Intraoperative waste in spine surgery: incidence, cost, and effectiveness of an educational program.

Abstract:

STUDY DESIGN:Prospective observational study. OBJECTIVE:This study aims to quantify the incidence of intraoperative waste in spine surgery and to examine the efficacy of an educational program directed at surgeons to induce a reduction in the intraoperative waste. SUMMARY OF BACKGROUND DATA:Spine procedures are associated with high costs. Implants are a main contributor of these costs. Intraoperative waste further exacerbates the high cost of surgery. METHODS:Data were collected during a 25-month period from one academic medical center (15-month observational period, 10-month post-awareness program). The total number of spine procedures and the incidence of intraoperative waste were recorded prospectively. Other variables recorded included the type of product wasted, cost associated with the product or implant wasted, and reason for the waste. RESULTS:Intraoperative waste occurred in 20.2% of the procedures prior to the educational program and in 10.3% of the procedures after the implementation of the program (P < 0.0001). Monthly costs associated with surgical waste were, on average, $17680 prior to the awareness intervention and $5876 afterwards (P = 0.0006). Prior to the intervention, surgical waste represented 4.3% of total operative spine budget. After the awareness program this proportion decrease to an average of 1.2% (P = 0.003). CONCLUSION:Intraoperative waste in spine surgery exacerbates the already costly procedures. Extrapolation of this data to the national level leads to an annual estimate of $126,722,000 attributable to intraoperative spine waste. A simple educational program proved to be and continues to be effective in making surgeons aware of the import of their choices and the costs related to surgical waste.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Soroceanu A,Canacari E,Brown E,Robinson A,McGuire KJ

doi

10.1097/BRS.0b013e31822a58c1

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

E1270-3

issue

19

eissn

0362-2436

issn

1528-1159

journal_volume

36

pub_type

杂志文章

相关文献

SPINE文献大全
  • Multiple vertebral osteotomies in the treatment of rigid adult spine deformities.

    abstract:STUDY DESIGN:Retrospective review of the clinical and radiographic results in adult revision spine deformity surgery using the techniques of osteotomies to effect spine balance and curve correction. OBJECTIVES:To assess the efficacy of multiple vertebral osteotomies in correction of rigid spine deformities in adult pa...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-200103010-00016

    authors: Voos K,Boachie-Adjei O,Rawlins BA

    更新日期:2001-03-01 00:00:00

  • Safety and efficacy of 1-stage surgical treatment of congenital spinal deformity associated with split spinal cord malformation.

    abstract:STUDY DESIGN:Retrospective clinical study. OBJECTIVE:The aim of this study was to evaluate retrospectively the safety and efficacy of 1-stage surgical treatment of 45 consecutive patients, who had progressive congenital spinal deformity associated with split spinal cord malformation (SSCM). SUMMARY OF BACKGROUND DATA...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e3182608988

    authors: Hui H,Tao HR,Jiang XF,Fan HB,Yan M,Luo ZJ

    更新日期:2012-12-01 00:00:00

  • Intradural venous varix: a rare cause of an intradural lumbar spine lesion.

    abstract:STUDY DESIGN:A case of intradural venous varix producing a mass-like lesion in the lumbar spine is reported. OBJECTIVE:To present a rare cause of an intradural mass lesion along the cauda equina. To present radiologic findings of this entity and to offer a hypothesis for its formation. SUMMARY OF BACKGROUND DATA:Epid...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.BRS.0000085359.59829.44

    authors: Moonis G,Hurst RW,Simon SL,Zager EL

    更新日期:2003-10-15 00:00:00

  • Degenerative spondylolisthesis. To fuse or not to fuse.

    abstract::Two groups of surgically treated patients with degenerative spondylolisthesis were compared. Those who had decompression accompanied by fusion had more favorable outcomes than those treated with decompression alone. ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:

    authors: Feffer HL,Wiesel SW,Cuckler JM,Rothman RH

    更新日期:1985-04-01 00:00:00

  • Pathogenesis of sciatic pain: a study of spontaneous behavior in rats exposed to experimental disc herniation.

    abstract:STUDY DESIGN:A new way to study pain in experimental animals without handling of the animals and based on registration of spontaneous behavior using video recordings. OBJECTIVES:To evaluate if experimental disc herniation in the rat may induce changes in spontaneous behavior. SUMMARY OF BACKGROUND DATA:The knowledge ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-200206150-00013

    authors: Olmarker K,Størkson R,Berge OG

    更新日期:2002-06-15 00:00:00

  • Radiographic measurement parameters in thoracolumbar fractures: a systematic review and consensus statement of the spine trauma study group.

    abstract:STUDY DESIGN:Systematic review. OBJECTIVES:To review the various radiographic parameters currently used to assess traumatic thoracolumbar injuries, emphasizing the validity and technique behind each one, to formulate evidence-based guidelines for a standardized radiographic method of assessment of these fractures. SU...

    journal_title:Spine

    pub_type: 杂志文章,多中心研究,评审

    doi:10.1097/01.brs.0000201261.94907.0d

    authors: Keynan O,Fisher CG,Vaccaro A,Fehlings MG,Oner FC,Dietz J,Kwon B,Rampersaud R,Bono C,France J,Dvorak M

    更新日期:2006-03-01 00:00:00

  • Seven- to 10-year outcome of decompressive surgery for degenerative lumbar spinal stenosis.

    abstract:STUDY DESIGN:Retrospective review and prospective follow-up of 88 patients who had decompressive laminectomy with or without fusion from 1983 to 1986. OBJECTIVE:To determine the 7- to 10-year outcome of surgery for degenerative lumbar spinal stenosis. SUMMARY OF BACKGROUND DATA:There is limited information on the imp...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199601010-00022

    authors: Katz JN,Lipson SJ,Chang LC,Levine SA,Fossel AH,Liang MH

    更新日期:1996-01-01 00:00:00

  • A pilot study evaluating the safety and efficacy of OP-1 Putty (rhBMP-7) as a replacement for iliac crest autograft in posterolateral lumbar arthrodesis for degenerative spondylolisthesis.

    abstract:STUDY DESIGN:A prospective, randomized, controlled, multicenter clinical study was conducted. OBJECTIVE:To compare the clinical and radiographic outcomes of patients treated with OP-1 (BMP-7) Putty to autogenous iliac crest bone graft for one-level uninstrumented posterolateral fusion of the lumbar spine following dec...

    journal_title:Spine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.brs.0000137062.79201.98

    authors: Vaccaro AR,Patel T,Fischgrund J,Anderson DG,Truumees E,Herkowitz HN,Phillips F,Hilibrand A,Albert TJ,Wetzel T,McCulloch JA

    更新日期:2004-09-01 00:00:00

  • Selective lumbosacral radiculography and block.

    abstract::Selective lumbosacral radiculography and block was performed on 106 patients, using 60% Conray or Dimer-X and 1% lidocaine mixed with corticosteroid. The technique of this method is reported, and the radiculographic findings and diagnostic value of this method are discussed. According to our experience, this method is...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-198001000-00013

    authors: Tajima T,Furukawa K,Kuramochi E

    更新日期:1980-01-01 00:00:00

  • A dynamic approach to spinal instability. Part I: Sensitization of intersegmental motion profiles to motion direction and load condition by instability.

    abstract:STUDY DESIGN:Human lumbar functional spinal units (FSUs) were moved throughout their range of motion in sagittal and lateral bending while the dynamics of this movement were computed in vitro. Functional spinal units were tested intact and after subsequent discectomy and unilateral facetectomy. OBJECTIVE:To establish ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199712150-00007

    authors: Ogon M,Bender BR,Hooper DM,Spratt KF,Goel VK,Wilder DG,Pope MH

    更新日期:1997-12-15 00:00:00

  • Virtual fluoroscopy: computer-assisted fluoroscopic navigation.

    abstract:STUDY DESIGN:In vitro accuracy assessment of a novel virtual fluoroscopy system. OBJECTIVES:To investigate a new technology combining image-guided surgery with C-arm fluoroscopy. SUMMARY OF BACKGROUND DATA:Fluoroscopy is a useful and familiar technology to all musculoskeletal surgeons. Its limitations include radiati...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-200102150-00009

    authors: Foley KT,Simon DA,Rampersaud YR

    更新日期:2001-02-15 00:00:00

  • The trabecular anatomy of the axis.

    abstract::This article describes the internal anatomy of C2. Although some C2 specimens showed a high density of trabecular bone throughout, a feature noted in all specimens was a void or very hypodense area of bone located immediately beneath the dens. The observed nonuniform distribution of trabecular bone within the axis is ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199310001-00003

    authors: Heggeness MH,Doherty BJ

    更新日期:1993-10-15 00:00:00

  • A new concept for making decisions regarding the surgical approach for cervical ossification of the posterior longitudinal ligament: the K-line.

    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

    authors: Fujiyoshi T,Yamazaki M,Kawabe J,Endo T,Furuya T,Koda M,Okawa A,Takahashi K,Konishi H

    更新日期:2008-12-15 00:00:00

  • Clinical and experimental studies on permeability of tracers in normal spinal cord and syringomyelia.

    abstract::Delayed CT Myelography (CTM) demonstrated intramedullary cavities in 18 patients, most of which appeared on the 6-hour scan. The attenuation values of the normal spinal cord increased progressively with time, and recorded a peak at 6 hours. The CT numbers of the gray matter of metrizamide were significantly high, as c...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-198807000-00005

    authors: Ikata T,Masaki K,Kashiwaguchi S

    更新日期:1988-07-01 00:00:00

  • A comparison of methods for measuring trunk list. A simple plumbline is the best.

    abstract:STUDY DESIGN:Trunk list was measured using three different techniques to compare accuracy, precision, and ease of use. OBJECTIVE:To obtain a reproducible technique for further studies of the nature, cause, and clinical relevance of trunk list. SUMMARY OF BACKGROUND DATA:Gravity-induced trunk list is a clinical sign t...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199607150-00011

    authors: McLean IP,Gillan MG,Ross JC,Aspden RM,Porter RW

    更新日期:1996-07-15 00:00:00

  • Back schools for nonspecific low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group.

    abstract:STUDY DESIGN:A systematic review within the Cochrane Collaboration Back Review Group. OBJECTIVES:To assess the effectiveness of back schools for patients with nonspecific low back pain (LBP). SUMMARY OF BACKGROUND DATA:Since the introduction of the Swedish back school in 1969, back schools have frequently been used f...

    journal_title:Spine

    pub_type: 杂志文章,评审

    doi:10.1097/01.brs.0000182227.33627.15

    authors: Heymans MW,van Tulder MW,Esmail R,Bombardier C,Koes BW

    更新日期:2005-10-01 00:00:00

  • Surgical anatomy of the vertebral arteries.

    abstract:STUDY DESIGN:This study compared direct measurements of the distances between the vertebral arteries in the cervical spines of human cadaver specimens with data obtained from axial computed tomography images of these specimens. OBJECTIVE:To determine whether the information obtained from a computed tomography scan can...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199609150-00004

    authors: Heary RF,Albert TJ,Ludwig SC,Vaccaro AR,Wolansky LJ,Leddy TP,Schmidt RR

    更新日期:1996-09-15 00:00:00

  • Sacropelvic fixation: techniques and complications.

    abstract:STUDY DESIGN:Literature-based topic review. OBJECTIVE:To review the indications and techniques for different sacropelvic fixation methods and to outline important associated complications. SUMMARY OF BACKGROUND DATA:Despite all the advances and new developments in spinal instrumentation techniques, fixation at the lu...

    journal_title:Spine

    pub_type: 杂志文章,评审

    doi:10.1097/BRS.0b013e3181f5cfae

    authors: Kebaish KM

    更新日期:2010-12-01 00:00:00

  • The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions.

    abstract:STUDY DESIGN:Asymptomatic volunteers underwent magnetic resonance imaging to investigate how different positions affect lumbar intervertebral discs. OBJECTIVE:To quantify sagittal migration of the lumbar nucleus pulposus in 6 functional positions. SUMMARY OF BACKGROUND DATA:Previous studies of the intervertebral disc...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e318067dccb

    authors: Alexander LA,Hancock E,Agouris I,Smith FW,MacSween A

    更新日期:2007-06-15 00:00:00

  • Flexibility of scoliosis. What does it mean? Is this terminology appropriate?

    abstract::This work is a critical analysis of the term "flexibility of scoliosis." The authors demonstrate that this measure includes two very different and noncorrelated phenomena: the collapse and the reducibility of the structural curve. In 228 paralytic curves, these two phenomena were quantified and correlated with differe...

    journal_title:Spine

    pub_type: 杂志文章

    doi:

    authors: Duval-Beaupère G,Lespargot A,Grossiord A

    更新日期:1985-06-01 00:00:00

  • The effect of body position and axial load on spinal canal morphology: an MRI study of central spinal stenosis.

    abstract:STUDY DESIGN:A method comparison study. OBJECTIVE:To investigate the effect of body position and axial load of the lumbar spine on disc height, lumbar lordosis, and dural sac cross-sectional area (DCSA). SUMMARY OF BACKGROUND DATA.: The effects of flexion and extension on spinal canal diameters and DCSA are well docum...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31815e395f

    authors: Madsen R,Jensen TS,Pope M,Sørensen JS,Bendix T

    更新日期:2008-01-01 00:00:00

  • Somatosensory cortical evoked potential changes after deformity correction.

    abstract::The somatosensory cortical evoked potentials recorded during posterior spine fusion and instrumentation for 99 consecutive patients with idiopathic scoliosis, 18 years of age or younger, were retrospectively reviewed. The potentials were recorded from scalp electrodes while synchronously stimulating both tibial nerves...

    journal_title:Spine

    pub_type: 杂志文章

    doi:

    authors: Albanese SA,Spadaro JA,Lubicky JP,Henderson NA

    更新日期:1991-08-01 00:00:00

  • Stress analysis of the lumbar disc-body unit in compression. A three-dimensional nonlinear finite element study.

    abstract::It has been argued that a clarification of the mechanical causes of low-back pain requires a knowledge of the states of stress and strain throughout the lumbo-sacral spine. Since a purely experimental approach cannot provide this information, analytical model studies, to supplement measurements, are called for. In the...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-198403000-00003

    authors: Shirazi-Adl SA,Shrivastava SC,Ahmed AM

    更新日期:1984-03-01 00:00:00

  • The use of dermatomal evoked responses during surgical procedures that use intrapedicular fixation of the lumbosacral spine.

    abstract::Monitoring of electrophysiologic function during intrapedicular fixation of the lumbosacral spine can be useful because this fixation technique has been associated with a significant number of postoperative radicular complications. Somatosensory evoked potentials (SEPs) traditionally have been used to monitor neurolog...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/00007632-199312000-00006

    authors: Toleikis JR,Carlvin AO,Shapiro DE,Schafer MF

    更新日期:1993-12-01 00:00:00

  • Magnetic transcranial brain stimulation: painless evaluation of central motor pathways. Normal values and clinical application in spinal cord diagnostics: upper extremities.

    abstract::Painless transcranial magnetic stimulation has been performed on 53 healthy adults in order to obtain normal values of central motor pathway conduction times to cervical segments innervating upper limb muscles. Central motor latency was 5.1 msec when recording from the biceps brachii and 5.2 msec when recording from t...

    journal_title:Spine

    pub_type: 杂志文章

    doi:

    authors: Dvorák J,Herdmann J,Theiler R

    更新日期:1990-03-01 00:00:00

  • Correlation of vertebral strength topography with 3-dimensional computed tomographic structure.

    abstract:STUDY DESIGN:Biomechanical and radiographical study. OBJECTIVE:To test the hypothesis that stiffness and strength at discrete sites of human lumbar vertebrae depend on the 3-dimentional structure and density of the vertebral-body bone elements, and can be evaluated using models based on vertebral bone characteristics ...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0b013e31826c670d

    authors: Noshchenko A,Plaseied A,Patel VV,Burger E,Baldini T,Yun L

    更新日期:2013-02-15 00:00:00

  • Assessment of pedicle screw placement utilizing conventional radiography and computed tomography: a proposed systematic approach to improve accuracy of interpretation.

    abstract:STUDY DESIGN:This was a human cadaver study to determine the accuracy of conventional radiography and computed radiography in the evaluation of pedicle screw placement and to identify methodology for more precise reading of these examinations. OBJECTIVES:To determine the accuracy of conventional radiography and comput...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.brs.0000112071.69448.a1

    authors: Learch TJ,Massie JB,Pathria MN,Ahlgren BA,Garfin SR

    更新日期:2004-04-01 00:00:00

  • Denosumab Treatment for Giant Cell Tumor of the Spine Including the Sacrum.

    abstract:STUDY DESIGN:This was a subanalysis of an international, multicenter, open-label study. OBJECTIVE:The aim of this study was to assess the efficacy and safety of denosumab in a subset of patients with giant cell tumors of bone (GCTB) of the spine including the sacrum from an international, open-label, single-arm, phase...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/BRS.0000000000003728

    authors: Bukata SV,Blay JY,Rutkowski P,Skubitz K,Henshaw R,Seeger L,Dai T,Jandial D,Chawla S

    更新日期:2020-10-08 00:00:00

  • Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury: a randomized prospective study in beagle dogs.

    abstract:STUDY DESIGN:Experimental dog model of acute spinal cord injury. OBJECTIVE:To compare the relative value of methylprednisolone, surgical decompression, or both for the treatment of traumatic spinal cord injury. SUMMARY OF BACKGROUND DATA:Acute spinal cord injury results from both primary damage to the spinal cord at ...

    journal_title:Spine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/BRS.0b013e31818786db

    authors: Rabinowitz RS,Eck JC,Harper CM Jr,Larson DR,Jimenez MA,Parisi JE,Friedman JA,Yaszemski MJ,Currier BL

    更新日期:2008-10-01 00:00:00

  • Outcomes of workers' compensation claimants with low back pain undergoing intradiscal electrothermal therapy.

    abstract:STUDY DESIGN:Case series. OBJECTIVE:To describe the outcomes of workers' compensation (WC) claimants who have had a lumbar intradiscal electrothermal therapy (IDET) procedure. SUMMARY OF BACKGROUND DATA:IDET was developed as a less invasive treatment alternative to fusion after failure of conservative treatment for d...

    journal_title:Spine

    pub_type: 杂志文章

    doi:10.1097/01.brs.0000092376.41688.1a

    authors: Webster BS,Verma S,Pransky GS

    更新日期:2004-02-15 00:00:00