LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 241

Search options

  1. Article ; Online: Recurrence of proximal junctional kyphosis after revision surgery for symptomatic proximal junctional kyphosis in patients with adult spinal deformity: incidence, risk factors, and outcomes.

    Funao, Haruki / Kebaish, Floreana N / Skolasky, Richard L / Kebaish, Khaled M

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

    2021  Volume 30, Issue 5, Page(s) 1199–1207

    Abstract: Purpose: Although proximal junctional kyphosis (PJK) is common after long spinal fusion, the outcomes of revision surgery for symptomatic PJK are unclear. Our aim was to assess the outcomes of revision surgery for symptomatic PJK in patients with adult ... ...

    Abstract Purpose: Although proximal junctional kyphosis (PJK) is common after long spinal fusion, the outcomes of revision surgery for symptomatic PJK are unclear. Our aim was to assess the outcomes of revision surgery for symptomatic PJK in patients with adult spinal deformity and elucidate the incidence and risk factors for recurrent PJK (rePJK).
    Methods: We evaluated standing radiographs and health-related quality of life (HRQOL) in patients who underwent revision surgery for symptomatic PJK with at least 2-year follow-up. Patients were assigned to the non-rePJK or rePJK group according to PJK recurrence.
    Results: Thirty-nine consecutive patients (mean age, 63 ± 11 years; 24 women) met the inclusion criteria. RePJK occurred in 12 patients (31%). There were significant differences in the following parameters between groups (non-rePJK vs. rePJK): initial proximal junctional sagittal Cobb angle (PJA) (26.6° vs. 35.6°), thoracic kyphosis (TK) (38.6° vs. 52.8°), and sagittal vertical axis (SVA) (9.3 vs. 15.9 cm), and pre- to postoperative SVA decrease (6.1 vs. 12.2 cm). Significant risk factors for rePJK were initial PJA > 40°, preoperative TK > 60°, preoperative SVA > 10.0 cm, correction of TK > 15°, and correction of SVA > 5.0 cm. HRQOL scores improved significantly; however, postoperative SRS-22r activity scores were significantly worse in the rePJK group vs the non-rePJK group.
    Conclusion: The incidence of rePJK was 31%. Risk factors for rePJK were large initial PJA, high preoperative TK and SVA, and greater correction of TK and SVA. HRQOL did not differ significantly between patients with vs without rePJK, except immediate postoperative SRS-22r activity scores.
    Level of evidence: III.
    MeSH term(s) Adult ; Aged ; Female ; Humans ; Incidence ; Kyphosis/surgery ; Middle Aged ; Postoperative Complications ; Quality of Life ; Reoperation ; Retrospective Studies ; Risk Factors ; Spinal Fusion
    Language English
    Publishing date 2021-01-15
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1115375-1
    ISSN 1432-0932 ; 0940-6719
    ISSN (online) 1432-0932
    ISSN 0940-6719
    DOI 10.1007/s00586-020-06669-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3437: 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)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Impact of Controlled Versus Uncontrolled mFI-5 Frailty on Perioperative Complications After Adult Spinal Deformity Surgery.

    Olson, Jarod / Mo, Kevin C / Schmerler, Jessica / Durand, Wesley M / Kebaish, Khaled M / Skolasky, Richard L / Neuman, Brian J

    Clinical spine surgery

    2024  

    Abstract: Study design: Retrospective review.: Objectives: We substratified the mFI-5 frailty index to reflect controlled and uncontrolled conditions and assess their relationship to perioperative complications.: Summary of background data: Risk assessment ... ...

    Abstract Study design: Retrospective review.
    Objectives: We substratified the mFI-5 frailty index to reflect controlled and uncontrolled conditions and assess their relationship to perioperative complications.
    Summary of background data: Risk assessment before adult spinal deformity (ASD) surgery is critical because the surgery is highly invasive with a high complication rate. Although frailty is associated with risk of surgical complications, current frailty measures do not differentiate between controlled and uncontrolled conditions.
    Methods: Frailty was calculated using the mFI-5 index for 170 ASD patients with fusion of ≥5 levels. Uncontrolled frailty was defined as blood pressure >140/90 mm Hg, HbA1C >7% or postprandial glucose >180 mg/dL, or recent chronic obstructive pulmonary disease (COPD) exacerbation, while on medication. Patients were divided into nonfrailty, controlled frailty, and uncontrolled frailty cohorts. The primary outcome measure was perioperative major and wound complications. Bivariate analysis was performed. Multivariable analysis assessed the relationship between frailty and perioperative complications.
    Results: The cohorts included 97 nonfrail, 54 controlled frail, and 19 uncontrolled frail patients. Compared with nonfrail patients, patients with uncontrolled frailty were more likely to have age older than 60 years (84% vs. 24%), hyperlipidemia (42% vs. 20%), and Oswestry Disability Index (ODI) score >42 (84% vs. 52%) (P<0.05 for all). Controlled frailty was associated with those older than 60 years (41% vs. 24%) and hyperlipidemia (52% vs. 20%) (P<0.05 for all). On multivariable regression analysis controlling for hyperlipidemia, functional independence, motor weakness, ODI>42, and age older than 60 years, patients with uncontrolled frailty had greater odds of major complications (OR 4.24, P=0.03) and wound complications (OR 9.47, P=0.046) compared with nonfrail patients. Controlled frailty was not associated with increased risk of perioperative complications (P>0.05 for all).
    Conclusions: Although patients with uncontrolled frailty had higher risk of perioperative complications compared with nonfrail patients, patients with controlled frailty did not, suggesting the importance of controlling modifiable risk factors before surgery.
    Level of evidence: 3.
    Language English
    Publishing date 2024-03-27
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2849646-2
    ISSN 2380-0194 ; 2380-0186
    ISSN (online) 2380-0194
    ISSN 2380-0186
    DOI 10.1097/BSD.0000000000001595
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 2427: 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)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: AM-PAC Mobility Score <13 Predicts Development of Ileus Following Adult Spinal Deformity Surgery.

    Olson, Jarod / Mo, Kevin C / Schmerler, Jessica / Harris, Andrew B / Lee, Jonathan S / Skolasky, Richard L / Kebaish, Khaled M / Neuman, Brian J

    Clinical spine surgery

    2024  

    Abstract: Study design: Retrospective review.: Objective: To determine whether the Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" score is associated with the development of postoperative ileus.: Summary of background data: Adult spinal deformity ( ...

    Abstract Study design: Retrospective review.
    Objective: To determine whether the Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" score is associated with the development of postoperative ileus.
    Summary of background data: Adult spinal deformity (ASD) surgery has a high complication rate. One common complication is postoperative ileus, and poor postoperative mobility has been implicated as a modifiable risk factor for this condition.
    Methods: Eighty-five ASD surgeries in which ≥5 levels were fused were identified in a single institution database. A physical therapist/physiatrist collected patients' daily postoperative AM-PAC scores, for which we assessed first, last, and daily changes. We used multivariable linear regression to determine the marginal effect of ileus on continuous AM-PAC scores; threshold linear regression with Bayesian information criterion to identify a threshold AM-PAC score associated with ileus; and multivariable logistic regression to determine the utility of the score thresholds when controlling for confounding variables.
    Results: Ten of 85 patients (12%) developed ileus. The mean day of developing ileus was postoperative day 3.3±2.35. The mean first and last AM-PAC scores were 16 and 18, respectively. On bivariate analysis, the mean first AM-PAC score was lower in patients with ileus than in those without (13 vs. 16; P<0.01). Ileus was associated with a first AM-PAC score of 3 points lower (Coef. -2.96; P<0.01) than that of patients without ileus. Patients with an AM-PAC score<13 had 8 times greater odds of developing ileus (P=0.023). Neither the last AM-PAC score nor the daily change in AM-PAC score was associated with ileus.
    Conclusions: In our institutional cohort, a first AM-PAC score of <13, corresponding to an inability to walk or stand for more than 1 minute, was associated with the development of ileus. Early identification of patients who cannot walk or stand after surgery can help determine which patients would benefit from prophylactic management.
    Level of evidence: Level-III.
    Language English
    Publishing date 2024-03-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2849646-2
    ISSN 2380-0194 ; 2380-0186
    ISSN (online) 2380-0194
    ISSN 2380-0186
    DOI 10.1097/BSD.0000000000001599
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 2427: 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)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: Clinical results and functional outcomes after three-column osteotomy at L5 or the sacrum in adult spinal deformity.

    Funao, Haruki / Kebaish, Floreana N / Skolasky, Richard L / Kebaish, Khaled M

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

    2020  Volume 29, Issue 4, Page(s) 821–830

    Abstract: Purpose: Three-column osteotomies at L5 or the sacrum (LS3COs) are technically challenging, yet they may be needed to treat lumbosacral kyphotic deformities. We investigated radiographic and clinical outcomes after LS3CO.: Methods: We analyzed 25 ... ...

    Abstract Purpose: Three-column osteotomies at L5 or the sacrum (LS3COs) are technically challenging, yet they may be needed to treat lumbosacral kyphotic deformities. We investigated radiographic and clinical outcomes after LS3CO.
    Methods: We analyzed 25 consecutive patients (mean age 56 years) who underwent LS3CO with minimum 2-year follow-up. Standing radiographs and health-related quality-of-life scores were evaluated. A new radiographic parameter ["lumbosacral angle" (LSA)] was introduced to evaluate sagittal alignment distal to the S1 segment.
    Results: From preoperatively to the final follow-up, significant improvements occurred in lumbar lordosis (from - 34° to - 49°), LSA (from 0.5° to 22°), and sagittal vertical axis (SVA) (from 18 to 7.3 cm) (all, p < .01). Mean Scoliosis Research Society (SRS)-22r scores in activity, pain, self-image, and satisfaction (p < .05), and Oswestry Disability Index scores (p < .01) also improved significantly. Patients with SVA ≥ 5 cm at the final follow-up experienced less improvement in SRS-22r satisfaction scores than those with SVA < 5 cm. Patients with LSA < 20° at the final follow-up had significantly lower SRS-22r activity scores than those with LSA ≥ 20° (p = .014). Two patients had transient neurologic deficits, and 11 patients underwent revision for proximal junctional kyphosis (5), pseudarthrosis (3), junctional stenosis (2), or neurologic deficit (1).
    Conclusions: LS3CO produced radiographic and clinical improvements. However, patients who remained sagittally imbalanced had less improvement in SRS-22r satisfaction score than those whose sagittal imbalance was corrected, and patients who maintained kyphotic deformity in the lumbosacral spine had lower SRS-22r activity scores than those whose lumbosacral kyphosis was corrected. These slides can be retrieved under Electronic Supplementary Material.
    MeSH term(s) Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Kyphosis/diagnostic imaging ; Kyphosis/surgery ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Osteotomy ; Retrospective Studies ; Sacrum/diagnostic imaging ; Sacrum/surgery ; Spinal Fusion ; Thoracic Vertebrae ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2020-01-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1115375-1
    ISSN 1432-0932 ; 0940-6719
    ISSN (online) 1432-0932
    ISSN 0940-6719
    DOI 10.1007/s00586-019-06255-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3437: 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)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article ; Online: Predicting 30-day mortality after surgery for metastatic disease of the spine: the H

    Musharbash, Farah N / Khalifeh, Jawad M / Raad, Micheal / Puvanesarajah, Varun / Lee, Sang H / Neuman, Brian J / Kebaish, Khaled M

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

    2023  Volume 32, Issue 7, Page(s) 2513–2520

    Abstract: Purpose: Scoring systems for metastatic spine disease focus on predicting long- to medium-term mortality or a combination of perioperative morbidity and mortality. However, accurate prediction of perioperative mortality alone may be the most important ... ...

    Abstract Purpose: Scoring systems for metastatic spine disease focus on predicting long- to medium-term mortality or a combination of perioperative morbidity and mortality. However, accurate prediction of perioperative mortality alone may be the most important factor when considering surgical intervention. We aimed to develop and evaluate a new tool, the H
    Methods: Using the National Surgical Quality Improvement Program database, we identified 1195 adults who underwent surgery for metastatic spine disease from 2010 to 2018. Incidence of 30-day mortality was 8.7% (n = 104). Independent predictors of 30-day mortality were used to derive the H
    Results: Predicted 30-day mortality was 1.8% for an H
    Conclusions: The H
    Level of evidence: Prognostic level III.
    MeSH term(s) Adult ; Humans ; Spinal Neoplasms/secondary ; Prognosis ; ROC Curve ; Spine/surgery
    Language English
    Publishing date 2023-04-25
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1115375-1
    ISSN 1432-0932 ; 0940-6719
    ISSN (online) 1432-0932
    ISSN 0940-6719
    DOI 10.1007/s00586-023-07713-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 3437: 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)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article ; Online: Sarcopenia as a Risk Factor for Complications Following Pedicle Subtraction Osteotomy.

    Babu, Jacob M / Wang, Kevin Y / Jami, Meghana / Durand, Wesley M / Neuman, Brian J / Kebaish, Khaled M

    Clinical spine surgery

    2023  Volume 36, Issue 5, Page(s) 190–194

    Abstract: Study design: Retrospective cohort.: Objective: The objective was to determine if sarcopenia is an independent risk factor for complications in adult spinal deformity (ASD) patients undergoing pedicle subtraction osteotomy (PSO) and define categories ...

    Abstract Study design: Retrospective cohort.
    Objective: The objective was to determine if sarcopenia is an independent risk factor for complications in adult spinal deformity (ASD) patients undergoing pedicle subtraction osteotomy (PSO) and define categories of complication risk by sarcopenia severity.
    Summary of background data: Sarcopenia is linked to morbidity and mortality in several orthopedic procedures. Data concerning sarcopenia in ASD surgery is limited, particularly with respect to complex techniques performed such as PSO. With the high surgical burden of PSOs, appropriate patient selection is critical for minimizing complications.
    Methods: We identified 73 ASD patients with lumbar CT/MRI scans who underwent PSO with spinal fusion ≥5 levels at a tertiary care center from 2005 to 2014. Sarcopenia was assessed by the psoas-lumbar vertebral index (PLVI). Using stratum-specific likelihood ratio analysis, patients were separated into 3 sarcopenia groups by complication risk. The primary outcome measure was any 2-year complication. Secondary outcome measures included intraoperative blood loss and length of stay.
    Results: The mean PLVI was 0.84±0.28, with 47% of patients having complications. Patients with a complication had a 27% lower PLVI on average than those without complications (0.76 vs. 0.91, P=0.021). Stratum-specific likelihood ratio analysis produced 3 complication categories: 32% complication rate for PLVI ≥ 0.81; 61% for PLVI 0.60-0.80; and 69% for PLVI < 0.60. Relative to patients with PLVI ≥ 0.81, those with PLVI 0.60-0.80 and PLVI < 0.60 had 3.2× and 4.3× greater odds of developing a complication (P<0.05). For individual complications, patients with PLVI < 1.0 had a significantly higher risk of proximal junctional kyphosis (34% vs. 0%, P=0.022), while patients with PLVI < 0.8 had a significantly higher risk of wound infection (12% vs. 0%, P=0.028) and dural tear (14% vs. 0%, P=0.019). There were no significant associations between sarcopenia, intraoperative blood loss, and length of stay.
    Conclusions: The increasing severity of sarcopenia is associated with a significantly and incrementally increased risk of complications following ASD surgery that require PSO.
    Level of evidence: Level III.
    MeSH term(s) Adult ; Humans ; Retrospective Studies ; Sarcopenia/complications ; Sarcopenia/diagnostic imaging ; Blood Loss, Surgical ; Risk Factors ; Osteotomy/adverse effects ; Osteotomy/methods ; Spinal Fusion/adverse effects ; Spinal Fusion/methods ; Treatment Outcome
    Language English
    Publishing date 2023-02-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2849646-2
    ISSN 2380-0194 ; 2380-0186
    ISSN (online) 2380-0194
    ISSN 2380-0186
    DOI 10.1097/BSD.0000000000001455
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 2427: 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)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article ; Online: Late spinal infections are more common after pediatric than after adult spinal deformity surgery.

    Ikwuezunma, Ijezie / Beutler, Graham J / Margalit, Adam / Jain, Amit / Kebaish, Khaled M / Sponseller, Paul D

    Spine deformity

    2022  Volume 10, Issue 4, Page(s) 817–823

    Abstract: Purpose: To compare the incidence, timing, and microbiologic factors associated with late spinal infection (onset ≥ 6 months after index operation) in pediatric versus adult spinal deformity patients who underwent instrumented posterior spinal fusion ( ... ...

    Abstract Purpose: To compare the incidence, timing, and microbiologic factors associated with late spinal infection (onset ≥ 6 months after index operation) in pediatric versus adult spinal deformity patients who underwent instrumented posterior spinal fusion (PSF).
    Methods: We retrospectively queried our institutional database for pediatric (aged ≤ 21 years) and adult patients who underwent instrumented PSF from 2000 to 2015. Inclusion criteria were > 12-month follow-up, spinal arthrodesis spanning 4 or more levels, and idiopathic or degenerative spinal deformity. We included 1260 patients (755 pediatric, 505 adult). Incidence, timing, and microbiologic and operative parameters of late spinal infections were compared using chi-squared and Fisher exact tests. Alpha = 0.05.
    Results: Late spinal infection occurred in 28 (3.7%) pediatric and 2 (0.39%) adult patients (p = 0.009). Mean onset of infection was 4.2 years (range 0.7-12) in pediatric patients and 4.0 years (range 0.7-7.3) in adults (p = 0.93). Pediatric patients underwent arthrodesis spanning more levels (mean ± standard deviation, 10 ± 2.0) compared with adults (8.4 ± 3.3) (p < 0.001). Adults experienced greater intraoperative blood loss (2085 ± 1491 mL) compared with pediatric patients (796 ± 452 mL) (p < 0.001). Culture samples yielded positive growth in 11 pediatric and 2 adult cases. Propionibacterium and coagulase-negative staphylococci were the most commonly detected microorganisms in both cohorts.
    Conclusion: Late spinal infections were significantly more common in pediatric patients than in adults after instrumented PSF for spinal deformity. Skin and indolent microorganisms were the primary identifiable causative bacteria in both cohorts.
    Level of evidence: III.
    MeSH term(s) Adult ; Child ; Humans ; Incidence ; Neurosurgical Procedures ; Retrospective Studies ; Spinal Fusion/adverse effects ; Spine/surgery
    Language English
    Publishing date 2022-03-18
    Publishing country England
    Document type Journal Article
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-022-00494-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  8. Article ; Online: Worsening pain and quality of life for spine surgery patients during the COVID-19 pandemic: Roles of psychological distress and patient activation.

    Bronheim, Rachel S / Kebaish, Khaled M / Jain, Amit / Neuman, Brian J / Skolasky, Richard L

    North American Spine Society journal

    2022  Volume 9, Page(s) 100103

    Abstract: Background: Public health measures during the COVID-19 pandemic have disrupted access to basic resources (income, food, housing, healthcare). The effects may impact patients differently based on socioeconomic status (SES), pre-existing psychological ... ...

    Abstract Background: Public health measures during the COVID-19 pandemic have disrupted access to basic resources (income, food, housing, healthcare). The effects may impact patients differently based on socioeconomic status (SES), pre-existing psychological distress, and patient activation (knowledge, skills, and motivation to manage healthcare). We examined changes in access to basic resources and in pain and health-related quality of life (HRQoL) during the pandemic and determined how pre-existing psychological distress and patient activation are associated with exacerbation or mitigation of effects on pain and HRQoL.
    Methods: This cross-sectional study assessed 431 patients in a longitudinal-outcomes registry who underwent or scheduled spine surgery at our institution and were surveyed about COVID-19 effects on accessing basic resources. We assessed pain (numeric rating scale) and HRQoL (PROMIS 29-Item Profile). Information on preoperative SES, psychological distress, patient activation, pain, and HRQoL was collected previously. We compared access to basic resources by SES. We compared changes from pre-COVID-19 to COVID-19 assessments of pain and HRQoL and proportions of patients reporting worsened pain and HRQoL stratified by psychological distress. We analyzed associations between patient activation and negative effects on HRQoL using multivariable linear regression. Alpha=0.05.
    Results: Respondents reported minor disruptions in accessing basic resources (no difference by SES) but significant worsening of back (p=.027) and leg pain (p=.013) and HRQoL (physical function, fatigue, p<0.001; satisfaction with participation in social roles, p=0.048) during COVID-19. Psychological distress was associated with clinically relevant worsening of back, pain, leg pain, and physical function all, (p<0.05). High patient activation was associated with less impairment of physical function (p=0.03).
    Conclusion: Patients with pre-existing psychological distress experienced greater worsening of pain and HRQoL. High patient activation appeared to mitigate worsening of physical function. Providers should screen for psychological distress and patient activation and enhance supports to manage pain and maintain HRQoL in at-risk patients.
    Language English
    Publishing date 2022-02-13
    Publishing country United States
    Document type Journal Article
    ISSN 2666-5484
    ISSN (online) 2666-5484
    DOI 10.1016/j.xnsj.2022.100103
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  9. Article: The Technique for Performing Posterior Vertebral Column Resection with En-Bloc Fixation/Reduction in Adult Spine Deformity Surgery.

    Raad, Micheal / Wang, Kevin / Kebaish, Khaled

    JBJS essential surgical techniques

    2022  Volume 12, Issue 1

    Abstract: Posterior vertebral column resection (pVCR) is a powerful tool for correcting rigid spinal deformity; however, it is a technically demanding procedure and may be associated with a substantial rate of complications: Description: All surgeries are ... ...

    Abstract Posterior vertebral column resection (pVCR) is a powerful tool for correcting rigid spinal deformity; however, it is a technically demanding procedure and may be associated with a substantial rate of complications
    Description: All surgeries are performed with the patient in the prone position under continuous neuromonitoring. The posterior approach to the spine and spinal instrumentation are performed in a standard fashion
    Alternatives: Alternative treatments to the pVCR include a standard pedicle-subtraction osteotomy.
    Rationale: A standard pedicle-subtraction osteotomy offers a substantial amount of correction; however, correction is limited to the sagittal plane because the wedge osteotomy is hinged on the anterior cortex. This limitation makes the pVCR a better candidate for patients with severe biplanar deformities.
    Expected outcomes: pVCR is a complicated and technically challenging procedure that offers substantial correction in the coronal and sagittal planes for patients with rigid spinal deformities. It has also been shown to significantly improve patient quality of life
    Important tips: Medial rib resection in the thoracic spine allows easy access to the lateral vertebral column.En-bloc fixation-reduction minimizes fixation failure above and below the level of resection and provides a rigid foundation during the correction maneuver.Ensure that the anterior column is disconnected all the way across in order to avoid excessive shortening of the spinal cord and the potential neurologic sequelae.Complete resection of the posterior cortex and scar tissue anterior to the dural sac is required prior to the correction maneuver.Ensure an adequate number of fixation points above and below the resection level.
    Language English
    Publishing date 2022-01-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747088-X
    ISSN 2160-2204
    ISSN 2160-2204
    DOI 10.2106/JBJS.ST.20.00038
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  10. Article ; Online: Inflation-adjusted medicare physician reimbursement for adult spinal deformity surgery substantially declined from 2002 to 2020.

    Mo, Kevin C / Ortiz-Babilonia, Carlos / Musharbash, Farah N / Raad, Micheal / Aponte, Juan Silva / Neuman, Brian J / Jain, Amit / Kebaish, Khaled M

    Spine deformity

    2023  Volume 12, Issue 2, Page(s) 263–270

    Abstract: Purpose: Physician fees for orthopaedic surgeons by the Centers for Medicare and Medicaid Services (CMS) are increasingly scrutinized. The present retrospective review aims to assess whether adult spinal deformity (ASD) surgeries are properly valued for ...

    Abstract Purpose: Physician fees for orthopaedic surgeons by the Centers for Medicare and Medicaid Services (CMS) are increasingly scrutinized. The present retrospective review aims to assess whether adult spinal deformity (ASD) surgeries are properly valued for Medicare reimbursement.
    Methods: Current Procedural Terminology (CPT) codes related to posterior fusion of spinal deformity of ≤ 6, 7-12, and ≥ 13 vertebral levels, as well as additional arthrodesis and osteotomy levels, were assessed for (1) Compound annual growth rate (CAGR) from 2002 to 2020, calculated using physician fee data from the CMS Physician Fee Schedule Look-Up Tool; and (2) work relative value units (RVUs) per operative minute, using data from the National Surgical Quality Improvement Program.
    Results: From 2002 to 2020, all CPT codes for ASD surgery had negative inflation-adjusted CAGRs (range, - 18.49% to - 27.66%). Mean physician fees for spinal fusion declined by 26.02% (CAGR, - 1.66%) in ≤ 6-level fusion, 27.91% (CAGR, - 1.80%) in 7- to 12-level fusion, and 28.25% (CAGR, - 1.83%) ≥ 13-level fusion. Fees for both 7-12 (P < 0.00001) and ≥ 13 levels (P < 0.00001) declined more than those for fusion of ≤ 6 vertebral levels. RVU per minute was lower for 7- to 12-level and ≥ 13-level (P < 0.00001 for both) ASD surgeries than for ≤ 6-level.
    Conclusions: Reimbursement for ASD surgery declined overall. CAGR for fusions of ≥ 7 levels were lower than those for fusions of ≤ 6 levels. For 2012-2018, ≥ 7-level fusions had lower RVU per minute than ≤ 6-level fusions. Revaluation of Medicare reimbursement for longer-level ASD surgeries may be warranted.
    Level of evidence: III.
    MeSH term(s) Aged ; Adult ; Humans ; United States ; Medicare ; Neurosurgical Procedures ; Physicians ; Quality Improvement ; Spinal Fusion
    Language English
    Publishing date 2023-11-30
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-023-00779-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top