ALAN SANDER HILIBRAND, M.D.

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This study looked at who gets invited to speak and serve on committees at major international spine surgery conferences. Out of 1,462 speakers, 56.2% were from Northern America, and a striking 89.7% came from high-income countries, with no speakers from low-income countries at all. This matters because it highlights the lack of diversity and global representation in important discussions about spine surgery, which can limit the perspectives and experiences shared in this medical field. Who this helps: This helps patients and communities in lower-income countries, as their needs and challenges might be overlooked in spine surgery practices.

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This study looked at how home care services after spinal surgery (lumbar fusion) affected patients' health outcomes and hospital visits. It involved 758 patients, where 13.6% received home care. The results showed that those with home care had a higher chance of needing to return to the hospital (12.6% vs. 3.51%) or having to undergo more surgery (13.6% vs. 1.07%), and even tended to report worse health after six months compared to those without home care. Who this helps: This information is valuable for doctors and healthcare providers when deciding on post-surgery care for patients.

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This study looked at how different surgical techniques for spinal fusion affect recovery in patients with a condition called degenerative spondylolisthesis, where one vertebra slips over another. It found that patients with milder forms of the condition (specifically CARDS type A and Meyerding grade 1) did better after surgery using a technique called PLDF, with improvement scores decreasing by 11.02 points and 10.15 points, respectively. In contrast, patients with more severe characteristics showed more improvement with a technique called TLIF. Who this helps: This benefits patients with degenerative spondylolisthesis by guiding treatment choices based on their specific condition.

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This study looked at how people across the United States access robotic spine surgery and found significant differences based on location and socioeconomic status. Researchers identified 91 robotic spine surgeons, mostly located in wealthier areas, with rural regions facing 22% lower odds of having access to these surgeries. The findings highlight the need to improve access for disadvantaged communities, especially where there is a higher number of older adults and uninsured individuals. Who this helps: This benefits patients who need robotic spine surgery, particularly those in rural or low-income areas.

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This study looked at what helps spine surgery fellows get full-time jobs at universities and contribute to research. Researchers analyzed 310 applications from 2017 to 2021 and found that having published research during residency, publishing before that, and showing interest in academic careers significantly increased the chances of getting a university job. Understanding these factors is important because it can help guide future applicants and programs in selecting candidates who are more likely to succeed in academic spine surgery. Who this helps: This helps future spine surgery candidates and educational programs.

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This study looked at factors that help predict which patients can safely be discharged from the hospital early after undergoing revision lumbar fusion surgery. Out of 479 patients, those who were discharged early (after about 1.85 days) reported better improvement in back and leg pain compared to those who stayed longer (about 4.37 days). Key factors for early discharge included being male and having a lower BMI, while longer surgery times and certain medical conditions made early discharge less likely. Who this helps: This information benefits patients undergoing revision lumbar fusion surgery, as it can lead to shorter hospital stays and improved recovery experiences.

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This study looked at how patients who used marijuana after surgery for neck or back problems managed their pain with other medications. Out of 126 patients, half used marijuana; those who had surgery on their lower back were more likely to have used opioids before their operation, but marijuana use did not affect their pain relief needs afterward. Interestingly, marijuana users recovering from neck surgery were more likely to also use a specific type of antidepressant called duloxetine. Who this helps: This research benefits patients undergoing surgery for neck or back issues.

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This study looked at how the type of insurance affects the recovery of patients aged 65 and older who underwent a specific neck surgery called anterior cervical discectomy and fusion (ACDF). Researchers found that although Medicare patients used to receive less reimbursement for the procedure, this didn’t affect their recovery outcomes compared to those with private or Medicare Advantage insurance. Specifically, 303 patients were examined, and while private insurance patients started with worse scores before surgery, they showed significant improvement one year post-surgery, indicating that insurance type doesn’t directly influence recovery outcomes. Who this helps: This research benefits elderly patients who need ACDF surgery and their healthcare providers.

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This study looked at how well patients with serious spine injuries do in two types of hospitals: Level I and Level II trauma centers. Researchers found that patients treated at Level I trauma centers had a 34% lower risk of dying in the hospital compared to those at Level II centers, even though they had more severe injuries. This matters because it shows that patients have better chances of survival when treated at more advanced trauma centers without facing more complications or longer hospital stays. Who this helps: This helps patients with severe spine injuries and their families.

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This study looked at how the alignment of the spine and pelvis changed over time in 413 adult patients who had a specific type of back surgery called single-level lumbar fusion. The researchers found that while some aspects of spinal alignment improved slightly over two to three years, more than half of the patients still had issues with balance, with 31% showing a significant mismatch in their spinal alignment and 57% having pelvic tilt issues. Understanding these changes helps doctors better predict which patients are likely to face ongoing problems after surgery. Who this helps: This helps patients undergoing single-level lumbar fusion and their doctors.

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This study looked at the trend in outpatient surgeries for cervical spine issues called anterior cervical discectomy and fusion (ACDF) in hospital-owned surgical centers from 2016 to 2022. Researchers found that the number of these procedures almost doubled from about 33,700 in 2016 to 73,000 in 2021, though it dipped slightly in 2022. The costs for these surgeries varied widely, with an average price of $57,600, and procedures in the West being 41% more expensive than those in the Northeast; importantly, the number of Medicare patients undergoing the surgery grew significantly. Who this helps: This information is valuable for patients seeking surgery, as well as healthcare providers and policymakers.

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This study looked at deaths that happen in the hospital after lumbar fusion surgery from 2016 to 2022. Out of over 1.1 million patients, only 0.11% (about 1,290 patients) died while in the hospital, with nearly half of those deaths occurring within the first week. The research found that older patients (especially those 75 and older), those undergoing more complex surgeries, and those with several health issues were at a higher risk of dying in the hospital. Who this helps: This information benefits doctors and older patients considering lumbar fusion surgery.

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This study looked at patients who underwent back surgery and compared those having their first surgery with those who had surgery after a previous one (called revision surgery). It found that revision patients had much higher long-term needs for pain medications; for example, they used an average of 1,550 morphine milligrams over two years, compared to 497 milligrams for first-time patients. This matters because it highlights the increased pain management challenges for revision patients and suggests that they may need more tailored support after surgery. Who this helps: This helps patients undergoing revision spine surgery and their doctors.

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This review examined how improving bone health before spine surgery can lead to better long-term recovery. Researchers found that poor bone quality is linked to complications like surgery failure and the need for additional surgeries. They emphasized the need for a consistent approach to assess and enhance bone health, suggesting that using different tests and treatment options can significantly reduce risks after surgery. Who this helps: This information benefits patients undergoing spine surgery by potentially improving their recovery and reducing complications.

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This study looked at lymphovascular invasion (LVI) in prostate cancer, which is a harmful characteristic that can affect treatment outcomes. Researchers analyzed data from 403 prostate cancer samples and identified 129 genes linked to LVI, mainly related to the body's immune response to viruses. They found that a specific score based on these genes could predict a lower risk of cancer recurring after treatment, independent of other clinical factors. Who this helps: This helps patients with prostate cancer by providing new insights into their condition and potential treatment strategies.

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This study looked at how depression affects recovery after back surgery called lumbar fusion. Out of 418 patients, about 30% had high levels of depression before surgery. Those with high depression reported worse recovery scores and were more likely to need another surgery within two years (13.4% compared to 5.15% for those without depression). Who this helps: This helps patients with depression who are considering back surgery, as well as their doctors in making treatment decisions.

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This study looked at how giving a medication called dexamethasone during surgery affects recovery for diabetic patients who have a specific neck surgery called posterior cervical decompression and fusion. It included 105 patients and found that while those who received dexamethasone had higher fluctuations in blood sugar levels, there were no significant differences in wound healing or overall surgical outcomes between the two groups. Interestingly, there was a trend suggesting that dexamethasone might lead to lower use of opioid painkillers one year after surgery, but the results weren't strong enough to make a definitive conclusion. Who this helps: This helps diabetic patients undergoing neck surgery and their doctors.

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This study looked at people with opioid use disorder (OUD) who were hospitalized for cervical fusion surgery between 2016 and 2022. The findings showed that older adults (ages 30-69) had significantly higher odds of having OUD, and these patients faced more complications, longer hospital stays (3.23 days compared to 2.47 days), and higher costs ($31,900 versus $27,000) than those without OUD. Understanding these trends is important because it can help doctors better prepare for and manage the care of these complex patients, potentially improving their outcomes. Who this helps: This helps patients with opioid use disorder and their doctors.

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This study looked at whether physical therapy (PT) after single-level lumbar fusion surgery helps reduce pain, lower opioid use, and improve overall recovery. Researchers analyzed data from 365 patients and found no differences in pain relief or opioid prescriptions between those who did and did not receive PT, suggesting PT did not impact recovery as intended. This is important because it shows that while PT might be safe, it may not always be needed for every patient after this type of surgery. Who this helps: This helps doctors and healthcare providers decide on the best recovery plans for their patients.

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This study looked at the results of two types of back surgeries—anterior cervical discectomy and fusion (ACDF) and posterior lumbar decompression and fusion (PLDF)—by comparing patients from a hospital database with those in a national quality program (NSQIP). They analyzed 9,829 patients, finding that while most complications were similar between the two groups, hospital ACDF patients had shorter surgery times and hospital stays. However, the hospital's PLDF patients had a significantly higher readmission rate within 30 days (3.13% at the hospital vs. 0.22% for NSQIP), highlighting some differences in outcomes based on where patients were treated. Who this helps: This helps patients considering these surgeries and the doctors who perform them.

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This study looked at how the reputation of orthopedic residency programs affects the success of applicants in getting into spine surgery fellowships. It found that those coming from top-ranked programs were significantly more likely to get interviews and to match with their preferred fellowship, with p-values indicating strong statistical significance (less than 0.01). This is important because it shows that where a doctor trains can greatly influence their future career opportunities in specialized fields. Who this helps: This helps applicants in orthopedic surgery and residency program directors.

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This study examined how two important proteins involved in cell signaling, G proteins and β-arrestins, interact with each other. The researchers found that when β-arrestins are brought to the cell surface, they can directly connect with G proteins, specifically Gαi. They discovered that different types of Gαi proteins vary in how well they associate with β-arrestin, influenced by specific regions of the protein. This matters because understanding how these proteins interact could lead to better drug development, as G protein-coupled receptors (targets for many medications) play a key role in many diseases. Who this helps: This helps patients by potentially improving treatments for various medical conditions.

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This study looked at how a condition called preoperative myelomalacia affects recovery after a specific neck surgery known as anterior cervical discectomy and fusion (ACDF). Out of 518 patients, those with myelomalacia reported slightly less neck pain one year later (average score of 2.11 vs. 2.58) and had lower rates of significant improvement in neck disability (48.5% vs. 60.3%) compared to those without this condition. Overall, myelomalacia did not negatively impact the recovery outcomes as much as other factors like smoking or the severity of their initial condition. Who this helps: This helps patients undergoing neck surgery by providing insight into recovery expectations.

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This study looked at how the number of steps people take before hip and knee surgery relates to their osteoarthritis severity and pain levels. Researchers found that patients with severe osteoarthritis (grade 4) walked less than those with milder forms (grades 1-3), taking an average of fewer steps per day, but they did not report more pain. This matters because tracking step counts can give doctors better insights into a patient's condition and help make decisions about treatment timing. Who this helps: Patients preparing for hip and knee surgery.

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This study looked at how quickly patients could return to driving after surgery for neck issues. It found that patients with myelopathy (a condition caused by spinal cord compression) took longer to return to driving than those with radiculopathy (nerve root issues). Specifically, after less than one month, myelopathy patients had worse driving scores (3.45 vs. 2.84) and were less likely to be driving again after one to three months (45% less likely). Who this helps: This information helps doctors make better decisions about when to lift driving restrictions for patients after neck surgery.

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This study looked at how the level of surgery in the lower back affects patients’ recovery after treatment for a slipped disc. Researchers compared outcomes for patients who had surgery higher up in the back (L1-L2, L2-L3) versus those who had surgery lower down (L4-L5, L5-S1). Although patients with upper lumbar decompression reported more pain and disability after a year, these differences were largely due to their age and health conditions rather than the type of surgery itself. Who this helps: This research benefits both doctors and patients by providing clearer expectations for recovery outcomes based on individual health factors.

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This study looked at how different definitions of anemia affect the need for blood transfusions in patients undergoing spinal surgery. Researchers found that among 2,257 patients, those identified as anemic according to various standards were more likely to require transfusions: 60% using the World Health Organization (WHO) criteria compared to just 14% for those who weren't anemic. The WHO definition was notably better at predicting the risk of complications after surgery, making it a crucial guideline for managing patients before their procedures. Who this helps: Patients undergoing spinal surgery can benefit from clearer definitions of anemia to reduce risks.

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This study looked at a specific aggressive type of prostate cancer called cribriform pattern 4 (CP4) and its effect on survival after surgery, focusing on how age influences this impact. Researchers found that men older than 60 with CP4 had a much lower chance of surviving for five years without disease progression (50.8%) compared to older men without this pattern (74.6%). This is important because it shows that CP4 is more harmful for older patients, which can help doctors provide better tailored treatment for their patients based on age. Who this helps: This benefits older prostate cancer patients and their doctors.

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This study looked at how mental health, specifically high levels of depression, affects recovery after a neck surgery called anterior cervical discectomy and fusion (ACDF). The researchers reviewed the medical records of 311 patients, finding that those with high depressive burden (93 patients) reported worse outcomes on measures of physical and mental health at one year after surgery, despite having similar surgical success. Specifically, these patients achieved less improvement in physical functioning scores, making it harder for them to see the benefits of the surgery. Who this helps: This research helps doctors understand the importance of addressing mental health in patients undergoing spine surgery, leading to better care and outcomes for patients with depression.

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This study looked at how having obstructive sleep apnea (OSA) affects recovery after a specific neck surgery called anterior cervical discectomy and fusion (ACDF). Researchers found that 6% of patients with OSA visited the emergency department within 30 days after surgery, compared to none in the group without OSA. However, the overall risk of complications, readmissions, and reoperations was similar for both groups, meaning OSA patients can expect safe outcomes just like those without the condition. Who this helps: This information benefits patients with obstructive sleep apnea and their doctors by providing reassurance about surgery safety and outcomes.

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This study examined how age affects recovery outcomes for patients undergoing a specific neck surgery called posterior cervical decompression and fusion (PCDF). Researchers found that while older patients (ages 60-79) had more health issues and underwent more complex surgeries than younger patients (ages 50-59), their improvement in neck-related pain and quality of life after the surgery was similar. This is important because it shows that older patients can still benefit significantly from this surgery, despite their age and additional health problems. Who this helps: This research helps older patients considering neck surgery and their doctors in making informed decisions about treatment options.

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This study looked at how the position of spinal cages, specific measurements of bone density (called Hounsfield units), and other factors affect the chances of the cage sinking after surgery to fuse vertebrae in the neck. Researchers found that cages placed in the middle of the vertebrae sank more often than those placed at the front—28% of middle-positioned cages sank compared to 10.5% for front-positioned cages. Surprisingly, the bone density measurements did not help predict which patients would experience sinking. Who this helps: Patients undergoing cervical spine surgery.

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This study looked at whether adding a procedure called foraminotomy during surgery for neck problems (specifically myeloradiculopathy) leads to better long-term results for patients. The researchers examined 107 patients who had surgery, finding that those who had the foraminotomy reported a bigger drop in arm pain after one year compared to those who didn't, with pain scores improving by an average of about 3 points for the foraminotomy group versus 1.25 points for the other group. This is important because it shows that for certain patients, the extra procedure can help alleviate arm pain effectively without increasing surgery risks or recovery time. Who this helps: Patients suffering from arm pain due to myeloradiculopathy.

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This study looked at how different imaging techniques before cervical spine surgery can predict the risk of developing C5 palsy, a serious complication that some patients experience afterwards. Researchers found that patients who developed C5 palsy had a greater angle in their spine before surgery, but overall, the imaging methods, including MRI and X-rays, did not effectively predict who would get this condition, showing only a slight correlation. This matters because understanding which patients are at risk could help doctors prepare better and potentially prevent C5 palsy. Who this helps: Patients undergoing cervical spine surgery and their doctors.

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This study looked at whether wearing a brace after surgery for lower back problems improves patient recovery. Researchers followed 170 patients who had lumbar fusion surgery, comparing those who wore a brace to those who didn't. They found no significant differences in pain relief or disability, except for a slight improvement in mental health scores for those who wore braces after one year, suggesting bracing may not be worth the cost and effort in most cases. Who this helps: Patients recovering from lumbar fusion surgery.

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This study looked at how the use and cost of endoscopic spine surgery in outpatient centers changed from 2018 to 2022. Researchers found that the number of these surgeries increased significantly, especially in the Western U.S., going from 4.3% of all procedures in 2018 to 31.0% in 2022. Overall, patients who paid for their own procedures faced the highest costs at around $70,000, whereas costs varied widely depending on insurance and location, underscoring the need to ensure fair access to care. Who this helps: This benefits patients needing spine surgery, especially those without insurance.

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This study compared two surgical methods, ALIF and P/TLIF, for treating a condition called lumbar spondylolisthesis. It found that patients undergoing P/TLIF had more complications like cerebrospinal fluid leaks (2.34 times more likely) and longer hospital stays (3.03 days) but lower costs ($35,513) compared to ALIF, which had a higher cost ($43,003) but shorter hospital stays (2.81 days). These results can help doctors choose the best surgical approach for their patients based on risk and cost. Who this helps: This helps patients and doctors decide the best treatment options for lumbar spondylolisthesis.

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This study looked at how being on dialysis affects the outcomes of patients undergoing a specific type of spine surgery called posterior cervical fusion. Out of nearly 168,000 patients studied, those on dialysis had a higher risk of serious complications like heart problems and infections, with 1.9% of them dying in the hospital compared to only 0.3% of those not on dialysis. These results are important because they indicate that dialysis patients need extra attention both before and after surgery to improve their care and outcomes. Who this helps: This benefits patients on dialysis and their doctors by highlighting the need for careful planning around their surgical treatment.

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This study looked at how using a diabetes and obesity medication called semaglutide affects patients who have single-level lumbar fusion surgery, a common spine procedure. Researchers found that patients taking semaglutide had lower readmission rates after surgery (8.7% compared to 11.4%) and also faced lower healthcare costs within 90 days after the operation. This matters because it shows that semaglutide can help improve recovery outcomes for these patients without increasing the risk of complications. Who this helps: Patients undergoing lumbar fusion surgery.

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This study looked at how metformin, a diabetes medication, affects recovery in diabetic patients who had spinal surgery. Researchers found that patients taking metformin needed fewer opioids for pain relief after surgery—31.8 mg versus 52.0 mg within the first 90 days—and reported better improvement in their physical health a year after surgery. This is important because it suggests metformin may help reduce pain medication use and improve recovery outcomes for these patients. Who this helps: Patients with diabetes undergoing spinal surgery.

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This study looked at how well patients recover after a specific spine surgery called posterior cervical decompression and fusion (PCDF) for a condition called mild degenerative cervical myelopathy (DCM). The researchers found that while patients with more severe DCM showed quicker functional improvements after surgery, by two years, about 42% of patients with mild DCM achieved significant recovery, which is similar to the rates in moderate and severe cases. This is important because it indicates that even patients with mild DCM can experience meaningful benefits from surgery, though it may take longer for those benefits to appear. Who this helps: This helps patients with mild DCM and their doctors make informed decisions about surgery.

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This study looked at how depression and psychotic disorders affect patients undergoing a specific back surgery called single-level lumbar fusion. Among over 792,000 patients, 17.7% had depression and 2.6% had psychotic disorders. Those with depression had higher chances of complications and longer hospital stays, while patients with psychotic disorders faced even greater risks and costs, averaging $41,097 compared to $38,117 for those without these mental health issues. Who this helps: Patients undergoing lumbar fusion and their healthcare providers.

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This study looked at how the condition of the discs next to the ones being operated on can impact recovery after neck surgery, specifically anterior cervical decompression and fusion. Researchers found that patients with higher degeneration grades in their adjacent discs (Pfirrmann grades III and IV) had a significant decrease in disk height two years after the surgery. This means that if a patient's disc health is poor before surgery, it can lead to more serious issues after surgery, though the rate of needing follow-up surgeries remains the same after five years. Who this helps: This information helps patients and doctors by providing insights on the importance of assessing disc health prior to neck surgery.

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This study compared two types of surgical screws—lateral mass screws and pedicle screws—used during a specific neck surgery to see how they affected recovery and pain management in patients. Researchers looked at 30 patients with lateral mass screws and 50 with pedicle screws and found that while the lateral mass group underwent a more extensive decompression and had shorter surgery times, both groups had similar recovery outcomes and opioid usage within a year after surgery. This information is important because it indicates that both screw types are effective, helping doctors choose the best option for their patients. Who this helps: This helps patients undergoing neck surgery and their doctors in making informed decisions about surgical options.

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The study looked at emergency department visits after lumbar fusion surgeries, comparing patients who had their first surgery (primary) to those who had revision surgeries (to fix problems from their first surgery). It found that 10.2% of revision patients visited the emergency department within 90 days post-surgery, compared to 6.86% of primary patients. Most patients visited the ER for pain, and while revision surgery increased the chance of an ER visit, it only raised the risk by 3.4%. Who this helps: This information is valuable for patients and doctors involved in lumbar fusion surgeries.