LIVIVO - Search results -

Search results

Result 1 - 10 of total 168

Search options

Article ; Online: Editorial. Trauma in patients with spinal ankylosing disorders is often underestimated and frequently overlooked despite the high likelihood of complications.

Grunert, Peter / Drazin, Doniel

2021 Volume 51, Issue 4, Page(s) E3

MeSH term(s)	Humans ; Spinal Diseases ; Spinal Fractures
Language	English
Publishing date	2021-09-22
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2021.7.FOCUS21436
Database	MEDical Literature Analysis and Retrieval System OnLINE

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.

Article ; Online: Spontaneous Spinal Hematoma in Patients Using Antiplatelets and Anticoagulants: A Systematic Review.

Kumar, Nitesh / Palmisciano, Paolo / Dhawan, Sanjay / Boakye, Maxwell / Drazin, Doniel / Sharma, Mayur

World neurosurgery

2024 Volume 184, Page(s) e185–e194

Abstract: Background: Spontaneous spinal hematoma (SSH) is a debilitating complication in patients taking either antiplatelet (AP) or anticoagulation (AC) medications. SSH is rare and, therefore, a systematic review is warranted to re-examine and outline trends, ... ...

Abstract	Background: Spontaneous spinal hematoma (SSH) is a debilitating complication in patients taking either antiplatelet (AP) or anticoagulation (AC) medications. SSH is rare and, therefore, a systematic review is warranted to re-examine and outline trends, clinical characteristics, and outcomes associated with SSH formation. Methods: PubMed, EMBASE, Scopus, and Web-of-Science were searched. Studies reporting clinical data of patients with SSH using AC medications were included. In addition, clinical studies meeting our a priori inclusion criteria limited to SSH were further defined in quality through risk bias assessment. Results: We included 10 studies with 259 patients' pooled data post-screening 3083 abstracts. Within the cohort (n = 259), the prevalence of idiopathic, nontraumatic SSH with concomitant treatment with AC medications was greater 191 (73.75%) compared with AP treatment (27%). The lumbar spine was the most common site of hematoma (41.70%), followed by the cervical (22.01%) and thoracic (8.49%) spine. Most patients had surgical intervention (70.27%), and 29.73% had conservative management. The pooled data suggest that immediate diagnosis and intervention are the best prognostic factors in clinical outcomes. American Spinal Injury Association grading at initial symptom onset and post-treatment showed the greatest efficacy in symptomatic relief (87.64%) and return of motor and sensory symptoms (39.19%). Conclusions: Our review suggested that AC medications were related to SSH in most patients (74%), followed by APs (27%) and combined ACs + APs (1.9%). We recommend prompt intervention, a high suspicion for patients with neurologic deficits and diagnostic imaging before intervention to determine a case-specific treatment plan.
MeSH term(s)	Humans ; Anticoagulants/adverse effects ; Hematoma, Epidural, Spinal/etiology ; Spinal Cord Diseases/complications ; Lumbar Vertebrae ; Risk Assessment ; Magnetic Resonance Imaging/adverse effects
Chemical Substances	Anticoagulants
Language	English
Publishing date	2024-01-24
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2024.01.082
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 1159: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Editorial. Is the rise in spinal infections an unexpected consequence of the opioid epidemic?

Many, Gina M / Drazin, Doniel

Neurosurgical focus

2020 Volume 46, Issue 1, Page(s) E5

MeSH term(s)	Humans ; Analgesics, Opioid ; Epidural Abscess ; Spine ; Substance Abuse, Intravenous
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2020-03-18
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2018.10.FOCUS18576
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Extensive spontaneous cervical epidural hematoma due to oral anticoagulant (dabigatran) successfully treated with reversal agent idarucizumab alone.

Uddin, Syed-Abdullah / Roma, Katerina / Ross, Lindsey / Hanna, George / Drazin, Doniel / Kim, Terrence T

Surgical neurology international

2022 Volume 13, Page(s) 259

Abstract: Background: Dabigatran is an anticoagulant (novel oral anticoagulant) that is a direct thrombin inhibitor and only recently has a reversal agent, idarucizumab, been made available (2015).: Case description: An 86-year-old male taking dabigatran for ... ...

Abstract	Background: Dabigatran is an anticoagulant (novel oral anticoagulant) that is a direct thrombin inhibitor and only recently has a reversal agent, idarucizumab, been made available (2015). Case description: An 86-year-old male taking dabigatran for atrial fibrillation, acutely presented with the spontaneous onset of neck pain and quadriparesis. When the MRI demonstrated a C2-T2 spinal epidural hematoma, the patient was given the reversal agent idarucizumab. Due to his attendant major comorbidities, he was managed nonoperatively. Over the next 7 days, the patient's neurological deficits resolved, and within 2 weeks, he had regained normal neurological function. Conclusion: In this case, a C2-T2 epidural cervical hematoma attributed to dabigatran that was responsible for an acute, spontaneous quadriparesis was successfully treated with the reversal agent idarucizumab without surgical intervention being warranted.
Language	English
Publishing date	2022-06-23
Publishing country	United States
Document type	Case Reports
ISSN	2229-5097
ISSN	2229-5097
DOI	10.25259/SNI_929_2021
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

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.

Article ; Online: Simulated Bundled Payments for 4 Common Surgical Approaches to Treat Degenerative Cervical Myelopathy: A Consideration to Break the Clinical Equipoise.

Jain, Nikhil / Sharma, Mayur / Wang, Dengzhi / Ugiliweneza, Beatrice / Drazin, Doniel / Boakye, Maxwell

publication RETRACTED

Clinical spine surgery

2022 , Page(s) E636–E642

Abstract: Study design: Retrospective cohort study.: Objective: The aim was to compare 90-day and 2-year reimbursements for ≥2-level anterior cervical discectomy and fusion (mACDF), anterior cervical corpectomy and fusion (ACCF), posterior laminectomy and ... ...

Abstract	Study design: Retrospective cohort study. Objective: The aim was to compare 90-day and 2-year reimbursements for ≥2-level anterior cervical discectomy and fusion (mACDF), anterior cervical corpectomy and fusion (ACCF), posterior laminectomy and fusion (LF) and laminoplasty (LP) done for degenerative cervical myelopathy (DCM). Summary of background data: In DCM pathologies where there exists a clinical equipoise in approach selection, a randomized controlled trial found that an anterior approach did not significantly improve patient-reported outcomes over posterior approaches. In the era of value and bundled payments initiatives, cost profile of various approaches will form an important consideration for decision making. Materials and methods: IBM MarketScan Research Database (2005-2018) was used to study beneficiaries (30-75 y) who underwent surgery (mACDF, ACCF, LF, LP) for DCM. Index hospital stay (operating room, surgeon, hospital services) and postdischarge inpatient, outpatient and prescription medication payments have been used to simulate 90-day and 2-year bundled payment amounts, along with their distribution for each procedure. Results: A total of 10,834 patients with median age of 54 years were included. The median 90-day payment was $46,094 (interquartile range: $34,243-$65,841) for all procedures, with LF being the highest ($64,542) and LP the lowest ($37,867). Index hospital was 62.4% (operating room: 46.6) and surgeon payments were 17.5% of the average 90-day bundle. There was significant difference in the index, 90-day and 2-year reimbursements and their distribution among procedures. Conclusion: In a national cohort of patients undergoing surgery for DCM, LP had the lowest complication rate, and simulated bundled reimbursements at 90 days and 2 years postoperatively. The lowest quartile 90-day payment for LF was more expensive than median amounts for mACDF, ACCF, and LP. If surgeons encounter scenarios of clinical equipoise in practice, LP is likely to result in maximum value as it is on an average 70% less expensive than LF over 90 days.
Language	English
Publishing date	2022-03-29
Publishing country	United States
Document type	Journal Article ; Retracted Publication
ZDB-ID	2849646-2
ISSN	2380-0194 ; 2380-0186
ISSN (online)	2380-0194
ISSN	2380-0186
DOI	10.1097/BSD.0000000000001315
Database	MEDical Literature Analysis and Retrieval System OnLINE

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

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Simulated bundled payments for four common surgical approaches to treat degenerative cervical myelopathy: a consideration to break the clinical equipoise.

Jain, Nikhil / Sharma, Mayur / Wang, Dengzhi / Ugiliweneza, Beatrice / Drazin, Doniel / Boakye, Maxwell

Journal of neurosurgery. Spine

2022 , Page(s) 1–8

Abstract: Objective: In degenerative cervical myelopathy (DCM) pathologies in which there exists a clinical equipoise in approach selection, a randomized controlled trial found that an anterior approach did not significantly improve patient-reported outcomes ... ...

Abstract	Objective: In degenerative cervical myelopathy (DCM) pathologies in which there exists a clinical equipoise in approach selection, a randomized controlled trial found that an anterior approach did not significantly improve patient-reported outcomes compared with posterior approaches. In this era of value and bundled payment initiatives, the cost profiles of various surgical approaches will form an important consideration in decision-making. The objective of this study was to compare 90-day and 2-year reimbursements for ≥ 2-level (multilevel) anterior cervical discectomy and fusion (mACDF), anterior cervical corpectomy and fusion (ACCF), posterior cervical laminectomy and fusion (LF), and cervical laminoplasty (LP) performed for DCM. Methods: The IBM MarketScan research database (2005-2018) was used to study beneficiaries 30-75 years old who underwent surgery using four approaches (mACDF, ACCF, LF, or LP) for DCM. Demographics, index surgery length of stay (LOS), complications, and discharge disposition were compared. Index admission (surgeon, hospital services, operating room) and postdischarge inpatient (readmission, revision surgery, inpatient rehabilitation), outpatient (imaging, emergency department, office visits, physical therapy), and medication-related payments were described. Ninety-day and 2-year bundled payment amounts were simulated for each procedure. All payments are reported as medians and interquartile ranges (IQRs; Q1-Q3) and were adjusted to 2018 US dollars. Results: A total of 10,834 patients, with a median age of 54 years, were included. The median 90-day payment was $46,094 (IQR $34,243-$65,841) for all procedures, with LF being the highest ($64,542) and LP the lowest ($37,867). Index hospital payment was 62.4% (surgery/operating room 46.6%) and surgeon payments were 17.5% of the average 90-day bundle. There were significant differences in the index, 90-day, and 2-year reimbursements and their distribution among procedures. Conclusions: In a national cohort of patients undergoing surgery for DCM, LP had the lowest complication rate and simulated bundled reimbursements at 90 days and 2 years postoperatively. The lowest quartile 90-day payment for LF was more expensive than median amounts for mACDF, ACCF, and LP. If surgeons encounter scenarios of clinical equipoise in practice, LP is likely to result in maximum value because it is 70% less expensive on average than LF over 90 days.
Language	English
Publishing date	2022-01-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2158643-3
ISSN	1547-5646 ; 1547-5654
ISSN (online)	1547-5646
ISSN	1547-5654
DOI	10.3171/2021.10.SPINE211105
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Uk I Zs.135 -Spine-: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
ab Jg. 2022: Lesesaal (EG)

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: The Phenotypes of Anxiety and Depression: Analysis of Combined Comorbidity and Treatment in Patients Undergoing Spinal Fusion.

Jain, Nikhil / Sharma, Mayur / Wang, Dengzhi / Ugiliweneza, Beatrice / Drazin, Doniel / Boakye, Maxwell

Neurosurgery

2022 Volume 91, Issue 1, Page(s) 103–114

Abstract: Background: Anxiety and depression are associated with suboptimal outcomes, higher complications, and cost of care after elective spine surgery. The effect of combined anxiety-depression and preoperative antidepressant treatment in spinal fusion ... ...

Abstract	Background: Anxiety and depression are associated with suboptimal outcomes, higher complications, and cost of care after elective spine surgery. The effect of combined anxiety-depression and preoperative antidepressant treatment in spinal fusion patients is not known. Objective: To study the burden of combined anxiety-depression and its impact on healthcare utilization and costs in patients undergoing spinal fusion and to study the prevalence and impact of antidepressant treatment preoperatively. Methods: This is a retrospective cohort study from the IBM MarketScan Research Database (2000-2018). Patients were studied in 7 different "phenotypes" of anxiety and depression based on combination of diagnoses and treatment. Outcome measures included healthcare utilization and costs from 1 year preoperatively to 2 years postoperatively. Bivariate and multivariable analyses have been reported. Results: We studied 75 087 patients with a median age of 57 years. Patients with combined anxiety-depression were associated with higher preoperative and postoperative healthcare utilization and costs, as compared with anxiety or depression alone. The presence of depression in patients with and without anxiety disorder was a risk factor for postoperative opioid use and 2-year reoperation rates, as compared with anxiety alone. Patients with anxiety and/or depression on antidepressants are associated with significantly higher healthcare costs and opioid use. The adjusted 2-year reoperation rate was not significantly different between treated and untreated cohorts. Conclusion: Spine surgeons should use appropriate measures/questionnaires to screen depressed patients for anxiety and vice versa because the presence of both adds significant risk of higher healthcare utilization and costs over patients with 1 diagnosis, especially anxiety alone.
MeSH term(s)	Analgesics, Opioid/therapeutic use ; Antidepressive Agents/therapeutic use ; Anxiety/epidemiology ; Anxiety Disorders/drug therapy ; Anxiety Disorders/epidemiology ; Comorbidity ; Depression/epidemiology ; Humans ; Phenotype ; Retrospective Studies ; Spinal Diseases/etiology ; Spinal Fusion/adverse effects
Chemical Substances	Analgesics, Opioid ; Antidepressive Agents
Language	English
Publishing date	2022-04-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000001935
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 539: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article: Machine learning in clinical diagnosis, prognostication, and management of acute traumatic spinal cord injury (SCI): A systematic review.

Dietz, Nicholas / Vaitheesh Jaganathan / Alkin, Victoria / Mettille, Jersey / Boakye, Maxwell / Drazin, Doniel

Journal of clinical orthopaedics and trauma

2022 Volume 35, Page(s) 102046

Abstract: Background: Machine learning has been applied to improve diagnosis and prognostication of acute traumatic spinal cord injury. We investigate potential for clinical integration of machine learning in this patient population to navigate variability in ... ...

Abstract	Background: Machine learning has been applied to improve diagnosis and prognostication of acute traumatic spinal cord injury. We investigate potential for clinical integration of machine learning in this patient population to navigate variability in injury and recovery. Materials and methods: We performed a systematic review using PRISMA guidelines through PubMed database to identify studies that use machine learning algorithms for clinical application toward improvements in diagnosis, management, and predictive modeling. Results: Of the 132 records identified, a total of 13 articles met inclusion criteria and were included in final analysis. Of the 13 articles, 5 focused on diagnostic accuracy and 8 were related to prognostication or management of traumatic spinal cord injury. Across studies, 1983 patients with spinal cord injury were evaluated with most classifying as ASIA C or D. Retrospective designs were used in 10 of 13 studies and 3 were prospective. Studies focused on MRI evaluation and segmentation for diagnostic accuracy and prognostication, investigation of mean arterial pressure in acute care and intraoperative settings, prediction of ambulatory and functional ability, chronic complication prevention, and psychological quality of life assessments. Decision tree, random forests (RF), support vector machines (SVM), hierarchical cluster tree analysis (HCTA), artificial neural networks (ANN), convolutional neural networks (CNN) machine learning subtypes were used. Conclusions: Machine learning represents a platform technology with clinical application in traumatic spinal cord injury diagnosis, prognostication, management, rehabilitation, and risk prevention of chronic complications and mental illness. SVM models showed improved accuracy when compared to other ML subtypes surveyed. Inherent variability across patients with SCI offers unique opportunity for ML and personalized medicine to drive desired outcomes and assess risks in this patient population.
Language	English
Publishing date	2022-10-20
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2596956-0
ISSN	2213-3445 ; 0976-5662
ISSN (online)	2213-3445
ISSN	0976-5662
DOI	10.1016/j.jcot.2022.102046
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Introduction. Ankylosing spondylitis.

Drazin, Doniel / Johnson, J Patrick / Perry, Tiffany / Wang, Michael Y / Chapman, Jens R / Meyer, Bernhard

Neurosurgical focus

2021 Volume 51, Issue 4, Page(s) E1

MeSH term(s)	Humans ; Severity of Illness Index ; Spondylitis, Ankylosing
Language	English
Publishing date	2021-09-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2026589-X
ISSN	1092-0684 ; 1092-0684
ISSN (online)	1092-0684
ISSN	1092-0684
DOI	10.3171/2021.7.FOCUS21437
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Patterns and Impact of Electronic Health Records-Defined Depression Phenotypes in Spine Surgery.

Boakye, Maxwell / Sharma, Mayur / Adams, Shawn / Chandler, Thomas / Wang, Dengzhi / Ugiliweneza, Beatrice / Drazin, Doniel

Neurosurgery

2021 Volume 89, Issue 1, Page(s) E19–E32

Abstract: Background: Preoperative depression is a risk factor for poor outcomes after spine surgery.: Objective: To understand effects of depression on spine surgery outcomes and healthcare resource utilization.: Methods: Using IBM's MarketScan Database, ... ...

Abstract	Background: Preoperative depression is a risk factor for poor outcomes after spine surgery. Objective: To understand effects of depression on spine surgery outcomes and healthcare resource utilization. Methods: Using IBM's MarketScan Database, we identified 52 480 patients who underwent spinal fusion. Retained patients were classified into 6 depression phenotype groups based on International Classification of Disease, 9th/10th Revision (ICD-9/10) codes and use/nonuse of antidepressant medications: major depressive disorder (MDD), other depression (OthDep), antidepressants for other psychiatric condition (PsychRx), antidepressants for physical (nonpsychiatric) condition (NoPsychRx), psychiatric condition only (PsychOnly), and no depression (NoDep). We analyzed baseline demographics, comorbidities, healthcare utilization/payments, and chronic opioid use. Results: Breakdown of groups in our cohort: MDD (15%), OthDep (12%), PsychRx (13%), NonPsychRx (15%), PsychOnly (12%), and NoDep (33%). Postsurgery: increased outpatient resource utilization, admissions, and medication refills at 1, 2, and 5 yr in the NoDep, PsychOnly, NonPsychRx, PsychRx, and OthDep groups, and highest in MDD. Postoperative opioid usage rates remained unchanged in MDD (44%) and OthDep (36%), and reduced in PsychRx (40%), NonPsychRx (31%), and PsychOnly (20%), with greatest reduction in NoDep (13%). Reoperation rates: 1 yr after index procedure, MDD, OthDep, PsychRx, NonPsychRx, and PsychOnly had more reoperations compared to NoDep, and same at 2 and 5 yr. In NoDep patients, 45% developed new depressive phenotype postsurgery. Conclusion: EHR-defined classification allowed us to study in depth the effects of depression in spine surgery. This increased understanding of the interplay of mental health will help providers identify cohorts at risk for high complication rates, and health care utilization.
MeSH term(s)	Depression ; Depressive Disorder ; Electronic Health Records ; Humans ; Retrospective Studies ; Spinal Diseases/surgery
Language	English
Publishing date	2021-04-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1093/neuros/nyab096
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 539: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

To top

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito