Research Roundup: Surgical Spine Surgery Insights and Effective Spondylodiscitis Treatment

More Functional Disability Seen in Japanese Patients With RA Who Undergo Cervical Spine Surgery

BMC Musuloskeletal Disorders

Shurei Sugita, M.D., and colleagues examined data from the National Database of Rheumatic Diseases by iR-net in Japan for the fiscal years 2003 to 2011 and included 39 patients of 60 patients who underwent cervical spine surgery for a rheumatoid arthritis (RA)-related cause. They only included patients who had data available for two consecutive years and excluded patients who required surgery for a reason unrelated to RA.

In the study group, Sugita and colleagues reported fusion surgery was the most frequently performed surgery with 29 patients (74.4 percent) undergoing the procedure. Laminoplasty was the second most frequently performed procedure, with 4 patients (10.25 percent) undergoing the procedure.

Sugita and colleagues found patients with RA who underwent cervical spine surgery had a higher disease activity than the matched control patients with RA, and the proportion of all patients who used biologics increased linearly during the study period. However, the investigators found the number of patients who underwent cervical spine surgery was unchanged during that time.

In the conclusion of the study, Sugita and colleagues noted physicians should evaluate cervical lesions, particularly in patients with high disease activity, in spite of the use of biologics.


Permanent Metal Cages an Option for Surgical Treatment of Spondylodiscitis
Orthopedics

In a recent study, researchers found that patients with spondylodiscitis who were treated with anterior debridement and reconstruction with an expandable metallic cage can maintain alignment without a risk of infection.

The retrospective study included 15 patients with spondylodiscitis who were treated surgically through the implantation of metal cages. Average follow-up time was 25 months. One patient required an additional surgery due to infection, but the infection was not at the site of the surgery.

Through a radiograph review, the researchers found treatment did not result in any extensive osteolysis around the metal cage or any severe collapse. Compared with initial postoperative radiographs, an average loss of 1.9 degrees of correction was seen in final follow-up radiographs.

“Retrospective studies continue to show that adding instrumentation to the construct can be done with little risk of recurrent deep infection,” the researchers concluded.


Shoulder Activity not Associated With Severity of Atraumatic Rotator Cuff Tear
American Journal of Sports Medicine

Among patients with atraumatic rotator cuff tears, shoulder activity was not associated with severity of the tear, but was affected by patients’ age, sex and occupation, according to study results.

Researchers prospectively enrolled patients with an atraumatic rotator cuff tear on magnetic resonance imaging in the Multicenter Orthopaedic Outcomes Network shoulder study of nonoperative treatment. Patients were asked to complete a previously validated shoulder activity scale; 434 patients completed the scale and were included in the analysis. Mean patient age was 62.7 years.

The researchers performed a regression analysis to assess the association of shoulder activity level to rota-tor cuff tear characteristics, including tendon involvement and traction, as well as patient factors such as age, sex, smoking and occupation.

Shoulder activity was not associated with severity of the rotator cuff tear, according to the researchers. However, shoulder activity was negatively associated with age and female sex. According to the regression model, 69-year-old patients with rotator cuff tears were 1.5 points less active on the 20-point scale vs. identical 56-year-old patients; female patients were 1.6 points less active vs. similar male patients. Occupation was also a significant predictor of shoulder activity level, with unemployed patients predicted to be 4.8 points less active compared with employed patients.