Journal of spinal disorders & techniques

Publisher: Lippincott, Williams & Wilkins

Current impact factor: 2.20

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 2.202
2013 Impact Factor 1.888
2012 Impact Factor 1.767
2011 Impact Factor 1.503
2010 Impact Factor 1.333
2009 Impact Factor 1.206
2008 Impact Factor 1.365
2007 Impact Factor 1.303
2006 Impact Factor 1.11
2005 Impact Factor 1.583
2004 Impact Factor 1.121
2003 Impact Factor 0.736
2002 Impact Factor 0.728

Impact factor over time

Impact factor

Additional details

5-year impact 2.04
Cited half-life 9.10
Immediacy index 0.28
Eigenfactor 0.01
Article influence 0.75
Other titles Journal of spinal disorders & techniques (Online), Journal of spinal disorders & techniques, Journal of spinal disorders and techniques, Journalofspinaldisorders &
ISSN 1539-2465
OCLC 49377308
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Lippincott, Williams & Wilkins

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    • Publisher last reviewed on 19/03/2015
  • Classification

Publications in this journal

  • No preview · Article · Jan 2016 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: A retrospective analysis. Objective: To evaluate the association between early postoperative dural sac cross-sectional area (DCSA) and radicular pain. Summary of background data: The correlation between postoperative magnetic resonance imaging (MRI) findings and postoperative neurological symptoms after lumbar decompression surgery is controversial. Methods: This study included 115 patients who underwent lumbar decompression surgery followed by MRI within 7 days postoperatively. There were 46 patients with early postoperative radicular pain, regardless of whether the pain was mild or similar to that before surgery. The intervertebral level with the smallest DCSA was identified on MRI and compared preoperatively and postoperatively. Risk factors for postoperative radicular pain were determined using univariate and multivariate analyses. Subanalysis according to absence/presence of a residual suction drain also was performed. Results: Multivariate regression analysis showed that smaller postoperative DCSA was significantly associated with early postoperative radicular pain (per -10 mm; odds ratio, 1.26). The best cutoff value for radicular pain was early postoperative DCSA of 67.7 mm. Even with a cutoff value of <70 mm, sensitivity and specificity are 74.3% and 75.0%, respectively. Early postoperative DCSA was significantly larger before suction drain removal than after (119.7±10.1 vs. 93.9±5.4 mm). Conclusions: Smaller DCSA in the early postoperative period was associated with radicular pain after lumbar decompression surgery. The best cutoff value for postoperative radicular pain was 67.7 mm. Absence of a suction drain at the time of early postoperative MRI was related to smaller DCSA.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: A retrospective study. Objective: To determine the definite cut-off value of initial correction rate (ICR) that could be predictive of bracing outcome in patients with adolescent idiopathic scoliosis. Summary of background data: Earlier studies showed that braced patients with a better ICR could finally have a higher probability of successful outcome. However, it remains controversial what definitive cut-off value of ICR is required to accurately predict the outcome. Materials and methods: A cohort of 488 adolescent idiopathic scoliosis patients who have completed the brace treatment with a minimum of 2-year follow-up were included in the current study. Curve progression of ≤5 degrees was used to define the success of brace treatment. The success group and the failure group were compared in terms of initial Risser sign, initial age, sex, curve pattern, initial curve magnitude, and ICR. The receiver operating characteristics curve was used to define the definite cut-off point of initial curve correction rate. A logistic regression model was created to determine the independent predictors of the bracing outcome. Results: At the beginning of brace treatment, the mean age of the cohort was 13.2±1.5 years, and the mean curve magnitude was 29.5 ± 6.6 degrees. At the final follow-up, 368 patients were successfully treated by bracing. Compared with the success group, the failure group was found to have significantly younger age, lower Risser sign, and lower ICR. According to the receiver operating characteristic curve, the best cut-off value of ICR was 10%. The logistic regression model showed that ICR was significantly associated with the outcome of brace treatment with an odds ratio of 9.61. Conclusions: Patients with low ICR, low Risser sign, and young age could have a remarkably high risk of bracing failure. A rate of 10% was the optimal cut-off point for ICR, which can be used to effectively stratify braced patients.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: Retrospective cohort study. Objective: To determine whether receipt of blood transfusion and preoperative anemia are associated with increased rates of 30-day all-cause readmission, and secondarily with a prolonged hospital stay after spinal surgery. Summary of background data: Increased focus on health care quality has led to efforts to determine postsurgical readmission rates and predictors of length of postoperative hospital stay. Although there are still no defined outcome measures specific to spinal surgery to which providers are held accountable, efforts to identify appropriate measures and to determine modifiable risk factors to optimize quality are ongoing. Methods: Records from 1187 consecutive spinal surgeries at Northwestern Memorial Hospital in 2010 were retrospectively reviewed and data were collected that described the patient, surgical procedure, hospital course, complications, and readmissions. Presence or absence of transfusion during the surgery and associated hospital course was treated as a binary variable. Multivariate negative binomial regression and logistic regression were used to model length of stay and readmission, respectively. Results: Nearly one fifth (17.8%) of surgeries received transfusions, and the overall readmission rate was 6.1%. After controlling for potential confounders, we found that the presence of a transfusion was associated with a 60% longer hospital stay [adjusted incidence rate ratio=1.60 (1.34-1.91), P<0.001], but was not significantly associated with an increased rate of readmission [adjusted odds ratio=0.81 (0.39-1.70), P=0.582]. Any degree of preoperative anemia was associated with increased length of stay, but only severe anemia was associated with an increased rate of readmission. Conclusions: Both receipt of blood transfusion and any degree of preoperative anemia were associated with increased length of hospital stay after controlling for other variables. Severe anemia, but not receipt of blood transfusion, was associated with increased rate of readmission. Our findings may help define actions to reduce length of stay and decrease rates of readmission.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: A retrospective study. Objective: The goal of this retrospective study was to describe the uncommon presentation of neurological deficits in patients with congenital kyphosis of the upper thoracic spine (T1-T4). Summary of background data: Congenital kyphosis is an uncommon deformity but can potentially lead to spinal cord compression and paraplegia, particularly in type I (failure of formation) deformities. Few reports have described compressive myelopathy associated with congenital kyphosis of the upper thoracic spine. Methods: Six patients with congenital kyphosis of the upper thoracic spine, including 2 adults and 4 pediatric patients, developed progressive or sudden onset of paraplegia. Angles of kyphosis ranged from 75 to 120 degrees. Magnetic resonance imaging demonstrated spinal cord thinning and compression at the kyphotic apex in all patients. All patients underwent decompressive and correctional surgery by single-stage posterior vertebral column resection or 2-stage anterior corpectomy fusion and posterior fixation. Neurological status was evaluated using the ASIA impairment classification and the motor score. Results: Postoperatively, all patients had 25%-80% correction of kyphosis. All patients improved neurologically between 0 and 2 ASIA scales after surgery. Among them, an adolescent patient presenting as acute ASIA A improved to ASIA E within 1 year after surgery. Another adolescent patient deteriorated from preoperative ASIA C to ASIA A in the immediate postoperative period but improved to ASIA D within 1 year after surgery. Conclusions: Congenital kyphosis of the upper thoracic spine has a high incidence of compressive myelopathy. Duration from onset of paraplegia to surgical intervention and severity of preoperative paraplegia are 2 key factors in determining neurological prognosis after surgery.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: Meta-analysis and dose estimation. Objective: The aim of this study was to estimate radiation dose during minimally invasive transforaminal lumbar interbody fusion (MiTLIF) compared with open transforaminal lumbar interbody fusion (OTLIF) and evaluate the risk of radiation-related disease. Summary of background data: MiTLIF was introduced to reduce soft tissue injury and shows favorable perioperative outcomes. However, the disadvantage of MiTLIF is that, compared with OTLIF, it involves high radiation exposure because MiTLIF usually depends on a fluoroscopic guide. The additional cancer risk due to medical radiation exposure during the MiTLIF procedure has not yet been assessed. Methods: We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials in June 2014 for studies directly comparing MiTLIF and OTLIF. Patient demographics, fluoroscopy time, intraoperative bleeding, and hospitalization period were extracted. The effective dose was converted from fluoroscopy time using formulas from prior studies. Results: Eight cohort studies with a total of 619 patients were identified. Mean fluoroscopy time was 39.42 seconds [95% confidence interval (CI), 38.01-40.83] during OTLIF and 94.21 seconds (95% CI, 91.51-96.91) during MiTLIF according to the meta-analysis. The pooled data revealed that patients who underwent MiTLIF were exposed to 2.4-fold more radiation than those who underwent OTLIF. Patients who underwent OTLIF and MiTLIF were exposed to 0.66 mSv (95% CI, 0.64-0.69) and 1.58 mSv (95% CI, 1.54-1.63) during the surgery, respectively. The lifetime risk of cancer was theoretically increased by 36.4×10 and 87.0×10 after OTLIF and MiTLIF, respectively. The risk of detrimental hereditary disorders associated with OTLIF and MiTLIF is 1.32×10 and 3.16×10, respectively. Conclusions: Patients who underwent MiTLIF were exposed to 2.4-fold more radiation than those who underwent OTLIF. Although the theoretical cancer risk associated with radiation exposure may be tolerable, stochastic effects should not be disregarded.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Retro-odontoid pseudotumors are noninflammatory masses formed posterior to the odontoid process. Because of their anatomy, the optimal surgical approach for resecting pseudotumors is controversial. Conventionally, 3 approaches are used: the anterior transoral approach, the lateral approach, and the posterior extradural approach; however, each approach has its limitations. The posterior extradural approach is the most common; however, it remains challenging due to severe epidural veins. Although regression of pseudotumors after fusion surgery has been reported, direct decompression and a pathologic diagnosis are ideal when the pseudotumor is large. We therefore developed a new microscopic surgical technique; transdural resection. After C1 laminectomy, the dorsal and ventral dura was incised while preserving the arachnoid. Removal of the pseudotumor was performed and both of the dura were repaired. The patient's clinical symptoms subsequently improved and the pathologic findings showed degenerative fibrocartilaginous tissue. In addition, no neurological deterioration, central spinal fluid leakage, or arachnoiditis was observed. Currently, the usefulness of the transdural approach has been reported for cervical and thoracic disk herniation. According to our results, the transdural approach is recommended for resection of retro-odontoid pseudotumors because it enables direct decompression of the spinal cord and a pathologic diagnosis.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
    Full-text · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Over the last 5 years, there has been a growing trend toward consolidation in the health care field. As reimbursement moves from a fee-for-service model to a value-based model, there will be continued pressure on physicians to either be a hospital employee or to be in a large multidisciplinary practice. This is largely due to the Accountable Care Act, which directs payers to utilize population-based cost analyses, rather than an individual patient-based analysis. To succeed in this environment, practices will have to break down traditional organizational barriers to create evidence-based algorithms for the treatment of individual diagnoses from the initial onset of symptoms until the resolution of symptoms.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: A prospective cohort double-center study. Objective: To assess the clinical effect of minimally invasive transforaminal lumbar interbody fusion (miTLIF) using the tunnel technique. Summary of background data: A series of short-term studies have indicated that miTLIF could reduce blood loss and improve clinical results. However, long-term clinical study and magnetic resonance imaging research are still scare. Methods: From January 2008 to January 2009, 187 patients with 1-segment lumbar disease requiring intervertebral fusion were enrolled in this study. Patients were divided into 2 groups according to the operative methods. Postoperative low back pain (LBP), postoperative lumbar function, the fusion rate, lower extremity pain relief, variation of lumbar lordosis, and implant failure were assessed. At 48 months postoperation, the cross-sectional area of the paraspinal muscle was measured using magnetic resonance imaging. Results: The mean duration of follow-up was 54.4±5.9 months. The intermuscular pressure generated by the tunnel in the miTLIF group was lower than that generated in the oTLIF group. Patients in the miTLIF group reported a lower degree of LBP at all timepoints. The ODI scores were similar to the VAS scores. No significant differences were found in fusion rate, lower extremity pain relief, lumbar lordosis, or implant failure rate. A significant difference was found between the 2 groups in postoperative cross-sectional area. Conclusions: This study confirmed the advantages of miTLIF in reducing postoperative LBP, improving postoperative quality of life and preventing paraspinal muscle atrophy compared with oTLIF, while achieving a similar therapeutic outcome. The lower intermuscular pressure generated by minimally invasive tunnel and subsequent moderate muscle atrophy were presumed to be possible reasons for its superiority.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: Prospective cohort study. Objective: To determine whether comorbidities and demographics, identified preoperatively, can impact patient outcomes and satisfaction after lumbar spine surgery. Summary of background data: The surgical treatment of lower back pain does not always eliminate a patient's pain and symptoms. Revision surgeries are costly and expose the patient to additional risk. We aim to identify patient characteristics that may suggest a greater or lesser likelihood of postsurgical success by examining patient-reported measures and outcomes after surgery. Methods: Preoperative smoking status, self-reported depression, prevalence of diabetes, obesity, level of education, and employment status were assessed in the context of patient outcome and satisfaction after lumbar spine surgery. Patients were contacted before surgery, and at 3 and 12 months postoperatively, and responded to Oswestry Disability Index (ODI) and EuroQol-5 Dimensions (EQ-5D) self-assessment examinations, as well as a satisfaction measure. Results: A total of 166 patients who underwent lumbar spine surgeries at Iowa Spine and Brain Institute, a department of Covenant Medical Center, and were included in the National Neurosurgery Quality and Outcomes Database were assessed preoperatively, and at 3 and 12 months postoperatively using self-assessment tools. Depression, smoking, and employment status were found to be significant factors in patient satisfaction. Depressed patients, smokers, and patients on disability at the time of surgery have worse ODI and EQ-5D scores at all of the timepoints (baseline, 3 months, and 12 months postsurgery). Conclusions: Depression, smoking, and employment status, specifically whether a patient is on disability at the time of surgery, are all significant factors in patient satisfaction after lumbar spine surgery. These factors are also shown in impact ODI and EQ-5D scores. Surgeons should consider these particular characteristics when developing a lower back pain treatment plan involving surgery.
    No preview · Article · Nov 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Postoperative epidural hematomas are rare complications following lumbar spine surgery, but if they are not quickly identified and treated they can lead to permanent neurological deficits. Epidural hematomas occur in approximately 0.10%-0.24% of all spine surgeries, and despite the fact that multiple large studies have been performed attempting to identify risk factors for this complication, there is still significant debate about the effect of subfascial drains, postoperative anticoagulation, and antiplatelet medication on the incidence of postoperative hematoma. The purpose of this manuscript is to review the epidemiology, etiology, diagnosis, and treatment of patients who develop a postoperative lumbar epidural hematoma.
    No preview · Article · Oct 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Regression models are commonly used in spine research today, and they can be used to explain or predict an outcome. A regression model can indicate the relative impact of each variable on the expected outcome, so when the model has been developed, it can be used to predict the outcome for a hypothetical patient.
    No preview · Article · Oct 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Study design: The efficacy of use of a drain tip culture for early detection of surgical-site infection (SSI) was investigated in 329 patients after spinal surgery. Objective: To examine the efficacy of a wound drain tip culture for detection of SSI in spinal surgery. Summary of background data: A complication of SSI after spinal surgery has high associated morbidity and mortality, and is often difficult to treat. Materials and methods: The subjects were patients who underwent spinal surgery at our institution between January 2010 and March 2013. All subjects were treated with antimicrobial prophylaxis based on evidence-based guidelines and were followed for at least 6 months after surgery. Data from culture studies using the distal tip of the wound drain were used for analysis. Results: Drain tip cultures were positive in 34 cases and there were 19 SSIs. Ten of the 34-tip culture-positive wounds developed SSI. Drain tip cultures had a sensitivity of 52%, specificity of 92%, positive predictive value (PPV) of 29%, and negative predictive value of 97% for predicting a wound infection. The association between a positive suction tip culture and wound infection was significant (P<0.05). The PPV for SSI was 60% in cases in which methicillin-resistant bacteria were detected in a drain tip, and the SSI rate in these cases differed significantly compared with those with non-methicillin-resistant bacteria (P=0.01). Conclusions: A drain tip culture is useful for early detection of SSI caused by methicillin-resistant bacteria.
    No preview · Article · Oct 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Objectives: To examine the relationship between cervical degeneration and spinal alignment by comparing patients with adult spinal deformity versus the control cohort. Summary of background data: The effect of degeneration on cervical alignment has been controversial. Methods: Cervical and full-length spine radiographs of 57 patients with adult spinal deformity and 78 patients in the control group were reviewed. Adult spinal deformity was classified into 3 types based on the primary characteristics of the deformity: "Degenerative flatback" group, "Positive sagittal imbalance" group, and "Hyperthoracic kyphosis" group. Cervical degeneration was assessed using the cervical degeneration index scoring system. Results: The "Degenerative flatback" group had significantly higher total cervical degeneration index score (25±7) than the control group (16±8), the "Positive sagittal imbalance" group (18±8), and the "Hyperthoracic kyphosis" group (12±7) (P<0.01). The "Degenerative flatback" group had significantly less cervical lordosis than the other groups. This reduced amount of cervical lordosis was thought to be induced by a compensatory decrease in thoracic kyphosis. In this group, increased cervical degeneration was significantly associated with a decrease in cervical lordosis. Significantly greater compensatory increase in cervical lordosis was noted in the "Positive sagittal imbalance" group (20±15 degrees) and the "Hyperthoracic kyphosis" group (26±9 degrees) compared with the control group (11±12 degrees) (P<0.02). Conclusions: Flat cervical spine coexisted with cervical degeneration when compensatory hypothoracic kyphosis was induced by degenerative flatback. In other situations, cervical lordosis could increase as a compensatory reaction against sagittal imbalance or hyperthoracic kyphosis.
    No preview · Article · Oct 2015 · Journal of spinal disorders & techniques

  • No preview · Article · Oct 2015 · Journal of spinal disorders & techniques
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    ABSTRACT: Purpose: Cervical spondylotic myelopathy (CSM) is a condition resulting from cervical stenosis. Manifestations of CSM include paresthesia in the extremities, loss of fine motor skills, balance problems, and bowel and bladder dysfunction in advanced disease. Laminoplasty is one surgical treatment option. The goal of laminoplasty is to reposition the laminae to expand the spinal canal, allowing the spinal cord to migrate posteriorly. There are various laminoplasty techniques; the main ones being open-door laminoplasty and double-door laminoplasty. This manuscript demonstrates a double-door laminoplasty otherwise known as a "French-door" laminoplasty discusses the indications and outcomes of this procedure. Methods: The double-door laminoplasty creates an opening in the midline of the spinous processes and a symmetrical expansion with hinges on both laminae. Bilateral troughs are drilled on each laminae using a bur, and opened liked a French-door, allowing the spinal cord to move posteriorly in the enlarged spinal canal. The space between the gapped laminae are then stabilized by allograft. Results: This manuscript presents the case of a 56-year-old man with CSM caused by multilevel cervical stenosis. The patient had classic signs and symptoms of CSM including problems with fine motor skills and walking difficulty. The video demonstrates the spinal cord decompression achieved with the French-door technique from C4 to C6 with a dome laminectomy at C3. Conclusions: There are many surgical treatments for cervical stenosis including anterior cervical discectomy and fusions and posterior procedures such as laminoplasty or laminectomy and fusion. The indications and technical pearls for French-door laminoplasty are presented as an effective option for the treatment of multilevel cervical stenosis.
    No preview · Article · Sep 2015 · Journal of spinal disorders & techniques