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Clinical Spine Surgery

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https://www.readbyqxmd.com/read/28719455/microscope-and-fiberscope-assisted-subarachnoid-subarachnoid-s-s-bypass-a-novel-surgical-technique-to-reestablish-cerebrospinal-fluid-flow-in-treating-dorsal-spinal-arachnoid-webs-diagnosed-by-cine-mri
#1
Yasushi Fujiwara, Hideki Manabe, Bunichiro Izumi, Takayuki Shima, Nobuo Adachi
A "dorsal spinal arachnoid web" is the thickened arachnoid band on the surface of the spinal cord which disturbs the cerebrospinal fluid (CSF) flow, known as a rare cause of thoracic myelopathy. The ideal treatment is controversial because of the risk of readhesion after simple resection of the web. A subarachnoid-subarachnoid bypass is a method to reestablish CSF flow through a silicon tube between the cranial and caudal subarachnoid space. This method is reported to be useful for traumatic syringomyelia, adhesive arachnoiditis, etc...
July 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28719454/the-difference-in-clinical-outcomes-after-anterior-cervical-fusion-disk-replacement-and-foraminotomy-in-professional-athletes
#2
Harry T Mai, Danielle S Chun, Andrew D Schneider, Andrew C Hecht, Joseph C Maroon, Wellington K Hsu
STUDY DESIGN: Retrospective case series. OBJECT: To compare postoperative outcomes of professional athletes treated for cervical disk herniation after anterior cervical discectomy and fusion (ACDF) and posterior foraminotomy (PF), or total disk replacement (TDR). SUMMARY OF BACKGROUND DATA: ACDF, PF, and TDR have all led to excellent outcomes in the general population but the unique demands in the professional athlete necessitate specific study...
July 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28719453/reliability-and-clinical-utility-of-the-cards-classification-for-degenerative-spondylolisthesis
#3
Garret L Sobol, Alan Hilibrand, Ashley Davis, Paul Millhouse, John Koerner, Christopher Kepler, Gregory D Schroeder, Jonathan D Krystal, Erik C Olsson, Jeffrey Rihn, David Greg Anderson, Alexander Vaccaro, Kristen Radcliff
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The objective of this study is to determine the reliability and clinical utility of the of the proposed CARDS classification for degenerative spondylolisthesis. BACKGROUND: The Clinical and Radiographic Degenerative Spondylolisthesis (CARDS) classification system was recently proposed as an alternative to the Meyerding system for classifying degenerative spondylolisthesis (DS). Unlike Meyerding, CARDS considers other relevant radiographic findings such as disk space collapse and segmental kyphosis to stratify DS into 4 radiographically discreet types...
July 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28719452/treatment-of-spinal-tumors-in-a-high-volume-center-has-direct-impact-on-local-recurrence-morbidity-and-mortality
#4
Ran Lador, Stefano Bandiera, Alessandro Gasbarrini, Riccardo Ghermandi, Stefano Boriani
OBJECTIVE OF THE STUDY: En bloc resections of spine tumors aim at locally controlling the disease for both improving the patient's quality of life as well as improving mortality. The purpose of this study was to compare the outcome between patients who were initially treated in a high volume specialized center, and patients who initially underwent either invasive diagnostic procedure or an initial surgical attempt to treat the disease in a different center. MATERIALS AND METHODS: A retrospective study of 1681 patients affected by spine tumors-treated from 1990 to 2015 by the same team...
July 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28692571/efficacy-of-target-drug-delivery-and-dead-space-reduction-using-antibiotic-loaded-bone-cement-for-the-treatment-of-complex-spinal-infection
#5
Soichiro Masuda, Shunsuke Fujibayashi, Bungo Otsuki, Hiroaki Kimura, Shuichi Matsuda
STUDY DESIGN: A retrospective study. OBJECTIVES: We have treated complex cases of surgical site infection (SSI) successfully using antibiotic-loaded bone cement to avoid the need for implant removal. In the present study, we describe a new treatment option for SSI. SUMMARY OF BACKGROUND DATA: Although there are several treatment options for SSI after spinal surgery involving instrumentation, several types of problems may arise and are difficult to cure...
July 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28692570/payor-reform-opportunities-for-spine-surgery-part-ii-the-potential-emergence-of-population-health
#6
Jason Scalise, David Jacofsky
The pressures on spine surgery to adopt value-based reimbursement models are being seen in the increased implementation of bundled payment strategies. Given that bundled payment models typically link payments to the initiation of the surgical episode in question, despite their potential cost-saving attributes, financial incentives remain tied to the volume of services being provided. As payors and policy makers look to find savings by focusing on waste and variation of care, more comprehensive models such population health strategies are now being develop and deployed...
July 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28692569/efficacy-of-conical-laminoplasty-after-thoracic-laminectomy
#7
Kazuyoshi Kobayashi, Shiro Imagama, Kei Ando, Yoshihiro Nishida, Naoki Ishiguro
STUDY DESIGN: Retrospective clinical study. OBJECTIVE: To evaluate the results of a new method of laminoplasty, referred to as conical laminoplasty. SUMMARY OF BACKGROUND DATA: In surgery for a thoracic intradural tumor, laminectomy is frequently used for tumor resection. However, laminoplasty may be more effective due to prevention of damage to the posterior elements. This method can be performed as recapping T-saw laminoplasty and conical laminoplasty which we refer...
July 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28692568/superior-segment-facet-joint-violation-during-instrumented-lumbar-fusion-is-associated-with-higher-reoperation-rates-and-diminished-improvement-in-quality-of-life
#8
Jay M Levin, Vincent J Alentado, Andrew T Healy, Michael P Steinmetz, Edward C Benzel, Thomas E Mroz
STUDY DESIGN: A retrospective cohort study at a single tertiary care center. OBJECTIVE: To determine the impact of superior segment facet joint violation (FJV) during lumbar fusion on reoperation rates and quality of life (QOL). SUMMARY OF BACKGROUND DATA: Although lumbar fusion is an efficacious and durable treatment for numerous spinal pathologies, adjacent segment degeneration remains a serious complication. FJV has been suggested to alter load-bearing capability and potentially contribute to adjacent segment degeneration...
July 7, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28678026/transoral-closed-reduction-of-fixed-atlanto-axial-rotatory-subluxation-aars-in-childhood-and-adolescence
#9
Dezsoe Jeszenszky, Tamas Fekete, Frank Kleinst├╝ck, Daniel Haschtmann, Markus Loibl
Atlanto-axial rotatory-subluxation (AARS) is the most common pediatric cervical spine injury. Patients usually present with contralateral rotation and inclination of the upper cervical spine after minor trauma, or associated with an infection of the upper respiratory tract. According to the authors, initial management of patients with acute and chronic AARS type I-II should comprise closed reduction and immobilization with a cervical collar or a Halo-Body-Jacket. Surgical options of open reduction or C1/2 fusion should be restricted to irreducible or recurrent subluxations...
July 3, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28671881/treatment-of-degenerative-lumbar-spondylolisthesis-with-fusion-or-decompression-alone-results-in-similar-rates-of-reoperation-at-5-years
#10
John S Vorhies, Tina Hernandez-Boussard, Todd Alamin
STUDY DESIGN: Population-based analysis of administrative discharge records from California, Florida, and New York inpatient, ambulatory, and emergency department settings between 2005 and 2011, utilizing Healthcare Cost and Utilization Project data. OBJECTIVE: We aimed to compare, and characterize rates of reoperation and readmission among patients with degenerative spondylolisthesis treated with surgical decompression alone versus fusion. SUMMARY OF BACKGROUND DATA: Degenerative lumbar spondylolisthesis with stenosis can be treated by decompression with or without fusion...
June 30, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650884/can-surgeon-demographic-factors-predict-postoperative-complication-rates-after-elective-spinal-fusion
#11
Danielle S Chun, Ralph W Cook, Joseph A Weiner, Michael S Schallmo, Kathryn A Barth, Sameer K Singh, Ryan D Freshman, Alpesh A Patel, Wellington K Hsu
STUDY DESIGN: Retrospective cohort. OBJECTIVE: Determine whether surgeon demographic factors influence postoperative complication rates after elective spine fusion procedures. BACKGROUND: Surgeon demographic factors have been shown to impact decision making in the management of degenerative disease of the lumbar spine. Complication rates are frequently reported outcome measurements used to evaluate surgical treatments, quality-of-care, and determine health care reimbursements...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650883/iliac-crest-bone-graft-a-minimally-invasive-harvesting-technique
#12
Gregory D Lopez, Fady Y Hijji, Ankur S Narain, Kelly H Yom, Kern Singh
Typical sources for graft material utilized in minimally invasive transforaminal lumbar interbody fusion include both autograft and allograft. Autograft is frequently utilized due to its theorized benefits in promoting fusion. During minimally invasive transforaminal lumbar interbody fusion, autograft is often obtained locally during the laminectomy and facetectomy. However, this locally obtained bone graft has exhibited questionable osteoconductive properties, often necessitating the addition of biologics to improve fusion rates...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650882/diagnostic-utility-of-intraoperative-neurophysiological-monitoring-for-intramedullary-spinal-cord-tumors-systematic-review-and-meta-analysis
#13
Tej D Azad, Arjun V Pendharkar, Viet Nguyen, James Pan, Ian D Connolly, Anand Veeravagu, Rita Popat, John K Ratliff, Gerald A Grant
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: The aim of this study was to systematically evaluate the diagnostic utility of intraoperative neurophysiological monitoring (IONM) for detecting postoperative injury in resection of intramedullary spinal cord tumors (IMSCT). SUMMARY OF BACKGROUND DATA: Surgical management of IMSCT can involve key neurological and vascular structures. IONM aims to assess the functional integrity of susceptible elements in real time...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650881/intraoperative-radiographic-technique-for-visualization-of-bicortical-or-tricortical-anteromedial-sacral-screw-placement
#14
Nikhil Jain, Elizabeth Yu
The bicortical anteromedial sacral screw trajectory is the most widely used for S1 screw fixation. The assessment of anterior cortex purchase is difficult on a lateral view due to the overlapping bony anatomy of the sacrum and pelvis. We describe the intraoperative radiographic technique for a personalized pelvic inlet view that is perpendicular to the superior sacral surface to visualize sacral screw placement. This technique allows for assessment of anterior cortex purchase with anteromedial angulation in the same view...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28650880/downward-laminotomy-technique-for-hidden-zone-foraminal-disk-herniations-technical-notes-and-preliminary-results
#15
Sait Naderi, Mehmet R Onen
INTRODUCTION: Hidden zone foraminal herniations are among the more rare forms of herniations. As exploration is difficult, and there is a close relationship between the nerve root and pedicle, many surgical approaches have been proposed. The aim of this study was to describe downward laminotomy as a new approach to these herniations. MATERIALS AND METHODS: A downward laminotomy technique was used in 5 cases with hidden zone foraminal disk herniation with no extension to the intervertebral disk space...
June 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28622189/subsidizing-the-sick-how-community-rating-works
#16
Anthony M DiGiorgio, Praveen V Mummaneni, Michael S Virk, Alok D Sharan
Insurance premium rates have typically been calculated using a variety of rating algorithms. Passage of the Patient Protection and Affordable Care Act mandated that all individual and small group plans must use the community rating method. This method gives the same insurance rate to all members of a community, with adjustments only being allowed based on age, geography, and tobacco use. This effectively raises rates on low-risk individuals to subsidize high-risk individuals. With President Trump and Congressional Republicans vowing to repeal the Patient Protection and Affordable Care Act, this lesser-known but controversial portion of the law may be abolished...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28622188/differences-in-fundamental-sagittal-pelvic-parameters-based-on-age-sex-and-race
#17
Robert K Merrill, Jun S Kim, Dante M Leven, Joung Heon Kim, Joshua J Meaike, Rachel S Bronheim, Kelly I Suchman, Doug Nowacki, Sunder S Gidumal, Samuel K Cho
STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To determine whether age, sex, and race have independent effects on sagittal pelvic parameters. SUMMARY OF BACKGROUND DATA: Pelvic parameters and sagittal balance correlate with health-related quality of life and are important for patient assessment and surgical planning. Age, sex, and race are 3 unalterable patient factors that may influence pelvic morphology. METHODS: We conducted a retrospective review of consecutive adult patients who presented to our radiology practice between 2010 and 2015 and had a standing, lateral lumbosacral radiograph...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28622187/radiographic-and-clinical-outcomes-of-anterior-and-transforaminal-lumbar-interbody-fusions-a-systematic-review-and-meta-analysis-of-comparative-studies
#18
Remi M Ajiboye, Haddy Alas, Gina M Mosich, Akshay Sharma, Sina Pourtaheri
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: Compare the radiographic and clinical outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF). SUMMARY OF BACKGROUND DATA: ALIF and TLIF are 2 methods of achieving spinal arthrodesis. There are conflicting reports with no consensus on the optimal interbody technique to achieve successful radiographic and clinical outcomes. The goal of this systematic review and meta-analysis was to compare the radiographic and clinical outcomes of ALIF to TLIF...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28622186/a-90-day-bundled-payment-for-primary-single-level-lumbar-discectomy-decompression-what-does-big-data-say
#19
Nikhil Jain, Sohrab S Virk, Frank M Phillips, Elizabeth Yu, Safdar N Khan
Episode-based bundling may become the major form of reimbursement for many elective spine procedures. As the amount for a 90-day episode of care is not known for a lumbar discectomy, we analyzed the previous reimbursements from Commercial payers (2007-Q2 2015), Medicare Advantage (2007-Q2 2015), and Medicare (2005-2012) for a primary single-level lumbar discectomy/decompression. Distribution of payments among various service providers was studied and a 90-day bundle was simulated. Depending on the payer type, the average facility costs constituted 59...
June 15, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28622185/a-comprehensive-meta-analysis-of-the-adjacent-segment-parameters-in-cervical-disk-arthroplasty-versus-anterior-cervical-discectomy-and-fusion
#20
Liang Dong, Dongqi Wang, Xiujin Chen, Tuanjing Liu, Zhengwei Xu, Mingsheng Tan, Dingjun Hao
STUDY DESIGN: This is a meta-analysis of controlled trials. OBJECTIVE: To assess the overall condition of adjacent segment of cervical disk arthroplasty (CDA) compared with anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: With the increase in CDA and ACDF, surgeons are taking more attention to adjacent segment degeneration (ASDeg) and adjacent segment disease (ASDis). There are more and more meta-analyses comparing the efficacy of CDA with ACDF, however, there are few meta-analyses referring to adjacent segment parameters, and investigators are still unable to arrive at the same conclusion...
June 15, 2017: Clinical Spine Surgery
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