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https://www.readbyqxmd.com/read/28549099/impact-of-resident-and-fellow-changeovers-on-patient-outcomes-a-nationwide-cross-sectional-study
#1
Jean-David Zeitoun, Jeanne Reboul-Marty, Jérémie H Lefèvre
Findings regarding the association of cohort changeovers with patient outcomes are mixed. We sought to examine the association of resident and fellow changeovers with a comprehensive set of indicators. We performed a cross-sectional comparative study including all French teaching and non-teaching hospitals. All-cause mortality and length of stay were assessed. Focused analysis for three medical conditions (myocardial infarction, intestinal hemorrhage, stroke) and three surgical procedures (colorectal, vascular and spine surgery) was performed regarding other quality and efficiency indicators (readmissions, intensive care unit admission, transfers)...
May 25, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28547575/incomplete-burst-fractures-of-the-thoracolumbar-spine-a-review-of-literature
#2
REVIEW
U J Spiegl, C Josten, B M Devitt, C-E Heyde
PURPOSE: The purpose of this review was to analyze the biomechanical basis of incomplete burst fractures of the thoracolumbar spine, summarize the available treatment options with evidence from the literature, and to propose a method to differentiate fracture severity. METHODS: The injury pattern, classification, and treatment strategies of incomplete burst fractures of the thoracolumbal spine have been described following a review of the literature. All level I-III studies, studies with long-term results and comparative studies were included and summarized...
May 25, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28526918/effect-of-problem-and-scripting-based-learning-on-spine-surgical-trainees-learning-outcomes
#3
Lin Cong, Qi Yan, Chenjing Sun, Yue Zhu, Guanjun Tu
PURPOSE: To assess the impact of problem and scripting-based learning (PSBL) on spine surgical trainees' learning outcomes. METHODS: 30 spine surgery postgraduate-year-1 residents (PGY-1s) from the First Hospital of China Medical University were randomly divided into two groups. The first group studied spine surgical skills and developed individual judgment under a conventional didactic model, whereas the PSBL group used PBL and Scripted model. A feedback questionnaire and the satisfaction of residents were evaluated by the first assistant surgeon immediately following each procedure...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28520623/the-sub-crestal-iliac-screw-a-technical-note-describing-a-free-hand-in-line-low-profile-iliac-screw-insertion-technique-to-avoid-side-connector-use-and-reduce-implant-complications
#4
Gabriel Liu, Muhammed Yaser Hasan, Hee-Kit Wong
STUDY-DESIGN: Case-series. OBJECTIVE: Report our modified iliac-screw insertion technique and its clinical outcomes. SUMMARY OF BACKGROUND DATA: Iliac-screws are one of the preferred methods for modern spinopelvic-fixation. However the technique is not without complications, predominantly due to iliac-screw head prominence, leading to pain and revisions. Conventional iliac-screw entry point is sited superficially at the posterior-superior-iliac-spine (PSIS) contributing to screw-head prominence...
May 17, 2017: Spine
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#5
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28472336/association-of-hospitalization-for-neurosurgical-operations-in-magnet-hospitals-with-mortality-and-length-of-stay
#6
Symeon Missios, Kimon Bekelis
BACKGROUND: The association of Magnet hospital status with improved surgical outcomes remains an issue of debate. OBJECTIVE: To investigate whether hospitalization in a Magnet hospital is associated with improved outcomes for patients undergoing neurosurgical operations. METHODS: A cohort study was executed using all patients undergoing neurosurgical operations in New York registered in the Statewide Planning and Research Cooperative System database from 2009 to 2013...
May 3, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28454778/decision-analysis-to-identify-the-ideal-treatment-for-adult-spinal-deformity-what-is-the-impact-of-complications-on-treatment-outcomes
#7
Emre Acaroglu, Umit Ozgur Guler, Aysun Cetinyurek-Yavuz, Selcen Yuksel, Yasemin Yavuz, Selim Ayhan, Montse Domingo-Sabat, Ferran Pellise, Ahmet Alanay, Francesco S Perez Grueso, Frank Kleinstück, Ibrahim Obeid
OBJECTIVE: The aim of this study was to analyze the impact of treatment complications on outcomes in adult spinal deformity (ASD) using a decision analysis (DA) model. METHODS: The study included 535 ASD patients (371 with non-surgical (NS) and 164 with surgical (S) treatment) from an international multicentre database of ASD patients. DA was structured in two main steps; 1) Baseline analysis (Assessing the probabilities of outcomes, Assessing the values of preference -utilities-, Combining information on probability and utility and assigning the quality adjusted life expectancy (QALE) for each treatment) and 2) Sensitivity analysis...
April 25, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28441684/development-of-consensus-based-best-practice-guidelines-for-postoperative-care-following-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#8
Nicholas D Fletcher, Michael P Glotzbecker, Michelle Marks, Peter O Newton
STUDY DESIGN: Delphi process with multiple iterative rounds using a nominal group technique. OBJECTIVE: The aim of this study was to use expert opinion to achieve consensus on various aspects of postoperative care following posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Significant variability exists in postoperative care following PSF for AIS, despite a relatively healthy patient population and continuously improving operative techniques...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28439703/the-impact-of-direct-vertebral-rotation-dvr-on-radiographic-outcome-in-surgical-correction-of-idiopathic-scoliosis
#9
Wiktor Urbanski, Michal J Wolanczyk, Wojciech Jurasz, Miroslaw Kulej, Piotr Morasiewicz, Szymon Lukasz Dragan, Marek Sasiadek, Szymon Feliks Dragan
INTRODUCTION: Recent developments of spinal instruments allow to address nearly all components of idiopathic scoliosis. Direct vertebral rotation (DVR) maneuver was introduced to correct apical axial vertebral rotation. It is however still not well established how efficiently DVR affects results of scoliosis correction. The object of the study was to evaluate en bloc apical vertebral rotation (DVR) and its impact on coronal and sagittal correction of the spine in patients undergoing surgical scoliosis treatment...
April 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28434102/outcomes-following-surgical-management-of-cauda-equina-syndrome-does-race-matter
#10
Amit Jain, Emmanuel Menga, Addisu Mesfin
Cauda equina syndrome (CES) is a surgical emergency requiring urgent spinal decompression. Our objective is to analyze the association between race and in-hospital outcomes (complications, mortality, length of stay, and discharge disposition) in patients with CES. This is a retrospective cohort study of CES patients identified via the Nationwide Inpatient Sample (NIS) from 2000 to 2010 in inpatient hospitalizations in the USA. The patient sample includes 46,017 patients ≥18 undergoing spine surgery for CES...
April 21, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28414677/a-rare-case-of-tropical-pyomysitis-acquired-on-vacation-in-a-healthy-male
#11
K Poole, T Tran
INTRODUCTION: Pyomyositis has traditionally been considered a tropical disease. Increasing prevalence has been observed in more northern climates, especially with HIV, immunosuppression, and IV drug abuse as predisposing factors. Pyomyositis has the tendency to mimic other conditions, such as muscle contusion, necrotizing fasciitis, or septic arthritis. The rarity of this disease and non-specificity of its symptoms often lead to delay in appropriate diagnosis and treatment. CASE: 24-year-old man, seen 2 days prior in orthopedics clinic and the Emergency Department for persistent gluteal pain thought to be due to right-sided sciatica, was admitted following worsening pain, diffuse generalized weakness with polyarthralgias and myalgias These symptoms were associated with night sweats, shaking chills, and difficulty walking...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413736/targeted-intraspinal-radiofrequency-ablation-for-lumbar-spinal-stenosis
#12
Robert E Jacobson, Michelle Granville, Jesse Hatgis DO
INTRODUCTION: By using a combination of magnetic resonance imaging (MRI) and computed tomography (CT) of the lumbar spine, it is possible to distinguish between spinal stenosis caused by bone compression and specific soft tissue epidural intraspinal lesions that cause localized spinal canal stenosis and neural compression. Examples include facet cysts and yellow ligament hypertrophy. Many of these patients are elderly with medical comorbidities that make open surgery problematic. MATERIALS & METHODS: This is a study of patients with predominantly soft tissue stenosis being treated with targeted intraspinal radiofrequency (RF) heat ablation...
March 10, 2017: Curēus
https://www.readbyqxmd.com/read/28399551/risks-factors-for-reoperation-in-patients-treated-surgically-for-degenerative-spondylolisthesis-a-subanalysis-of-the-8-year-data-from-the-sport-trial
#13
Michael C Gerling, Dante Leven, Peter G Passias, Virgnie Lafage, Kristina Bianco, Alexandra Lee, Tamara S Morgan, Jon D Lurie, Tor D Tosteson, Wenyan Zhao, Kevin F Spratt, Kristen Radcliff, Thomas J Errico
STUDY DESIGN: Retrospective analysis of prospective data from the degenerative spondylolisthesis (DS) arm of the Spine Patient Outcomes Research Trial. OBJECTIVE: To identify risk factors for reoperation in patients treated surgically for DS and compare outcomes between patients who underwent reoperation with non-reoperative patients. SUMMARY OF BACKGROUND DATA: Several studies have examined outcomes following surgery for DS, but few have identified risk factors for reoperation...
April 10, 2017: Spine
https://www.readbyqxmd.com/read/28377245/postoperative-non-pathological-fever-after-spinal-surgery-incidence-and-risk-factor-analysis
#14
Junghan Seo, Jin Hoon Park, Eun Hee Song, Young-Seok Lee, Sang Ku Jung, Sang Ryong Jeon, Seung Chul Rhim, Sung Woo Roh
BACKGROUND: Although there are many postoperative febrile causes, surgical site infection has always been considered as one of the major causes, but it should be excluded; we encountered many patients who showed delayed postoperative fever that was not related to wound infection after spinal surgery. We aimed to determine the incidence of delayed postoperative fever and its characteristics after spinal surgery, and to analyze the causal factors. METHODS: A total of 250 patients who underwent any type of spinal surgery were analyzed...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28364424/symptomless-multi-variable-apnea-prediction-index-assesses-obstructive-sleep-apnea-risk-and-adverse-outcomes-in-elective-surgery
#15
M Melanie Lyons, Brendan T Keenan, Junxin Li, Tanya Khan, Nabil Elkasabanny, Colleen M Walsh, Noel N Williams, Allan I Pack, Indira Gurubhagavatula
Study Objective: To validate that the symptomless Multi-Variable Apnea Prediction index (sMVAP) is associated with Obstructive Sleep Apnea (OSA) diagnosis and assess the relationship between sMVAP and adverse outcomes in patients having elective surgery. We also compare associations between Bariatric surgery, where preoperative screening for OSA risk is mandatory, and non-Bariatric surgery groups who are not screened routinely for OSA. Methods: Using data from 40 432 elective inpatient surgeries, we used logistic regression to determine the relationship between sMVAP and previous OSA, current hypertension, and postoperative complications: extended length of stay (ELOS), intensive-care-unit-stay (ICU-stay), and respiratory complications (pulmonary embolism, acute respiratory distress syndrome, and/or aspiration pneumonia)...
March 1, 2017: Sleep
https://www.readbyqxmd.com/read/28356152/mid-term-outcome-following-revision-surgery-of-clavicular-non-and-malunion-using-anatomic-locking-compression-plate-and-iliac-crest-bone-graft
#16
Marc Beirer, Ingo J Banke, Norbert Harrasser, Moritz Crönlein, Dominik Pförringer, Stefan Huber-Wagner, Peter Biberthaler, Chlodwig Kirchhoff
BACKGROUND: Treatment of clavicular non- and malunion is still challenging. Current surgical procedures often result in frustrating functional outcome along with high-grade subjective impairment and increased rates of revision surgery. However, the combination of biological augmentation with vital bone graft and a biomechanically sufficient fixation system seems to be a promising concept of treatment. METHODS: In this retrospective study, 14 patients with a mean age of 44 years (26-67 years) suffering from non-union (n = 11) and/or malunion (n = 3) of the clavicle were enrolled...
March 29, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28349384/extended-surgery-for-t4-lung-cancer-a-30-years-experience
#17
P G Dartevelle, D Mitilian, E Fadel
T4 non-small cell lung carcinomas (NSCLC) were deemed unresectable. Advances in surgery have challenged this dogma. We describe technical aspects and result on superior vena cava (SVC), carinal, thoracic inlet tumor surgeries, and resection under cardiopulmonary bypass (CPB). SVC reconstruction requires hemodynamic control to reverse SVC clamping cerebral effects and excellent cephalic venous bed patency. Among 50 SVC resections, including 25 carinal pneumonectomies, post-operative mortality rate was 8%. In the N0-N1 group, 5- and 10-year survival rates were 46...
March 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28346762/predicting-the-pain-continuum-after-adolescent-idiopathic-scoliosis-surgery-a-prospective-cohort-study
#18
V Chidambaran, L Ding, D L Moore, K Spruance, E M Cudilo, V Pilipenko, M Hossain, P Sturm, S Kashikar-Zuck, L J Martin, S Sadhasivam
BACKGROUND: Chronic postsurgical pain (CPSP) affects half a million children annually in the United States, with dire socioeconomic consequences, including long-term disability into adulthood. The few studies of CPSP in children are limited by sample size, follow-up duration, non-homogeneity of surgical procedure and factors evaluated. METHODS: In a prospective study of 144 adolescents undergoing a single major surgery (spine fusion), we evaluated demographic, perioperative, surgical and psychosocial factors as predictors of a continuum of postsurgical pain: immediate, pain maintenance at 2-3 months (chronic pain/CP) and persistence of pain a year (persistent pain/PP) after surgery...
March 27, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28344731/review-of-physical-activity-benefits-and-potential-considerations-for-individuals-with-surgical-fusion-of-spine-for-scoliosis
#19
EDITORIAL
Rumit Singh Kakar, Kathy J Simpson, Bhibha M DAS, Cathleen N Brown
Evidence-based recommendations for physical activity following spinal fusion surgeries for idiopathic scoliosis are limited, specifically in the adolescent population. Individuals with scoliosis treated operatively or non-operatively have been reported to participate in less than 1-3 days/week of even mildly strenuous physical exercises. Over 40% of individuals with scoliosis returned to sports at a level lower than pre-operative participation levels or did not return at all post spinal fusion. It is particularly important for human movement specialists, such as physical therapists, occupational therapists, athletic trainers and kinesiologists to assist these individuals effectively transition to and maintain engagement in physical activity...
2017: International Journal of Exercise Science
https://www.readbyqxmd.com/read/28336484/lumbar-mri-findings-in-patients-with-and-without-waddell-signs
#20
J S Cox, S Blizzard, H Carlson, J Hiratza, J U Yoo
BACKGROUND CONTEXT: Waddell Signs (WS), introduced as a method to establish patients with substantial psychosocial components to their low back pain, carry a negative association despite no literature evaluating whether physical disease is associated with them. PURPOSE: To compare lumbar MRI findings between the patients with and without Waddell's Signs. STUDY DESIGN: Retrospective cohort study based on prospectively collected data PATIENT SAMPLE: Thirty patients aged 35-55 with an ODI score >50 randomly selected such that there was an even distribution of patients based on number of WS OUTCOME MEASURES: ODI and SF-12 scores, number of WS, presence and severity of spinal pathology METHODS: MRIs were reviewed by three spine specialists blinded to clinical exam findings, number of WS, and patient identity...
March 20, 2017: Spine Journal: Official Journal of the North American Spine Society
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