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Article ; Online: Commentary: Patient satisfaction in spinal surgery: should we be addressing customer service or health improvement?

Bederman, S Samuel

The spine journal : official journal of the North American Spine Society

2013 Volume 13, Issue 5, Page(s) 507–509

MeSH term(s)	Depression/psychology ; Female ; Humans ; Male ; Patient Satisfaction ; Reoperation/psychology ; Spinal Stenosis/surgery
Language	English
Publishing date	2013-05
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2013.02.031
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Zs.A 5898: Show issues

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Article ; Online: Commentary: The degenerative lumbar spine: a chronic condition in search of a definitive solution.

Bederman, S Samuel

The spine journal : official journal of the North American Spine Society

2012 Volume 12, Issue 2, Page(s) 98–100

MeSH term(s)	Decompression, Surgical/statistics & numerical data ; Diskectomy/statistics & numerical data ; Female ; Humans ; Intervertebral Disc Displacement/surgery ; Low Back Pain/surgery ; Lumbar Vertebrae/surgery ; Male ; Spinal Fusion/statistics & numerical data
Language	English
Publishing date	2012-02
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2012.01.005
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Zs.A 5898: Show issues

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Article ; Online: Commentary: Toward a unified model for investigating health service use in degenerative spinal disorders.

Bederman, S Samuel

The spine journal : official journal of the North American Spine Society

2011 Volume 11, Issue 7, Page(s) 610–612

MeSH term(s)	Back Pain/economics ; Female ; Health Care Costs ; Humans ; Intervertebral Disc Displacement/economics ; Male ; Mental Disorders/economics ; Orthopedic Procedures/economics
Language	English
Publishing date	2011-07
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2011.04.017
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Zs.A 5898: Show issues

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Article ; Online: Predicting prognosis in sick-listed low back pain patients: sneaking a peak inside the black box.

Bederman, S Samuel

The spine journal : official journal of the North American Spine Society

2010 Volume 10, Issue 8, Page(s) 728–730

MeSH term(s)	Humans ; Low Back Pain/diagnosis ; Pain Measurement ; Prognosis
Language	English
Publishing date	2010-08
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	2037072-6
ISSN	1878-1632 ; 1529-9430
ISSN (online)	1878-1632
ISSN	1529-9430
DOI	10.1016/j.spinee.2010.05.008
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Zs.A 5898: Show issues

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Article ; Online: An Approach to Lumbar Revision Spine Surgery in Adults.

Bederman, S Samuel / Le, Vu H / Pahlavan, Sohrab

The Journal of the American Academy of Orthopaedic Surgeons

2016 Volume 24, Issue 7, Page(s) 433–442

Abstract: Along with the increase in lifestyle expectations in the aging population, a dramatic rise in surgical rates has been observed over the past 2 decades. Consequently, the rate of revision spine surgery is expected to increase. A systematic approach to ... ...

Abstract	Along with the increase in lifestyle expectations in the aging population, a dramatic rise in surgical rates has been observed over the past 2 decades. Consequently, the rate of revision spine surgery is expected to increase. A systematic approach to treatment is required for the adult patient presenting with late or chronic complications after spinal surgery. Patient assessment includes elucidating current symptoms and knowledge of the previous surgery, performing a detailed assessment, and obtaining appropriate studies. Subsequently, differential diagnoses are formulated based on whether the pathology arises from the same levels or adjacent levels of the spine and whether it relates to the previous decompression or fusion. Finally, familiarity with different surgical approaches is imperative in treating the common pathologies encountered in this patient population.
MeSH term(s)	Adult ; Decompression, Surgical/adverse effects ; Decompression, Surgical/methods ; Humans ; Lumbar Vertebrae/surgery ; Middle Aged ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Reoperation/methods ; Spinal Diseases/etiology ; Spinal Diseases/surgery ; Spinal Fusion/adverse effects ; Spinal Fusion/methods
Language	English
Publishing date	2016-07
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1200524-1
ISSN	1940-5480 ; 1067-151X
ISSN (online)	1940-5480
ISSN	1067-151X
DOI	10.5435/JAAOS-D-14-00181
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Zs.A 4048: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 274: Show issues

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Article ; Online: Outcomes of Varus Valgus Constrained Versus Rotating-Hinge Implants in Total Knee Arthroplasty.

Malcolm, Tennison L / Bederman, S Samuel / Schwarzkopf, Ran

Orthopedics

2016 Volume 39, Issue 1, Page(s) e140–8

Abstract: The stability of a total knee arthroplasty is determined by the ability of the prosthesis components in concert with supportive bone and soft tissue structures to sufficiently resist deforming forces transmitted across the knee joint. Constrained ... ...

Abstract	The stability of a total knee arthroplasty is determined by the ability of the prosthesis components in concert with supportive bone and soft tissue structures to sufficiently resist deforming forces transmitted across the knee joint. Constrained prostheses are used in unstable knees due to their ability to resist varus and valgus transformative forces across the knee. Constraint requires inherent rigidity, which can facilitate early implant failure. The purpose of this study was to describe the comparative indications for surgery and postoperative outcomes of varus valgus constrained knee (VVK) and rotating-hinge knee (RHK) total knee arthroplasty prostheses. Seven retrospective observational studies describing 544 VVK and 254 RHK patients with an average follow-up of 66 months (range, 7-197 months) were evaluated. Patients in both groups experienced similar failure rates (P=.74), ranges of motion (P=.81), and Knee Society function scores (P=.29). Average Knee Society knee scores were 4.2 points higher in VVK patients compared with RHK patients, indicating minimal mid-term clinical differences may exist (P<.0001). Absent collateral ligament support is an almost universal indication for RHK implantation vs VVK. Constrained device implantation is routinely guided by inherent stability of the knee, and, when performed, similar postoperative outcomes can be achieved with VVK and RHK prostheses.
MeSH term(s)	Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/instrumentation ; Arthroplasty, Replacement, Knee/methods ; Biomechanical Phenomena/physiology ; Female ; Humans ; Joint Instability/surgery ; Knee Joint/surgery ; Knee Prosthesis ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2016-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	424447-3
ISSN	1938-2367 ; 0147-7447
ISSN (online)	1938-2367
ISSN	0147-7447
DOI	10.3928/01477447-20151228-07
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Zs.A 1487: Show issues

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Article ; Online: Randomized trials in surgery: how far have we come?

Bederman, S Samuel / Wright, James G

The Journal of bone and joint surgery. American volume

2012 Volume 94 Suppl 1, Page(s) 2–6

Abstract: Randomized controlled trials continue to be at the pinnacle of the evidence hierarchy. With this unique vantage point, they inform medical practice, clinical guidelines, health policy, and reimbursement. Prior to an emphasis on randomized controlled ... ...

Abstract	Randomized controlled trials continue to be at the pinnacle of the evidence hierarchy. With this unique vantage point, they inform medical practice, clinical guidelines, health policy, and reimbursement. Prior to an emphasis on randomized controlled trials, traditional clinical research consisted primarily of uncontrolled case series and expert opinions. Randomized controlled trials are a true experiment in clinical practice and provide the most valid answers to clinical questions by reducing bias originating from patients, providers, and investigators. Riding on the coattails of other medical subspecialties, orthopaedic surgeons have recognized the importance of evidence-based medicine. From 1975 to 2005, the number of Level-I studies increased over fivefold and comprised >20% of studies published in The Journal of Bone and Joint Surgery (American Volume) (JBJS). With the emergence of comparative effectiveness research, the definition and methods of best evidence may continue to evolve. In conclusion, substantial improvements in both the quantity and the quality of randomized controlled trials in orthopaedic surgery have occurred, although unique considerations still limit their widespread use.
MeSH term(s)	Evidence-Based Medicine/trends ; Humans ; Orthopedic Procedures/trends ; Orthopedics/trends ; Randomized Controlled Trials as Topic/trends
Language	English
Publishing date	2012-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	220625-0
ISSN	1535-1386 ; 0021-9355
ISSN (online)	1535-1386
ISSN	0021-9355
DOI	10.2106/JBJS.K.01627
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Zs.MO 464: Show issues

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Article: Saphenous Nerve Somatosensory-Evoked Potentials Monitoring During Lateral Interbody Fusion.

Jain, Nick / Alluri, Ram / Phan, Kevin / Yanni, Daniel / Alvarez, Andrew / Guillen, Herbierto / Mnatsakanyan, Lilit / Bederman, S Samuel

Global spine journal

2020 Volume 11, Issue 5, Page(s) 722–726

Abstract: Study design.: Retrospective cohort study.: Objectives: To clinically evaluate saphenous nerve somatosensory-evoked potentials (SSEPs) as a reliable and predictable way to detect upper lumbar plexus injury intraoperatively during lateral lumbar trans- ...

Abstract	Study design.: Retrospective cohort study. Objectives: To clinically evaluate saphenous nerve somatosensory-evoked potentials (SSEPs) as a reliable and predictable way to detect upper lumbar plexus injury intraoperatively during lateral lumbar trans-psoas interbody fusion (LLIF). Methods: Saphenous nerve SSEPs were obtained by stimulation of inferior medial thigh with needle electrodes and recording from transcranial potentials. The primary outcome was measured by testing reproducibility of SSEPs at baseline, changes during the procedure, and relevance to standard modalities. Significant SSEP changes were compared with actual postoperative nerve complications. The sensitivity and specificity of saphenous SSEPs to detect postoperative lumbar plexus nerve injury was calculated. Results: A total of 62 patients were included in the study. Reliable saphenous SSEPs were recorded on the LLIF approach side in 52/62 patients. Persistent saphenous SSEP reduction of amplitude of >50% in 6 cases was observed during expansion of the tubular retractor or during the procedure. Two of 6 patients postoperatively had femoral nerve sensory deficits, and 5 of 6 patients had mild femoral nerve motor weakness, all of which resolved at an average of 12 weeks postoperatively (range 2-24 weeks). One patient had saphenous SSEP changes but demonstrated intraoperative recovery and had no postoperative clinical deficits. Saphenous SSEPs demonstrated 52% to 100% sensitivity and 90% to 100% specificity for detecting postoperative femoral nerve complications. Conclusion: Saphenous SSEPs can be used to detect electrophysiological changes to prevent femoral nerve injury during LLIF. Intraoperative SSEP recovery after amplitude reduction or loss may be a prognostic factor for final clinical outcome.
Language	English
Publishing date	2020-05-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/2192568220922979
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Article ; Online: The Influence of Insurance Status on the Surgical Treatment of Acute Spinal Fractures.

Daly, Michael C / Patel, Madhukar S / Bhatia, Nitin N / Bederman, S Samuel

Spine

2016 Volume 41, Issue 1, Page(s) E37–45

Abstract: Study design: A retrospective, propensity score, multivariate analysis of the National Trauma Data Bank (NTDB) between 2008 and 2011.: Objective: The aim of this study was to determine the relationship between insurance status and rates of surgery ... ...

Abstract	Study design: A retrospective, propensity score, multivariate analysis of the National Trauma Data Bank (NTDB) between 2008 and 2011. Objective: The aim of this study was to determine the relationship between insurance status and rates of surgery for acute spinal fractures with and without spinal cord injury (SCI). Summary of background data: The decision for surgery in patients with spinal fractures is often based on fracture pattern and stability, associated SCI, and the presence of ligamentous and other associated injuries. It is poorly understood how nonclinical factors, such as insurance status, influence the decision for surgical intervention in patients sustaining spinal trauma. Methods: Using NTDB admission years 2008 to 2011, we included patients 18 to 64 years old who sustained a fracture of the cervical or thoracolumbar spine. Patients were excluded if they sustained polytrauma (Injury Severity Score ≥27) or a major injury (Abbreviated Injury Scale severity ≥3) to the head, thorax, or abdomen. Our main outcome measure was surgical versus nonsurgical treatment for spinal injury; our main predictor was insurance status. Hierarchical multivariate regression analysis and propensity scores were used to determine the relationship between insurance status and surgical treatment, controlling for other factors. We calculated adjusted odds ratios (ORs) for rates of surgery. Results: Our propensity score multivariate analysis demonstrated significantly higher rates of surgery in patients with SCI (OR = 11.76, P < 0.001), insurance (OR = 1.27, P < 0.001), white (OR = 1.21, P = 0.018) versus black race, blunt trauma (OR = 5.63, P < 0.001), shock (OR = 1.62, P < 0.001), higher Glasgow Coma Scale (GCS) score (OR = 1.02, P = 0.002), transfer from lower acuity hospital (OR = 1.51, P < 0.001), and treatment at teaching hospitals (OR = 1.49, P < 0.001). Multivariable subgroup analysis of SCI patients similarly revealed higher surgical rates for insured patients (OR = 1.46, P < 0.001) than those without insurance. Conclusion: Patients with traumatic spine fractures were more likely to receive surgery if they were insured, regardless of the presence of SCI.
MeSH term(s)	Adolescent ; Adult ; Female ; Humans ; Insurance Coverage/statistics & numerical data ; Male ; Middle Aged ; Odds Ratio ; Propensity Score ; Spinal Fractures/epidemiology ; Spinal Fractures/surgery ; Young Adult
Language	English
Publishing date	2016-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000001177
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Zs.A 1305: Show issues

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Article ; Online: Cost Variation Within Spinal Fusion Payment Groups.

Wright, David J / Mukamel, Dana B / Greenfield, Sheldon / Bederman, S Samuel

Spine

2016 Volume 41, Issue 22, Page(s) 1747–1753

Abstract: Study design: Retrospective, large administrative database.: Objective: To investigate cost variation within current spinal fusion diagnosis-related groups (DRGs).: Summary of background data: Medicare reimbursement to hospitals for spinal fusion ... ...

Abstract	Study design: Retrospective, large administrative database. Objective: To investigate cost variation within current spinal fusion diagnosis-related groups (DRGs). Summary of background data: Medicare reimbursement to hospitals for spinal fusion surgery is provided as a fixed payment for each admission based on DRG. This assumes that patients can be grouped into homogenous units of resource use such that a single payment will cover the costs of hospitalization for most patients within a given DRG. However, major differences in costs exist for different methods of spinal fusion surgery. A previous study in total joint arthroplasty (TJA) showed that variation within DRGs can lead to differences between hospital costs and Medicare reimbursement, resulting in predictable financial losses to hospitals and hindering access to care for some patients. No study to our knowledge has investigated cost variation within current spinal fusion DRGs. Methods: Direct hospital costs were obtained from the 2011 Nationwide Inpatient Sample (NIS) for patients in spinal fusion DRGs 453-460 and TJA DRGs 466-470. Our primary outcome was the coefficient of variation (CV), defined as the ratio of the standard deviation (SD) to the mean (CV = SD/mean × 100), for all costs within a given DRG. CVs were compared to an established TJA benchmark for within-DRG cost variation. Results: CVs for costs within spinal fusion DRGs ranged from 44.16 to 52.6 and were significantly higher than the CV of 38.2 found in the TJA benchmark group (P < 0.0001). Conclusion: As in TJA, the cost variation observed within spinal fusion DRGs in this study may be leading to differences between costs and reimbursement that places undue financial burden on some hospitals and potentially compromises access to care for some patients. Future studies should seek to identify drivers of cost variation to determine whether changes can be made to further homogenize current payment groups and ensure equal access for all patients. Level of evidence: 3.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Diagnosis-Related Groups/economics ; Health Expenditures ; Hospital Costs ; Hospitalization/economics ; Humans ; Infant ; Medicare/economics ; Middle Aged ; Retrospective Studies ; Spinal Fusion/economics ; United States ; Young Adult
Language	English
Publishing date	2016-04-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000001649
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