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Article: Minimally Invasive Revision of Luque Plate Instrumentation: A Case Report.

Derman, Peter B / Rogers-LaVanne, Mary P / Satin, Alexander M

2024 Volume 16, Issue 1, Page(s) e53120

Abstract: Extension of existing spinal fusions may necessitate the removal of or linkage to prior constructs. Knowledge of previously placed instrumentation is critical to success in these revision scenarios. The Luque spinal instrumentation system, developed in ... ...

Abstract	Extension of existing spinal fusions may necessitate the removal of or linkage to prior constructs. Knowledge of previously placed instrumentation is critical to success in these revision scenarios. The Luque spinal instrumentation system, developed in the late 1980s, is a legacy pedicle screw and plate system that may be encountered during revision operations today. A 67-year-old male with a remote history of L4-S1 fusion with Luque instrumentation presented with bilateral lower extremity neurogenic claudication due to adjacent segment disease at L3-4. Decompression and extension of fusion to the L3-4 level were performed using minimally invasive techniques. Of note, posterior instrumentation was extended by removing prior L4 pedicle screws with a 7 mm female hexagonal driver through tubular retractors, leaving the Luque plates in place, placing modern pedicle screws at L4 (through the plates) and L3, and linking these with standard rods. The surgery and post-operative course were uncomplicated, and the patient experienced complete resolution of his pre-operative claudication symptoms. Extension of prior Luque plate instrumented fusion can be accomplished minimally invasively without removing the plates themselves, resulting in greater operative efficiency and less surgical morbidity.
Language	English
Publishing date	2024-01-28
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.53120
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Article ; Online: Device profile of the FlareHawk interbody fusion system, an endplate-conforming multi-planar expandable lumbar interbody fusion cage.

Derman, Peter B / Yusufbekov, Rachelle / Braaksma, Brian

Expert review of medical devices

2023 Volume 20, Issue 5, Page(s) 357–364

Abstract: Introduction: The FlareHawk Interbody Fusion System is a family of lumbar interbody fusion devices (IBFDs) that include FlareHawk7, FlareHawk9, FlareHawk11, TiHawk7, TiHawk9, and TiHawk11. These IBFDs offer a new line of multi-planar expandable ... ...

Abstract	Introduction: The FlareHawk Interbody Fusion System is a family of lumbar interbody fusion devices (IBFDs) that include FlareHawk7, FlareHawk9, FlareHawk11, TiHawk7, TiHawk9, and TiHawk11. These IBFDs offer a new line of multi-planar expandable interbody devices designed to provide mechanical stability, promote arthrodesis, and allow for restoration of disc height and lordosis through a minimal insertion profile during standard open and minimally invasive posterior lumbar fusion procedures. The two-piece interbody cage design consists of a PEEK outer shell that expands in width, height, and lordosis with the insertion of a titanium shim. Once expanded, the open architecture design allows for ample graft delivery into the disc space. Areas covered: The design and unique features of the FlareHawk family of expandable fusion cages are described. The indications for their use are discussed. Early clinical and radiographic outcome studies using the FlareHawk Interbody Fusion System are reviewed, and properties of competitor products are outlined. Expert opinion: The FlareHawk multi-planar expandable interbody fusion cage is unique amongst the many lumbar fusion cages currently on the market. The multi-planar expansion, open architecture, and adaptive geometry set it apart from its competitors.
MeSH term(s)	Humans ; Lordosis/surgery ; Retrospective Studies ; Spinal Fusion/methods ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery
Language	English
Publishing date	2023-04-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2250857-0
ISSN	1745-2422 ; 1743-4440
ISSN (online)	1745-2422
ISSN	1743-4440
DOI	10.1080/17434440.2023.2198123
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Article: Collagen Matrix Inlay Graft for Management of Incidental Durotomy During Full-Endoscopic Lumbar Spine Surgery: Technique and Case Series.

Derman, Peter B / Rogers-LaVanne, Mary P / Satin, Alexander M

International journal of spine surgery

2023 Volume 17, Issue 3, Page(s) 399–406

Language	English
Publishing date	2023-06-14
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4599
ISSN	2211-4599
DOI	10.14444/8457
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Article ; Online: Cervical Disk Arthroplasty and Range of Motion at 7 Years: Impact on Adjacent Level Degeneration.

Satin, Alexander M / Rogers-LaVanne, Mary P / Derman, Peter B

Clinical spine surgery

2023 Volume 36, Issue 3, Page(s) 83–89

Abstract: Study design: Secondary analysis of data collected in a prospective, randomized, noninferiority Food and Drug Administration (FDA) Investigational Device Exemption (IDE) clinical trial.: Objective: The objective of this study was to evaluate the ... ...

Abstract	Study design: Secondary analysis of data collected in a prospective, randomized, noninferiority Food and Drug Administration (FDA) Investigational Device Exemption (IDE) clinical trial. Objective: The objective of this study was to evaluate the impact of range of motion (ROM) following single-level cervical disk arthroplasty (CDA) on the development of radiographic adjacent level degeneration (ALD). Summary of background data: The rationale for CDA is that maintenance of index-level ROM will decrease adjacent level stresses and ultimately reduce the development of ALD compared with anterior cervical discectomy and fusion. However, little information is available on the impact of hypermobility on the development of ALD after CDA. Materials and methods: Radiographic assessments were evaluated for index-level flexion-extension ROM and ALD. Continuous data was assessed using 1-way analysis of variance. The relationship between ALD progression and ROM was evaluated using χ 2 tests. The α was set at 0.05. Results: More ALD progression was observed after anterior cervical discectomy and fusion than CDA ( P =0.002 at the superior and P =0.049 at the inferior level). Furthermore, there was an association between ALD progression and ROM ( P =0.014 at the superior level and P =0.050 at the inferior level) where patients with mid-ROM after CDA experienced the lowest frequency of ALD progression at the superior and inferior levels. Patients with the lowest and highest ROM after CDA experienced a greater increase in ALD score at the inferior level ( P =0.046). Sex and age were associated with ROM groups ( P =0.001 and 0.023, respectively). Conclusions: While maintenance of index-level ROM is protective after CDA, patients with the highest ROM after CDA have similar rates of ALD progression to the lowest ROM and greater increases in ALD compared with mid-ROM after CDA. High ROM after CDA may contribute to ALD progression.
MeSH term(s)	Humans ; Intervertebral Disc Degeneration/diagnostic imaging ; Intervertebral Disc Degeneration/surgery ; Treatment Outcome ; Prospective Studies ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/surgery ; Spinal Fusion ; Diskectomy ; Arthroplasty ; Range of Motion, Articular
Language	English
Publishing date	2023-02-20
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2849646-2
ISSN	2380-0194 ; 2380-0186
ISSN (online)	2380-0194
ISSN	2380-0186
DOI	10.1097/BSD.0000000000001446
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Article ; Online: Review of Prospective Trials for Degenerative Cervical Myelopathy.

Satin, Alexander M / Rush, Augustus J / Derman, Peter B

Clinical spine surgery

2022 Volume 35, Issue 10, Page(s) 410–417

Abstract: Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction in adults. DCM refers to a collection of degenerative conditions that cause the narrowing of the cervical canal resulting in neurological dysfunction. A lack of high- ... ...

Abstract	Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord dysfunction in adults. DCM refers to a collection of degenerative conditions that cause the narrowing of the cervical canal resulting in neurological dysfunction. A lack of high-quality studies and a recent increase in public health awareness has led to numerous prospective studies evaluating DCM. Studies evaluating the efficacy of surgical intervention for DCM can be characterized by the presence (comparative) or absence (noncomparative) of a nonoperative control group. Noncomparative studies predominate due to concerns regarding treatment equipoise. Comparative studies have been limited by methodological issues and have not produced consistent findings. More recent noncomparative studies have established the safety and efficacy of surgical intervention for DCM, including mild myelopathy. The optimal surgical intervention for DCM remains controversial. A recent randomized clinical trial comparing dorsal and ventral techniques found similar improvements in patient-reported physical function at early follow-up. Recent prospective studies have enriched our understanding of DCM and helped guide current treatment recommendations.
MeSH term(s)	Adult ; Humans ; Neck ; Prospective Studies ; Qualitative Research ; Spinal Cord Diseases/surgery ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2022-10-21
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2849646-2
ISSN	2380-0194 ; 2380-0186
ISSN (online)	2380-0194
ISSN	2380-0186
DOI	10.1097/BSD.0000000000001407
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Article: Cervical Disc Arthroplasty: Rationale and History.

Derman, Peter B / Zigler, Jack E

International journal of spine surgery

2020 Volume 14, Issue s2, Page(s) S5–S13

Abstract: Biomechanical studies have demonstrated that cervical fusion results in increased motion and intradiscal pressures at adjacent levels. Cervical disc arthroplasty (CDA) is an alternative treatment for cervical radiculopathy and myelopathy resulting from ... ...

Abstract	Biomechanical studies have demonstrated that cervical fusion results in increased motion and intradiscal pressures at adjacent levels. Cervical disc arthroplasty (CDA) is an alternative treatment for cervical radiculopathy and myelopathy resulting from degenerative disc disease. By maintaining segmental motion, surgeons hope to avoid some of the primary drawbacks of anterior cervical discectomy and fusion (ACDF), such as pseudoarthrosis and adjacent segment disease. First introduced in the 1960s, CDA has evolved over the years with changes to implant geometry and materials. Early devices produced suboptimal outcomes, but more recent generations of implants have shown long-term outcomes rivaling or even surpassing those of ACDF. In this article, the rationale for CDA as well as the history of such devices is reviewed.
Language	English
Publishing date	2020-09-29
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4599
ISSN	2211-4599
DOI	10.14444/7086
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Article ; Online: Cervical Decompression Surgery Normalizes Gait Ground Reaction Forces in Patients With Cervical Spondylotic Myelopathy.

Haddas, Ram / Derman, Peter B

Spine

2020 Volume 45, Issue 18, Page(s) E1134–E1141

Abstract: Study design: Prospective cohort study.: Objective: Investigate the effect of surgical decompression and fusion on gait ground reaction forces (GRFs) parameters in patients with cervical spondylotic myelopathy (CSM) and to compare these values to ... ...

Abstract	Study design: Prospective cohort study. Objective: Investigate the effect of surgical decompression and fusion on gait ground reaction forces (GRFs) parameters in patients with cervical spondylotic myelopathy (CSM) and to compare these values to those of healthy controls. Summary of background data: Surgical intervention to alleviate spinal cord compression is typically recommended in cases of CSM. While the primary aim of surgery is to halt disease progression, the literature suggests that some symptomatic improvement is often observed postoperatively. Gait analysis via measurement of GRFs is a particularly sensitive means of quantifying changes in ambulatory function, but no comprehensive analysis has been published in the setting of CSM. Methods: Forty patients with symptomatic CSM underwent gait analysis with measurement of horizontal and vertical GRFs before and 3 months after surgery. Thirty healthy controls (H) underwent the same battery of tests. Comparisons were made between the pre- and postoperative profiles of patients with CSM as well as to that of the control group. Results: Before surgery, patients with CSM exhibited disturbances in GRF magnitudes: significantly greater maximum weight acceptance (Pre: 113.7 vs. H: 101.1% body weight [BW], P = 0.040) and push off forces (Pre: 112.2 vs. H: 101.4% BW, P = 0.044), and timing: maximum weight acceptance occurred earlier while mid-stance (Pre: 15.8 vs. H: 17.8% gait cycle [GC], P = 0.018), toe-off (Pre: 65.0 vs. H: 62.9% GC, P = 0.001), braking (Pre: 55.6 vs. H: 54.2% GC, P = 0.003), and propulsion occurred (Pre: 11.9 vs. H: 10.6% GC, P = 0.011) later compared with healthy controls. Surgery improved all GRF parameters (P < 0.039), but postoperative gait profiles did not completely normalize to levels observed in the control group. Conclusion: These observations combined with published data on gait muscle activation and gait patterns in CSM patients support the idea that patients with CSM have an altered gait profile consistent with a series of poorly controlled near falls. Surgical intervention was observed to produce improvements in but not complete resolution of these gait disturbances. These data provide a more comprehensive understanding of gait in the setting of CSM. Level of evidence: 3.
MeSH term(s)	Adult ; Aged ; Cervical Vertebrae/surgery ; Cohort Studies ; Decompression, Surgical/methods ; Electromyography/methods ; Female ; Gait/physiology ; Gait Analysis/methods ; Humans ; Male ; Middle Aged ; Prospective Studies ; Spinal Cord Compression/physiopathology ; Spinal Cord Compression/surgery ; Spinal Cord Diseases/physiopathology ; Spinal Cord Diseases/surgery ; Spondylosis/physiopathology ; Spondylosis/surgery
Language	English
Publishing date	2020-04-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000003531
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Article ; Online: Preservation of Motion in Spine Surgery.

Preston, Gordon / Hoffmann, Jacob / Satin, Alexander / Derman, Peter B / Khalil, Jad G

The Journal of the American Academy of Orthopaedic Surgeons

2023 Volume 31, Issue 7, Page(s) e356–e365

Abstract: The number of spinal procedures and spinal fusions continues to grow. Although fusion procedures have a high success rate, they have inherent risks such as pseudarthrosis and adjacent segment disease. New innovations in spine techniques have sought to ... ...

Abstract	The number of spinal procedures and spinal fusions continues to grow. Although fusion procedures have a high success rate, they have inherent risks such as pseudarthrosis and adjacent segment disease. New innovations in spine techniques have sought to eliminate these complications by preserving motion in the spinal column. Several techniques and devices have been developed in the cervical and lumbar spine including cervical laminoplasty, cervical disk ADA, posterior lumbar motion preservation devices, and lumbar disk ADA. In this review, advantages and disadvantages of each technique will be discussed.
MeSH term(s)	Humans ; Spinal Fusion/methods ; Laminoplasty ; Lumbar Vertebrae/surgery ; Lumbosacral Region ; Cervical Vertebrae/surgery
Language	English
Publishing date	2023-03-06
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-22-00956
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Article: Complication avoidance in minimally invasive spinal surgery.

Derman, Peter B / Phillips, Frank M

Journal of spine surgery (Hong Kong)

2019 Volume 5, Issue Suppl 1, Page(s) S57–S67

Abstract: Minimally invasive techniques in spinal surgery allow surgeons to perform operations with less of the approach-related morbidity inherent to traditional open procedures. Yet these muscle-sparing procedures come with a unique set of risks that stem from ... ...

Abstract	Minimally invasive techniques in spinal surgery allow surgeons to perform operations with less of the approach-related morbidity inherent to traditional open procedures. Yet these muscle-sparing procedures come with a unique set of risks that stem from the novel approaches, limited exposure, and/or a restricted working corridor that they employ. The literature suggests that these operations can be performed without an increased rate of complication once the associated learning curve has been surmounted, suggesting that knowledge of and experience with the nuances of these procedures are essential for patient safety. The present article describes the complications specific to a variety of minimally invasive spinal surgeries and provides guidance on how to avoid them.
Language	English
Publishing date	2019-07-26
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2874556-5
ISSN	2414-4630 ; 2414-469X
ISSN (online)	2414-4630
ISSN	2414-469X
DOI	10.21037/jss.2019.04.03
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Article: Complication avoidance and management in ambulatory spine surgery.

Sheha, Evan D / Derman, Peter B

Journal of spine surgery (Hong Kong)

2019 Volume 5, Issue Suppl 2, Page(s) S181–S190

Abstract: The positive safety profile and potential cost savings associated with ambulatory spine surgery have resulted in an increasing number of spine procedures being performed on an outpatient basis. As indications become more inclusive and the variety and ... ...

Abstract	The positive safety profile and potential cost savings associated with ambulatory spine surgery have resulted in an increasing number of spine procedures being performed on an outpatient basis. As indications become more inclusive and the variety and volume of ambulatory procedures grow, the incidence of complications may rise. Limiting adverse events in the outpatient setting starts with patient selection. Surgeons should be aware of the potential complications and associated risk factors for common ambulatory spine procedures and employ strategies to limit and appropriately manage them. Protocols which include patient education, multimodal anesthesia and analgesia, standardized post-operative monitoring, and safe discharge planning are also essential for maximizing safety in the ambulatory setting.
Language	English
Publishing date	2019-09-05
Publishing country	China
Document type	Journal Article ; Review
ZDB-ID	2874556-5
ISSN	2414-4630 ; 2414-469X
ISSN (online)	2414-4630
ISSN	2414-469X
DOI	10.21037/jss.2019.08.06
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