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Spine surgery outcomes

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https://www.readbyqxmd.com/read/27913961/prediction-of-postoperative-clinical-recovery-of-drop-foot-attributable-to-lumbar-degenerative-diseases-via-a-bayesian-network
#1
Shota Takenaka, Hiroyuki Aono
BACKGROUND: Drop foot resulting from degenerative lumbar diseases can impair activities of daily living. Therefore, predictors of recovery of this symptom have been investigated using univariate or/and multivariate analyses. However, the conclusions have been somewhat controversial. Bayesian network models, which are graphic and intuitive to the clinician, may facilitate understanding of the prognosis of drop foot resulting from degenerative lumbar diseases. QUESTIONS/PURPOSES: (1) To show a layered correlation among predictors of recovery from drop foot resulting from degenerative lumbar diseases; and (2) to develop support tools for clinical decisions to treat drop foot resulting from lumbar degenerative diseases...
December 2, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27911238/managing-overlapping-surgery-an-analysis-of-1018-neurosurgical-and-spine-cases
#2
Jian Guan, Andrea A Brock, Michael Karsy, William T Couldwell, Meic H Schmidt, John R W Kestle, Randy L Jensen, Andrew T Dailey, Richard H Schmidt
OBJECTIVE Overlapping surgery-the performance of parts of 2 or more surgical procedures at the same time by a single lead surgeon-has recently come under intense scrutiny, although data on the effects of overlapping procedures on patient outcomes are lacking. The authors examined the impact of overlapping surgery on complication rates in neurosurgical patients. METHODS The authors conducted a retrospective review of consecutive nonemergent neurosurgical procedures performed during the period from May 12, 2014, to May 12, 2015, by any of 5 senior neurosurgeons at a single institution who were authorized to schedule overlapping cases...
December 2, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27909654/bone-substitutes-and-expanders-in-spine-surgery-a-review-of-their-fusion-efficacies
#3
Abhijeet Kadam, Paul W Millhouse, Christopher K Kepler, Kris E Radcliff, Michael G Fehlings, Michael E Janssen, Rick C Sasso, James J Benedict, Alexander R Vaccaro
STUDY DESIGN: A narrative review of literature. OBJECTIVE: This manuscript intends to provide a review of clinically relevant bone substitutes and bone expanders for spinal surgery in terms of efficacy and associated clinical outcomes, as reported in contemporary spine literature. SUMMARY OF BACKGROUND DATA: Ever since the introduction of allograft as a substitute for autologous bone in spinal surgery, a sea of literature has surfaced, evaluating both established and newly emerging fusion alternatives...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27909651/hybrid-decompression-and-fixation-technique-for-the-treatment-of-multisegmental-cervical-spondylotic-myelopathy
#4
Barón Zárate-Kalfopulos, Walter Araos-Silva, Alejandro Reyes-Sánchez, Luis Miguel Rosales-Olivarez, Armando Alpizar-Aguirre, Francisco Lopez Melendez
BACKGROUND: Cervical spondilotic myelopathy (CSM) is defined as the compromise of the spinal cord due to degenerative changes of the cervical spine. It is the most common cause of spinal cord dysfunction in patients over 55 years. An early surgical management it is paramount to achieve better neurological outcome. There is still controversy regarding the appropriate surgical treatment for multisegmental CSM involving three or more levels. The hybrid decompression and fixation technique combines one or two level corpectomy and a single level discectomy in order to obtain optimum decompression and fixation in patients with multilevel cervical myelopathy...
2016: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/27906946/long-term-follow-up-results-of-percutaneous-endoscopic-lumbar-discectomy
#5
Sang Soo Eun, Sang-Ho Lee, Luigi Andrew Sabal
BACKGROUND: Open lumbar microdiscectomy (OLM) has been considered the gold standard in the management of lumbar disc herniation (LDH) for its favorable outcomes in long-term follow-up. Nowadays, percutaneous endoscopic lumbar discectomy (PELD) is gaining recognition. However, greatest limitation of studies of PELD is the lack of long-term follow-up outcomes. OBJECTIVE: To investigate the long-term outcomes of PELD in terms of clinical and radiographic findings and revision surgery rate...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27904963/10-year-follow-up-after-implantation-of-the-bryan-cervical-disc-prosthesis
#6
Joost Dejaegher, Joris Walraevens, Johannes van Loon, Frank Van Calenbergh, Philippe Demaerel, Jan Goffin
PURPOSE: Cervical arthroplasty is being used as an alternative for cervical fusion, but long-term follow-up results have rarely been reported. In this paper, we present 10-year follow-up results after implantation of the Bryan Cervical Disc Prosthesis in a single center. METHODS: 89 patients underwent implantation of a single-level Bryan Cervical Disc Prosthesis to treat radiculopathy and/or myelopathy. Clinical (Neurological Success, Neck Disability Index (NDI), Neck- and Arm-Pain, and SF-36) and radiological follow-up was prospectively organized up to 10 years after surgery...
November 30, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27903338/-ultrasound-imaging-increases-first-attempt-success-rate-of-neuraxial-block-in-elderly-patients
#7
J Geng, X L Chen, X D Wang, X Y Guo, M Li
Objective: To verify whether preprocedural ultrasound of the lumbar spine could improve first-attempt success rate (defined as a successful neuraxial anesthesia with only one skin puncture) of neuraxial block in elderly patients. Methods: From septemble 2015 to February 2016, 200 elderly patients undergoing lower-limb surgery with neuraxial block at the Peking Universty Third Hospital were enrolled in this study.RandA 1.0 software was used to randomize patients into two groups: conventional surface landmark-guided group (group LM) and ultrasound-assisted group (group US)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27901415/burden-of-surgical-site-infections-associated-with-select-spine-operations-and-involvement-of-staphylococcus-aureus
#8
Harshila Patel, Hanane Khoury, Douglas Girgenti, Sharon Welner, Holly Yu
BACKGROUND: Spine operations may be indicated for treatment of diseases including vertebral injuries, degenerative spinal conditions, disk disease, spinal misalignments, or malformations. Surgical site infection (SSI) is a clinically important complication of spine surgery. Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA), is a leading cause of post-spinal SSIs. METHODS: PubMed and applicable infectious disease conference proceedings were searched to identify relevant published studies...
November 30, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27900269/vitamin-d-and-spine-surgery
#9
REVIEW
Thomas Mabey, Weerasak Singhatanadgige, Wicharn Yingsakmongkol, Worawat Limthongkul, Sittisak Honsawek
Vitamin D is crucial for musculoskeletal health, maintenance, and function. Vitamin D insufficiency is common among patients undergoing spine surgery and the ideal vitamin D level for spine surgery has yet to be investigated. There is a high prevalence of hypovitaminosis D in patients with musculoskeletal pain regardless of surgical intervention. With the frequency and costs of spine surgery increasing, it is imperative that efforts are continued to reduce the impact on patients and healthcare services. Studies into vitamin D and its associations with orthopaedic surgery have yielded alarming findings with regards to the prevalence of vitamin D deficiency...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27896677/results-of-database-studies-in-spine-surgery-can-be-influenced-by-missing-data
#10
Bryce A Basques, Ryan P McLynn, Michael P Fice, Andre M Samuel, Adam M Lukasiewicz, Daniel D Bohl, Junyoung Ahn, Kern Singh, Jonathan N Grauer
BACKGROUND: National databases are increasingly being used for research in spine surgery; however, one limitation of such databases that has received sparse mention is the frequency of missing data. Studies using these databases often do not emphasize the percentage of missing data for each variable used and do not specify how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to examine whether different treatments of missing data can influence the results of spine studies...
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27891033/transthoracic-approach-for-lesions-involving-the-anterior-dorsal-spine-a-multidisciplinary-approach-with-good-outcomes
#11
Srikant Balasubramaniam, Devendra K Tyagi, Sheikh H Zafar, Hemant V Savant
INTRODUCTION: Anterior approach provides excellent visualization and access to the anterior thoracic spine. It may be used alone, in combination with a posterior midline approach or in a staged or sequential fashion. AIMS: To analyse our institutional experience in transthoracic approaches and to determine the safety and benefit of this approach in our patient series. MATERIALS AND METHODS: A total of 16 patients were operated for varying lesions of body of dorsal vertebra by the transthoracic approach...
October 2016: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#12
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27888676/revision-surgery-for-cervical-artificial-disc-surgical-technique-and-clinical-results
#13
J Onken, A Reinke, J Radke, T Finger, S Bayerl, P Vajkoczy, B Meyer
OBJECTIVE: Cervical artificial disc replacement (C-ADR) was developed with the goal of preserving mobility of the cervical segment in patients with degenerative disc disease. So far, little is known about experiences with revision surgery and explantation of C-ADRs. Here, we report our experience with revision the third generation, Galileo-type disc prosthesis from a retrospective study of two institutions. PATIENTS AND METHODS: Between November 2008 and July 2016, 16 patients with prior implantation of C-ADR underwent removal of the Galileo-type disc prosthesis (Signus, Medizintechnik, Germany) due to a call back by industry...
October 31, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27886877/minimally-invasive-treatment-of-spine-trauma
#14
REVIEW
Jason E McGowan, Christian B Ricks, Adam S Kanter
The role for minimally invasive surgery (MIS) continues to expand in the management of spinal pathology. In the setting of trauma, operative techniques that can minimize morbidity without compromising clinical efficacy have significant value. MIS techniques are associated with decreased intraoperative blood loss, operative time, and morbidity, while providing patients with comparable outcomes when compared with conventional open procedures. MIS interventions further enable earlier mobilization, decreased hospital stay, decreased pain, and an earlier return to baseline function when compared with traditional techniques...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27885477/impact-of-old-age-on-patient-report-outcomes-and-cost-utility-for-anterior-cervical-discectomy-and-fusion-surgery-for-degenerative-spine-disease
#15
Silky Chotai, Scott L Parker, J Alex Sielatycki, Ahilan Sivaganesan, Harrison L Kay, Joseph B Wick, Matthew J McGirt, Clinton J Devin
PURPOSE: With growing older population and increasing rates of cervical spinal surgery, it is vital to understand the value of cervical surgery in this population. We set forth to determine the cost utility following anterior cervical decompression and fusion (ACDF) for degenerative disease in older patients. METHODS: Patients undergoing ACDF for degenerative diseases were enrolled into prospective longitudinal registry. Patient-reported outcomes (PROs) were recorded at baseline, 1-year, and 2-year postoperatively...
November 24, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27885472/a-prospective-randomized-trial-comparing-anterior-cervical-discectomy-and-fusion-versus-plate-only-open-door-laminoplasty-for-the-treatment-of-spinal-stenosis-in-degenerative-diseases
#16
Yun-Qi Jiang, Xi-Lei Li, Xiao-Gang Zhou, Chong Bian, Han-Ming Wang, Jian-Ming Huang, Jian Dong
OBJECTIVE: For three or more involved cervical levels, there is a debate over which approach yields the best outcomes for the treatment of multilevel cervical degenerative disease. Our objective is to compare the radiological and clinical outcomes of two treatments for multilevel cervical degenerative disease: anterior cervical discectomy and fusion (ACDF) versus plate-only open-door laminoplasty (laminoplasty). METHODS: Patients were randomized on a 1:1 randomization schedule with 17 patients in the ACDF group and 17 patients in the laminoplasty group...
November 24, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27879951/multidisciplinary-management-of-spontaneous-spinal-infections-there-is-a-correlation-between-timing-type-of-treatment-and-outcome-a-multivariate-analysis-of-an-observational-cohort-study
#17
Alessandro Landi, Alessandro DI Bartolomeo, Nicola Marotta, Giancarlo Iaiani, Maurizio Domenicucci, Massimo Chiara, Maurizio Salvati, Roberto Delfini
BACKGROUND: Spontaneous Spinal Infections SSI represent a rare and serious pathological entity. We've tried to study a correlation between type of treatment, timing of treatment and clinical outcome through a multivariate analysis of an observational cohort study with the aim to define what is the optimal clinico-therapeutic management. METHODS: We perform a retrospective observational cohort study on all consecutive patients observed in our Institute in a period of 13 years; From 2001 to 2014 we enrolled 50 consecutive patients with symptomatic spontaneous spinal infections (no previous surgery or recent infection in other site), confirmed with diagnostic imaging...
November 23, 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/27879571/radiographic-predictors-for-mechanical-failure-following-adult-spinal-deformity-surgery-a-retrospective-cohort-study-in-138-patients
#18
Dennis Winge Hallager, Sven Karstensen, Naeem Bukhari, Martin Gehrchen, Benny Dahl
STUDY DESIGN: Retrospective cohort study at a single institution. OBJECTIVE: We aimed at estimating the rate of revision procedures and identify radiographic predictors of mechanical failure following adult spinal deformity surgery. SUMMARY OF BACKGROUND DATA: Mechanical failure rates following adult spinal deformity surgery range 12% to 37% in literature. While the importance of spinal and spino-pelvic alignment is well documented for surgical outcome and ideal alignment has been proposed as sagittal vertical axis (SVA) < 5 cm, pelvic tilt < 20° and lumbar lordosis (LL) = pelvic incidence ± 9°, the role of radiographic sagittal spine parameters and alignment targets as predictors for mechanical failure remains uncertain...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27879568/effect-of-immunotherapy-status-on-outcomes-in-patients-with-metastatic-melanoma-to-the-spine
#19
Ganesh M Shankar, Bryan D Choi, Benjamin L Grannan, Kevin Oh, John H Shin
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: We performed a retrospective study of patients treated at our institution over the last 3 years to assess predictive value of immunotherapy exposure on overall survival of patients with metastatic melanoma to the spine in an effort to better inform surgical decision making. SUMMARY OF BACKGROUND DATA: Modern management of metastatic melanoma includes adjuvant targeted therapies and immunomodulators that have shown to significantly improve overall survival...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27879567/collar-fixation-is-not-mandatory-after-cervical-laminoplasty-a-randomized-controlled-trial
#20
Tetsuro Hida, Yoshihito Sakai, Kenyu Ito, Sadayuki Ito, Shiro Imagama, Naoki Ishiguro, Atsushi Harada
STUDY DESIGN: Prospective randomized controlled study OBJECTIVES.: To determine the effect of collar-aided fixation on outcomes following laminoplasty for cervical compressive myelopathy. SUMMARY OF BACKGROUND DATA: Patients are often placed in a Philadelphia collar for weeks after cervical laminoplasty. However, the benefit of postoperative collar use remains controversial. We hypothesized that treatment outcomes in postoperative pain in patients without collars would not be inferior to the outcomes in patients using Philadelphia collars for two weeks...
November 22, 2016: Spine
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