Design and Implementation of an Enhanced Recovery After Surgery (ERAS) Program for Minimally Invasive Lumbar Decompression Spine Surgery: Initial Experience
Conclusion. This report comprises the first description of a comprehensive, evidence-based ERAS for spine pathway, tailored for lumbar decompression/microdiscectomy resulting in short LoS, minimal complications, and no readmissions within 90 days of surgery. Level of Evidence: 3 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

Comparative Analysis of Two Transforaminal Lumbar Interbody Fusion Techniques: Open TLIF: Versus: Wiltse MIS TLIF
Conclusion. In comparing Wiltse MIS TLIF to Open TLIF, the minimally invasive paramedian Wiltse approach demonstrated the lowest EBL, LOS, readmission rates, and complications, but longer fluoroscopy times when compared with the traditional open approach. Level of Evidence: 3 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

A Strategy for Risk-adjusted Ranking of Surgeons and Practices Based on Patient-reported Outcomes After Elective Lumbar Surgery
Conclusion. This study presents a novel strategy for the risk-adjusted, PRO-based ranking of spine surgeons and practices. This can help identify positive and negative outliers, thereby forming the basis for large-scale quality improvement. Assuming adequate coverage of baseline risk adjustment, the choice of surgeon matters when considering PROs after lumbar surgery; however, the choice of site appears to matter more. Level of Evidence: 3 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

Optimizing the Volume–Value Relationship in Laminectomy: An Evidence-Based Analysis of Outcomes and Economies of Scale
The objective of the present study was to establish evidence-based volume thresholds for surgeons and hospitals predictive of enhanced value in the setting of laminectomy. Summary of Background Data. Previous studies have attempted to characterize the relationship between volume and value; however, none to the authors’ knowledge has employed an evidence-based approach to identify thresholds yielding enhanced value. Methods. In total, 67,758 patients from the New York Statewide Planning and Research Cooperative System database undergoing laminectomy in the period 2009 to 2015 were included. We used stratum-speci...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: OUTCOMES Source Type: research

Comparison of Short-term Outcomes After Lumbar Fusion Between an Orthopedic Specialty Hospital and Tertiary Referral Center
This study compared the perioperative outcomes for lumbar fusion procedures performed at an OSH and TRC. Summary of Background Data. The role of an OSH for lumbar fusion procedures has not been defined. Methods. A large institutional database was searched for single-level lumbar fusions performed between 2013 and 2016. Comparisons were made between procedures performed at the OSH and TRC in terms of operative time, total operating room (OR) time, length of stay (LOS), inpatient rehabilitation utilization, postoperative 90-day readmission, reoperation, and mortality rates. Results. A total of 101 patients at the OS...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: OUTCOMES Source Type: research

Reliability and Validity of the Turkish Version of the Fremantle Back Awareness Questionnaire
Conclusion. The FreBAQ-T is a valid, reliable, and unidimensional scale for patients with CLBP. This scale will allow assessing back-specific perception in the Turkish population with CLBP. Level of Evidence: 3 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Group and Individual-level Change on Health-related Quality of Life in Chiropractic Patients With Chronic Low Back or Neck Pain
Study Design. A prospective observational study. Objective. The aim of this study was to evaluate group-level and individual-level change in health-related quality of life among persons with chronic low back pain or neck pain receiving chiropractic care in the United States. Summary of Background Data. Chiropractors treat chronic low back and neck pain, but there is limited evidence of the effectiveness of their treatment Methods. A 3-month longitudinal study of 2024 patients with chronic low back pain or neck pain receiving care from 125 chiropractic clinics at six locations throughout the United States was con...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Cost and Hospital Resource Utilization of Staphylococcus aureus Infection Post Elective Posterior Instrumented Spinal Fusion Surgeries in U.S. Hospitals: A Retrospective Cohort Study
Study Design. A retrospective cohort study. Objective. The aim of this study was to assess hospital resource utilization and costs associated with Staphylococcus aureus infection within 180 days post elective posterior instrumented spinal fusion surgeries (index surgery) between 2010 and 2015. Summary of Background Data. Surgical site infections (SSIs) and blood stream infections (BSIs) post spinal fusion surgeries are associated with worse clinical outcomes and increased costs. Economic data specific to the most common pathogen of infections post spinal fusion surgeries, S. aureus, are limited. Methods. We anal...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Halo Gravity Traction Can Mitigate Preoperative Risk Factors and Early Surgical Complications in Complex Spine Deformity
Study Design. Retrospective review of prospective cohort. Objective. We sought to examine the role of halo gravity traction (HGT) in reducing preoperative surgical risk. Summary of Background Data. The impact of HGT on procedure choice, preoperative risk factors, and surgical complications has not been previously described. Methods. Patients treated with HGT before primary surgery were included. The FOCOS Score (FS) was used to quantify operative risk. FS was calculated using patient-factors (ASIA, body mass index, etiology), procedure-factors (PcF; osteotomy planned, number of levels fused, etc.), and curve mag...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Prognostic Factors for Patients With Undifferentiated High Grade Pleomorphic Sarcoma of the Spine
Study Design. Retrospective survival analysis of 44 undifferentiated high grade pleomorphic sarcoma (UPS) of the spine. Objective. To identify factors related to overall survival (OS) and help decision making in the treatment of undifferentiated high grade pleomorphic sarcoma of the spine. Summary of Background Data. UPS is an aggressive malignant tumor rarely originating from the spine. Due to its scarcity, only a few studies had been reported to describe the clinical features, treatments, and outcomes of sporadic cases, devoid of evaluation on prognostic factors. Methods. Enrolled in this survival analysis wer...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Safety of Outpatient Single-level Cervical Total Disc Replacement: A Propensity-Matched Multi-institutional Study
Conclusion. The perioperative outcomes evaluated in the current study support the conclusion that, for appropriately selected patients, single-level CTDR can be safely performed in the outpatient setting without increased rates of 30-day perioperative complications or readmissions compared with inpatient CTDR or outpatient single-level ACDF. Level of Evidence: 3 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Effect of Prosthesis Width and Depth on Heterotopic Ossification After Cervical Disc Arthroplasty
Study Design. Retrospective analysis. Objective. To investigate the effect of width and depth of the inserted cervical disc prosthesis on heterotopic ossification (HO) after cervical disc arthroplasty, and to explore the relationship between clinical outcome and HO. Summary of Background Data. The mechanism of HO formation still remains unknown. Footprint mismatch of cervical disc prosthesis was common in cervical arthroplasty. Compared with endplate, some inserted prostheses were smaller in width and length. Methods. Retrospectively analyze the patients who underwent cervical disc arthroplasty with Prestige-LP ...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Anterior and Posterior Approaches for Cervical Myelopathy: Clinical and Radiographic Outcomes
Conclusion. When the benefits of one approach over the other are not self-evident, the anterior approach is recommended, as it was associated with a shorter hospital stay and more successful restoration of cervical lordosis than posterior surgery. Level of Evidence: 3 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Secreted Factors From Intervertebral Disc Cells and Infiltrating Macrophages Promote Degenerated Intervertebral Disc Catabolism
Conclusion. The biologic interactions between infiltrating macrophages and native disc cells under degenerated disc inflammatory environment lead to an increasingly severe inflammatory conditions, which may be a self-stimulated process from the macrophages infiltration occurrence Level of Evidence: 5 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Estrogen Deficiency Exacerbates Intervertebral Disc Degeneration Induced by Spinal Instability in Rats
Conclusion. The present study demonstrated that estrogen deficiency exacerbated IDD induced by spinal instability, while estrogen supplementation alleviated the progression of disc degeneration related to osteoporosis. Level of Evidence: N/A (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Spinal Manipulative Therapy Effects in Autonomic Regulation and Exercise Performance in Recreational Healthy Athletes: A Randomized Controlled Trial
Study Design. A randomized, double blind, parallel groups, sham-controlled trial. Objective. The aim of this study was to analyze the acute effects of spinal manipulative therapy (SMT) on performance and autonomic modulation. Summary of Background Data. The use of SMT is progressively spreading from the clinical to the sporting context owing to its purported ergogenic effects. However, its effects remain unclear. Methods. Thirty-seven male recreational athletes (aged 37 ± 9 years) who had never received SMT were assigned to a sham (n = 19) or actual SMT group (n = 18). Study endpoints included...
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

Ten-year Outcomes of Cervical Disc Replacement With the BRYAN Cervical Disc: Results From a Prospective, Randomized, Controlled Clinical Trial
Conclusion. CDA can preserve and maintain motion in the long term compared with ACDF. There was a trend toward fewer adjacent segment surgeries for BRYAN disc that did not reach significance. Significant improvement in CDA NDI scores may suggest better long-term success for CDA as compared to fusion. Level of Evidence: 2 (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

“The Pena Palace in the Sintra Mountains in Portugal”
No abstract available (Source: Spine)
Source: Spine - April 18, 2019 Category: Orthopaedics Tags: IMAGERY Source Type: research

30-day Mortality Following Surgery for Spinal Epidural Abscess: Incidence, Risk Factors, Predictive Algorithm, and Associated Complications
Study Design. Retrospective case-control study. Objective. To determine incidence and timing of mortality following surgery for spinal epidural abscess (SEA), identify risk factors for mortality, and identify complications associated with mortality. Summary of Background Data. SEA is a serious condition with potentially devastating sequelae. There is a paucity of literature characterizing mortality following surgery for SEA. Methods. The National Surgical Quality Improvement Program (NSQIP) database was used. Patients with a diagnosis of SEA were included. A Cox proportional hazards model identified independent ...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

Safety and Efficacy of Revision Minimally Invasive Lumbar Decompression in the Ambulatory Setting
Study Design. A retrospective analysis. Objective. The aim of this study was to investigate differences in perioperative outcomes between patients undergoing revision minimally invasive lumbar spine decompression (MIS LD) in the ambulatory and hospital-based surgical settings. Summary of Background Data. Revision LD has been associated with an increased risk of complications compared with primary LD. Furthermore, ambulatory primary LD has been demonstrated to be a safe and viable option in appropriately selected patients. However, there is a paucity of information comparing hospital-based versus ambulatory outcomes...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

Predictive Model for Medical and Surgical Readmissions Following Elective Lumbar Spine Surgery: A National Study of 33,674 Patients
Conclusion. In this study we present internally validated predictive models for medical and surgical readmission after elective lumbar spine surgery. These findings set the stage for targeted interventions with a potential to reduce unnecessary readmissions, and also suggest that medical and surgical readmissions be treated as distinct clinical events. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

Comparison of Postoperative Outcomes According to Compensatory Changes of the Thoracic Spine Among Patients With a T1 Slope More Than 40°
Study Design. Retrospective study of postoperative outcomes of adult spinal deformity (ASD) surgery. Objective. To clarify the differences in postoperative outcomes depending on the presence or absence of thoracic compensatory changes among patients with a T1 slope (TS) more than 40°. Summary of Background Data. Loss correction after ASD surgery is more likely to occur when preoperative TS is more than 40°. When preoperative TS is more than 40°, some cases involve compensatory changes in the thoracic spine and decreased thoracic kyphosis (TK); others involve increased TK without compensatory changes. M...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: OUTCOMES Source Type: research

Surgical Outcomes for Drop Body Syndrome in Adult Spinal Deformity
This study included 243 consecutive patients (age 66 ± 17 years; range 22–78) who were treated surgically for ASD and were followed at least 2 years (mean follow-up 3.7 ± 2.3 years). DBS was defined as a primary lumbar kyphosis with PI–LL>40°, Cobb angle (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: OUTCOMES Source Type: research

French-Canadian Adaptation and Validation of the Swiss Spinal Stenosis Questionnaire for Patients With Lumbar Spinal Stenosis
Conclusion. The French-Canadian version of the SSSQ is a reliable and valid questionnaire consistent with the original English version. This new version will help French-speaking clinicians and scientists document changes in condition and treatment satisfaction in patients with LSS. Level of Evidence: 2 (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

A Cost-utility Analysis of Percutaneous Endoscopic Lumbar Discectomy for L5-S1 Lumbar Disc Herniation: Transforaminal: versus: Interlaminar
Study Design. A cost-utility analysis (CUA). Objective. The aim of this study was to evaluate the cost-effectiveness of percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID) techniques for the treatment of L5-S1 lumbar disc herniation (LDH). Summary of Background Data. The annual cost of treatment for lumbar disc herniation is staggering. As the two major approaches of percutaneous endoscopic lumbar discectomy (PELD): percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID) have gained recognitio...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

How Common Is Medial and Lateral Shoulder Discordance in Lenke 1 and 2 Curves?: A Preoperative Analysis of Medial and Lateral Shoulder Balance Among 151 Lenke 1 and 2 Adolescent Idiopathic Scoliosis Patients
Study Design. Retrospective study of prospectively collected data. Objective. To analyze the incidence and the patterns of medial and lateral shoulder discordance among Lenke 1 and 2 patients. Summary of Background Data. Postoperative shoulder imbalance (PSI) is still common in Lenke 1 and 2 adolescent idiopathic scoliosis (AIS). This could be due to presence of medial dan lateral shoulder discordance. Methods. One hundred fifty-one Lenke 1 and 2 AIS patients were recruited. Lenke 1 curves were subclassified into Lenke 1-ve (flexible) (proximal thoracic side bending [PTSB] Cobb angle (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Predictors of a Non-home Discharge Destination Following Spinal Fusion for Adolescent Idiopathic Scoliosis (AIS)
Study Design. Retrospective cohort study. Objective. Analyze risk factors associated with a non-home discharge following spinal fusions in adolescent idiopathic scoliosis (AIS). Summary of Background Data. Current evidence is limited with regard to which patient-level and provider/hospital-level factors predict a non-home discharge disposition following spinal fusions in AIS. Identifying these factors can allow providers to identify which patients would ultimately require facility care and can be discharged early to these facilities to reduce hospital costs. Methods. The 2012 to 2016 American College of Surgeons...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Coronal Imbalance in Adult Spinal Deformity Following Posterior Spinal Fusion With Instrument: A Related Parameters Analysis
Study Design. A retrospective radiographic study. Objective. To explore the radiological parameters which correlated to postoperative immediately coronal imbalance in adult spinal deformity (ASD) and to determine whether preoperative coronal imbalance affects postoperative coronal imbalance following posterior multi-level fusion with instruments and osteotomy operation. Summary of Background Data. There was paucity of literature paying attention to the postoperative immediately coronal imbalance after operation. Methods. The study included 67 consecutive patients with ASD who underwent posterior multi-level fusi...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Alert Timing and Corresponding Intervention With Intraoperative Spinal Cord Monitoring for High-Risk Spinal Surgery
Conclusion. Our prospective multicenter study identified potential neural damage in 9.5% of cases and 52% rescue cases using IONM. Although the rescue ratios for t-OPLL and IMSCT were relatively low, appropriate intervention immediately after an IONM alert may prevent neural damage even in high-risk spinal surgeries. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Don’t You Wish You Had Fused to the Pelvis the First Time: A Comparison of Reoperation Rate and Correction of Pelvic Obliquity
Study Design. A multicenter retrospective study. Objective. The aim of this study was to compare pelvic obliquity correction and reoperation rate in neuromuscular scoliosis patients who had their pelvis included in a posterior spinal fusion (pelvic fusion, PF) at their index procedure versus revision procedures. Summary of Background Data. There is limited information on outcomes specific to fusing to the pelvis for neuromuscular scoliosis in a revision operation versus index surgery. Methods. Charts and radiographs were reviewed of patients with PF for neuromuscular scoliosis from January 2003 to August 2015 at...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Does Extension Dysfunction Affect Postoperative Loss of Cervical Lordosis in Patients Who Undergo Laminoplasty?
Conclusion. In our study sample, we found that there is no relation between T1 slope and LCL. We have identified a new factor, EF, that could predict LCL after laminoplasty. No significant kyphotic changes after laminoplasty occurred particularly when the EF was greater than or equal to 14°. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Incidence, Risk Factors, and Clinical Implications of Postoperative Hematoma Requiring Reoperation Following Anterior Cervical Discectomy and Fusion
Study Design. Retrospective study of prospectively collected data. Objective. To determine the incidence, timing, risk factors, and clinical implications of postoperative hematoma requiring reoperation after anterior cervical discectomy and fusion (ACDF). Summary of Background Data. Postoperative hematomas requiring reoperation are rare but potentially catastrophic complications after ACDF. However, there has been a lack of large cohort studies investigating these complications in the ACDF population despite increasing outpatient procedure volume. Methods. Patients who underwent ACDF in the 2012 to 2016 National...
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research

Skeletal Muscle Cell Oxidative Stress as a Possible Therapeutic Target in a Denervation-Induced Experimental Sarcopenic Model
Conclusion. The current in vitro and in vivo study demonstrated the possible involvement of oxidative stress in sarcopenic pathology. NAC represents a potential anti-sarcopenic drug candidate, preventing amyotrophy and fatty degeneration. Level of Evidence: 4 (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: BASIC SCIENCE Source Type: research

Additional Sacroplasty Does Not Improve Clinical Outcome in Minimally Invasive Navigation-Assisted Screw Fixation Procedures for Nondisplaced Insufficiency Fractures of the Sacrum
Conclusion. This comparative study indicates noninferiority of NSF compared to NSF + SP for sacral insufficiency fractures, and could not confirm clinical advantages of additional SP concerning pain relief, improvement of fracture-related disability, or time from surgery to discharge. Therefore, additional sacroplasty is not recommended to enhance the clinical benefit for patients receiving image-guided sacral screw fixation. Level of Evidence: 2 (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

Patients Cannot Reliably Distinguish the Iliac Crest Bone Graft Donor Site From the Contralateral Side After Lumbar Spine Fusion: A Patient-blinded Randomized Controlled Trial
Conclusion. This study showed that, during the first year after lumbar fusion surgery via a single midline incision approach, patients could not reliably identify the iliac crest used for bone graft harvesting and this iliac crest was not more painful than the untouched contralateral iliac crest. Therefore, donor site pain should not be the main reason to use bone graft alternatives for lumbar spinal fusion. Level of Evidence: 2 (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research

“The Sea of Clouds and Telpher in Mount Huangshan”
No abstract available (Source: Spine)
Source: Spine - March 30, 2019 Category: Orthopaedics Tags: IMAGERY Source Type: research

To the editor:
No abstract available (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: LETTER Source Type: research

Pedicle Screw Placement Using Augmented Reality Surgical Navigation With Intraoperative 3D Imaging: A First In-Human Prospective Cohort Study
Conclusion. ARSN can be clinically used to place thoracic and lumbosacral pedicle screws with high accuracy and with acceptable navigation time. Consequently, the risk for revision surgery and complications could be minimized. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

Practice Variation Among Surgeons Treating Lumbar Spinal Stenosis in a Single Institution
Study Design. A retrospective study. Objective. The aim of this study was to examine practice variation in the treatment of lumbar spinal stenosis and identify targets for reducing variation. Summary of Background Data. Lumbar spinal stenosis is a degenerative condition susceptible to practice variation. Reducing variation aims to improve quality, increase safety, and lower costs. Establishing differences in surgeons’ practices from a single institution can help identify personalized variation. Methods. We identified adult patients first diagnosed with lumbar spinal stenosis between 2003 and 2015 in three ...
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: SURGERY Source Type: research

Time Taken to Return to Work Does Not Influence Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion: A 5-Year Follow-Up Study
Conclusion. Patients who RTW late have significantly poorer preoperative SF-36 physical component scores and higher ODI, NASS NS, NPRS back/leg pain scores. Surgeons should be cognizant that working adults with poorer preoperative function will tend to return to work later, but should reassure them that they will likely achieve similar clinical outcomes, satisfaction and expectation fulfilment when compared with patients who returned to work early. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: OUTCOMES Source Type: research

Cross-cultural Adaptation and Validation of the Simplified-Chinese Version of Neck Bournemouth Questionnaire for Patients in Mainland China
Conclusion. The SC-NBQ demonstrated good internal consistency, test-retest reliability, and construct validity, and may be used for the evaluation of NP in Chinese-speaking patients. Level of Evidence: 2 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Psychometric Properties Study of the Oswestry Disability Index in a Spanish Population With Previous Lumbar Disc Surgery: Homogeneity and Validity
Study Design. Evaluation of the psychometric properties of a questionnaire. Objective. To assess the psychometric properties of the Spanish version of the Oswestry Disability Index (ODI) in a Spanish population with previous lumbar disc surgery. Summary of Background Data. ODI is frequently used for measuring disability in spinal disorders. In 1995, ODI was translated and transculturally adapted into the Spanish context; its content and apparent validity, internal consistency and test–retest reliability were demonstrated for a Spanish population with lumbar pain. However, this score has not been tested in ter...
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Evaluating the Quality, Content, and Readability of Online Resources for Failed Back Spinal Surgery
Conclusion. The quality and content of available online information for FBSS were poor. The readability of online information in our results showed a significantly higher reading level than the sixth-grade level recommended by the AMA and NIH. Level of Evidence: 4 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Changes in the Use of Lumbar Arthrodesis Procedures Within Accountable Care Organizations
Conclusion. Our results indicate that ACOs may effectively curtail the use of lumbar fusion procedures, particularly among patients with spinal stenosis. As these interventions are often associated with higher complications and need for reoperation, such practices might accrue additional health care savings for Medicare beyond those realized during the index surgical period. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Improvement in Work Ability, Psychological Distress and Pain Sites in Relation to Low Back Pain Prognosis: A Longitudinal Observational Study in Primary Care
Conclusion. More pain sites, higher psychological distress, or lower work ability showed higher disability, more pain, and lower quality of life in patients with LBP. Only improvement in work ability was consistently related to successful outcomes. Level of Evidence: 2 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

Epidemiological State, Predictors of Early Mortality, and Predictive Models for Traumatic Spinal Cord Injury: A Multicenter Nationwide Cohort Study
Conclusion. Over the 12-year period, patient characteristics, etiology, and post-SCI outcomes significantly changed. We identified eight prognostic factors of early mortality. A predictive model including these factors showed excellent performance and may improve treatment strategies, healthcare resource allocation, and counseling. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research

Comparing the Diagnostic Accuracies of F-18 Fluorodeoxyglucose Positron Emission Tomography and Magnetic Resonance Imaging for the Detection of Spondylodiscitis: A Meta-analysis
Conclusion. The current meta-analysis shows that F-18 FDG PET has better diagnostic accuracy than MRI for the detection of spondylodiscitis. Further large multicenter studies would be necessary to substantiate the diagnostic accuracies of F-18 FDG PET and MRI for spondylodiscitis. Level of Evidence: 2 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Preoperative Age and Prognostic Nutritional Index Are Useful Factors for Evaluating Postoperative Delirium Among Patients With Adult Spinal Deformity
Conclusion. The risk factors of postoperative delirium after ASD surgery were PNI less than 49.7 and age more than 68.5 years. Patients who undergo ASD surgery beyond these preoperative cut-off values should be cautioned about delirium and be required to provide adequate informed consent. Level of Evidence: 3 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

Replication Study for the Association of GWAS-associated Loci With Adolescent Idiopathic Scoliosis Susceptibility and Curve Progression in a Chinese Population
Conclusion. This study replicated the associations of four GWAS-associated SNPs with occurrence of AIS in our Chinese population. However, none of these SNPs was associated with curve severity and progression. The results suggest that curve progression may be determined by environmental (nongenetic) factor, but further study with a larger sample size is required to address this issue. Level of Evidence: 4 (Source: Spine)
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: DEFORMITY Source Type: research

Risk of Surgical Site Infection and Mortality Following Lumbar Fusion Surgery in Patients With Chronic Steroid Usage and Chronic Methicillin-Resistant Staphylococcus aureus Infection
Study Design. A retrospective database analysis among Medicare beneficiaries Objective. The aim of this study was to determine the effect of chronic steroid use and chronic methicillin-resistant Staphylococcus aureus (MRSA) infection on rates of surgical site infection (SSI) and mortality in patients 65 years of age and older who were treated with lumbar spine fusion. Summary of Background Data. Systemic immunosuppression and infection focus elsewhere in the body are considered risk factors for SSI. Chronic steroid use and previous MRSA infection have been associated with an increased risk of SSI in some surgical p...
Source: Spine - March 19, 2019 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research