Abstract:
STUDY DESIGN:Propensity score matched retrospective study using a nationwide longitudinal database. OBJECTIVE:To quantify the longitudinal economic impact of venous thromboembolism (VTE) complications in spinal fusion patients. SUMMARY OF BACKGROUND DATA:VTE is a rare and serious complication that may occur after spine surgery. The long-term socioeconomic impact understanding of these events has been limited by small sample sizes and a lack of longitudinal follow-up. We provide a comparative economic outcomes analysis of these complications. METHODS:We identified 204,308 patients undergoing spinal fusion procedures in a national billing claims database (MarketScan) between 2006 and 2010. Cohorts were balanced using 50:1 propensity score matching and outcome measures compared at 6, 12, and 18 months postoperation. RESULTS:A total of 1196 (0.6%) patients developed postoperative VTE, predominantly occurring following lumbar fusion (69.7%). Postoperative VTE patients demonstrated an increase in hospital length of stay (7.8 vs. 3.3 d, P<0.001) and a decreased likelihood of being discharged home (71% vs. 85%, P<0.001). A $26,306 increase in total hospital payments (P<0.001) was observed, with a disproportionate increase seen in hospital payments ($22,103, P<0.001), relative to physician payments ($1766, P=0.001).At 6, 12, and 18 months postfusion, increased rates of readmission and follow-up clinic visits were observed. Delayed readmissions were associated with decreased length of stay (3.6 vs. 4.6 d, P<0.001), but increased total payments, averaging at $21,270 per readmission. VTE patients generated greater cumulative outpatient service payments, costing $8075, $11,134, and $13,202 more at 6, 12, and 18 months (P<0.001). CONCLUSIONS:VTEs are associated with longer hospitalizations, a decreased likelihood of being discharged home, and overall increases of hospital resource utilization and cost in inpatient and outpatient settings. VTE patients generate greater charges in the outpatient setting and are more likely to become readmitted at 6, 12, and 18 months after surgery, demonstrating a significant socioeconomic impact long after occurrence. LEVEL OF EVIDENCE:Level III-therapeutic.
journal_name
Clin Spine Surgjournal_title
Clinical spine surgeryauthors
Li AY,Azad TD,Veeravagu A,Bhatti I,Li A,Cole T,Desai A,Ratliff JKdoi
10.1097/BSD.0000000000000450subject
Has Abstractpub_date
2017-12-01 00:00:00pages
E1392-E1398issue
10eissn
2380-0186issn
2380-0194journal_volume
30pub_type
杂志文章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: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: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:STUDY DESIGN:Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP), a prospectively collected multicenter surgical outcomes database. OBJECTIVE:To determine the effect of preoperative nutritional status, as measured by serum albumin concentration, on outcomes following anterior cervical d...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000181
更新日期:2016-05-01 00:00:00
abstract:STUDY DESIGN:Retrospective database review. OBJECTIVE OF THE STUDY:The objective of the study was to assess whether bone morphogenetic protein (BMP) decreases the risk of revision surgery in elderly patients treated with 3-7 level or 8 or greater level fusions. SUMMARY OF BACKGROUND DATA:Revision spine surgery in the...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000489
更新日期:2017-08-01 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:This was a meta-analysis study. OBJECTIVE:To compare different posterior spine fixation methods for burst fracture fixation. SUMMARY OF BACKGROUND DATA:This study was performed to elucidate if the current body of literature supports one posterior spinal fusion fixation method for burst fracture to minimi...
journal_title:Clinical spine surgery
pub_type: 杂志文章,meta分析
doi:10.1097/BSD.0000000000000763
更新日期:2019-03-01 00:00:00
abstract:STUDY DESIGN:This is a retrospective single-center and single-surgeon study. OBJECTIVE:We investigated the correlation between lower instrumented vertebra (LIV) and spinal mobility 2 years after posterior spinal fusion with pedicle screws for adolescent idiopathic scoliosis (AIS) for optimal LIV selection. SUMMARY OF...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000794
更新日期:2019-08-01 00:00:00
abstract:STUDY DESIGN:An in vitro biomechanical study. OBJECTIVE:To determine the fracture reduction achieved by a novel inflatable bone tamp under simulated physiological load. SUMMARY OF BACKGROUND DATA:Previous biomechanical studies have showed that kyphoplasty allows near-total restoration of lost vertebral height in unlo...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e31829a37ce
更新日期:2017-02-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001013
更新日期:2020-12-01 00:00:00
abstract:STUDY DESIGN:An observational prospective cohort study. OBJECTIVE:To investigate the influence of natural history on the recovery of patients with cervical spondylotic myelopathy (CSM) after anterior cervical decompression. SUMMARY OF BACKGROUND DATA:The natural history of CSM has not been clearly elucidated, it rema...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000873
更新日期:2019-10-01 00:00:00
abstract:STUDY DESIGN:Retrospective case-control study. OBJECTIVE:To compare the incidence, management, and outcome of incidental durotomy in revision microdiscectomy with open and minimal-access surgery. SUMMARY OF BACKGROUND DATA:Incidental durotomy occurs with a variable incidence of 3%-27% in spine surgery. The highest ra...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000279
更新日期:2017-12-01 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::Because of the rising health care costs in the United States, there has been a focus on value-based care and improving the cost-effectiveness of surgical procedures. Patient-reported outcome measures (PROMs) can not only give physicians and health care providers immediate feedback on the well-being of the patients but...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000982
更新日期:2020-05-01 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
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e318288a900
更新日期:2016-11-01 00:00:00
abstract:STUDY DESIGN:Observational study. OBJECTIVES:The objectives of this study are (1) to quantify social media use among active American Cervical Spine Research Society (CSRS) members; (2) to determine if there is an association between practice setting, region, or years of active membership and social media use. SUMMARY...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001127
更新日期:2021-01-04 00:00:00
abstract::Adjacent segment disease (ASD) is disappointing long-term outcome for both the patient and clinician. In contrast to adjacent segment degeneration, which is a common radiographic finding, ASD is less common. The incidence of ASD in both the cervical and lumbar spine is between 2% and 4% per year, and ASD is a signific...
journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000442
更新日期:2017-04-01 00:00:00
abstract:STUDY DESIGN:Expansive pedicle screws (EPS) and polymethylmethacrylate-augmented pedicle screws (PMMA-PS) were inserted into osteoporotic synthetic bones, which were then tested by radiographic and biomechanical examinations. OBJECTIVE:To compare the stability of EPS and PMMA-PS with that of a conventional pedicle scr...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e31828bfc85
更新日期:2016-08-01 00:00:00
abstract:STUDY DESIGN:Retrospective Cohort. OBJECTIVE:To determine if an association exists between surgery day and length of stay or hospital costs after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). SUMMARYOF BACKGROUND DATA:Length of inpatient stay after orthopedic procedures has been identified as ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
abstract:STUDY DESIGN:This is a level III retrospective cohort study. OBJECTIVE:To investigate association between prophylactic tranexamic acid (TXA) administration before 1 and 2-level posterior lumbar interbody fusion operations and perioperative blood loss (including intraoperative blood loss and postoperative drain output)...
journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2019-08-01 00:00:00
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journal_title:Clinical spine surgery
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更新日期:2020-03-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2017-06-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2020-12-14 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/BSD.0000000000000842
更新日期:2020-02-01 00:00:00
abstract::Randomized clinical trials often represent the highest level of clinical evidence available to evaluate the efficacy of an intervention in clinical medicine. Although the process of randomization serves to maximize internal validity, the external validity, or generalizability, of such studies depends on several factor...
journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2017-11-01 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::Central cord syndrome (CCS) represents a clinical phenomenon characterized by disproportionately greater motor impairment of the upper than of the lower extremities, bladder dysfunction. CSS is the most common form of incomplete traumatic spinal cord injury. The initial description of CSS was reported in 1887 secondar...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000731
更新日期:2018-12-01 00:00:00
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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
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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