Abstract:
STUDY DESIGN:Retrospective review of prospectively collected data. OBJECTIVE:Assess outcomes of adult spinal deformity (ASD) surgery performed by one versus two attending surgeons. SUMMARY OF BACKGROUND DATA:ASD centers have developed two attending teams to improve efficiency; their effects on complications and outcomes have not been reported. METHODS:Patients with ASD with five or more levels fused and more than 2-year follow-up were included. Estimated blood loss (EBL), length of stay (LOS), operating room (OR) time, complications, quality of life (Health Related Quality of Life), and x-rays were analyzed. Outcomes were compared between one-surgeon (1S) and two-surgeon (2S) centers. A deformity-matched cohort was analyzed. RESULTS:A total of 188 patients in 1S and 77 in 2S group were included. 2S group patients were older and had worse deformity based on the Scoliosis Research Society-Schwab classification (P < 0.05). There were no significant differences in levels fused (P = 0.57), LOS (8.7 vs 8.9 days), OR time (445.9 vs 453.2 min), or EBL (2008 vs 1898 cm; P > 0.05). 2S patients had more three-column osteotomies (3CO; P < 0.001) and used less bone morphogenetic protein 2 (BMP-2; 79.9% vs 15.6%; P < 0.001). The 2S group had fewer intraoperative complications (1.3% vs 11.1%; P = 0.006). Postoperative (6 wk to 2 yr) complications were more frequent in the 2S group (4.8% vs 15.6%; P < 0.002). After matching for deformity, there were no differences in (9.1 vs 10.1 days), OR time (467.8 vs 508.4 min), or EBL (3045 vs 2247 cm; P = 0.217). 2S group used less BMP-2 (20.6% vs 84.8%; P < 0.001), had fewer intraoperative complications (P = 0.015) but postoperative complications due to instrumentation failure/pseudarthrosis were more frequent (P < 0.01). CONCLUSION:No significant differences were found in LOS, OR time, or EBL between the 1S and 2S groups, even when matching for severity of deformity. 2S group had less BMP-2 use, fewer intraoperative complications but more postoperative complications. LEVEL OF EVIDENCE:2.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Gomez JA,Lafage V,Scuibba DM,Bess S,Mundis GM Jr,Liabaud B,Hanstein R,Shaffrey C,Kelly M,Ames C,Smith JS,Passias PG,Errico T,Schwab F,International Spine Study Group.doi
10.1097/BRS.0000000000002071subject
Has Abstractpub_date
2017-07-01 00:00:00pages
992-998issue
13eissn
0362-2436issn
1528-1159pii
00007632-201707010-00010journal_volume
42pub_type
杂志文章,多中心研究相关文献
SPINE文献大全abstract::The effect of partial chest wall resection on subsequent production of spinal deformity was studied in six pediatric patients. The following observations are made: Scoliosis secondary to chest wall resection in the pediatric age group is progressive. The degree of curvature is related to the number of ribs resected. A...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198509000-00005
更新日期:1985-09-01 00:00:00
abstract:STUDY DESIGN:This case report shows primary natural killer (NK)/T-cell lymphoma originating in the spine as the first case of successful treatment with autologous stem cell transplantation, along with case presentation and literature review. OBJECTIVE:For the proper treatment of this spinal tumor, the pathologic confi...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182407b0b
更新日期:2012-05-01 00:00:00
abstract:STUDY DESIGN:A 12-year prospective study of pre-existing and de novo degenerative lumbar scoliosis (DLS) among community-based female volunteers. OBJECTIVE:To investigate serial entire spine radiographs of healthy female volunteers and to clarify radiographical characteristics and predictors of pre-existing and de nov...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182575eaa
更新日期:2012-09-15 00:00:00
abstract:STUDY DESIGN:Investigation on architecture of lumbar pedicle. OBJECTIVE:To determine morphological properties of pedicular cancellous bone. SUMMARY OF BACKGROUND DATA:Many researchers have been stimulated to study trabecular architecture by improvements in stereological technology. Although the structure of vertebral...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000168373.24644.9f
更新日期:2005-07-01 00:00:00
abstract::Idiopathic juvenile osteoporosis is an unusual condition appearing in the prepubertal child who is otherwise normal. Characteristically, the condition is of variable severity and of limited duration and always affect the spine. One of the major complications of idiopathic juvenile osteoporosis has been residual kyphos...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198101000-00001
更新日期:1981-01-01 00:00:00
abstract:STUDY DESIGN:Case report. OBJECTIVE:To describe a rare case of tenosynovial giant cell tumor, diffuse type/pigmented villonodular synovitis (PVNS) in a pars defect in a patient with lumbar spondylolysis. SUMMARY OF BACKGROUND DATE:PVNS rarely occurred in lumbar spine, and no studies in the English literature have rep...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000000923
更新日期:2015-06-15 00:00:00
abstract:STUDY DESIGN:A three-dimensional, nonlinear finite element analysis was performed to predict the in situ contact interaction of prosthesis components of the Prodisc-L in a multisegmental lumbar model following total disc replacement (TDR). OBJECTIVE:Efforts were made to investigate how the TDR implant contact characte...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181ae23d1
更新日期:2009-09-15 00:00:00
abstract:STUDY DESIGN:In vitro biomechanical investigation. OBJECTIVE:To assess differences in kyphosis after balloon kyphoplasty (BKP) or vertebral body stenting (VBS). SUMMARY OF BACKGROUND DATA:Cement augmentation techniques allow early mobilization in patients with osteoporotic thoracolumbar fractures. Biomechanically, th...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000000470
更新日期:2014-09-01 00:00:00
abstract:STUDY DESIGN:A prospective study of patients whose spinal cord tumors were managed surgically with a unique posterior method of removing and replacing the posterior spinal elements using T-saw ("recapping T-saw laminoplasty"). OBJECTIVES:To examine the safety and efficacy of the recapping T-saw laminoplasty technique ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199907010-00015
更新日期:1999-07-01 00:00:00
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
更新日期:2004-02-15 00:00:00
abstract:STUDY DESIGN:Cadaveric laboratory study. OBJECTIVE:To compare the accuracy, efficiency, and safety of intraoperative cone beam-computed tomography with navigation (O-ARM) with traditional intraoperative fluoroscopy (C-ARM) for the placement of pedicle screws. SUMMARY OF BACKGROUND DATA:Radiation exposure remains a co...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182a51d1e
更新日期:2013-10-15 00:00:00
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
更新日期:1993-10-15 00:00:00
abstract:STUDY DESIGN:Case report. OBJECTIVE:To report a case of an acute intracranial subdural hematoma that formed due to cerebrospinal fluid (CSF) leak following lumbar surgery. SUMMARY OF BACKGROUND DATA:Intracranial hypotension may occur when CSF is removed from the subarachnoid space. Intracranial subdural hematoma form...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000192208.66360.29
更新日期:2005-12-15 00:00:00
abstract:STUDY DESIGN:This was an experimental study to compare various methods of storing rib autograft between stages of spinal surgery. OBJECTIVE:The authors' goal was to determine the optimum conditions for storing bone graft, while preserving its osteogenic potential. SUMMARY OF BACKGROUND DATA:It never has been demonstr...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199404000-00004
更新日期:1994-04-01 00:00:00
abstract:STUDY DESIGN:A prospective, randomized, controlled, multicenter clinical study. OBJECTIVE:To evaluate the safety and feasibility of osteogenic protein (OP)-1 in 1-level lumbar spine instrumented posterolateral fusions. SUMMARY OF BACKGROUND DATA:Instrumented posterolateral fusion with the use of autograft is a common...
journal_title:Spine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/BRS.0b013e3181d3cf28
更新日期:2010-05-20 00:00:00
abstract:STUDY DESIGN:Randomized controlled trial. OBJECTIVES:To compare high- and low-intensity back schools with usual care in occupational health care. SUMMARY OF BACKGROUND DATA:The content and intensity of back schools vary widely and the methodologic quality of randomized controlled trials is generally weak. Until now, ...
journal_title:Spine
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.brs.0000216443.46783.4d
更新日期:2006-05-01 00:00:00
abstract:STUDY DESIGN:In vivo measurements of low back flexion posture and muscle activity before, during, and after static flexion. OBJECTIVE:To identify the occurrence of creep and muscle fatigue development in the low back during static upper body deep flexion that resembled an above ground work posture. SUMMARY OF BACKGRO...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181aa6a55
更新日期:2009-08-01 00:00:00
abstract:STUDY DESIGN:Retrospective review. OBJECTIVE:To assess the effectiveness of apical lordosating osteotomy (ALO) and minimal segment fixation through a posterior approach for correcting thoracic or thoracolumbar osteoporotic kyphosis (OK). SUMMARY OF BACKGROUND DATA:Current surgical options for OK involve a risk of com...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000170450.77554.bc
更新日期:2005-07-15 00:00:00
abstract::In this study, the authors evaluated the stiffness of motion segments in intact spines in two spine fracture models, and with each of five implant systems used for posterior fixation of thoracolumbar spine fractures. The devices represented a cross-section of types, including those employing sublaminar wires with and ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198805000-00003
更新日期:1988-05-01 00:00:00
abstract:STUDY DESIGN:Controlled laboratory study in a cadaveric model. OBJECTIVE:To determine if removing shoulder pads using the elevated torso technique generated less spinal segment motion than using the flat torso method. SUMMARY OF BACKGROUND DATA:Guidelines for care of the injured football player with a suspected spina...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31819794e7
更新日期:2009-04-01 00:00:00
abstract:STUDY DESIGN:Retrospective analysis of computed tomographic images of 92 normal pediatric cervical vertebrae. OBJECTIVE:The aim of this study was to ascertain the feasibility of the pedicle, intralaminar, and lateral mass screws fixation in children. SUMMARY OF BACKGROUND DATA:Fixation techniques of C7 vertebrae are ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002742
更新日期:2018-12-15 00:00:00
abstract:STUDY DESIGN:A retrospective review of a case of coccygodynia caused by a previously unreported coccygeal morphology. OBJECTIVES:To draw attention to a previously undiagnosed pathology. BACKGROUND:This case adds to the recently described variants of coccygeal anatomy. METHODS:The authors present the case of a 42-yea...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000127194.97062.17
更新日期:2004-06-15 00:00:00
abstract::Since abnormal motion is a quantitative phenomenon and present primarily in the two lowest vertebral spaces, a roentgen examination method yielding the maximum mobility would appear to be suitable. When performing extension-flexion radiographs of the lumbar spine, positioning of patients varies considerably. The prese...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199002000-00011
更新日期:1990-02-01 00:00:00
abstract:STUDY DESIGN:The distribution of the lumbar plexus was analyzed using cadavers. OBJECTIVE:To clarify the safety zone to prevent nerve injuries with respect to retroperitoneal endoscopic surgery. SUMMARY OF BACKGROUND DATA:Surgical approaches to the retroperitoneal space vary among surgeons. Recently, retroperitoneal ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.BRS.0000049226.87064.3B
更新日期:2003-03-01 00:00:00
abstract:STUDY DESIGN:This anatomic study tested placement of C2 pedicle screws using cadaver specimens. OBJECTIVES:To further assess the safety of transpedicular screw placement in the axis by comparing two surgical techniques. SUMMARY OF BACKGROUND DATA:Transpedicular screw fixation of traumatic spondylolisthesis of the axi...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199603150-00005
更新日期:1996-03-15 00:00:00
abstract:STUDY DESIGN:An in vivo landrace model of cement augmentation of pedicle screw was established, and axial pull-out tests and histological analysis were performed. OBJECTIVE:To investigate the long-term in vivo biomechanical performance of pedicle screws augmented with calcium sulfate cement. SUMMARY OF BACKGROUND DAT...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318184e750
更新日期:2008-11-01 00:00:00
abstract:STUDY DESIGN:A case report is presented. OBJECTIVE:To describe a case of severe symptomatic lumbar stenosis in an adult gorilla successfully treated with decompressive surgery. SUMMARY OF BACKGROUND DATA:Although spinal degenerative disease is thought to be less common in apes than in humans, gorillas and bonobos are...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000112075.03500.5b
更新日期:2004-03-01 00:00:00
abstract:STUDY DESIGN:This was a single-institute retrospective study. OBJECTIVE:To describe perioperative and postoperative complications in elderly who underwent multilevel minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) while identifying predictors of complications. SUMMARY OF BACKGROUND DATA:The numbe...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000003369
更新日期:2020-06-01 00:00:00
abstract:STUDY DESIGN:A systematic review of randomized controlled trials. BACKGROUND:Although several rehabilitation programs, physical fitness programs, or protocols regarding instruction for patients to return to work after lumbar disc surgery have been suggested, little is known about the efficacy of these treatments, and ...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/01.BRS.0000042520.62951.28
更新日期:2003-02-01 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