Abstract:
STUDY DESIGN:Large multicenter retrospective cohort study. OBJECTIVE:The objective of this study was to analyze the effect of fusion timing on inpatient outcomes in a nationally representative population with thoracolumbar fracture and concurrent neurological injury. SUMMARY OF BACKGROUND DATA:Among thoracolumbar trauma admissions, concurrent neurological injury is associated with greater long-term morbidity. There is little consensus on optimal surgical timing for these patients; previous investigations fail to differentiate thoracolumbar fracture with and without neurological injury. MATERIALS AND METHODS:We analyzed 19,136 nonelective National Inpatient Sample cases (2004-2014) containing International Classifications of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes for closed thoracic/lumbar fracture with neurological injury and procedure codes for primary thoracolumbar/lumbosacral fusion, excluding open/cervical fracture. Timing classification from admission to fusion was same-day, 1-2-, 3-6-, and ≥7-day delay. Primary outcomes included in-hospital mortality, complications, and infection; secondary outcomes included total and postoperative length of stay and charges. Logistic regressions and generalized linear models with gamma distribution and log-link evaluated the effect of surgical timing on primary and secondary outcomes, respectively, controlling for age, sex, fracture location, fusion approach, multiorgan system injury severity score, and medical comorbidities. RESULTS:Patients undergoing surgery ≤72 hours (n=12,845) had the lowest odds of in-hospital cardiac [odds ratio (OR)=0.595; 95% confidence interval (CI), 0.357-0.991] and respiratory complications (OR=0.495; 95% CI, 0.313-0.784) and infection (OR=0.615; 95% CI, 0.390-0.969). No differences were observed between same-day (n=4724) and 1-2-day delay (n=8121) (P>0.05). Lowest odds of hemorrhage or hematoma was observed following 3-6-day delay (OR=0.467; 95% CI, 0.236-0.922). A ≥7-day delay to fusion (n=2,002) was associated with greatest odds of hemorrhage/hematoma (OR=2.019; 1.107-3.683), respiratory complications (OR=1.850; 95% CI, 1.076-3.180), and infection (OR=3.155; 95% CI, 1.891-5.263) and greatest increases in mean postoperative length of stay (4.26% or 35.3% additional days) and charges (163,562 or 71.7% additional US dollars) (P<0.001). CONCLUSIONS:Patients with thoracolumbar fracture and associated neurological injury who underwent surgery within 3 days of admission experienced fewer in-hospital complications. These benefits may be due to secondary injury mechanism avoidance and earlier mobilization. LEVEL OF EVIDENCE:Level III.
journal_name
Clin Spine Surgjournal_title
Clinical spine surgeryauthors
Ruddell JH,DePasse JM,Tang OY,Daniels AHdoi
10.1097/BSD.0000000000001078subject
Has Abstractpub_date
2020-10-06 00:00:00eissn
2380-0186issn
2380-0194pub_type
杂志文章abstract:STUDY DESIGN:A retrospective cohort study. OBJECTIVE:To examine the association between the American Society of Anesthesiologists (ASA) score and patient-reported outcomes (PROs) after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARY OF BACKGROUND DATA:Few studies have investigated the co...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000930
更新日期:2020-02-01 00:00:00
abstract:STUDY DESIGN:A prospective study and a technique note. OBJECTIVES:To introduce a new entrance technique for C2 pedicle screw placement and to measure the related linear and angular parameters about the entrance point on computed tomography (CT) images. The safety of this technique for patients with atlantoaxial instab...
journal_title:Clinical spine surgery
pub_type: 临床试验,杂志文章
doi:10.1097/BSD.0000000000000164
更新日期:2017-06-01 00:00:00
abstract:STUDY DESIGN:A retrospective study. OBJECTIVE:To investigate whether proximal junctional kyphosis (PJK) or obvious proximal junctional angle (PJA) changes in the sagittal plane develops following short fusion in children younger than 10 years of age with congenital scoliosis, and to investigate the possible risk facto...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000245
更新日期:2017-05-01 00:00:00
abstract:STUDY DESIGN:A retrospective study of preoperative and postoperative magnetic resonance imaging (MRI) findings in spinal ependymoma. OBJECTIVE:The goal of the study was to examine MRI features, including the syrinx component volume, after surgical resection of spinal ependymoma, and to relate these features to extent ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001061
更新日期:2020-08-28 00:00:00
abstract:STUDY DESIGN:This was a cross-sectional study. OBJECTIVE:The objective of this study is to report the impact of COVID-19 on spine surgery fellow education and readiness for practice. SUMMARY OF BACKGROUND DATA:COVID-19 has emerged as one of the most devastating global health crises of our time. To minimize transmissi...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001073
更新日期:2020-10-02 00:00:00
abstract:STUDY DESIGN:This was a prospective study. OBJECTIVE:To determine patient awareness of surgeon-industry relationships, how these relationships affect patient perceptions of surgeons, and which relationships cause the greatest concern to patients. SUMMARY OF BACKGROUND DATA:The prevalence of orthopedic surgeon-industr...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000915
更新日期:2020-04-01 00:00:00
abstract:STUDY DESIGN:Case series. OBJECTIVE:To evaluate radiographic and clinical outcomes of adults with spinal deformity treated with multilevel anterior column releases (ACR). SUMMARY OF BACKGROUND DATA:Pedicle subtraction osteotomy can be used effectively to correct spinal deformity; however, it is not without complicati...
journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000377
更新日期:2016-05-01 00:00:00
abstract:STUDY DESIGN:Retrospective review of North American and Japanese adult spinal deformity (ASD) database. OBJECTIVE:To investigate the ethnical differences in radiographic parameters and Scoliosis Research Society (SRS)-22 between North American and Japanese ASD. SUMMARY OF BACKGROUND DATA:Previous comparison study bet...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000610
更新日期:2018-06-01 00:00:00
abstract:STUDY DESIGN:A prospective single-surgeon nonrandomized clinical study. OBJECTIVE:To evaluate the radiographic and clinical outcomes, by fixation type, in extreme lateral interbody fusion (XLIF) patients and provide an algorithm for determining patients suitable for stand-alone XLIF. SUMMARY OF BACKGROUND DATA:XLIF m...
journal_title:Clinical spine surgery
pub_type: 临床试验,杂志文章
doi:10.1097/BSD.0b013e3182aa4c94
更新日期:2017-03-01 00:00:00
abstract:STUDY DESIGN:A retrospective case series describing teardrop fracture of the axis. OBJECT:The purpose of the study was to clarify the clinical features, the mechanism of injury, and the potential instability of extension teardrop fractures of the axis, so as to emphasize the importance of recognizing this injury as a ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e31828984f9
更新日期:2016-02-01 00:00:00
abstract:STUDY DESIGN:Biomechanical ex vivo study. OBJECTIVE:To determine if topping off instrumentation can reduce the hypermobility in the adjacent segments when compared with the classic rigid spinal instrumentation. SUMMARY OF THE BACKGROUND DATA:Long rigid instrumentation might increase the mechanical load in the adjacen...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000244
更新日期:2017-05-01 00:00:00
abstract::For a company to provide high value to its customers, its organization design is critical. As health care transitions to a value-based model, it is critical that spinal care organizations are structured in such a way that they can maximize value to both the patient and the payers. This article will discuss the 3 most ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000529
更新日期:2017-04-01 00:00:00
abstract:STUDY DESIGN:Retrospective analysis of prospectively collected clinical data. OBJECTIVE:To assess the long-term outcome of patients with monosegmental L4/5 degenerative spondylolisthesis treated with the dynamic Dynesys device. SUMMARY OF BACKGROUND DATA:The Dynesys system has been used as a semirigid, lumbar dorsal ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e318277ca7a
更新日期:2016-03-01 00:00:00
abstract::As the cost of health care continues to rise, government and commercial payors are implementing strategies as a means of reducing the overall expenditure of health care dollars. The largest savings will be not just in more cost-effective treatments but in strategies that can avoid the need for treatments in the first ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000541
更新日期:2018-10-01 00:00:00
abstract:STUDY DESIGN:A case series study. OBJECTIVE:To investigate the electrophysiological location of nerve root entrapment in patients with isthmic spondylolisthesis. SUMMARY OF BACKGROUND DATA:Although the lesion of the nerve root in patients with isthmic spondylolisthesis has been thought to be located at the pars inter...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000047
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:Hidden zone foraminal herniations are among the more rare forms of herniations. As exploration is difficult, and there is a close relationship between the nerve root and pedicle, many surgical approaches have been proposed. The aim of this study was to describe downward laminotomy as a new approach to thes...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000562
更新日期:2018-05-01 00:00:00
abstract::Spinal surgery has been revolutionized by advances in instrumentation, bone graft substitutes, and perioperative care. Extensive dissection, creation of large areas of dead space, and the use of instrumentation in compromised patients, however, predisposes to high rates of wound complications. Postoperative wound comp...
journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000936
更新日期:2020-02-01 00:00:00
abstract:STUDY DESIGN:Description of a navigated, single-step, minimally invasive technique for the placement of pedicle screws. OBJECTIVE:To describe a new technique for minimally invasive placement of pedicle screws in the lumbar spine using O-arm and StealthStation navigation in combination. SUMMARY OF BACKGROUND DATA:Mini...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000616
更新日期:2018-06-01 00:00:00
abstract:STUDY DESIGN:Retrospective cohort. OBJECTIVE:To determine whether a genetic test is associated with successful Providence bracing for adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA:Genetic factors have been defined that predict the risk of progression of AIS in a polygenic fashion. From these data,...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e3182aa4ce1
更新日期:2016-04-01 00:00:00
abstract:STUDY DESIGN:In vitro biomechanical study of cervical intervertebral distraction. OBJECTIVE:To investigate the forces required for distraction to different heights in an in vitro C5-C6 anterior cervical distraction model, focusing on the influence of the intervertebral disk, posterior longitudinal ligament (PLL), and ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000160
更新日期:2017-06-01 00:00:00
abstract:STUDY DESIGN:Prospective cohort study. OBJECTIVE:To determine whether comorbidities and demographics, identified preoperatively, can impact patient outcomes and satisfaction after lumbar spine surgery. SUMMARY OF BACKGROUND DATA:The surgical treatment of lower back pain does not always eliminate a patient's pain and ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000331
更新日期:2017-07-01 00:00:00
abstract:STUDY DESIGN:A retrospective 1-year cost-utility analysis. OBJECTIVE:To determine the cost-effectiveness of using recombinant human bone morphogenic protein (rhBMP-2) in addition to autograft for 1- and 2-level lumbar fusions. SUMMARY OF BACKGROUND DATA:rhBMP-2 has been studied extensively to identify its benefits, r...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000079
更新日期:2016-02-01 00:00:00
abstract:STUDY DESIGN:A decision analysis. OBJECTIVE:To perform a decision analysis utilizing postoperative complication data, in conjunction with health-related quality of life (HRQoL) utility scores, to rank order the average health utility associated with various surgical approaches used to treat symptomatic thoracic disk h...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000375
更新日期:2017-08-01 00:00:00
abstract:STUDY DESIGN:A retrospective cohort study. OBJECTIVE:The objective of this study was to determine if patient satisfaction is predicted by improvement in health-related quality of life (HRQOL) metrics. SUMMARY OF BACKGROUND DATA:Patient satisfaction is becoming an increasingly common proxy for treatment quality; howev...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000887
更新日期:2020-03-01 00:00:00
abstract:STUDY DESIGN:This is a cross-sectional study. OBJECTIVE:To investigate spine surgeons' attitudes regarding preoperative anxiety measurement, management, and responsibility. SUMMARY OF BACKGROUND DATA:The vast majority of patients scheduled for spine surgery experience preoperative anxiety. However, there are currentl...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000705
更新日期:2019-02-01 00:00:00
abstract::Syrinx can be secondary to many etiologies, including tumor, Chiari malformation, tethered cord, or sequelae of infection or trauma. Posttraumatic syringomyelia, a potential complication of spinal injury, can insidiously present years after the initial event. Expansion of the cerebrospinal fluid-filled cyst can lead t...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000835
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the safety and efficacy of posterior unilateral vertebral column resection (PUVCR) as revision surgery for severe thoracolumbar angular kyphosis. PATIENTS AND METHODS:This is a retrospective cohort study. Adult patients undergoing revision surgery for severe thora...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001123
更新日期:2020-12-14 00:00:00
abstract:STUDY DESIGN:This was a systematic literature review. OBJECTIVE:The purpose of this systematic literature review was to aggregate all evidence characterizing the learning curve of instrumented minimally invasive surgery (MIS) techniques in spinal surgery and summarize what, if any, consideration has been given to surg...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001052
更新日期:2021-02-01 00:00:00
abstract:PURPOSE:The aim of this publication is to present a case of idiopathic spinal cord herniation (ISCH) associated with a transdural disk herniation, demonstrate an operative technique used to treat this condition and provide an updated review the literature. BACKGROUND CONTEXT:ISCH is an infrequent condition that can ca...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000896
更新日期:2020-07-01 00:00:00
abstract:STUDY DESIGN:Surgical technique. OBJECTIVE:To evaluate the efficacy of a novel groove-entry technique for thoracic percutaneous pedicle screw (PPS) insertion. SUMMARY OF BACKGROUND DATA:Minimally invasive spine stabilization (MISt) using posterior thoracolumbar instrumentation has many advantages over open procedures...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000461
更新日期:2017-03-01 00:00:00