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https://www.readbyqxmd.com/read/29290132/defining-the-minimum-clinically-important-difference-for-grade-i-degenerative-lumbar-spondylolisthesis-insights-from-the-quality-outcomes-database
#1
Anthony L Asher, Panagiotis Kerezoudis, Praveen V Mummaneni, Erica F Bisson, Steven D Glassman, Kevin T Foley, Jonathan Slotkin, Eric A Potts, Mark E Shaffrey, Christopher I Shaffrey, Domagoj Coric, John J Knightly, Paul Park, Kai-Ming Fu, Clinton J Devin, Kristin R Archer, Silky Chotai, Andrew K Chan, Michael S Virk, Mohamad Bydon
OBJECTIVE Patient-reported outcomes (PROs) play a pivotal role in defining the value of surgical interventions for spinal disease. The concept of minimum clinically important difference (MCID) is considered the new standard for determining the effectiveness of a given treatment and describing patient satisfaction in response to that treatment. The purpose of this study was to determine the MCID associated with surgical treatment for degenerative lumbar spondylolisthesis. METHODS The authors queried the Quality Outcomes Database registry from July 2014 through December 2015 for patients who underwent posterior lumbar surgery for grade I degenerative spondylolisthesis...
January 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29280934/causes-and-timing-of-unplanned-90-day-readmissions-following-spine-surgery
#2
Jeffrey Hills, Ahilan Sivaganesan, Inamullah Khan, Silky Chotai, Benjamin Weisenthal, Thomas Freeman, Marjorie Butler, Joseph Wick, Joshua Daryoush, Anthony Asher, Clinton J Devin
STUDY DESIGN: Retrospective Cohort Study OBJECTIVE.: To evaluate the causes, timing, and factors associated with unplanned 90-day readmissions following elective spine surgery. SUMMARY OF BACKGROUND DATA: Unplanned readmissions after spine surgery are costly and an important determinant of the value of care. Several studies using database information have reported on rates and causes of readmission. However, these often lack the clinical detail and actionable data necessary to guide early post-discharge interventions...
December 26, 2017: Spine
https://www.readbyqxmd.com/read/29276258/lumbar-spine-surgeries-and-medication-usage-during-hospital-stay-one-center-perspective
#3
Neena K Sharma, Busuyi Olotu, Asha Mathew, Lemuel R Waitman, Rafia Rasu
Background: Pain after spine surgery is usually managed with opioid and nonopioids. The rate of lumbar spine surgeries (LSS) is rising, but current practices on LSS are not known. A current trend in LSS and medication usage by age group is needed to gain a better understanding of how LSS and its pain management vary by age. Objective: The aim of this study was to report current practices of LSS of discectomy, laminectomy, and fusion in patients aged 18 and older and to gain an understanding of medication use for management of LSS...
December 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29248305/state-of-the-art-transforaminal-percutaneous-endoscopic-lumbar-surgery-under-local-anesthesia-discectomy-foraminoplasty-and-ventral-facetectomy
#4
REVIEW
Koichi Sairyo, Takashi Chikawa, Akihiro Nagamachi
Transforaminal (TF) percutaneous endoscopic surgery for the lumbar spine under the local anesthesia was initiated in 2003 in Japan. Since it requires only an 8-mm skin incision and damage of the paravertebral muscles would be minimum, it would be the least invasive spinal surgery at present. At the beginning, the technique was used for discectomy; thus, the procedure was called PELD (percutaneous endoscopic lumbar discectomy). TF approach can be done under the local anesthesia, there are great benefits. During the surgery patients would be in awake and aware condition; thus, severe nerve root damage can be avoided...
December 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29229340/an-unusual-case-of-ureteral-perforation-in-minimally-invasive-pedicle-screw-instrumentation-and-review-of-the-literature
#5
Edward Fomekong, Julien Pierrard, Etienne Danse, Bertrand Tombal, Christian Raftopoulos
BACKGROUND: and Importance: Injury of the ureter is a potentially devastating complication most often reported in gynecologic, colorectal, vascular pelvic surgery or endoscopic procedures for ureteric pathologies. We report a rare case of ureteral rupture occurring as a complication of percutaneous pedicle screw placement. CLINICAL PRESENTATION: A 60-year old man complained of unbearable abdominal pain on the day after right L4-L5 transforaminal intervertebral fusion and percutaneous pedicle screw placement...
December 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29201578/vertebral-compression-fractures-after-lumbar-instrumentation
#6
Michelle Granville, Aldo Berti, Robert E Jacobson
Lumbar spinal stenosis (LSS) is primarily found in an older population. This is a similar demographic group that develops both osteoporosis and vertebral compression fractures (VCF). This report reviewed a series of patients treated for VCF that had previous lumbar surgery for symptomatic spinal stenosis. Patients that only underwent laminectomy or fusion without instrumentation had a similar distribution of VCF as the non-surgical population in the mid-thoracic, or lower thoracic and upper lumbar spine. However, in the patients that had previous short-segment spinal instrumentation, fractures were found to be located more commonly in the mid-lumbar spine or sacrum adjacent to or within one or two spinal segments of the spinal instrumentation...
September 29, 2017: Curēus
https://www.readbyqxmd.com/read/29200177/effect-of-body-mass-on-oxygenation-and-intra-abdominal-pressure-when-using-a-jackson-surgical-table-in-the-prone-position-during-lumbar-surgery
#7
Liya Ni, Yuhua Fan, Jinjun Bian, Xiaoming Deng, Yu Ma
STUDY DESIGN: Prospective observational study. OBJECTIVE: To test the hypothesis that different types of surgical frame and the patient's body mass index can affect pulmonary compliance, intra-abdominal pressure (IAP), and oxygenation. SUMMARY OF BACKGROUND DATA: The oxygenation index (PaO2/FiO2) and IAP are known to be associated with body mass index (BMI) when patients are in the supine position. However, there are few reports on the correlation between BMI, the oxygenation index, and IAPin the prone position, especially when a Jackson surgical table is used...
December 1, 2017: Spine
https://www.readbyqxmd.com/read/29158098/risk-factors-of-postoperative-sacroiliac-joint-pain-for-posterior-lumbar-surgery%C3%AF-an-at-least-2-year-follow-up-retrospective-study
#8
Fulin Guan, Yang Sun, Lin Zhu, Guofa Guan, Ming Chen, Zhiyong Chi, Di Tian, Zhange Yu, Jiaao Gu
PURPOSE: A retrospective study was conducted to clarify the risk factors of postoperative sacroiliac joint pain (SIJP) for posterior open lumbar surgery. PATIENTS AND METHODS: A total of 472 patients who underwent posterior lumbar surgery between January 2011 and December 2014 were included in this analysis. We recorded basic characteristics, surgical characteristics and SIJP information of each patient. RESULTS: The incidence of postoperative SIJP is 13...
November 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29152432/acute-changes-in-mentation-in-a-patient-with-hepatic-cirrhosis-treated-with-high-doses-of-dexamethasone
#9
Luis Dabul, Andrew Droney, Juan Oms, Marcos A Sanchez-Gonzalez
Despite the anti-inflammatory benefits of steroids in the management of multiple medical conditions, they are associated with undesired metabolic and psychiatric side effects. We present a case of a 57-year-old Hispanic man with hepatic cirrhosis due to hepatitis C and no past medical history of psychiatric illnesses who became delirious after treatment with high doses of intravenous Dexamethasone. The patient presented to Larkin Community Hospital, USA with complaints of lower back pain requiring treatment with steroids for severe lumbar central canal stenosis...
September 10, 2017: Curēus
https://www.readbyqxmd.com/read/29138974/medical-complications-and-mortality-in-octogenarians-undergoing-elective-spinal-fusion-surgeries
#10
Sharad Rajpal, E Lee Nelson, Alan T Villavicencio, Jayratna Telang, Roshan Kantha, Kara Beasley, Sigita Burneikiene
BACKGROUND: The consequences of suffering postoperative complications in elderly undergoing spinal surgeries may be different compared to younger patients. The primary objective of this study was to identify the types and frequency of medical complications and mortality rates in patients 80 years of age or older undergoing elective spinal fusion surgeries for degenerative spinal disease. METHODS: A prospective observational study with a retrospective chart review was performed, which included all consecutive patients ≥80 years old undergoing elective spinal fusion surgeries from May 2012 to August 2015...
November 14, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29119045/lumbar-stenosis-surgery-spine-surgeons-not-insurance-companies-should-decide-when-enough-is-better-than-too-much
#11
EDITORIAL
Nancy E Epstein
Background: Lumbar surgery for spinal stenosis is the most common spine operation being performed in older patients. Nevertheless, every time we want to schedule surgery, we confront the insurance industry. More often than not they demand patients first undergo epidural steroid injections (ESI); clearly they are not aware of ESI's lack of long-term efficacy. Who put these insurance companies in charge anyway? We did. How? Through performing too many unnecessary or overly extensive spinal operations (e...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29102751/epidural-steroids-at-closure-post-microdiscectomy-laminectomy-for-reduction-of-post-operative-analgesia-systematic-review-and-meta-analysis
#12
Ash Wilson-Smith, Nicholas Chang, Victor M Lu, Ralph J Mobbs, Matthew Fadhil, Declan Lloyd, Sara Kim, Kevin Phan
BACKGROUND: This review assessed the efficacy of epidural steroid administration on the reduction of pain, hospital stay time and use of opioid analgesics postoperatively. METHODS: We searched Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials (CCRCT) and Cochrane Database of Systematic Reviews (CDSR) for studies utilizing epidural steroids through any route following lumbar surgery. The primary study outcomes included pre- and postoperative pain as assessed through the use of a Visual Analogue Scale (VAS), length of hospital stay and postoperative use of opioid analgesics...
November 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29095409/increased-volume-of-lumbar-surgeries-for-herniated-intervertebral-disc-disease-and-cost-effectiveness-analysis-a-nationwide-cohort-study
#13
Chi Heon Kim, Chun Kee Chung, Myo Jeong Kim, Yunhee Choi, Min-Jung Kim, Seokyung Hahn, Sukyoun Shin, Jong-Myung Jung, Jun Ho Lee
STUDY DESIGN: Retrospective cohort study of a nationwide database OBJECTIVE.: The primary objective was to summarize the use of surgical methods for lumbar herniated intervertebral disc disease (HIVD) at two different time periods under the national health insurance system (NHIS). The secondary objective was to perform a cost-effectiveness analysis by utilizing incremental cost-effectiveness ratio (ICER). SUMMARY OF BACKGROUND DATA: The selection of surgical method for HIVD may or may not be consistent with cost effectiveness under NHIS, but this issue has rarely been analyzed...
October 31, 2017: Spine
https://www.readbyqxmd.com/read/29069040/predictive-validity-of-the-acs-nsqip-surgical-risk-calculator-in-geriatric-patients-undergoing-lumbar-surgery
#14
Xiao Wang, Yanting Hu, Binjiang Zhao, Yue Su
The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29066932/efficiency-of-spinal-anesthesia-versus-general-anesthesia-for-lumbar-spinal-surgery-a-retrospective-analysis-of-544-patients
#15
John T Pierce, Guy Kositratna, Mark A Attiah, Michael J Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, Paul J Marcotte, W Andrew Kofke, William C Welch
BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29050716/postoperative-spine-dressing-changes-are-unnecessary
#16
Ravi S Bains, Mayur Kardile, Lance K Mitsunaga, Sukhraj Bains, Nirmal Singh, Cary Idler
INTRODUCTION: There is minimal literature regarding when dressing changes should be performed. We present the dressing change protocol adopted by our institution. The purpose of this study was to provide an update of our experience with this dressing change protocol over a 15-year period. METHODS: Effective January 2005, we implemented our universal protocol of no dressing changes for five days after surgery. Reviewing a health system administrative database, all spine surgery cases involving instrumentation performed at our institution were captured...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29042816/incidence-and-predictive-factors-of-spinal-cord-stimulation-treatment-after-lumbar-spine-surgery
#17
Merja Vakkala, Voitto Järvimäki, Hannu Kautiainen, Maija Haanpää, Seppo Alahuhta
INTRODUCTION: Spinal cord stimulation (SCS) is recommended for the treatment of postsurgical chronic back and leg pain refractory to other treatments. We wanted to estimate the incidence and predictive factors of SCS treatment in our lumbar surgery cohort. PATIENTS AND METHODS: Three questionnaires (a self-made questionnaire, the Oswestry Low Back Pain Disability Questionnaire, and the Beck Depression Inventory) were sent to patients aged 18-65 years with no contraindications for the use of SCS, and who had undergone non-traumatic lumbar spine surgery in the Oulu University Hospital between June 2005 and May 2008...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29016955/is-a-history-of-severe-episodic-low-back-pain-an-indicator-of-a-discogenic-etiology
#18
David Levi, Diana Carnahan, Scott Horn, Josh Levin
Objective: To determine if a history of severe episodic low back pain (LBP) correlates with positive discography. Methods: A retrospective chart review identified patients undergoing discography from January 2012 through February 2016. The review determined if the patient's LBP began or continued with severe disabling episodes (lasting a minimum of two days). A gradual onset or initiating event with continuous symptoms was considered a nonepisodic history. Patients were excluded for unclear record, workers' compensation, litigation, prior lumbar surgery, radiologic instability, or indeterminate discography...
June 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28960162/patient-characteristics-of-smokers-undergoing-lumbar-spine-surgery-an-analysis-from-the-quality-outcomes-database
#19
Anthony L Asher, Clinton J Devin, Brandon McCutcheon, Silky Chotai, Kristin R Archer, Hui Nian, Frank E Harrell, Matthew McGirt, Praveen V Mummaneni, Christopher I Shaffrey, Kevin Foley, Steven D Glassman, Mohamad Bydon
OBJECTIVE In this analysis the authors compare the characteristics of smokers to nonsmokers using demographic, socioeconomic, and comorbidity variables. They also investigate which of these characteristics are most strongly associated with smoking status. Finally, the authors investigate whether the association between known patient risk factors and disability outcome is differentially modified by patient smoking status for those who have undergone surgery for lumbar degeneration. METHODS A total of 7547 patients undergoing degenerative lumbar surgery were entered into a prospective multicenter registry (Quality Outcomes Database [QOD])...
September 29, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28913559/risk-factors-for-implant-removal-after-spinal-surgical-site-infection
#20
Naoya Tsubouchi, Shunsuke Fujibayashi, Bungo Otsuki, Masanori Izeki, Hiroaki Kimura, Masato Ota, Takeshi Sakamoto, Akira Uchikoshi, Shuichi Matsuda
PURPOSE: Few studies have investigated the risk factors for implant removal after treatment for spinal surgical site infection (SSI). Therefore, there is no firmly established consensus for the management of implants. We aimed to investigate the incidence and risk factors for implant removal after SSI managed with instrumentation, and to examine potential strategies for avoiding implant removal. METHODS: Following a survey of seven spine centers, we retrospectively reviewed the records of 55 patients who developed SSI and were treated with reoperation, out of 3967 patients who had spinal instrumentation between 2003 and 2012...
September 14, 2017: European Spine Journal
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