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Spinal Adjustment

(no author information available yet)
OBJECTIVEThe AANS launched the Quality Outcomes Database (QOD), a prospective longitudinal registry that includes demographic, clinical, and patient-reported outcome (PRO) data to measure the safety and quality of spine surgery. Registry data offer "real-world" insights into the utility of spinal fusion and decompression surgery for lumbar spondylolisthesis. Using the QOD, the authors compared the initial 12-month outcome data for patients undergoing fusion and those undergoing laminectomy alone for grade 1 degenerative lumbar spondylolisthesis...
November 1, 2018: Journal of Neurosurgery. Spine
(no author information available yet)
OBJECTIVEAdult spinal deformity surgery is an effective way of treating pain and disability, but little research has been done to evaluate the costs associated with changes in health outcome measures. This study determined the change in quality-adjusted life years (QALYs) and the cost per QALY in patients undergoing spinal deformity surgery in the unique environment of a military healthcare system (MHS).METHODSPatients were enrolled between 2011 and 2017. Patients were eligible to participate if they were undergoing a thoracolumbar spinal fusion spanning more than 6 levels to treat an underlying deformity...
December 1, 2018: Neurosurgical Focus
Jeannette R Mahoney, Joe Verghese
Background: The ability to integrate information across sensory modalities is an integral aspect of mobility. Yet, the association between visual-somatosensory (VS) integration and gait performance has not been well-established in aging. Methods: A total of 333 healthy older adults (mean age 76.53 ± 6.22; 53% female) participated in a visual-somatosensory simple reaction time task and underwent quantitative gait assessment using an instrumented walkway. Magnitude of VS integration was assessed using probability models, and then categorized into four integration classifications (superior, good, poor, or deficient)...
2018: Frontiers in Aging Neuroscience
Mitsuru Yagi, Naobumi Hosogane, Nobuyuki Fujita, Eijiro Okada, Satoshi Suzuki, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
BACKGROUND CONTEXT: Corrective surgery for adult spinal deformity (ASD) improves health-related quality of life but has high complication rates. Predicting a patient's risk of perioperative and late postoperative complications is difficult, although several potential risk factors have been reported. PURPOSE: To establish an accurate, ASD-specific model for predicting the risk of postoperative complications, based on baseline demographic, radiographic, and surgical invasiveness data in a retrospective case series...
December 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Sayantan Deb, Ryan Brewster, Arjun Vivek Pendharkar, Anand Veeravagu, John Ratliff, Atman Desai
OF BACKGROUND DATA: Primary osseous spinal neoplasms (POSNs) include locally aggressive tumors such as osteosarcoma, chondrosarcoma, Ewing sarcoma, and chordoma. For such tumors, surgical resection is associated with improved survival for patients. Socioeconomic predictors of receiving surgery, however, have not been studied. OBJECTIVE: To examine the independent effect of race on receiving surgery and survival probability in patients with POSN. STUDY DESIGN: A total of 1904 patients from the SEER program at the National Cancer Institute database, all diagnosed with POSN of the spinal cord, vertebral column, pelvis, or sacrum from 2003 through 2012 were included in the study...
December 7, 2018: Clinical Spine Surgery
Anuj Patel, Robert P Runner, J Taylor Bellamy, John M Rhee
BACKGROUND CONTEXT: Exposure of unintended levels (defined as a spinal segment outside the intended surgical levels) is unnecessary and potentially adds to operative time and patient morbidity. Wrong-level surgery (defined as decompression, instrumentation, or fusion of a spinal segment not part of the intended surgical procedure) clearly adds to morbidity as well as putting the surgeon at medicolegal risk. PURPOSE: To describe a localization technique for posterior lumbar spine surgery to minimize both unintended-level exposure and wrong-level surgery...
December 7, 2018: Spine Journal: Official Journal of the North American Spine Society
Jonas M Getzmann, Ksenija Slankamenac, Kai Sprengel, Lijo Mannil, Pietro Giovanoli, Jan A Plock
INTRODUCTION: Combined burn trauma is rather uncommon and frequently difficult to manage. Historically combined burn trauma contributed to high mortality rates in severely injured patients. The purpose of this study was to determine the incidence, mechanisms and impact of non-thermal injuries in patients with severe burns. METHODS: The charts of 2536 patients admitted to the Burn Center of the University Hospital Zurich between 1977 and 2013 were reviewed and retrospectively analyzed...
November 13, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Amber M Beynon, Jeffrey J Hebert, Bruce F Walker
Background: Despite widespread use by manual therapists, there is little evidence regarding the reliability of thoracic spine static palpation to test for a manipulable lesion using stiffness or tenderness as diagnostic markers. We aimed to determine the interrater agreement of thoracic spine static palpation for segmental tenderness and stiffness and determine the effect of standardised training for examiners. The secondary aim was to explore expert consensus on the level of segmental tenderness required to locate a "manipulable lesion"...
2018: Chiropractic & Manual Therapies
Raphaële Charest-Morin, Alana M Flexman, Michael Bond, Tamir Ailon, Nicolas Dea, Marcel Dvorak, Brian Kwon, Scott Paquette, Charles G Fisher, John Street
PURPOSE: 'After-hours' non-elective spinal surgeries are frequently necessary, and often performed under sub-optimal conditions. This study aimed (1) to compare the characteristics of patients undergoing non-elective spine surgery 'After-hours' as compared to 'In-hours'; and (2) to compare the perioperative adverse events (AEs) between those undergoing non-elective spine surgery 'after-hours' as compared to 'in-hours'. METHODS: In this retrospective study of a prospective non-elective spine surgery cohort performed in a quaternary spine center, surgery was defined as 'in-hours' if performed between 0700 and 1600 h from Monday to Friday or 'after-hours' if more than 50% of the operative time occurred between 1601 and 0659 h, or if performed over the weekend...
December 6, 2018: European Spine Journal
Huipeng Yin, Kun Wang, Yong Gao, Yukun Zhang, Wei Liu, Yu Song, Shuai Li, Shuhua Yang, Zengwu Shao, Cao Yang
BACKGROUND: Junction tuberculous spondylitis involves the stress transition zone of the spine and has a high risk of progression to kyphosis or paraplegia. Problems still exist with treatment for spinal junction tuberculosis. This study investigated the surgical approach and clinical outcomes of junction spinal tuberculosis. METHODS: From June 1998 to July 2014, 77 patients with tuberculous spondylitis were enrolled. All patients received 2-3 weeks of anti-tuberculous treatment preoperatively; treatment was prolonged for 2-3 months when active pulmonary tuberculosis was present...
December 6, 2018: Journal of Orthopaedic Surgery and Research
Marco Burkhard, Philipp Fürnstahl, Mazda Farshad
PURPOSE: To evaluate whether 3D-printed vertebrae offer realistic haptic simulation of posterior pedicle screw placement and decompression surgery with normal to osteoporotic-like properties. METHODS: A parameterizable vertebra model was developed, adjustable in cortical and cancellous bone thicknesses. Based on this model, five different L3 vertebra types (α, β, γ1, γ2, and γ3) were designed and fourfold 3D-printed. Four spine surgeons assessed each vertebra type and a purchasable L3 Sawbones vertebra...
December 3, 2018: European Spine Journal
Jordan W Squair, Raveena Dhaliwal, Jacquelyn J Cragg, Rebecca Charbonneau, Christopher Grant, Aaron A Phillips
Small-scale studies indicate that spinal cord injury (SCI) may lead to significant gastrointestinal and bladder dysfunction. However, how the prevalence of chronic disease related to these dysfunctions compares to non-SCI individuals and whether there are robust relationships to level and severity of injury are still unclear. Here, our goal was to provide high-level evidence on the association between bladder and gastrointestinal dysfunction and SCI using population-level data from the Canadian Community Health Survey (CCHS) and the SCI Community Survey...
December 1, 2018: Journal of Neurotrauma
Wesley M Durand, J Mason DePasse, Steven L Bokshan, Adam E M Eltorai, Alan H Daniels
BACKGROUND: Smoking is a known risk factor for inferior health outcomes. Retrospective analyses of large datasets may assess whether such risk is manifested or mitigated in clinical practice. While many risk factor analyses utilize the NSQIP and NIS, such investigations are seldom directly compared. METHODS: This investigation utilized the NIS and NSQIP datasets. The primary outcome measures were perioperative complications. NSQIP complications were stratified based on occurrence pre- vs...
November 27, 2018: World Neurosurgery
(no author information available yet)
BACKGROUND: Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury...
November 26, 2018: Lancet Neurology
(no author information available yet)
OBJECTIVEHealthcare costs continue to escalate. Approaches to care that have comparable outcomes and complications are increasingly assessed for quality improvement and, when possible, cost containment. Efforts to identify components of care to reduce length of stay (LOS) have been ongoing. Spinal anesthesia (SA), for select lumbar spine procedures, has garnered interest as an alternative to general anesthesia (GA) that might reduce cost and in-hospital LOS and accelerate recovery. While clinical outcomes with SA or GA have been studied extensively, few authors have looked at the cost-analysis in relation to clinical outcomes...
October 1, 2018: Journal of Neurosurgery. Spine
Nicholas T Olney, Antje Bischof, Howard Rosen, Eduardo Caverzasi, William A Stern, Catherine Lomen-Hoerth, Bruce L Miller, Roland G Henry, Nico Papinutto
BACKGROUND: The spectrum of motor neuron disease (MND) includes numerous phenotypes with various life expectancies. The degree of upper and lower motor neuron involvement can impact prognosis. Phase sensitive inversion recovery (PSIR) imaging has been shown to detect in vivo gray matter (GM) and white matter (WM) atrophy in the spinal cord of other patient populations but has not been explored in MND. METHODS: In this study, total cord, WM and GM areas of ten patients with a diagnosis within the MND spectrum were compared to those of ten healthy controls (HC)...
2018: PloS One
(no author information available yet)
OBJECTIVEInsurance disparities can have relevant effects on outcomes after elective lumbar spinal surgery. The aim of this study was to evaluate the association between private/public payer status and patient-reported outcomes in adult patients who underwent decompression surgery for lumbar spinal stenosis.METHODSA sample of 100 patients who underwent surgery for lumbar spinal stenosis from 2012 to 2014 was evaluated as part of the prospectively collected Quality Outcomes Database at a single institution. Outcome measures were evaluated at 3 months and 12 months, analyzed in regard to payer status (private insurance vs Medicare/Veterans Affairs insurance), and adjusted for potential confounders...
October 1, 2018: Journal of Neurosurgery. Spine
Colum D MacKinnon
The review demonstrates that control of posture and locomotion is provided by systems across the caudal-to-rostral extent of the neuraxis. A common feature of the neuroanatomic organization of the postural and locomotor control systems is the presence of key nodes for convergent input of multisensory feedback in conjunction with efferent copies of the motor command. These nodes include the vestibular and reticular nuclei and interneurons in the intermediate zone of the spinal cord (Rexed's laminae VI-VIII)...
2018: Handbook of Clinical Neurology
V A Eley, A Chin, R Sekar, T Donovan, A Krepska, M Lawrence, S Bell, K Ralfe, S McGrath, L Webb, A Robinson, A van Zundert, L Marquart
BACKGROUND: Body mass index does not indicate the distribution of adipose tissue. Central adiposity may be measured using ultrasound measurement of subcutaneous fat thickness. This study determined if the abdominal subcutaneous fat thickness measured correlated with skin-to-epidural space distance at delivery, and compared this with the booking body mass index. METHODS: We analysed a sub-set of participants from a single-centre, prospective cohort study that assessed the relationship between subcutaneous fat thickness and maternity outcomes...
October 19, 2018: International Journal of Obstetric Anesthesia
Maggie E Horn, Julie M Fritz
BACKGROUND: Patients seek care from physical therapists for neck pain but it is unclear what the association of the timing of physical therapy (PT) consultation is on 1-year healthcare utilization and costs. The purpose of this study was to compare the 1-year healthcare utilization and costs between three PT timing groups: patients who consulted a physical therapist (PT) for neck pain within 14 days (early PT consultation), between 15 and 90 days (delayed PT consultation) or between 91 and 364 days (late PT consultation)...
November 26, 2018: BMC Health Services Research
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