant improvement in health-related quality-of-life metrics as a result of the index procedure at final follow-up evaluation. This is the largest series to date to analyze the incidence of an epidural hematoma following cervical spine surgery , and this study suggest that an epidural hematoma occurs in approximately 1 out of cervical spine surgeries.

Prompt diagnosis and treatment may improve the chance of making a complete neurologic recovery, but patients who develop this complication do not show improvements in the health-related quality-of-life measurements. Vertebral artery injuries in cervical spine surgery. Vertebral artery injuries VAIs are rare but serious complications of cervical spine surgery , with the potential to cause catastrophic bleeding, permanent neurologic impairment, and even death.

The present literature regarding incidence of this complication largely comprises a single surgeon or small multicenter case series. We sought to gather a large sample of high-volume surgeons to adequately characterize the incidence and risk factors for VAI, management strategies used, and patient outcomes after VAI. The study was constructed as a cross-sectional study comprising all cervical spine patients operated on by the members of the international Cervical Spine Research Society CSRS.

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For each surgeon surveyed, we collected self-reported measures to include the number of cervical cases performed in the surgeon's career, the number of VAIs encountered, the stage of the case during which the injury occurred, the management strategies used, and the overall patient outcome after injury. An anonymous question web-based survey was distributed to the members of the CSRS. Statistical analysis was performed using Student t tests for numerical outcomes and chi-squared analysis for categorical variables. The overall incidence of VAI was 0. Posterior instrumentation of the upper cervical spine The most common management of VAI was by.

A comparative analysis of minimally invasive and open spine surgery patient education resources. The Internet has become a widespread source for disseminating health information to large numbers of people.

Such is the case for spine surgery as well. Given the complexity of spinal surgeries , an important point to consider is whether these resources are easily read and understood by most Americans. The average national reading grade level has been estimated to be at about the 7th grade. In the present study the authors strove to assess the readability of open spine surgery resources and minimally invasive spine surgery resources to offer suggestions to help improve the readability of patient resources.

Online patient education resources were downloaded in from 50 resources representing either traditional open back surgery or minimally invasive spine surgery. Each resource was assessed using 10 scales from Readability Studio Professional Edition version Patient education resources representing traditional open back surgery or minimally invasive spine surgery were all found to be written at a level well above the recommended 6th grade level.

In general, minimally invasive spine surgery materials were written at a higher grade level. The readability of patient education resources from spine surgery websites exceeds the average reading ability of an American adult. Revisions may be warranted to increase quality and patient comprehension of these resources to effectively reach a greater patient population.

The evolution of image-guided lumbosacral spine surgery. Techniques and approaches of spinal fusion have considerably evolved since their first description in the early s. The incorporation of pedicle screw constructs into lumbosacral spine surgery is among the most significant advances in the field, offering immediate stability and decreased rates of pseudarthrosis compared to previously described methods.