Costs and complications of increased length of stay following adolescent idiopathic scoliosis surgery

Accelerated discharge protocols for scoliosis surgery have recently been described in the literature. There are limited data describing the association of length of stay (LOS) during the index admission with postoperative outcomes. We sought to define the economic and clinical implications of an additional 1 day in the hospital for scoliosis surgery. The Statewide Planning and Research Cooperative System database was used to identify patients with adolescent idiopathic scoliosis who underwent spinal fusion from 1 October 2007 to 30 September 2012 at high-volume institutions (>20 cases/year) in the state of New York. Regression models were adjusted for age, sex, race, insurance, comorbidity score, and perioperative complications during the index admission. Among the 1286 patients with AIS who underwent spinal fusion, the mean LOS was 4.90 days [95% confidence interval (CI)=4.84–4.97; SD=1.19]. In the perioperative period, 605 (47.05%) underwent transfusion and 202 (15.71%) had problems with pain control. An additional 1 day in the hospital was associated with $11 033 (95% CI=7162–14 904; P
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: SPINE Source Type: research

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Conditions:   Pain, Postoperative;   Pain;   Scoliosis;   Spinal Fusion Intervention:   Sponsor:   Nantes University Hospital Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionAdults with spastic diplegic CP who received their first orthopaedic intervention more than 15  years ago (based on ISA) showed similar incidence of spinal deformities as reported in the younger CP population, suggesting stability of spinal curvature into adulthood.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
CONCLUSIONS: RF occurred in 11.8% of patients with MRCs after ASD surgery. Most RFs occurred at the lumbosacral junction or adjacent level (77%). Interbody fusion at the lumbosacral junction (L5-S1 or L4-S1 level) could significantly prevent the occurrence of RF after MRCs for ASD. PMID: 31783347 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery.Spine - Category: Neurosurgery Authors: Tags: J Neurosurg Spine Source Type: research
ConclusionsCutibacterium acnes found in discs and vertebrae during surgery for disc herniation in adults with degenerated discs may be caused by contamination, as findings in this group were similar to findings in a control group of young patients with scoliosis and non-degenerated discs. Furthermore, such findings were almost always combined with bacterial findings on the skin and/or in the wound. There was no association between preoperative Modic changes and bacterial findings. Antibiotic treatment of lumbar disc herniation with sciatica and/or low back pain, without signs of clinical discitis/spondylitis, should be ser...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
Conclusion. Anxiety and mood are potentially modifiable risk factors that have the greatest impact on pre- and postoperative pain. These results can be used to identify higher-risk patients and develop preoperative therapeutic protocols to improve postoperative outcomes. Level of Evidence: 3
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
ConclusionThe surgical treatment of postirradiation kyphotic spinal deformity is challenging, with common postoperative complications such as infection, instrumentation failure, and pseudarthrosis. However, with modern surgical techniques and spinal instrumentation, excellent deformity correction can be achieved and maintained. We recommend performing a two-stage procedure for cervicothoracic deformity, with anterior release followed by posterior fusion and instrumentation. In thoracolumbar deformities, correction can be achieved through single-stage posterior fusion. Rigid spinopelvic fixation with sacral-alar-iliac screw...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Publication date: November 2019Source: Spine Deformity, Volume 7, Issue 6Author(s): Jussi P. Repo, Ville T. Ponkilainen, Arja H. Häkkinen, Jari Ylinen, Paula Bergman, Kati KyröläAbstractStudy DesignObservational cohort study.ObjectivesTo measure and compare the structural validity of the Oswestry Disability Index (ODI) and the Scoliosis Research Society–30 (SRS-30) questionnaire in an adult population with prolonged degenerative thoracolumbar disease.Summary of Background DataThe ODI and the SRS-30 are commonly used patient-reported outcome instruments to assess back-specific disability and symptoms re...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
Publication date: November 2019Source: Spine Deformity, Volume 7, Issue 6Author(s): Tracey P. Bastrom, Carrie E. Bartley, Peter O. Newton, Harms Study GroupAbstractStudy DesignObservational.ObjectiveTo examine changes in patient-reported two-year postoperative outcomes via the Scoliosis Research Society (SRS)-24 Outcomes Instrument from 2001 through 2015.Summary of Background DataTechniques for correction of adolescent idiopathic scoliosis (AIS) have evolved over the years, but it is unclear how these changes have impacted patient-reported outcomes.MethodsAIS patients with two-year postoperative follow-up from a prosp...
Source: Spine Deformity - Category: Orthopaedics Source Type: research
ConclusionThe case reported, herein, demonstrates the feasibility of SA in elderly patients undergoing lengthy complex lumbar surgeries who have been designated “high-risk” patients (ASA > II) and provides support for future investigation into surgical and anesthesia treatment options for geriatric high-risk patients presenting with complex lumbar spine pathologies.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionsSpinal LGG is a rare entity with significant long-term effects. Although surgery is the most common initial treatment option, more in-depth analysis of molecular biomarkers may improve stratification and prognostication.
Source: Journal of Neuro-Oncology - Category: Cancer & Oncology Source Type: research
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