Occipitocervical arthrodesis has a variety of indications to treat craniocervical and atlantoaxial pathologies for which a selective cervical fusion would not provide sufficient stability. Over time, the indications for occipitocervical fusions (OCFs) have evolved, as new technologies and surgical techniques were developed. In this bibliometric analysis, we aim to explore the progression of OCF literature over time, analyzing the trends in publications and citations, publishing countries and authors, keywords, and topics. The Web of Science database was used for data retrieval on July 3, 2024, with the search "occipitocervical fusion" OR "occipito-cervical fusion" OR "occipitocervical arthrodesis" OR "occipital cervical fusion" OR "occipital cervical arthrodesis" OR ("OCF" AND "spine surgery"). Excel was used to create the citation analysis and publication trend figures, along with the publishing countries and author analysis. The bibliometric software VosViewer was used to generate the keyword co-occurrence network visualizations. Overall, 762 articles were extracted. The number of pertinent publications and citations increased until 2020 before beginning to decrease. We found that Ehlers Danlos syndrome has become a more prevalent topic, as the association between Ehlers Danlos syndrome and craniocervical instability has received further scrutiny. "Dysphagia" continues to be a commonly cited topic, while, conversely, rheumatoid arthritis has decreased in publication frequency, possibly related to advances in medical management and surgical techniques. Overall, the United States, China, and Japan are the top publishing countries. This analysis of OCF literature provides a helpful overview of emerging trends and clinician concerns, especially as seen through the perspective of time.

Background: Spondylodiscitis is a growing infectious condition with significant morbidity. The impact of multifocal involvement remains understudied. This study compared 90-day all-cause readmission rates between patients with solitary versus multifocal spondylodiscitis and identified the associated risk factors. Methods: A retrospective analysis of the 2020 Nationwide Readmissions Database was conducted. Adult patients with primary spondylodiscitis were identified using ICD-10 codes and categorized into solitary or multifocal involvement groups. Demographic, clinical, and surgical data were extracted. Descriptive statistics and multivariate logistic regression were performed. Results: Of 6132 patients, 585 (9.6%) had multifocal disease. Multifocal patients were slightly younger (58.9 vs. 60.3 years; p = 0.049); had longer hospital stays (14.7 vs. 11.4 days; p < 0.001), time to readmission (p < 0.001); and surgery was more common (p = 0.003). Ninety-day readmission rates were similar (35.6% vs. 34.9%; p = 0.766). Type 2 diabetes was the only comorbidity significantly associated with multifocal disease (p = 0.020) and independently predicted readmission (aOR 1.236). Surgery and longer length of stay were protective (aOR 0.743; 0.0990). Conclusions: Multifocal spondylodiscitis is relatively common but not an independent risk factor for readmission. Readmission rates of both cohorts were similar. Surgery and prolonged hospitalization may reduce readmission risk.

A corpectomy of the lumbar spine is a widely performed surgical procedure with numerous indications. Previous research predominantly focused on various surgical techniques and their outcomes, lacking a general and comprehensive analysis of factors affecting this procedure. With this study, we aimed to assess the all-cause 90-day readmission rate and identify risk factors for adverse events following a lumbar corpectomy. Utilizing the 2020 Nationwide Readmissions Database adults (>18 years) were selected by ICD-10 procedure category codes for lumbar corpectomy. Patients with adult deformity or degenerative conditions were excluded due to coding inconsistencies. Demographic information and clinical data, including comorbidities, was extracted. Patients were categorized by their readmission status. The primary outcome was readmission, with multivariable logistic regression analysis used to identify independent risk factors. A total of 3,238 patients were included, with 20.8% readmitted. The readmission group was significantly older and had higher comorbidity burdens. Malignancy had the greatest odds of readmission (OR 3.172, p=.002), with spondylodiscitis also showing significant association (OR 2.177, p=.030). Fractures were significantly more frequent in the single admission group and not associated with readmission (OR 1.235, p=.551). Medical comorbidities differed significantly between the groups with a variety of them being identified as risk factors. We established an all-cause 90-day readmission rate of 20.8%, which is in range of other procedures in spine surgery but underscores the severity of lumbar corpectomy. Underlying pathologies have a greater impact on the readmission rate compared to medical comorbidities. These findings highlight the importance of preoperative patient selection, especially when performing more invasive procedures. However, the study's limitations may limit the generalizability of the findings.

Spinal alignment has become a focal point of spine deformity surgery amid an increased emphasis on global balance. Following a strong focus on thoracolumbar alignment, the cervical spine has recently emerged as a key area for further investigations. We applied formal bibliographic analytic techniques to assess trends regarding cervical sagittal alignment over time. Data was collected from the Clarivate Web of Science, PubMed, and Scopus databases on 08/02/2025 utilizing the keyword search ("cervical" OR "cervical spine") AND ("sagittal imbalance" OR "sagittal balance" OR "sagittal alignment" OR "sagittal malalignment"). Excel was used to create the publication years, citations per year, publishing journals, countries, author figures. VosViewer was used to create the network visualizations of keyword co-occurrence, cocitation, country copublication, and coauthorship analyses. We identified an over ten-fold increase every fifteen years in cervical sagittal alignment-related publications, starting with one study published in 1994 rising to 161 published in 2023. This trend outpaces global increases in spine publications by over sixfold. Notable jumps occurred from both 2012-2013 and 2016-2017, with over 50% increases in publications year over year. In the last five years, there has been an increasing focus on deformity, laminectomy, and motion. Cervical sagittal alignment has received a rapid and disproportionate increase in publications in the last ten years which may reflect increased interest in personalized surgery through deformity correction and motion preservation. Our study provides a graphic perspective on this topic and reflects the importance of spinal alignment in all sections of the spinal column.

Study design: Database study. Objectives: Acute traumatic central cord syndrome (atCCS) is the most common incomplete spinal cord injury in the US, characterized by motor weakness of the upper extremities with relative sparing of the lower extremities and varying degrees of bladder dysfunction and sensory changes caudal to the lesion. Hypoalbuminemia (HA) has previously been associated with poorer outcomes following acute spinal cord injury. We hypothesized that patients with atCCS and HA treated non-surgically experienced worse outcomes than those without HA. Methods: Data was collected using the Pearldiver ^TM database and included adult patients who sustained atCCS from 2010-2022Q2. Pearson χ2 test and Welch’s t -test were used to evaluate differences in demographic and clinical data. Univariate analysis and multivariate logistic regression were performed. Results: HA in conjunction with non-surgical care of atCCS was associated with an increased risk of development of renal failure and pressure ulcers as well as longer length of stay and two-year mortality. There was no significant increase in odds ratios for 90-day hospital readmission, pneumonia, UTI, respiratory failure, or sepsis. Conclusions: Patients with hypoalbuminemia after atCCS treated non-surgically are at an increased risk of developing complications such as renal failure, pressure ulcers, longer lengths of stay and increased mortality. Surprisingly, respiratory failure, pneumonia, and sepsis were not found to be statistically different between patients with atCCS with and without HA. Inherent to a database study there are predictable limitations, however a large-scale analysis could help further delineate physiologic factors affecting outcomes of atCCS patients.

Background/Objectives: Primary spondylodiscitis (SD) cases surging in incidence globally remain a diagnostic and therapeutic challenge for physicians. The effect of lesion location on outcomes remains unclear. This study aims to assess the 90-day all-cause readmission rate in patients suffering from spondylodiscitis in different regions of the spine, with a secondary objective of comparing in-hospital mortality rates. Methods: Utilizing the 2020 Nationwide Readmissions Database (NRD), USA, adult patients (>18 years) were selected by diagnosis with ICD-10 codes for primary spondylodiscitis. Patients were categorized by localization into eight groups, excluding multifocal patients. Comparative analysis and logistic regressions were performed. Results: Among 5547 patients, lumbar SD was most prevalent, followed by thoracic and lumbo-sacral regions. Cervical SD had the lowest readmission rate (31.3%) and lower odds versus lumbar SD (adjusted OR = 0.73; p = 0.007). Other regions showed no significant differences. In-hospital mortality varied by location. The sacral region, renal failure, and advanced age were the strongest mortality predictors. Conclusions: While the incidence of spondylodiscitis varies by location on the spine, we found no significant differences in readmission rates across regions. However, there were substantial differences in in-hospital mortality rates. Comorbidities, particularly renal failure and advanced age, appear to outweigh spinal localization as risk factors for mortality and readmission.