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Clinical Spine Surgery

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https://www.readbyqxmd.com/read/28538083/preoperative-opioid-use-a-risk-factor-for-poor-return-to-work-status-after-single-level-cervical-fusion-for-radiculopathy-in-a-workers-compensation-setting
#1
Mhamad Faour, Joshua T Anderson, Arnold R Haas, Rick Percy, Stephen T Woods, Uri M Ahn, Nicholas U Ahn
STUDY DESIGN: Retrospective comparative case-control study. OBJECTIVES: The objectives of this study are: (1) How preoperative opioid use impacts RTW status after single-level cervical fusion for radiculopathy? and (2) What are other postsurgical outcomes affected by preoperative opioid use? SUMMARY OF BACKGROUND DATA: Opioid use has increased significantly in the past decade. The use of opioids has a drastic impact on workers' compensation population, an at-risk cohort for poorer surgical and functional outcomes than the general population...
May 19, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28538082/risk-factors-associated-with-failure-to-reach-minimal-clinically-important-difference-in-patient-reported-outcomes-following-minimally-invasive-transforaminal-lumbar-interbody-fusion-for-spondylolisthesis
#2
Fady Y Hijji, Ankur S Narain, Daniel D Bohl, Kelly H Yom, Krishna T Kudaravalli, Gregory D Lopez, Kern Singh
STUDY DESIGN: Retrospective cohort. OBJECTIVE: To determine risk factors associated with failure to reach the minimal clinically important difference (MCID) in patient-reported outcomes (PROs) for patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) for spondylolisthesis. SUMMARY OF BACKGROUND DATA: The MCID of PROs are often utilized to determine the benefit of spinal procedures. However, negative predictive factors for reaching MCID in patients surgically treated for lumbar spondylolisthesis have been difficult to elucidate...
May 19, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28538081/is-body-mass-index-a-risk-factor-for-revision-procedures-after-minimally-invasive-transforaminal-lumbar-interbody-fusion
#3
Ankur S Narain, Fady Y Hijji, Daniel D Bohl, Kelly H Yom, Krishna T Kudaravalli, Kern Singh
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To determine if an association exists between body mass index (BMI) and the rate of revision surgery after single-level minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA: MIS TLIF is an effective treatment for lumbar degenerative disease. Previous studies in the orthopedic literature have associated increased BMI with increased postoperative complications and need for revision...
May 19, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28486280/payor-reform-opportunities-for-spine-surgery-part-iii-population-health-programs-and-converging-strategies
#4
Jason Scalise, David Jacofsky
As the cost of health care continues to rise, government and commercial payors are implementing strategies as a means of reducing the overall expenditure of health care dollars. The largest savings will be not just in more cost-effective treatments but in strategies that can avoid the need for treatments in the first place. Although the savings from popular payor reform strategies like bundled payments are tied to the initiation of the clinical episode, population health programs utilize a variety of tactics to decrease the need for health care utilization overall...
May 8, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28486278/interventional-approaches-to-low-back-pain
#5
Ariana M Nelson, Geeta Nagpal
Chronic low back pain (LBP) places a tremendous economic burden on society due to both direct and indirect costs. Health care costs for adults with chronic LBP have steadily increased over the past 20 years, coinciding with a large increase in the utilization of spinal injections, surgical interventions, opioid medications, and physical therapy. The treatment of LBP is best approached by a multimodal and even multidisciplinary approach with a combination of physical rehabilitation, pharmacologic management, psychological intervention, spinal injections, and surgical intervention with a goal of improving the functional status of the patient...
May 8, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28452795/association-between-allogeneic-blood-transfusion-and-postoperative-infection-in-major-spine-surgery
#6
Christian Fisahn, Shiveindra Jeyamohan, Daniel C Norvell, Richard S Tubbs, Marc Moisi, Jens R Chapman, Jeni Page, Rod J Oskouian
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study is to compare the incidence of infection in patients who do and do not receive blood transfusions in major deformity surgery (>8 levels). SUMMARY OF BACKGROUND DATA: Postoperative infections increase morbidity and mortality rates in spine surgery and generate additional costs for the health care system. It has been proposed that blood transfusions increase the risk of wound infection, urinary tract infection, pneumonia, and sepsis...
April 27, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28402988/incidence-and-factors-predictive-of-dysphagia-and-dysphonia-after-anterior-operation-with-multilevel-cervical-spondylotic-myelopathy
#7
Shunzhi Yu, Zhi Chen, Ning Yan, Tiesheng Hou, Shisheng He
STUDY DESIGN: Retrospective database analysis. OBJECTIVE OF THE STUDY: The objective of the study was to quantify the incidence of dysphagia and dysphonia and assess the associated risk factors after multilevel cervical anterior operation. SUMMARY OF BACKGROUND DATA: Anterior approach for multilevel cervical spondylotic myelopathy has been developed and obtained favorable outcomes. As number of fused levels increased, the operation difficulty, invasiveness and operative risks are higher...
April 11, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28394776/correlation-analysis-between-modic-change-of-cervical-vertebrae-and-intramedullary-high-signal-intensity
#8
Hao Zhou, Jin Fan, Peng Sun, Wei Zhou, Qingqing Li, Lipeng Yu, Guoyong Yin
PURPOSE: Clinical studies have shown that endplate Modic change in the cervical spine and intramedullary high signal intensity often occurs simultaneously. We aimed to investigate whether there is a correlation between Modic change and intramedullary high signal intensity, and to explore the possible risk factors. MATERIALS AND METHODS: In total, 133 patients with cervical spondylotic myelopathy treated at the First Affiliated Hospital of Nanjing Medical University between May 2009 and March 2013 were enrolled in the study...
April 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28394774/the-impact-of-l5-sacralization-on-fusion-rates-and-clinical-outcomes-after-single-level-posterior-lumbar-interbody-fusion-plif-at-l4-l5-level
#9
Gun Woo Lee, Ji-Hoon Shin, Seung Min Ryu, Myun-Whan Ahn
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To determine the impact of L5 sacralization on fusion rates and clinical outcomes after single-level posterior lumbar interbody fusion (PLIF) surgery at the L4-L5 level. SUMMARY OF BACKGROUND DATA: L5 sacralization can produce greater stress concentration at the adjacent segment (L4-L5); therefore, L4-L5 PLIF surgery in patients with L5 sacralization may negatively affect fusion rate and be associated with poor clinical outcomes...
April 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28368866/spinopelvic-parameters-in-asymptomatic-subjects-without-spine-disease-and-deformity-a-systematic-review-with-meta-analysis
#10
Andriy Noshchenko, Lilian Hoffecker, Christopher M J Cain, Vikas V Patel, Evalina L Burger
STUDY DESIGN: A systematic review with meta-analysis. OBJECTIVE: To combine published data, focusing on the development of optimal spinopelvic parameters in adult asymptomatic subjects without spine deformity while taking into consideration the impact of potential confounders. SUMMARY OF BACKGROUND DATA: A well-grounded approach to define the optimal spinopelvic parameters is necessary for planning surgical correction of spine deformity. MATERIALS: Selection criteria: (1) randomized and nonrandomized prospective, cross-sectional, and retrospective studies; (2) participants: asymptomatic subjects without spine deformity aged above 18 years; (3) studied parameters: lumbar lordosis (LL), pelvic incidence, sacral slope, and pelvic tilt; (4) potential confounders: method of measurement, sex, age, ethnicity, weight, height, and body mass index...
March 31, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28338491/perioperative-management-of-blood-loss-in-spine-surgery
#11
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Hamid Hassanzadeh
Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent. Perioperative methods have been established to combat the excessive blood loss and decrease the need for blood products...
March 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28319468/the-impact-of-cage-dimensions-positioning-and-side-of-approach-in-extreme-lateral-interbody-fusion
#12
Marjan Alimi, Gernot Lang, Rodrigo Navarro-Ramirez, Moritz Perrech, Connor Berlin, Christoph P Hofstetter, Yu Moriguchi, Eric Elowitz, Roger Härtl
STUDY DESIGN: This is a retrospective single-center study. OBJECTIVE: The aim of the study was to evaluate the impact of cage characteristics and position toward clinical and radiographic outcome measures in patients undergoing extreme lateral interbody fusion (ELIF). SUMMARY OF BACKGROUND DATA: ELIF is utilized for indirect decompression and minimally invasive surgical treatment for various degenerative spinal disorders. However, evidence regarding the influence of cage characteristics in patient outcome is minimal...
March 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28266959/morphometric-analysis-of-the-retroperitoneal-vessels-with-respect-to-lateral-access-surgery-in-adult-scoliosis
#13
Heeren S Makanji, Hai Le, Kirkham B Wood, Louis G Jenis, Thomas D Cha
STUDY DESIGN: Cross-sectional study reviewing 62 magnetic resonance imaging or computed tomography scans from consecutive adult patients with scoliotic spinal deformity in the thoracolumbar spine. OBJECTIVE: To investigate the variation in anatomic position of retroperitoneal vessels in relationship to curve direction, location, magnitude, and axial rotation of curves in adult scoliosis. SUMMARY OF BACKGROUND DATA: The minimally invasive lateral approach to the thoracolumbar spine avoids manipulation of abdominal and retroperitoneal structures and decreases risk of injury to paraspinal musculature...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28266958/vancomycin-powder-regimen-for-prevention-of-surgical-site-infection-in-complex-spine-surgeries
#14
Michael Van Hal, Joon Lee, Dann Laudermilch, Chinedu Nwasike, James Kang
STUDY DESIGN: In total, 496 patients of a single surgeon cohort examining the surgical-site infection (SSI) rates with the addition of vancomycin powder in both diabetic and revision spine surgery cases. A historical control group of 652 patients were compared from the same surgeon over an earlier time period before the inception of using vancomycin powder prophylaxis. OBJECTIVE: The objective of this study was to describe and compare the rates of infection in high-risk patient populations while using vancomycin powder...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28266957/complication-rate-in-minimally-invasive-revision-lumbar-discectomy-a-case-series-and-technical-note
#15
Daniel R Felbaum, Jeffrey J Stewart, Casey Distaso, Faheem A Sandhu
Revision lumbar discectomy, given the disruption of anatomic planes, can be a more technically complicated operation. Historically, it may have higher complication rates than first-time microdiscectomy. Recently, minimally invasive tubular discectomy (MITD) has been reported as an equivalent treatment to traditional approaches and may have better utility for revision surgery. A retrospective review of MITDs performed by the senior surgeon (F.A.S.) on 42 patients with single-level, recurrent disk herniation was analyzed...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28266955/clinical-outcomes-after-posterior-lumbar-interbody-fusion-comparison-of-cortical-bone-trajectory-and-conventional-pedicle-screw-insertion
#16
Shota Takenaka, Yoshihiro Mukai, Kosuke Tateishi, Noboru Hosono, Takeshi Fuji, Takashi Kaito
STUDY DESIGN: This study is a retrospective cohort study using prospectively collected data. OBJECTIVE: To compare the effectiveness of posterior lumbar interbody fusion (PLIF) using the cortical bone trajectory (CBT) and conventional pedicle screw (PS) techniques. SUMMARY OF BACKGROUND DATA: There are few published studies to date comparing PLIF using CBT technique with PLIF using the conventional PS technique. METHODS: We studied 119 consecutive patients who underwent single-level PLIF between 2010 and 2014 with a minimum 12-month follow-up...
March 6, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28244892/3d-navigation-guided-resection-of-giant-ventral-cervical-intradural-schwannoma-with-360-degree-stabilization
#17
Ibrahim Hussain, Rodrigo Navarro-Ramirez, Gernot Lang, Roger Härtl
Giant schwannomas are defined as intradural extramedullary tumors that span >2 vertebral body lengths. Although uncommon, these lesions can cause significant mass effect on the spinal cord and subsequent neurologic compromise. Gross total resection is the goal of operative intervention, however, is extremely challenging in cases where the tumor occupies a ventral, midline position within the lower cervical thecal sac. Using a representative case presentation, we describe an adult male with insidious progression of upper extremity radicular pain and paresthesias, found to have a ventral, solid/cystic C5-C7 giant schwannoma...
February 27, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525494/optimal-entry-point-and-trajectory-for-anterior-c1-lateral-mass-screw
#18
Yong Hu, Wei-Xin Dong, William Ryan Spiker, Zhen-Shan Yuan, Xiao-Yang Sun, Jiao Zhang, Hui Xie, Todd J Albert
STUDY DESIGN: A radiographic analysis of the anatomy of the C1 lateral mass using computed tomography (CT) scans and Mimics software. OBJECTIVE: To define the anatomy of the C1 lateral mass and make recommendations for optimal entry point and trajectory for anterior C1 lateral mass screws. SUMMARY OF BACKGROUND DATA: Although various posterior insertion angles and entry points for screw insertion have been proposed for posterior C1 lateral mass screws, no large series have been performed to assess the ideal entry point and optimal trajectory for anterior C1 lateral mass screw placement...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525493/influence-of-myelography-and-postmyelographic-ct-on-therapeutic-decisions-in-degenerative-diseases-of-the-cervical-spine
#19
Thomas Westermaier, Christina Doerr, Christian Stetter, Thomas Linsenmann, Stefan Koehler, Joerg Eriskat, Laszlo Solymosi, Ralf-Ingo Ernestus
STUDY DESIGN: A retrospective analysis of clinical records and radiologic imaging by 3 independent reviewers to assess the indication for surgical treatment with and without myelography and postmyelographic computed tomography (MCT). OBJECTIVE: To evaluate whether myelography and MCT obtained in addition to magnetic resonance imaging (MRI) influence therapeutic decisions in degenerative diseases of the cervical spine. SUMMARY OF BACKGROUND DATA: MRI has become the standard examination in spinal diseases...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28525492/degenerative-cervical-disc-disease-long-term-changes-in-sagittal-alignment-and-their-clinical-implications-after-cervical-interbody-fusion-cage-subsidence-a-prospective-study-with-standalone-lordotic-tantalum-cages
#20
Félix Tomé-Bermejo, Julián A Morales-Valencia, Javier Moreno-Pérez, Juan Marfil-Pérez, Elena Díaz-Dominguez, Angel R Piñera, Luis Alvarez
STUDY DESIGN: A retrospective, observational study of prospectively collected outcomes. OBJECTIVE: To investigate the long-term clinical course of anterior cervical discectomy and fusion with interbody fusion cages (ACDF-IFC) with lordotic tantalum implants and to correlate the radiologic findings with the clinical outcomes, with special emphasis on the significance and the influence of implant subsidence. SUMMARY OF BACKGROUND DATA: Cage subsidence is the most frequently reported complication after ACDF-IFC...
June 2017: Clinical Spine Surgery
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