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AOA Critical Issues: Promoting Leadership Development Among Orthopaedic Faculty
Pub Date: 4/1/2024Journal: J Bone Joint Surg Am. 2024 Apr 1.Authors: Evalina Burger Alexander Ghanayem Mary K MulcaheyPMID: 38557798All orthopaedic surgeons are leaders in the operating room and clinic, and many orthopaedic surgeons choose to pursue other formal leadership roles. Effective leaders are proficient communicators, have high emotional intelligence, have a growth mindset, create structure, and facilitate teamwork. Participating in formal leadership training offered through the American Orthopaedic Association, the American Academy of Orthopaedic Surgeons, or advanced degree programs can facilitate the development...
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Catastrophic acute failure of pelvic fixation in adult spinal deformity requiring revision surgery: a multicenter review of incidence, failure mechanisms, and risk factors
Pub Date: 9/3/2022Journal: J Neurosurg Spine. 2022 Sep 2;38(1):98-106.Authors: Christopher T Martin Kenneth J Holton Benjamin D Elder Jeremy L Fogelson Anthony L Mikula Christopher J Kleck David Calabrese Evalina L Burger David Ou-Yang Vikas V Patel Han Jo Kim Francis Lovecchio Serena S Hu Kirkham B Wood Robert Harper S Tim Yoon Dheera Ananthakrishnan Keith W Michael Adam J Schell Isador H Lieberman Stanley Kisinde Christopher J DeWald Michael T Nolte Matthew W Colman Frank M Phillips Daniel E Gelb Jacob Bruckner Lindsey B Ross J Patrick Johnson Terrence T Kim Neel Anand Joseph S Cheng Zach Plummer Paul Park Mark E Oppenlander Jonathan N Sembrano Kristen E Jones David W PollyPMID: 36057123CONCLUSIONS: Acute catastrophic failures involved large-magnitude surgical corrections and likely resulted from high mechanical strain on the pelvic instrumentation. Patients with large corrections may benefit from anterior structural support placed at the most caudal motion segment and multiple rods connecting to more than 2 pelvic fixation points. If failure occurs, salvage with a minimum of 4 rods and 4 pelvic fixation points can be successful.
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Alternative Uses of O-Arm and Stealth Navigation Technology Over 10 Years: The University of Colorado Experience
Pub Date: 7/25/2022Journal: Orthopedics. 2023 Mar-Apr;46(2):e89-e97.Authors: Mellissa R Delcont David C Ou-Yang Evalina L Burger Vikas V Patel Nolan M Wessell Christopher J KleckPMID: 35876781Intraoperative computed tomography scanning with O-arm and use of Stealth navigation can improve surgical outcomes in a variety of orthopedic subspecialties. In spine surgery, the accuracy, precision, and safety of pedicle screw and interbody implant placement has improved. This technology is now routinely used in percutaneous pedicle screw placement and minimally invasive sacroiliac joint fusion. Other applications include, but are not limited to, isthmic pars defect repair, lumbosacral...
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Osteoporosis: An Update on Screening, Diagnosis, Evaluation, and Treatment
Pub Date: 7/25/2022Journal: Orthopedics. 2023 Jan-Feb;46(1):e20-e26.Authors: Shahbaaz A Sabri Joseph C Chavarria Cheryl Ackert-Bicknell Christine Swanson Evalina BurgerOsteoporosis screening, diagnosis, and treatment have gained much attention in the health care community over the past 2 decades. During this time, creation of multispecialty awareness programs (eg, "Own the Bone," American Orthopedic Association; "Capture the Fracture," International Osteoporosis Foundation) and improvements in diagnostic protocols have been evident. Significant advances in technology have elucidated elements of genetic predisposition for decreased bone mineral density in the...
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Blockade of Osteoclast-Mediated Bone Resorption With a RANKL-Inhibitor Enhances Bone Formation in a Rat Spinal Fusion Model
Pub Date: 7/7/2022Journal: Spine (Phila Pa 1976). 2022 Aug 15;47(16):1165-1171.Authors: Karin A Payne Nichole M Shaw Christopher B Erickson Peter Yarger Yangyi Yu Todd Baldini Christopher J Kleck Vikas V Patel Evalina L BurgerPMID: 35797625CONCLUSIONS: This study indicates that OPG inhibited osteoclast bone resorption, which led to greater bone at the fusion site. Future studies investigating OPG on its own or in combination with an osteogenic factor to improve spinal fusion outcomes are warranted to further elucidate its potential therapeutic effect.
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Pre-Operative Planning in Complex Deformities and Use of Patient-Specific UNiD™ Instrumentation
Pub Date: 4/8/2022Journal: Global Spine J. 2022 Apr;12(2_suppl):40S-44S.Authors: David Ou-Yang Evalina L Burger Christopher J KleckCONCLUSIONS: The use of pre-operative planning software and UNiD patient-specific rods has been shown to improve surgeon's ability to achieve spinopelvic alignment parameters, specifically SVA and PI-LL, along with other possible benefits. Further research is needed regarding long-term value of the technology.
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The University of Colorado Virtual Physical Examination for Spine Surgeons: A Preliminary Study
Pub Date: 11/30/2021Journal: Orthopedics. 2022 Jan-Feb;45(1):e7-e10.Authors: Nolan M Wessell Christopher Kleck David Ou-Yang Christina L Goldstein Evalina Burger Vikas PatelPMID: 34846242As coronavirus disease 2019 (COVID-19) reached pandemic status, in-person orthopedic clinics across the United States were forced to close as many states adopted stay-at-home orders. Previously, the use of telemedicine in orthopedic practices was minimal for a variety of reasons, one being the inability to perform a physical examination in a specialty reliant on direct patient contact for diagnosis and treatment. A prospective cohort of 52 patients consented to participate in a novel virtual...
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Laser Marking of Spine Rods Is Strongly Associated With Risk of Clinical Rod Failure
Pub Date: 10/29/2021Journal: J Am Acad Orthop Surg. 2022 Jan 15;30(2):e252-e263.Authors: Reed Ayers Andriy Noschenko David Ou-Yang Evalina Burger Vikas Patel Christopher J KleckPMID: 34715690INTRODUCTION: What is overlooked in clinical studies are the possibilities of manufacturing and design aspects of the instrumentation that could initiate rod fracture. Although revision because of hardware fracture is a small fraction of the overall revision rates (12.1% to 13.7%), there are sufficient numbers of revision cases where hardware removed can undergo a thorough metallurgic analysis. This study is unique in that rod characteristics, such as alloy, surface markings, and fracture type,...
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Postoperative pelvic incidence (PI) change may impact sagittal spinopelvic alignment (SSA) after instrumented surgical correction of adult spine deformity (ASD)
Pub Date: 4/19/2021Journal: Spine Deform. 2021 Jul;9(4):1093-1104.Authors: Christopher J Kleck Andriy Noshchenko Evalina L Burger Christopher M J Cain Vikas V PatelPMID: 33871832CONCLUSION: Preoperative variability and postoperative instability of PI diminish the applicability of the PI-LL < 10° goal to plan correction of LL. An alternative method is offered.
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Radius of Curvature in Patient-Specific Short Rod Constructs Versus Standard Pre-Bent Rods
Pub Date: 2/9/2021Journal: Int J Spine Surg. 2020 Dec;14(6):944-948.Authors: Katherine Branche Rahwa Netsanet Andriy Noshchenko Evalina Burger Vikas Patel David Ou-Yang Christopher J KleckCONCLUSIONS: PSSR demonstrate more acute ROC than industry standard rods. In PSRs, the most lordosis occurs between L4-S1 and flattens out at the thoracolumbar junction, mimicking the normal distribution of lumbar lordosis. PSSRs could help achieve or maintain sagittal alignment and prevent the sequela of flat back syndrome.
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Toxicology Screening Testing in Patients Undergoing Spine Surgery: A Prospective Observational Pilot Study
Pub Date: 11/12/2020Journal: Ther Drug Monit. 2021 Feb 1;43(1):136-138.Authors: Claudia F Clavijo Anthony M Oliva Colleen Dingmann Alexander Kaizer Uwe Christians Evalina Burger Vikas Patel Christopher J Kleck Scott A Vogel Benjamin K Scott Daniel J Janik Leslie C Jameson Adit A GindeCONCLUSIONS: TST in patients presenting for spine surgery is a useful tool to detect substances taken by patients because self-report is often inaccurate. Discrepancies decrease the opportunity for preoperative optimization and adequate perioperative preparation.
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Corrosion of Titanium Spinal Explants Is Similar to That Observed in Oil Field Line Pipe Steel: Evidence of Microbial-Influenced Corrosion In Vivo
Pub Date: 1/21/2020Journal: Orthopedics. 2020 Jan 1;43(1):62-67.Authors: Reed Ayers Vikas Patel Evalina Burger Christopher Cain David Ou-Yang Nolan Wessell Christopher KleckPMID: 31958342Current explanations of biomedical alloy degradation are focused on the physicochemical mechanisms of galvanic, pitting, crevice, and fretting corrosion. Ultimately, these studies dismiss the corrosion mechanism as a function of the local microbiome. Sixty spine hardware constructs were examined immediately after explantation for biofilm formation. Marked rod sections were imaged using scanning electron microscopy with energy dispersive x-ray spectroscopy. Backscatter mode was employed to better...
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Validation of Pre-operative Templating for Total Disc Replacement Surgery
Pub Date: 2/27/2019Journal: Int J Spine Surg. 2019 Feb 22;13(1):84-91.Authors: Justin F M Hollenbeck Jill A Fattor Vikas Patel Evalina Burger Paul J Rullkoetter Christopher M J CainCONCLUSIONS: FE analyses accurately predicted ROM in this cohort and can facilitate selection of the optimal implant size and location that we believe will increase the chance of achieving clinical success with the application of this technology.
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The Prevalence of the Use of MIS Techniques in the Treatment of Adult Spinal Deformity (ASD) Amongst Members of the Scoliosis Research Society (SRS) in 2016
Pub Date: 1/21/2019Journal: Spine Deform. 2019 Mar;7(2):319-324.Authors: Neel Anand Aniruddh Agrawal Evalina L Burger Emmanuelle Ferrero Jeremy L Fogelson Takashi Kaito Michael O LaGrone Jean-Charles Le Huec Jung-Hee Lee Ram Mudiyam Yutaka Sasao Jonathan N Sembrano Per D Trobisch Shu-Hua YangPMID: 30660228CONCLUSIONS: The low rate of adoption of these techniques among the SRS members may be due to the false perception that there is not enough data to support that MIS techniques are better. This and the fact that a practitioner needs to be facile at different MIS techniques may be the true impediment to the adoption of MIS techniques in the treatment of ASD.
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Pelvic Incidence Changes Between Flexion and Extension
Pub Date: 10/24/2018Journal: Spine Deform. 2018 Nov-Dec;6(6):753-761.Authors: Nicholas Schroeder Andriy Noschenko Evalina Burger Vikas Patel Christopher Cain David Ou-Yang Christopher KleckPMID: 30348355CONCLUSIONS: PI is a dynamic parameter that changes between flexion and extension. Changes in SS are the main factor involved in these changes, implicating movement through the sacroiliac joints as the cause. Obese patients have greater changes in PI from flexion to extension.
Welcome to Evalina Burger-Van der Walt Lab
Lab Director, Evalina Burger-Van der Walt, MD,
Professor and Chair
Evalina Burger-Van der Walt, MD
Professor and Chair
CU Orthopedics
Scoliosis Research: Dr. Evalina Burger's Orthopedic Lab at CU Anschutz
The Evalina Burger van der Walt, MD lab at the University of Colorado focuses on a wide range of research objectives within the field of orthopedics. Dr. Burger, with a particular interest in scoliosis, investigates the etiology of this condition and the factors that contribute to the progression of spinal curves. A key area of study involves exploring humoral and transmembrane RNA messenger pathways within the lymphocytes of scoliosis patients. This research is currently supported by a grant from the Anschutz Foundation, enabling the lab to delve deeper into understanding the underlying molecular mechanisms of scoliosis.In addition to her work on scoliosis etiology, Dr. Burger's lab also delves into the metallurgic properties of spinal implants and their impact on the long-term outcomes of scoliosis treatment. This aspect of the research aims to identify how the characteristics of spinal implants contribute to the loss of correction and failures observed over time. Dr. Burger has made significant contributions to this area and has an extensive publication record in the field.
Through a multidisciplinary approach and leveraging their expertise in molecular pathways, bioinformatics, and materials science, the lab under Dr. Burger's guidance strives to enhance our understanding of scoliosis, improve treatment strategies, and ultimately advance the field of orthopedics. By investigating these critical aspects, the lab aims to pave the way for innovative interventions and improve long-term patient outcomes in scoliosis management.
Our Research
Analysis of Prognostic Cell Signaling Factors in Adolescent Idiopathic Scoliosis Adolescent idiopathic scoliosis (AIS) is the most prevalent form of spinal deformity, accounting for 80% of pediatric scoliosis and impacts 2-4% of children. AIS affects predominantly girls and is defined by a lateral spinal curvature, lacking a known neuromuscular cause or genetic origin. Despite its prevalence and impact on child health, the etiology of AIS and molecular mechanisms underlying its development and progression remain poorly understood. Identifying potential markers for curve progression in AIS will help in development of a diagnostic to better predict spinal curve progression.
Publications
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AOA Critical Issues: Promoting Leadership Development Among Orthopaedic Faculty
Pub Date: 4/1/2024Journal: J Bone Joint Surg Am. 2024 Apr 1.Authors: Evalina Burger Alexander Ghanayem Mary K MulcaheyPMID: 38557798All orthopaedic surgeons are leaders in the operating room and clinic, and many orthopaedic surgeons choose to pursue other formal leadership roles. Effective leaders are proficient communicators, have high emotional intelligence, have a growth mindset, create structure, and facilitate teamwork. Participating in formal leadership training offered through the American Orthopaedic Association, the American Academy of Orthopaedic Surgeons, or advanced degree programs can facilitate the development...
Contact Us
Contact Us
Evalina Burger, MD
B202
Room 4601
12631 E. 17th Avenue
Aurora, CO 80045
Assistant phone: 303-724-2971