Abstract:
STUDY DESIGN:Retrospective analysis of nationwide Veterans Health Administration clinical and administrative data. OBJECTIVE:Examine the association between HIV infection and the rate of spine surgery for degenerative spine disease. SUMMARY OF BACKGROUND DATA:Combination antiretroviral therapy has prolonged survival in HIV-infected patients, increasing the prevalence of chronic conditions such as degenerative spine disease that may require spine surgery. METHODS:We studied all HIV-infected patients under care in the Veterans Health Administration from 1996 to 2008 (n = 40,038) and uninfected comparator patients (n = 79,039) matched on age, sex, race, year, and geographic region. The primary outcome was spine surgery for degenerative spine disease, defined by International Classification of Diseases, Ninth Revision procedure and diagnosis codes. We used a multivariate Poisson regression to model spine surgery rates by HIV infection status, adjusting for factors that might affect suitability for surgery (demographics, year, comorbidities, body mass index, combination antiretroviral therapy, and laboratory values). RESULTS:Two hundred twenty-eight HIV-infected and 784 uninfected patients underwent spine surgery for degenerative spine disease during 700,731 patient-years of follow-up (1.44 surgeries per 1000 patient-years). The most common procedures were spinal decompression (50%) and decompression and fusion (33%); the most common surgical sites were the lumbosacral (50%) and cervical (40%) spine. Adjusted rates of surgery were lower for HIV-infected patients (0.86 per 1000 patient-years of follow-up) than for uninfected patients (1.41 per 1000 patient-years; incidence rate ratio 0.61, 95% confidence interval: 0.51-0.74, P < 0.001). Among HIV-infected patients, there was a trend toward lower rates of spine surgery in patients with detectable viral load levels (incidence rate ratio 0.76, 95% confidence interval: 0.55-1.05, P = 0.099). CONCLUSION:In the Veterans Health Administration, HIV-infected patients experience significantly reduced rates of surgery for degenerative spine disease. Possible explanations include disease prevalence, emphasis on treatment of nonspine HIV-related symptoms, surgical referral patterns, impact of HIV on surgery risk-benefit ratio, patient preferences, and surgeon bias.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
King JT Jr,Gordon AJ,Perkal MF,Crystal S,Rosenthal RA,Rodriguez-Barradas MC,Butt AA,Gibert CL,Rimland D,Simberkoff MS,Justice ACdoi
10.1097/BRS.0b013e318228f32dsubject
Has Abstractpub_date
2012-04-01 00:00:00pages
612-22issue
7eissn
0362-2436issn
1528-1159journal_volume
37pub_type
杂志文章相关文献
SPINE文献大全abstract:STUDY DESIGN:Animal in vivo study. OBJECTIVE:To test the capability of high-density collagen gel to repair annular defects. SUMMARY OF BACKGROUND DATA:Annular defects are associated with spontaneous disc herniations and disc degeneration, which can lead to significant morbidity. Persistent annular defects after surgi...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000000103
更新日期:2014-02-01 00:00:00
abstract:STUDY DESIGN:Retrospective analysis. OBJECTIVE:To compare outcomes and complication rates between patients with and without Parkinson's disease (PD) patients undergoing surgery for adult spinal deformity (ASD). SUMMARY OF BACKGROUND DATA:There is limited literature evaluating the impact of PD on long-term outcomes af...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002998
更新日期:2019-07-15 00:00:00
abstract:STUDY DESIGN:A literature-based review. OBJECTIVES:To review management and controversies and to present authors recommendations. SUMMARY OF BACKGROUND DATA:There is considerable controversy regarding indication for surgery, role for decompression alone, and decompression with fusion with or without instrumentation. ...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/01.brs.0000155579.88537.8e
更新日期:2005-03-15 00:00:00
abstract:STUDY DESIGN:In vitro study to determine occupational radiation exposure during lumbar fluoroscopy. OBJECTIVES:To assess radiation exposure to the spine surgeon during fluoroscopically assisted thoracolumbar pedicle screw placement. SUMMARY OF BACKGROUND DATA:Occupational radiation exposure during a variety of fluoro...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200010150-00016
更新日期:2000-10-15 00:00:00
abstract:STUDY DESIGN:Case report. OBJECTIVE:To describe a patient with ischemic orbital compartment syndrome after undergoing spinal surgery in a prone position. SUMMARY OF BACKGROUND DATA:Ocular complications after nonocular surgery are devastating. The most common etiology is ischemic optic neuropathy. Orbital compartment ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31817c55c2
更新日期:2008-07-15 00:00:00
abstract:STUDY DESIGN:Cadaveric in vitro computed tomography (CT) imaging study. OBJECTIVE:To examine minimum pedicle diameter from transverse and coronal CT reconstructions of thoracolumbar spine specimens and compare their degree of disparity, if any. Pedicle angulation in coronal and transverse planes was measured and their...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001628
更新日期:2016-11-15 00:00:00
abstract::An electronic bone growth stimulator (EBGS) had been devised to facilitate lumbosacral fusion in the early 1970s, using a totally implanted device which delivers a steady 5 microA at each of four cathodes. The use of the device is reserved for patients in whom painful and abnormal motion is demonstrated to be the majo...
journal_title:Spine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007632-198803000-00026
更新日期:1988-03-01 00:00:00
abstract:STUDY DESIGN:A case report. OBJECTIVE:To describe an effective surgical option for sacral tuberculosis (TB). SUMMARY OF BACKGROUND DATA:Sacral TB is a rare cause of low back pain. A differential diagnosis of TB should always be made, especially in India where TB cases are on a rampant rise with increasing drug resist...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182540579
更新日期:2012-06-15 00:00:00
abstract:STUDY DESIGN:Longitudinal repeated-measures; within-subject control. OBJECTIVE:We examined the extent to which an isometric plantar flexion training protocol attenuates bone loss longitudinally after SCI. SUMMARY OF BACKGROUND DATA:After spinal cord injury (SCI), bone mineral density (BMD) of paralyzed extremities ra...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000201303.49308.a8
更新日期:2006-03-01 00:00:00
abstract:STUDY DESIGN:A retrospective, multicenter, case-controlled study. OBJECTIVE:The aim of this study was to investigate the clinical and radiographical differences between thoracic idiopathic spinal cord herniation (ISCH) and spinal arachnoid cyst (SAC). SUMMARY OF BACKGROUND DATA:ISCH and SAC are relatively rare diseas...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002013
更新日期:2017-08-15 00:00:00
abstract:STUDY DESIGN:An in vivo model of scoliosis was established in immature goats. OBJECTIVE:To assess the feasibility, reliability, and complications of the innovative animal model. SUMMARY OF BACKGROUND DATA:Among the methods of creating a scoliotic model, posterior asymmetric tethering of spine yielded encouraging resu...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181b1fdd0
更新日期:2009-10-01 00:00:00
abstract:STUDY DESIGN:A prospective, within-patient comparison of two methods for functional radiography of lumbar spine with consecutive patients. OBJECTIVE:To evaluate the usefulness of traction-compression radiography compared with conventional flexion-extension radiography in diagnosis of lumbar spinal instability. SUMMAR...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199701150-00012
更新日期:1997-01-15 00:00:00
abstract:STUDY DESIGN:An in vitro biologic study of the effects of adenovirus expressing bone morphogenetic proteins (BMPs) and adenovirus expressing Sox9 on extracellular matrix metabolism by bovine nucleus pulposus cells. OBJECTIVE:To compare the effects of recombinant adenoviral vectors expressing various BMPs (2, 3, 4, 5, ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000232792.66632.d8
更新日期:2006-09-01 00:00:00
abstract:STUDY DESIGN:T1rho relaxation was quantified and correlated with intervertebral disc degeneration and proteoglycan content in cadaveric human lumbar spine tissue. OBJECTIVE:To show the use of T1rho-weighted magnetic resonance imaging (MRI) for the assessment of degeneration and proteoglycan content in the human interv...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000217708.54880.51
更新日期:2006-05-15 00:00:00
abstract::Two hundred five patients with neck pain were evaluated clinically and roentgenographically for a minimum of 10 years after onset of symptoms. Seventy-nine percent had a decrease in pain, and 43% were free of pain; however, 32% had moderate or severe residual pain. Patients who had been injured and initially had sever...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198701000-00001
更新日期:1987-01-01 00:00:00
abstract:STUDY DESIGN:To report a new index, the K-line, for deciding the surgical approach for cervical ossification of the posterior longitudinal ligament (OPLL). OBJECTIVE:To analyze the correlation between the K-line-based classification of cervical OPLL patients and their surgical outcome. SUMMARY OF BACKGROUND DATA:Prev...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318188b300
更新日期:2008-12-15 00:00:00
abstract:STUDY DESIGN:This study developed and independently applied a spine tumor classification system, referred to as the Weinstein-Boriani-Biagini system, in a retrospective analysis of a series of patients with spinal giant cell tumors from three institutions. OBJECTIVE:To evaluate factors of potential prognostic signific...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199708010-00018
更新日期:1997-08-01 00:00:00
abstract:STUDY DESIGN:This study is an analysis of national survey data from 5 sample years. OBJECTIVES:The authors characterized the frequency of office visits for low back pain, the content of ambulatory care, and how these vary by physician specialty. SUMMARY OF BACKGROUND DATA:Few recent data are available regarding ambul...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199501000-00003
更新日期:1995-01-01 00:00:00
abstract:STUDY DESIGN:Prospective consecutive series. OBJECTIVE:To evaluate the efficacy of minimal invasive surgery for acute lumbar fractures by means of balloon kyphoplasty with calcium phosphate plus segmental short posterior instrumented fusion. SUMMARY OF BACKGROUND DATA:In the surgical treatment of lumbar fractures wit...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318166e0bb
更新日期:2008-03-15 00:00:00
abstract:STUDY DESIGN:Retrospective review of prospectively-collected, multicenter adult spinal deformity (ASD) database. OBJECTIVE:The aim of this study was to evaluate the rate of patients who accrue catastrophic cost (CC) with ASD surgery utilizing direct, actual costs, and determine the feasibility of predicting these outl...
journal_title:Spine
pub_type: 杂志文章,多中心研究
doi:10.1097/BRS.0000000000003242
更新日期:2020-03-01 00:00:00
abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:To evaluate the clinical outcomes of 4 different procedures for the treatment of adjacent multisegmental spinal tuberculosis (AMSST) and to investigate the selection strategy of the optimal procedure with respect to focal characteristics. SUMMARY OF BACKGROUND DATA:Because ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000000053
更新日期:2014-01-01 00:00:00
abstract:STUDY DESIGN:Retrospective analysis of prospective data. OBJECTIVE:To assess the relationship between MRI signal intensity changes, clinical presentation, and surgical outcome in degenerative cervical myelopathy (DCM). SUMMARY OF BACKGROUND DATA:Several studies have sought to assess the extent of spinal cord dysfunct...
journal_title:Spine
pub_type: 杂志文章,多中心研究
doi:10.1097/BRS.0000000000002234
更新日期:2017-12-15 00:00:00
abstract:STUDY DESIGN:A study examining the clinical protocol of scoliosis wound irrigation, demonstrating povidone-iodine's (PVI) effect on human osteoblast cells. Primary and immortal cell line osteoblasts were treated with 0.35% PVI for 3 minutes, and analyzed for proliferation rate, oxidative capacity, and mineralization. ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001332
更新日期:2016-05-01 00:00:00
abstract:STUDY DESIGN:A case series is reported. OBJECTIVE:To improve understanding of the potential mechanisms associated with cerebral microemboli during scoliosis surgery in adolescents. SUMMARY OF BACKGROUND DATA:Paradoxical cerebral fat microembolization during scoliosis surgery has been associated with right-to-left shu...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200108010-00017
更新日期:2001-08-01 00:00:00
abstract::Microlumbar discectomy is a new surgical technique for the treatment of herniated lumbar disc. The operating microscope and special instruments enable the surgeon to remove the herniated portion of the disc without laminectomy through a 1-inch skin incision. A transfusion was never necessary. In a followup study of 14...
journal_title:Spine
pub_type: 杂志文章
doi:
更新日期:1978-06-01 00:00:00
abstract:STUDY DESIGN:A case report and review of the literature are presented. OBJECTIVE:To describe an extremely rare case of combined extraforaminal and intradiscal cement leakage in different vertebral levels following percutaneous vertebroplasty. SUMMARY OF BACKGROUND DATA:Cement leaks in vertebroplasty are relatively co...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/BRS.0b013e31805c0b25
更新日期:2007-05-20 00:00:00
abstract::Neurologic complications resulting from surgery for 384 cases of cervical myelopathy (cervical soft disc herniation, spondylosis, ossification of the posterior longitudinal ligament) were reviewed. Surgical procedures performed included 134 anterior interbody fusions (Cloward or Robinson-Smith technique), 70 subtotal ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199111000-00006
更新日期:1991-11-01 00:00:00
abstract::Improving spinal fusion by optimizing scaffold and surface engineering is a topic of interest for both surgeons and researchers. Concerns regarding patient safety with off-label use of bone morphogenetic protein (BMP) have increased, and patients are choosing minimally invasive spine surgery to lessen morbidity by avo...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001426
更新日期:2016-04-01 00:00:00
abstract:STUDY DESIGN:The classification system was derived through a literature review and expert opinion of experienced spine surgeons. In addition, a multicenter reliability and validity study of the system was conducted on a collection of trauma cases. OBJECTIVES:To define a novel classification system for subaxial cervica...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/BRS.0b013e3181557b92
更新日期:2007-10-01 00:00:00
abstract:STUDY DESIGN:Prospective cohort study. OBJECTIVES:To investigate whether physical performance, grip strength, cognitive function, and depression symptomatology are risk factors for incident low back pain (LBP) over a 2-year period in seniors. SUMMARY OF BACKGROUND DATA:LBP is common in the older age groups, but littl...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000222021.00531.ea
更新日期:2006-06-15 00:00:00