omplications following lumbar spine fusion.Level of Evidence 3.
  Randomized, double-blinded, controlled trial.
 
  To investigate the effectiveness of local intraoperative corticosteroids at decreasing the severity of swallowing difficulty following multilevel anterior cervical discectomy and fusion (ACDF).
 
  Dysphagia is a common complication after ACDF, and while for most patients the symptoms are mild and transient, some patients can suffer from severe dysphagia resulting in significant postoperative morbidity. Previous studies investigating the local application of corticosteroids are limited.
 
  This was a prospective, randomized, double-blinded, controlled trial of patients undergoing 2, 3, or 4 level ACDF for radiculopathy and/or myelopathy. Patients undergoing multilevel ACDF were randomized to receive local corticosteroid in the retropharyngeal space or placebo (no steroid). Dysphagia was assessed using validated outcomes including the Eating Assessment Tool-10 (Eat-10) and Swallowing Quality of Life (SWAL-QOL) Questionnaire both preoperatively and at 1 day (POD1),l need to be established in future studies.Level of Evidence 1.
 Local administration of corticosteroid after multilevel ACDF can decrease postoperative severity and symptomatology of dysphagia during the immediate postoperative period to 1-month postoperatively. The long-term effects of local steroid administration on fusion and other complications will need to be established in future studies.Level of Evidence 1.
  Retrospective review.
 
  The aim of this study was to develop a surgical invasiveness index for metastatic spine tumor surgery (MSTS) that can serve as a standardized tool in predicting intraoperative blood loss and surgical duration; for the purpose of ascertaining resource requirements and aiding in patient education.
 
  Magnitude of surgery is important in the metastatic spine disease (MSD) population since these patients have a continuing postoperative oncological process; a consideration that must be taken into account to maintain or improve quality of life. Surgical invasiveness indices have been established for general spine surgery, adult deformity, and cervical deformity, but not yet for spinal metastasis.
 
  Demographic, oncological, and procedural data were collected from consecutive patients that underwent MSTS. Binary logistic regression, using median values for surgical duration and intraoperative estimated blood loss (EBL), was used to determine statistical significance of variables to be includh the goal of improving patient outcomes and quality of life.Level of Evidence 4.
 Long surgical duration and high blood loss were strongly predicted by the newly developed SMII. The use of the SMII may aid in preoperative risk assessment with the goal of improving patient outcomes and quality of life.Level of Evidence 4.
  Cross-sectional database study.
 
  The objective of this study was to develop an algorithm for the automated measurement of spinopelvic parameters on lateral lumbar radiographs with comparable accuracy to surgeons.
 
  Sagittal alignment measurements are important for the evaluation of spinal disorders. Manual measurement methods are time consuming and subject to rater-dependent error. Thus, a need exists to develop automated methods for obtaining sagittal measurements. Previous studies of automated measurement have been limited in accuracy, inapplicable to common plain films, or unable to measure pelvic parameters.
 
  Images from 816 patients receiving lateral lumbar radiographs were collected sequentially and used to develop a convolutional neural network (CNN) segmentation algorithm. 653 (80%) of these radiographs were used to train and validate the CNN. This CNN was combined with a computer vision algorithm to create a pipeline for the fully-automated measurement of spinopelvic parameters from lateral lumbar radiographs. The remaining 163 (20%) of radiographs were used to test this pipeline. 40 radiographs were selected from the test set and manually measured by three surgeons for comparison.
 
  The CNN achieved an area under the receiver operating curve of 0.956. Algorithm measurements of L1-S1 cobb angle, pelvic incidence, pelvic tilt, and sacral slope were not significantly different from surgeon measurement. In comparison to gold standard measurement, the algorithm performed with a similar mean absolute difference to spine surgeons for L1-S1 Cobb angle (4.30 ± 4.14° vs 4.99 ± 5.34°), pelvic tilt (2.14 ± 6.29° vs 1.58 ± 5.97°), pelvic incidence (4.56 ± 5.40° vs 3.74 ± 2.89°), and sacral slope (4.76 ± 6.93° vs 4.75 ± 5.71°).
 
  This algorithm measures spinopelvic parameters on lateral lumbar radiographs with comparable accuracy to surgeons. The algorithm could be used to streamline clinical workflow or perform large scale studies of spinopelvic parameters.
 
  3.
 3.
  A retrospective analysis of a single-center consecutive series of patients.
 
  To test the hypothesis that using a mobile intraoperative computed tomography in combination with spinal navigation would result in better accuracy of lateral mass and pedicle screws between C3 and T5 levels, compared to cone-beam computed tomography and traditional 2D fluoroscopy.
 
  Use of spinal navigation associated with 3D imaging has been shown to improve accuracy of screw positioning in the cervico-thoracic region. However, use of iCT imaging compared to a cone-beam CT has not been fully investigated in these types of surgical interventions.
 
  We retrospectively analyzed a series of patients who underwent posterior cervico-thoracic fixations using different intraoperative imaging systems in a single hospital. We identified three different groups of patients Group A, operated under 2D-fluoroscopic guidance without navigation; Group B O-arm guidance with navigation; Group C iCT AIRO guidance with navigation. Primary outcome wa Evidence 3.
 Use of high-quality CT associated with spinal navigation significantly improved accuracy of screw positioning in the cervico-thoracic region.Level of Evidence 3.
  Longitudinal.
 
  To evaluate whether the rate of patients who report low health-related quality of life (HRQOL) scores at 2 years following surgical correction of adolescent idiopathic scoliosis (AIS) improves by 5 years postoperatively.
 
  HRQOL scores are dependent upon a number of factors and even in instances of good surgical correction of a spinal deformity, are not guaranteed to be high postoperatively. Understanding how a low HRQOL score varies over the postoperative period can help surgeons more effectively counsel patients and temper expectations.
 
  A multicenter database was reviewed for patients with both 2 and 5-year follow-up after spinal fusion and instrumentation for AIS.  https://www.selleckchem.com/products/cc-930.html  From a cohort of 916 patients, 52 patients with low HRQOL scores at their 2-year follow-up were identified and reevaluated at 5-year follow-up. A low HRQOL outcome was defined as having SRS-22 domain or total scores less than 2 standard deviations below the mean score. Reoperations were also evaluated to determine if they were associated with HRQOL scores.