Abstract:
OBJECTIVE:The purpose of the present study was to assess for gender-based differences in the usage and cost of maximal nonoperative therapy before spinal fusion surgery in patients with symptomatic lumbar stenosis or spondylolisthesis. METHODS:A large insurance database was queried for patients with symptomatic lumbar stenosis or spondylolisthesis undergoing index lumbar decompression and fusion procedures from 2007 to 2016. This database consists of 20.9 million covered lives and includes private or commercially insured and Medicare Advantage beneficiaries. Only patients continuously active within the Humana insurance system for ≥5 years before the index operation were eligible. Usage was characterized by the cost billed to the patient, prescriptions written, and number of units billed. RESULTS:A total of 4133 patients (58.5% women) underwent 1-, 2-, or 3-level posterior lumbar instrumented fusion. A significantly greater percentage of female patients used nonsteroidal anti-inflammatory drugs (P < 0.0001), lumbar epidural steroid injections (P = 0.0044), physical and/or occupational therapy (P < 0.0001), and muscle relaxants (P < 0.0001). The total direct cost associated with all maximal nonoperative therapy before index spinal fusion was $9,000,968, with men spending $3,451,479 ($2011.35 per patient) and women spending $5,549,489 ($2296.02 per patient). When considering the quantity of units billed, women used 61.5% of the medical therapy units disbursed despite constituting 58.5% of the cohort. When normalized by the number of pills billed per patient using therapy, female patients used more nonsteroidal anti-inflammatory drugs, opioids, and muscle relaxants. CONCLUSIONS:These results suggest that gender differences exist in the use of nonoperative therapies for symptomatic lumbar stenosis or spondylolisthesis before fusion surgery.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Davison MA,Vuong VD,Lilly DT,Desai SA,Moreno J,Cheng J,Bagley C,Adogwa Odoi
10.1016/j.wneu.2018.08.131subject
Has Abstractpub_date
2018-12-01 00:00:00pages
e580-e592eissn
1878-8750issn
1878-8769pii
S1878-8750(18)31914-4journal_volume
120pub_type
杂志文章abstract:OBJECTIVE:To determine whether Thoracolumbar Injury Classification and Severity Score (TLICS) and the Thoracolumbar AOSpine Injury Score (TL AOSIS) have any superiority to each other in terms of the reliability of their recommendations for guiding the treatment strategy of thoracolumbar spine injuries. METHODS:A total...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.02.013
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Scalp arteriovenous malformation is a rare disease. In terms of treatment, surgical removal is often effective and performed. With the development of endovascular treatments, a combination of surgical removal and embolization is now often performed. CASE DESCRIPTION:A 44-year-old man presented with a mass i...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.02.138
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Anterior skull base neoplastic and vascular lesions can receive significant blood supply from the anterior and posterior ethmoidal artery. Although useful in preoperative embolization of middle meningeal artery branches, endovascular techniques for the occlusion of anterior ethmoidal artery expose the parent ...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2015.06.005
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:In clipping surgery, it can be advantageous to dissect an adherent artery from the aneurysmal dome to achieve complete clipping. Bypass surgery can be useful to reconstruct an adherent artery when dissection of the artery is technically difficult or risky. We report the effectiveness of tailor-made intracran...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.074
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Fluorescence guidance has a demonstrated potential in maximizing the extent of high-grade glioma resection. Different fluorophores (fluorescent biomarkers), including 5-aminolevulinic acid (5-ALA) and fluorescein, have been examined with the use of several imaging techniques. Our goal was to review the state ...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2013.06.014
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To evaluate effects of holmium:yttrium-aluminum-garnet (Ho:YAG) laser ablation on postoperative low back pain and improving functional status in patients with lumbar disc herniation undergoing transforaminal endoscopic lumbar discectomy (TELD). METHODS:The study enrolled 220 patients with lumbar disc herniat...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.265
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Given the genetic and proteomic advances of the past decade, understanding of the molecular etiopathogenesis of several complex diseases is increasing. Intervertebral disc disease (IVDD) is no different from other complex diseases where both environmental and genetic constituents are considered causes. This ...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2011.07.014
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:To report new results with ethylene oxide sterilization and new experiences with autogenous bone flaps autoclaved at a high or low temperature for preservation of a bone flap after decompressive craniectomy. METHODS:In 45 patients who underwent a decompressive craniectomy, we determined bone flap preservatio...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.03.042
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To investigate potential risk factors for cerebral hyperperfusion syndrome (CHS) after surgery in patients with moyamoya disease (MMD) using phase-contrast magnetic resonance imaging (MRI). METHODS:The study included 84 adult patients (89 brain hemispheres) with MMD who underwent surgery. Preoperative phase-...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.04.191
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To compare surgical clipping with endovascular coiling in terms of recovery from oculomotor nerve palsy (ONP) in the management of posterior communicating artery (PCoA) aneurysms causing third nerve palsy. METHODS:We conducted a systematic review of the literature and meta-analysis. RESULTS:The meta-analysi...
journal_title:World neurosurgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.wneu.2015.09.026
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the clinical outcomes of diagnostic transforaminal epidural injection (DTEI) in selective percutaneous endoscopic lumbar discectomy for multilevel disc herniation with monoradicular symptom. METHODS:A prospective randomized clinical study was performed from November 2013...
journal_title:World neurosurgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.wneu.2019.02.102
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Anaplastic large cell lymphoma (ALCL) is a malignant non-Hodgkin lymphoma, typically associated with anaplastic lymphoma kinase (ALK) expression. In some cases, lack of ALK translocation correlated with a more unfavorable prognosis. CASE DESCRIPTION:We describe a case of ALK(-) ALCL that manifested as a pro...
journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2015.11.020
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Medical implications of 3-dimensional (3D) printing technology have evolved and are increasingly used. Surgical spine oncology involves at times complex resection using various surgical approaches and unique spinal reconstruction. As high general complication rates, including hardware failure, are reported, ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.09.002
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Tuberculous meningitis (TBM) is an endemic infectious disease in developing countries, and it can become a serious illness in children. Treatment of TBM is more difficult and prone to failure than treatment of pulmonary tuberculosis. TBM causes hydrocephalus, cerebral edema, increased intracranial pressure, ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.12.007
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Symptomatic anterior arterial steno-occlusion is often associated with neurofunctional deficits or a high risk of recurrent stroke or both. Although both medical and endovascular treatments are useful and suitable, few studies have investigated the continued use of indirect encephaloduroarteriosynangiosis (E...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.02.012
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Asymptomatic or minor symptom meningiomas (AMSMs) in the elderly are incidental findings, with no consensus reached on the optimal management strategy. In the present study, we aimed to determine the surgical risk factors for elderly patients with AMSMs using a nationwide registry database in Japan. METHODS...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2021.01.001
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:Consistent data on head injury is lacking especially in the low- and middle-income countries. Our study tries to characterize patients with head injury at the emergency department of one of the few tertiary public hospitals giving neurosurgical care in the country. METHODS:A retrospective cross-sectional st...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.03.044
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Aneurysms of the extracranial vertebral artery are rare, and the treatment options are not standardized. We present a case of an extracranial vertebral artery aneurysm treated with flow diversion. CASE DESCRIPTION:In a 72-year-old woman, computed tomography angiography demonstrated a right extracranial vert...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.03.064
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Reports of cerebral aneurysm and aneurysm rupture during pregnancy are rare in the literature. Aneurysms might rupture and cause intracranial hemorrhage during or after pregnancy. Aneurysmal subarachnoid hemorrhage during pregnancy presents a challenge regarding treatment and management. No institution has r...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.04.238
更新日期:2020-08-01 00:00:00
abstract::The reach to expose the peritrigonal/atrial territories poses special challenges. The highly functional overlying cortices and white matter tracts, such as the optic radiations lateral to the ventricle, postcentral gyrus laterally and more superficially, and the thalamus anteroinferiorly, constrain the surgical corrid...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.08.150
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Several factors associated with interrupted and continuous suturing techniques affect the quality of bypass anastomosis. It is difficult to determine the impact of these factors during surgery. The primary objective of this study was to evaluate factors with the potential to influence the quality of bypass a...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.09.031
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Intracranial psammomatous meningiomas (PMs) are rarely reported due to their extremely low incidence. Knowledge about intracranial PMs is therefore poor. This study aimed to analyze the incidence, clinical features, radiologic findings, and surgical outcomes of intracranial PMs. METHODS:Approximately 5651 in...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.01.056
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:In endovascular embolization of intracranial aneurysms, a tortuous cervical internal carotid artery can limit guiding catheter access to a sufficiently high position. Although intermediate distal access catheters can go beyond the tortuous segment of internal carotid arteries, they may increase the risk of p...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.06.023
更新日期:2017-09-01 00:00:00
abstract::This case Video 1 demonstrates a microsurgical technique for trapping and excision of 2 ruptured mycotic aneurysms. The patient was a 64-year-old man with severe mitral regurgitation and valvular vegetations suggestive of endocarditis. On examination, the patient presented with speech difficulty. Preoperative imaging ...
journal_title:World neurosurgery
pub_type:
doi:10.1016/j.wneu.2020.01.145
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Segmental instability traditionally is investigated with flexion and extension (F/E) radiographs. We sought to determine whether motion between upright and supine (U/S) views can serve as an alternative sensitive diagnostic tool that predicts similar outcomes. METHODS:Ambispective collection of data was perf...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.06.066
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Limited information exists evaluating the impact of hospital caseload and elective admission on outcomes after patients have undergone extracranial-intracranial (ECIC) bypass surgery. Using the Nationwide Inpatient Sample (NIS) for 2001-2014, we evaluated the impact of hospital caseload and elective admissio...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2017.09.082
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The Timed Up and Go (TUG) test, as a measure of objective functional impairment in lumbar degenerative disk disease (DDD), complements patient-reported outcome measures (PROMs) of subjective functional impairment. METHODS:Prospective 2-center study on consecutive patients scheduled for surgical treatment fo...
journal_title:World neurosurgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.wneu.2016.11.039
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:The transcanal transpromontorial approach has been introduced to remove vestibular schwannomas. As with other techniques, preservation of the facial nerve (FN) is challenging. This pilot study described FN outcomes of patients preoperatively and postoperatively assessed with electromyography (EMG) and blink ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2020.10.139
更新日期:2020-11-12 00:00:00
abstract:BACKGROUND:The biopsy is recognized as the most accurate method to determine the histologic characterization of sellar germ cell tumors. It is difficult to evaluate the prognosis before histologic confirmation. OBJECTIVE:This study aimed to evaluate the independent prognostic risk factors of patients with sellar germ ...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2018.01.028
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Although targeted by radiotherapy, recurrence in glioblastoma occurs mainly periresectionally owing to tumor infiltration. An increase in the apparent diffusion coefficient (ADC) has been shown in the large high-T2 area on magnetic resonance imaging posttreatment; however, until now ADC has not been investig...
journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.04.129
更新日期:2016-08-01 00:00:00