Studying Adherence to Reporting Standards in Kinesiology: A Post-publication Peer Review Brief Report

To demonstrate how post-publication peer reviews-using journal article reporting standards-could improve the design and write-up of kinesiology research, the authors performed a post-publication peer review on one systematic literature review published in 2020. Two raters (1st & 2nd authors) critically appraised the case article between April and May 2021. The latest Journal Article Reporting Standards by the American Psychological Association relevant to the review were used: i.e., Table 1 (quantitative research standards) and Table 9 (research synthesis standards). A standard fully met was deemed satisfactory. Per Krippendorff's alpha-coefficient, inter-rater agreement was moderate for Table 1 (k-alpha = .57, raw-agreement = 72.2%) and poor for Table 9 (k-alpha = .09, raw-agreement = 53.6%). A 100% consensus was reached on all discrepancies. Results suggest the case article's Abstract, Methods, and Discussion sections required clarification or more detail. Per Table 9 standards, four sections were largely incomplete: i.e., Abstract (100%-incomplete), Introduction (66%-incomplete), Methods (75%-incomplete), and Discussion (66%-incomplete). Case article strengths included tabular summary of studies analyzed in the systematic review and a cautionary comment about the review's generalizability. The article's write-up gave detail to help the reader understand the scope of the study and decisions made by the authors. However, adequate detail was not provided to assess the credibility of all claims made in the article. This could affect readers' ability to obtain critical and nuanced understanding of the article's topics. The results of this critique should encourage (continuing) education on journal article reporting standards for diverse stakeholders (e.g., authors, reviewers).

Surgical Technique of Central and Over-the-Top Full-Endoscopic Decompression of the Cervical Spine: A Technical Note

Endoscopic surgery of the cervical spine is constantly evolving and the spectrum of its indications has expanded in recent decades. Full-endoscopic techniques have standardized the procedures for posterior and anterior access. The full-endoscopic approach was developed to treat degenerative diseases with the least possible invasion and without causing instability of the cervical spine. The posterior full-endoscopic approach is indicated for the treatment of diseases of the lateral part of the vertebral segment, such as herniations and stenoses of the lateral recess and vertebral foramen. There has been little discussion of this approach to the treatment of central stenosis of the cervical spine. This technical note describes a step-by-step surgical technique for central and over-the-top full-endoscopic decompression in the cervical spine, using a 3.7 mm working channel endoscope. This technique has already been shown to be effective in a recent case series with a 4.7 mm working channel endoscope, and may represent a new treatment option for central or bilateral lateral recess stenosis. There is also the possibility of a bilateral full-endoscopic approach, but this may be associated with greater muscle damage and a longer operative time. Case series and comparative studies should be encouraged to confirm the safety and utility of this technique.

Lumbar lateral interbody fusion: step-by-step surgical technique and clinical experience

Lateral lumbar interbody fusion (LLIF) is a minimally invasive surgical approach used to treat a variety of degenerative and deformity conditions of the lumbar spine such as advanced degenerative disease, degenerative scoliosis, foraminal and central stenosis. It has emerged as an alternative to the traditional posterior and anterior lumbar approaches with some potential benefits such as lower blood loss and shorter hospital stay. In this article, we provide our single institutional surgical experience including main indications and contraindications, a step-by-step surgical technique description, a detailed preoperative imaging assessment with a focus on magnetic resonance imaging (MRI) psoas anatomy, operative room (OR) setup and patient positioning. A descriptive surgical technical note of the following steps is provided: positioning and fluoroscopic confirmation, incision and intraoperative level confirmation, discectomy and endplate preparation, implant size selection and insertion and final fluoroscopic control, hemostasis check and wound closure along with an instructional surgical video with tips and pearls, postoperative patient care recommendations, common approach-related complications, along with our historical clinical institutional group experience. Finally, we summarize our research experience in this surgical approach with a focus on LLIF as a standalone procedure. Based on our experience, LLIF can be considered an effective surgical technique to treat degenerative lumbar spine conditions. Proper patient selection is mandatory to achieve good outcomes. Our institutional experience shows higher fusion rates with good clinical outcomes and a relatively low rate of complications.

All-Inside Anterior Cruciate Ligament Reconstruction Technique: Tips and Tricks

The all-inside anterior cruciate ligament reconstruction (ACLR) technique was developed to improve patient outcomes by reducing the procedure's invasiveness, minimizing complications and pain, and enabling faster postoperative recovery. This study presents a detailed description of the all-inside ACLR technique, which involves the use of quadrupled semitendinosus (ST) graft and suspension devices at both tibial and femoral sites, as well as valuable tips for avoiding complications that may arise during the procedure. The surgical procedure employs retrograde drills to create bony sockets for graft passage, which are then fixed with suspension devices at both the tibial and femoral sites. This technique has no specific restrictions and may be applied to all patients with anterior cruciate ligament (ACL) injuries. The literature reports the advantages, good clinical outcomes, and medium- to long-term graft survival achieved with the all-inside ACLR technique. However, the complications and disadvantages associated with the technique must be considered.

A Novel Technique for Pars Defect Direct Repair with a Modified Smiley Face Rod for Spondylolysis and Isthmic Spondylolisthesis

Introduction

Lumbar spondylolysis is a common fatigue fracture of the pars interarticularis of the lamina of the lumbar spine in adolescent athletes presenting with pars clefts. Some pseudarthrotic lumbar spondylolysis causes low back pain or radiculopathy. This study presents a case of pseudarthrotic lumbar spondylolysis that was successfully treated using a modified smiley face rod technique.

Technical Note

We developed a modified smiley face rod technique, which places pedicle screws in the lateral edge of the pedicle to preserve the erector spinae muscles and inserts a U-shaped rod between the spinous processes to preserve the supraspinous ligament. When a U-shaped rod penetrates the interspinous ligament subcutaneously, the resection of the supraspinous ligaments can be avoided. When the screw head is positioned more anterolaterally, a compression force is applied perpendicular to the surface of the pars cleft by rod clamping. This intrasegmental fusion technique preserves the mobile segment and simultaneously repairs the pars cleft. It is less invasive and more appropriate than interbody fusion for young athletes to avoid the possibility of future adjacent segment disorders.

Conclusions

This is a minimally invasive procedure that can easily achieve bone fusion and should be introduced for patients who are suffering from the symptoms of pseudarthrotic lumbar spondylolysis.

Application of the oblique lateral interbody fusion technique in salvage surgery: technical note and case series

Objective

The oblique lateral interbody fusion (OLIF) technique is a promising interbody fusion technique. This study summarizes the technical aspects of OLIF as a salvage surgery and the preliminary outcomes of a series of cases.

Patients and methods

A retrospective review of patients with leg or back pain induced by pseudoarthrosis or adjacent segment disease after posterior lumbar interbody fusion/transforaminal lumbar interbody fusion was done. These patients underwent salvage OLIF surgeries in our institution from January 2021 to March 2022. Variables such as the demographic, clinical, surgical, and radiological characteristics of the enrolled patients were recorded and analyzed.

Results

Eight patients (five females and three males; mean age 69.1 ± 5.7 years, range 63-80 years) were enrolled in this study. The mean operative time was 286.25 min (range: 230-440 min), and the estimated blood loss was 90 ml (range: 50-150 ml). Only one of the eight patients experienced a complication of lower limb motor weakness, which disappeared within 5 days after surgery. The latest data showed that the mean intervertebral space height increased from 8.36 mm preoperatively to 12.70 mm and the mean segmentary lordosis increased from 8.92° preoperatively to 15.05°. Bone fusion was achieved in all but one patient, who was followed up for only 3 months. The JOA scores Japanese Orthopaedic Association (JOA) Scores for low back pain of all patients significantly improved at the final follow-up.

Conclusion

OLIF provides a safe and effective salvage strategy for patients with failed posterior intervertebral fusion surgery. Patients effectively recovered intervertebral and foraminal height with no additional posterior direct decompression.

Minimally invasive microsurgical decompression of the lumbar spine using a novel robotised digital microscope: A preliminary experience

BACKGROUND

The operative microscope (OM) represents, to date, the standard for neurosurgical procedures. However, new technologies have been proposed during the latest years to overcome its limitations, from high-quality exoscopes to complex robotised visualisation systems. We report our preliminary experience with a novel digital robotised microscope, the BHS RoboticScope (RS), for minimally invasive spinal surgery.

METHODS

We employed the RS in five consecutive patients who underwent bilateral lumbar spine decompression through a monolateral approach. Patient outcomes, device technical characteristics and the surgeon's personal perspectives have been evaluated.

RESULTS

No complications occurred. All procedures were concluded without switching to the microscope. Image quality, lightning, depth perception and freedom of movement were judged satisfactory as compared to the standard microscope.

CONCLUSION

The easy maneuverability and the high quality of pictures provided by the RS device improve the surgeon's comfort in deep fields, representing an effective option for minimally invasive spinal procedures.

Prepontine cisternal routine for intrathecal targeted drug delivery in craniofacial cancer pain treatment: technical note

Intrathecal targeted drug delivery provides effective relief for cancer-related pain. However, its validation in management of craniofacial pain remains much less widely practiced, mainly due to the localized diffusion of analgesic agent with current approach. Here, we report our experience of prepontine cisternal routine for placement and implantation of intrathecal targeted drug delivery in two cases of cancer-related craniofacial pain. Lumbar cannulation was applied and the intrathecal catheter tip was positioned at the prepontine cistern under fluoroscopic guidance during the surgical implantation. Postoperative imaging confirmed that the catheter tip was successfully placed in the prepontine cisternal space. Satisfactory control of pain was achieved after intrathecal therapy, with significant reduction of background and breakthrough cancer pain. None obvious complications were observed in this study. Thus, our novel intrathecal routine may provide an alternative option for craniofacial pain caused by tumor, who were insufficiently treated by oral analgesic agents.

Sideway Aspiration Technique for Thrombus in a Sharply Bifurcated Branch of a Large Vessel

Objective

Standard thrombectomy techniques, including stent retrieval and a direct aspiration first pass technique, are not effective when the occluded vessel is narrow and sharply bifurcated from the main trunk. Here, we present a new and alternative method for patients with such anatomical features and describe two cases treated by this method.

Case Presentations

Case 1 was a 66-year-old woman who presented with consciousness disturbance and left hemiparesis. MRA suggested a right middle cerebral artery occlusion. Case 2 was an 86-year-old man who presented with sudden onset of consciousness disturbance; MRA indicated occlusion of the basilar artery. Both cases were successfully treated by our new method. First, we navigated a microcatheter, microguidewire, and aspiration catheter into the patent and visible branch adjacent to the occluded branch. The aspiration catheter was then carefully pulled back with continuous mechanical aspiration. When reverse blood flow from the aspiration catheter was suspended, we slightly advanced the catheter and caught the thrombus. Complete recanalization was attained in the two cases treated with this technique, which was named as sideway aspiration technique (SAT).

Conclusion

Although it warrants further study, SAT may be a potentially safe and effective method for thrombectomy in cases with thrombus in a sharply bifurcated branch.

Endoscopic Surgery for Supratentorial Deep Cavernous Malformation Adjacent to Cortical Spinal Tract: Preliminary Experience and Technical Note

In this study, we aimed to introduce a technical note and to explore the efficacy of endoscopic surgery combined with diffusion tensor imaging (DTI) navigation for supratentorial deep cerebral cavernous malformations (CCM). A prospectively maintained database of CCM patients was reviewed to identify all CCM patients treated by endoscopic surgery. The sagittal T1-weighted anatomical magnetic resonance imaging (MRI) and DTI were acquired before surgery. Endoscopic surgery was planned and performed based on preoperative DTI images and intraoperative DTI navigation. All patients were followed up more than 6 months. Motor function deficit and modified Rankin scale (mRS) scores were documented on follow-up. A final mRS score of 0–2 was considered a good outcome, and a final mRS score >2 was considered a poor outcome. Second DTI and 3DT1 were performed at 3 months after surgery. We tracked the ipsilateral corticospinal tract (CST) on pre- and postoperative DTI images. The overall mean FA values and the number of fibers of tracked CST were compared on pre- and postoperative DTI images. Risk factors associated with motor deficits and poor outcomes were analyzed. Seven patients with deep CCM and treated by endoscopic surgery were enrolled in this study. The mean value of preoperative mRS was 1.5 ± 0.98, but that score recovered to 0.86 ± 1.22 3 months later. The mRS scores were improved significantly according to statistical analysis (p = 0.012). According to the Spearman non-parametric test, only the fiber number of ipsilateral CST on postoperative DTI was significantly associated with muscle strength 6 months after surgery (p = 0.032). Compared with preoperative CST characteristics on DTI, the change of FA value (p = 0.289) and fiber number (p = 0.289) of ipsilateral CST on postoperative DTI was not significant It meant that the CST was protected during endoscopic surgery. Endoscopic surgery based on DTI navigation might be an effective method to protect fiber tracts in supratentorial deep CCM patients and improve long-term outcomes. However, more studies and cases are needed to confirm our findings.

Novel Surgical Procedure for Half Palmaris Longus Transfer during Opponensplasty of the Thumb for Patients with Carpal Tunnel Syndrome: A Technical Note

Thumb opposition is an essential movement for daily use of the hand, including precise pinching/grasping and fine and complicated hand movement. Although studies have reported use of several donor tendons for opponensplasty, opponensplasty using the palmaris longus (i.e., Camitz opponensplasty) has been used in patients with loss of opposition function due to longstanding carpal tunnel syndrome. The procedure involves a simple, useful tendon transfer and does not cause functional deficits. To obtain enough length to transfer the tendon to the metacarpophalangeal joint of the thumb, the PL tendon should be obtained with the palmar aponeurosis. However, the palmar aponeurosis is not always available for opponensplasty, as it is occasionally thin and insufficient for elongation of the palmaris longus. An extended skin incision over the palm can cause painful scar formation and postoperative residual pain. This procedure restores the palmar abduction function of the thumb but not opposition function. In the present article, we describe a modification of Camitz opponensplasty that uses a half-split palmaris longus, which is long enough to anchor to the insertion of the adductor pollicis at the metacarpophalangeal joint of the thumb.

Technical note: Novel use of recombinant tissue plasminogen activator for the evacuation of an acute extensive spinal epidural haematoma in a patient with coagulopathy

Spontaneous extensive spinal epidural haematoma poses a unique challenge for the neurosurgeon. Performing extensive laminectomies to remove all of the compressive haematoma can destabilise the patient's spinal column, which may require fixation. This is further complicated in patients with significant coagulopathy. We present a novel use of recombinant tissue plasminogen activator (rt-PA) in a patient with therapeutic coagulopathy, presenting with myelopathy secondary to an acute extensive spinal epidural haematoma. To the best of our knowledge, this is the first case of acute multilevel spinal epidural haematoma that has been successfully evacuated via single level laminectomy and topically applied rt-PA.

Quick Arthroscopic Repair of Ulnar-Sided Triangular Fibrocartilage Complex Tears: Technical Note

Triangular fibrocartilage complex (TFCC) tears can cause ulnar-sided wrist pain. Arthroscopy is important in treatment and diagnosis, and arthroscopic repair of TFCC tears is indicated after failure of nonsurgical treatments such as cast immobilization, splinting, and administration of nonsteroidal anti-inflammatory drugs for more than 3 months. Several arthroscopic procedures have been described, including inside-out, outside-in, and all-arthroscopic techniques. However, these arthroscopic procedures are time-consuming and technically demanding. This article presents a straightforward technique of arthroscopic inside-out repair that uses double-loop sutures for ulnar-sided TFCC tears.