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Vanderbilt spine

Tim Adamson, Saniya S Godil, Melissa Mehrlich, Stephen Mendenhall, Anthony L Asher, Matthew J McGirt
OBJECTIVE In an era of escalating health care costs and pressure to improve efficiency and cost of care, ambulatory surgery centers (ASCs) have emerged as lower-cost options for many surgical therapies. Anterior cervical discectomy and fusion (ACDF) is one of the most prevalent spine surgeries performed, and the frequency of its performance is rapidly increasing as the aging population grows. Although ASCs offer significant cost advantages over hospital-based surgical centers, concern over the safety of outpatient ACDF has slowed its adoption...
June 2016: Journal of Neurosurgery. Spine
Matthew J McGirt, Scott L Parker, Anthony L Asher, Dan Norvell, Ned Sherry, Clinton J Devin
STUDY DESIGN: Literature review and case example. OBJECTIVE: Describe methodological considerations of spine surgery registries. Review existing spine surgery registries. Describe the Vanderbilt Prospective Spine Registry (VPSR) as a case example and demonstrate its impact on comparative effectiveness research, value analysis, quality improvement, and practice-based learning. SUMMARY OF BACKGROUND DATA: To bend the cost curve and ultimately achieve sustainability in health care, medical providers and surgical treatments of the highest quality and effectiveness must be preferentially used and purchased...
October 15, 2014: Spine
Charles G Fisher, Tony Goldschlager, Stefano Boriani, Peter Pal Varga, Michael G Fehlings, Mark H Bilsky, Mark B Dekutoski, Alessandro Luzzati, Richard P Williams, Sigurd Berven, Dean Chou, Jeremy J Reynolds, Nasir A Quraishi, Laurence D Rhines, Chetan Bettegowda, Ziya L Gokaslan
Study Type‚ÄÉRetrospective cohort. Introduction‚ÄÉThe treatment of rare neoplastic conditions is challenging, especially because studies providing high levels of evidence are often lacking. Such is the case with primary tumors of the spine (PTS), which have a low incidence, are pathologically heterogeneous, and have diverse treatment approaches.1 Despite these difficulties, appropriate evidence-based care of these complex patients is imperative. Failure to follow validated oncologic principles may lead to unnecessary mortality and profound morbidity...
October 2013: Evidence-based Spine-care Journal
Matthew J McGirt, Theodore Speroff, Saniya Siraj Godil, Joseph S Cheng, Nathan R Selden, Anthony L Asher
In terms of policy, research, quality improvement, and practice-based learning, there are essential principles--namely, quality, effectiveness, and value of care--needed to navigate changes in the current and future US health care environment. Patient-centered outcome measurement lies at the core of all 3 principles. Multiple measures of disease-specific disability, generic health-related quality of life, and preference-based health state have been introduced to quantify disease impact and define effectiveness of care...
January 2013: Neurosurgical Focus
T S Douglas, N H Mann, A L Hodge
Health care practitioners believe that patient education enhances patients' compliance with treatment, their medical outcomes, and their quality of life. This study evaluated an existing method of noncomputerized structured preoperative education delivered by a nurse specialist and implemented and evaluated a computer-assisted instruction (CAI) tool for nonsurgical patients in the Vanderbilt Orthopaedic Spine Service. These patient education modalities were assessed with regard to the patient health concepts measured in the Short Form-36 Health Survey and, in addition, for preoperative education, with regard to the length of patient hospital stay...
February 1998: Journal of Spinal Disorders
J L Netterville, M J Koriwchak, M Winkle, M S Courey, R H Ossoff
The anterior cervical approach is commonly used for access to the cervical spine. Vocal fold paralysis (VFP), a complication of this approach, is underrepresented in the literature. A review of the database of the Vanderbilt Voice Center revealed 289 patients with VFP, including 16 patients who developed paralysis as a result of an anterior cervical approach. The paralysis was on the right side in all but 1 patient. Compared to patients who developed VFP after thyroidectomy and carotid endarterectomy, patients with VFP after an anterior cervical approach have a higher incidence of aspiration and dysphagia, suggesting the presence of trauma to the superior laryngeal and pharyngeal branches as well as the recurrent branch of the vagus nerve...
February 1996: Annals of Otology, Rhinology, and Laryngology
D L Phillips, G W Brick, D M Spengler
Between January 1, 1975 and November 1, 1986, 77 patients with acute unstable thoracic or lumbar spine fractures underwent reduction, posterior stabilization with dual Harrington distraction rods, and fusion with autogenous iliac crest bone graft at Vanderbilt University Medical Center. Beginning March 1985, in 25 patients, segmental interspinous wires were employed, in addition to the Harrington rods, to augment the surgical construct. Clinical and radiographic analysis was performed to determine if differences existed between the two groups...
1988: Journal of Spinal Disorders
M J McNamara, D P Devito, D M Spengler
Combined, single-stage anterior and posterior approaches for acute surgical management of cervical spine injury allows for early restoration of anatomic alignment and decompression. Six patients underwent single-stage anterior decompression and posterior instrumentation and fusion at Vanderbilt University Medical Center between 1984-1989. There was no late deformity. Five patients had incomplete neurologic deficits, and each improved a minimum of one Frankel classification. One patient had complete neurologic deficit at the C5 level...
December 1991: Journal of Spinal Disorders
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