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Spine economics

Anita Mohandas, Chris Summa, W Bradley Worthington, Jason Lerner, Kevin T Foley, Robert J Bohinski, Gregory B Lanford, Carol Holden, Richard N W Wohns
STUDY DESIGN: Delphi Panel expert panel consensus and narrative literature review OBJECTIVE.: To obtain expert consensus on best practices for patient selection and perioperative decision making for outpatient anterior cervical surgery (anterior cervical disc fusion (ACDF) and cervical total disc replacement (CTDR)). SUMMARY OF BACKGROUND DATA: Spine surgery in ambulatory settings is becoming a preferred option for both patients and providers. The transition from traditional inpatient environments has been enabled by innovation in anesthesia protocols and surgical technique, as well as favorable economics...
October 6, 2016: Spine
Alexander Y Li, Tej D Azad, Anand Veeravagu, Inderpreet Bhatti, Amy Li, Tyler Cole, Atman Desai, John K Ratliff
STUDY DESIGN: Propensity score matched retrospective study using a nationwide longitudinal database. OBJECTIVE: To quantify the longitudinal economic impact of venous thromboembolism (VTE) complications in spinal fusion patients. SUMMARY OF BACKGROUND DATA: VTE is a rare and serious complication that may occur after spine surgery. The long-term socioeconomic impact understanding of these events has been limited by small sample sizes and a lack of longitudinal follow-up...
October 12, 2016: Clinical Spine Surgery
Olaf Suess, Markus Schomacher
Aim. Transpedicular screw fixation is widely used in spinal surgery. But the insertion of pedicle screws can sometimes be challenging because of the variability in pedicle size and the proximity of nerve roots. Methods. We detected intraoperatively the sensitivity for iatrogenic pedicel perforation with a hand-held electronic conductivity measurement device (ECD) that measures electrical conductivity of tissue-medium surrounding the instrument tip. ECD was used to guide the placement of 84 pedicle screws in 15 patients undergoing surgery for tumor or degenerative spinal disease at various spinal levels from T8 to L5...
2016: Advances in Medicine
David N Bernstein, Amit Jain, David Brodell, Yue Li, Paul T Rubery, Addisu Mesfin
OBJECTIVE: To analyze overall trends of elective cervical spine surgery in the United States from 2003-13 with the goal of determining whether the economic downturn had an impact. METHODS: Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) were used in order to identify elective cervical spine surgery procedures in the Nationwide Inpatient Sample (NIS) from 2003-13. National Health Expenditure, Gross Domestic Product (GDP) and Standard and Poor's (S&P) 500 Index were used as measures of economic performance...
September 22, 2016: World Neurosurgery
Yi Feng, Brian Egan, Jinxi Wang
Low back pain (LBP) is a major cause of disability and imposes huge economic burdens on human society worldwide. Among many factors responsible for LBP, intervertebral disc degeneration (IDD) is the most common disorder and is a target for intervention. The etiology of IDD is complex and its mechanism is still not completely understood. Many factors such as aging, spine deformities and diseases, spine injuries, and genetic factors are involved in the pathogenesis of IDD. In this review, we will focus on the recent advances in studies on the most promising and extensively examined genetic factors associated with IDD in humans...
September 2016: Genes & Diseases
Varun Puvanesarajah, Hamid Hassanzadeh
STUDY DESIGN: Retrospective database review. OBJECTIVE: To identify whether dural tears increase costs and the risk of wound complications and serious adverse events during the postoperative period following primary lumbar discectomy in elderly Medicare beneficiaries. SUMMARY OF BACKGROUND DATA: Rates of incidental durotomy during lumbar spine surgery range from 1 to 17%. The full economic and medical burden of this complication remains unclear, particularly as it occurs during lumbar discectomy in elderly patients...
August 31, 2016: Spine
Alok D Sharan, Gregory D Schroeder, Michael E West, Alexander R Vaccaro
As spinal care transitions from individual practitioners working in a volume-based reimbursement system toward multidisciplinary health care organizations working in a population-based model with value-based reimbursement, it is critical that insurance companies, administrators, and spine care provider have a clear understanding of how incentives change physician behavior. This article will introduce the concept of behavior economics, and discuss 9 principles relevant to physician decision-making.
August 19, 2016: Clinical Spine Surgery
Lorias Espinoza Daniel, Vicente González Carranza, Fernando Chico Ponce de León, Fernando Pérez Escamirosa, Arturo Minor Martinez
BACKGROUND: Navigation technology is used for training in various medical specialties, not least image-guided spinal interventions. Navigation practice is an important educational component that allows residents to understand how surgical instruments interact with complex anatomy and to learn basic surgical skills such as the tri-dimensional mental interpretation of bi-dimensional data. However, inexpensive surgical simulators for spinal surgery are lacking. We therefore designed a low-cost spinal surgery simulator (Spine MovDigSys 01) to allow 3D navigation using 2D images without altering or limiting the surgeon's natural movement...
August 12, 2016: World Neurosurgery
Amirali Sayadipour, Chrisopher K Kepler, Rajnish Mago, Kenneth M Certa, Mohammad R Rasouli, Alexander R Vaccaro, Todd J Albert, David G Anderson
BACKGROUND: It has been suggested, although not proven, that presence of concomitant psychiatric disorders may increase the inpatient costs for patients undergoing elective surgery. This study was designed to test the hypothesis that elective lumbar fusion surgery is more costly in patients with under treatment for depression. METHODS: This is a retrospective case-control study of 142 patients who underwent elective lumbar fusion. Of those 142 patients, 41 patients were chronically using an antidepressant medication that considered as a "study group", and 101 patients were not taking an antidepressant medication that considered as a "control group"...
June 2016: Archives of Bone and Joint Surgery
John A Kanis, Nicholas C Harvey, Cyrus Cooper, Helena Johansson, Anders Odén, Eugene V McCloskey
UNLABELLED: This systematic review identified assessment guidelines for osteoporosis that incorporate FRAX. The rationale for intervention thresholds is given in a minority of papers. Intervention thresholds (fixed or age-dependent) need to be country-specific. INTRODUCTION: In most assessment guidelines, treatment for osteoporosis is recommended in individuals with prior fragility fractures, especially fractures at spine and hip. However, for those without prior fractures, the intervention thresholds can be derived using different methods...
December 2016: Archives of Osteoporosis
Yoshifumi Horie, Haruna Watanabe, Hitomi Takanobu, Ayano Yagi, Takahiro Yamagishi, Taisen Iguchi, Norihisa Tatarazako
The effects of endocrine disruptors, including anti-androgenic chemicals, on aquatic environments have received increased attention in recent years. Currently, the method used to screen chemicals for anti-androgenic activity is called the androgenized female stickleback screen, and it was established by the Organization of Economic Cooperation and Development in 2011 using the three-spined stickleback. However, screening chemicals for anti-androgenic activity has yet to be established using Japanese medaka...
July 27, 2016: Journal of Applied Toxicology: JAT
Do-Keun Kim, Hyunkeun Lim, Dae Cheol Rim, Chang Hyun Oh
OBJECTIVE: Spinal fusion operation is an effective treatment in the spinal pathology, but it could change the physiological distribution of load at the instrumented and adjacent segments. This retrospective study compared the radiological and clinical outcomes of patients undergoing lumbar fusion with semirigid rods versus rigid rods system. METHODS: Using transpedicular fixation and posterior lumbar interbody fusion at the level of L4/L5, 20 patients were treated with semirigid rods (WavefleX, SR group), and 20 patients with rigid rods (titanium, RR group)...
June 2016: Korean Journal of Spine
Bernadette K Johnson, R Dawn Comstock
OBJECTIVE: Describe chest and abdominal injury epidemiology among US high school athletes. DESIGN: Retrospective analysis of longitudinal surveillance data. SETTING: Injury data from 2005/06 to 2013/14 academic years were collected using an internet-based surveillance system. PARTICIPANTS: A large sample of US high schools. ASSESSMENT OF RISK FACTORS: Injuries sustained as a function of sport. MAIN OUTCOME MEASURES: Chest, rib, thoracic spine, and abdominal injuries sustained during high school athletic events...
July 15, 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Małgorzata Węgierska, Marta Dura, Einat Blumfield, Paweł Żuchowski, Marzena Waszczak, Sławomir Jeka
Rheumatoid arthritis (RA) is a chronic systemic connective tissue disease. The development of comorbidities often occurs in the course of RA. One of them is osteoporosis, which has serious social and economic effects and may contribute to the increase in the degree of disability and premature death of the patient. Due to the young age in which RA disease occurs, densitometry (DXA) of the lumbar spine is the basic examination in osteoporosis diagnostics. In the course of RA, much more frequently than in healthy persons of the same age, osteoporotic fractures of vertebral bodies occur, which hinder a correct assessment in the DXA test...
2016: Reumatologia
Joel Martin, Timothy Y Wang, Daniel B Loriaux, Rupen Desai, Owoicho Adogwa, Maragatha Kuchibhatla, Isaac O Karikari, Carlos Antonio Bagley, Oren N Gottfried
INTRODUCTION: Hospital readmission after surgery results in a substantial economic burden, and several recent studies have investigated the impact of race and ethnicity on hospital readmission rates, with the goal to identify hospitals and patients with high readmission risk. METHODS: This single-institution, retrospective cohort study assesses the impact of race, along with preoperative and intraoperative risk factors, on 30-day readmission rates following spinal surgery...
August 2016: Neurosurgery
A Manikandan, M Durka, M Amutha Selvi, S Arul Antony
Spine Mn(x)Co₁₋xAl₂O₄ (x = 0, 0.3 and 0.5) nanoparticles were synthesized using Sesamum indicum (S. indicum) plant extracted microwave-assisted combustion method. S. indicum plant extract simplifies the process, provides an alternative process for a simple, economical and environment friendly synthesis. The absence of surfactant/catalysts has led to a simple, cheap and fast method of synthesis of spinel nanoparticles. The as-synthesized spinel nanoparticles were characterized by X-ray diffraction (XRD), Fourier transform infrared (FT-IR) spectroscopy, high resolution scanning electron microscopy (HR-SEM), high resolution transmission electron microscopy (HR-TEM), energy dispersive X-ray analysis (EDX), Brunauer Emmett Teller (BET) surface area analysis, UV-Visible diffuse reflectance spectroscopy (DRS), Photoluminescence (PL) spectroscopy, and vibrating sample magnetometer...
January 2016: Journal of Nanoscience and Nanotechnology
Alvaro Foieri, Ana M Marino De Remes Lenicov, Eduardo G Virla
Notozulia entreriana (Berg) (Hemiptera: Cercopidae) is one of the most common spittlebugs inhabiting the subtropical region of the America, inflicting important economic damage to grass crops. The immature stages are described and illustrated; the main characteristics that distinguish instars are the body size, color, number of flagellomeres, and number of tibial and metatarsomere spines. A key for identification of nymphs is provided as a tool to develop field studies.  Nine host plants, all belonging to Poaceae, are recorded as breeding and feeding host plants from different localities in northern Argentina...
2016: Zootaxa
Douglas S Weinberg, Joshua K Napora, William H West, Dominic C Grimberg, Heather A Vallier
Clavicle fractures are common in adults. Recent studies have shown that operative treatment of clavicle fractures has benefits in many situations. However, there is controversy about the indications. Data on social outcomes are limited. A total of 434 patients with 436 clavicle fractures treated both operatively and nonoperatively at a level 1 trauma center were identified. Narcotic use was recorded 2, 4, 6, 8, 10, 12, 14, and 16 weeks after injury for both treatment groups. Other descriptive data included age, sex, laterality, hand dominance, rib fractures, smoking, alcohol use, employment, long bone or spine fracture, open clavicle fracture, and mechanism of injury...
September 1, 2016: Orthopedics
J Laso, M Margallo, J Celaya, P Fullana, A Bala, C Gazulla, A Irabien, R Aldaco
The anchovy canning industry has high importance in the Cantabria Region (North Spain) from economic, social and touristic points of view. The Cantabrian canned anchovy is world-renowned owing to its handmade and traditional manufacture. The canning process generates huge amounts of several food wastes, whose suitable management can contribute to benefits for both the environment and the economy, closing the loop of the product life cycle. Life cycle assessment methodology was used in this work to assess the environmental performance of two waste management alternatives: Head and spine valorisation to produce fishmeal and fish oil; and anchovy meat valorisation to produce anchovy paste...
August 2016: Waste Management & Research
Tigran Avoundjian, Risha Gidwani, Dorcas Yao, Jeanie Lo, Patricia Sinnott, Neil Thakur, Paul G Barnett
PURPOSE: Lumbar spine (LS) MRI overuse may be identified in administrative data, but these data may lack the detailed clinical information needed to correctly assess overuse. The aim of this study was to compare chart review with analysis of administrative data to determine the appropriateness of LS MRI. METHODS: The sensitivity and specificity of the administrative method were determined, with inappropriateness regarded as the positive result, as if chart review determined the true state...
September 2016: Journal of the American College of Radiology: JACR
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