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Article ; Online: Passive or active drainage system for chronic subdural haematoma-a single-center retrospective follow-up study.

Majewska, Paulina / Madsbu, Mattis A / Sagberg, Lisa Millgård / Gulati, Sasha / Jakola, Asgeir Store / Solheim, Ole

2024 Volume 166, Issue 1, Page(s) 89

Abstract: Background: Postoperative drainage systems have become a standard treatment for chronic subdural hematoma (CSDH). We previously compared treatment results from three Scandinavian centers using three different postoperative drainage systems and concluded ...

Abstract	Background: Postoperative drainage systems have become a standard treatment for chronic subdural hematoma (CSDH). We previously compared treatment results from three Scandinavian centers using three different postoperative drainage systems and concluded that the active subgaleal drainage was associated with lower recurrence and complication rates than the passive subdural drainage. We consequently changed clinical practice from using the passive subdural drainage to the active subgaleal drainage. Objective: The aim of the present study was to assess a potential change in reoperation rates for CSDH after conversion to the active subgaleal drainage. Methods: This single-center cohort study compared the reoperation rates for recurrent same-sided CSDH and postoperative complication rates between patients treated during two study periods (passive subdural drainage cohort versus active subgaleal drainage cohort). Results: In total, 594 patients were included in the study. We found no significant difference in reoperation rates between the passive subdural drain group and the active subgaleal drain group (21.6%, 95% CI 17.5-26.4% vs. 18.0%, 95% CI 13.8-23.2%; p = 0.275). There was no statistical difference in the rate of serious complications between the groups. The operating time was significantly shorter for patients operated with the active subgaleal drain than patients with the passive subdural drain (32.8 min, 95% CI 31.2-34.5 min vs. 47.6 min, 95% CI 44.7-50.4 min; p < 0.001). Conclusions: Conversion from the passive subdural to the active subgaleal drainage did not result in a clear reduction of reoperation rates for CSDH in our center.
MeSH term(s)	Humans ; Follow-Up Studies ; Cohort Studies ; Retrospective Studies ; Hematoma, Subdural, Chronic/surgery ; Reoperation
Language	English
Publishing date	2024-02-19
Publishing country	Austria
Document type	Journal Article
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-024-05967-6
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Article ; Online: Is surgery for recurrent lumbar disc herniation worthwhile or futile? A single center observational study with patient reported outcomes.

Lønne, Vetle Vangen / Madsbu, Mattis A / Salvesen, Øyvind / Nygaard, Øystein / Solberg, Tore K / Gulati, Sasha

Brain & spine

2022 Volume 2, Page(s) 100894

Abstract: Objective: To examine outcomes and complications following microdiscectomy for recurrent lumbar disc herniation.: Methods: Prospectively collected data for patients operated at the Department of Neurosurgery, St. Olavs University Hospital, Norway, ... ...

Abstract	Objective: To examine outcomes and complications following microdiscectomy for recurrent lumbar disc herniation. Methods: Prospectively collected data for patients operated at the Department of Neurosurgery, St. Olavs University Hospital, Norway, were obtained from the Norwegian Registry for Spine Surgery from May 2007 through July 2016. All patients underwent lumbar microdiscectomy. The primary outcome was change in the Oswestry Disability Index (ODI) at one year. Secondary endpoints were change in quality of life measured with EuroQol 5 Dimensions (EQ-5D), back and leg pain measured with numerical rating scales (NRS), complications, and duration of surgery and hospital stays. Results: 276 patients were enrolled in the study. A total of 161 patients (58.3%) completed one-year follow-up. The mean improvement in ODI at one year was 27.1 points (95% CI 23.1 to 31.0, P <0.001). The mean improvement in EQ-5D at one year of 0.47 points (95% CI 0.40-0.54, P <0.001), representing a large effect size (Cohens D = 1.3). The mean improvement in back pain and leg pain NRS were 4.3 points (95% CI 2.2-3.2, P <0.001) and 3.8 points (95% CI 2.8-3.9, P <0.001), respectively. Nine patients (3.3%) experienced intraoperative complications, and 15 (5.5%) out of 160 patients reported complications within three months following hospital discharge. Conclusions: This study shows that patients operated for recurrent lumbar disc herniation in general report significant clinical improvement.
Language	English
Publishing date	2022-05-11
Publishing country	Netherlands
Document type	Journal Article
ISSN	2772-5294
ISSN (online)	2772-5294
DOI	10.1016/j.bas.2022.100894
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Article ; Online: Surgery for herniated lumbar disc in private vs public hospitals: A pragmatic comparative effectiveness study.

Madsbu, Mattis A / Salvesen, Øyvind / Carlsen, Sven M / Westin, Steinar / Onarheim, Kristian / Nygaard, Øystein P / Solberg, Tore K / Gulati, Sasha

Acta neurochirurgica

2020 Volume 162, Issue 3, Page(s) 703–711

Abstract: Background: There is limited evidence on the comparative performance of private and public healthcare. Our aim was to compare outcomes following surgery for lumbar disc herniation (LDH) in private versus public hospitals.: Methods: Data were obtained ...

Abstract	Background: There is limited evidence on the comparative performance of private and public healthcare. Our aim was to compare outcomes following surgery for lumbar disc herniation (LDH) in private versus public hospitals. Methods: Data were obtained from the Norwegian registry for spine surgery. Primary outcome was change in Oswestry disability index (ODI) 1 year after surgery. Secondary endpoints were quality of life (EuroQol EQ-5D), back and leg pain, complications, and duration of surgery and hospital stays. Results: Among 5221 patients, 1728 in the private group and 3493 in the public group, 3624 (69.4%) completed 1-year follow-up. In the private group, mean improvement in ODI was 28.8 points vs 32.3 points in the public group (mean difference - 3.5, 95% CI - 5.0 to - 1.9; P for equivalence < 0.001). Equivalence was confirmed in a propensity-matched cohort and following mixed linear model analyses. There were differences in mean change between the groups for EQ-5D (mean difference - 0.05, 95% CI - 0.08 to - 0.02; P = 0.002) and back pain (mean difference - 0.2, 95% CI - 0.2, - 0.4 to - 0.004; P = 0.046), but after propensity matching, the groups did not differ. No difference was found between the two groups for leg pain. Complication rates was lower in the private group (4.5% vs 7.2%; P < 0.001), but after propensity matching, there was no difference. Patients operated in private clinics had shorter duration of surgery (48.4 vs 61.8 min) and hospital stay (0.7 vs 2.2 days). Conclusion: At 1 year, the effectiveness of surgery for LDH was equivalent in private and public hospitals.
MeSH term(s)	Adult ; Female ; Hospitals, Private/statistics & numerical data ; Hospitals, Public/statistics & numerical data ; Humans ; Intervertebral Disc Degeneration/surgery ; Intervertebral Disc Displacement/surgery ; Length of Stay/statistics & numerical data ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Neurosurgical Procedures/adverse effects ; Neurosurgical Procedures/statistics & numerical data ; Norway ; Postoperative Complications/epidemiology ; Quality of Life ; Treatment Outcome
Language	English
Publishing date	2020-01-04
Publishing country	Austria
Document type	Comparative Study ; Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-019-04195-7
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Article ; Online: Microdiscectomy for Lumbar Disc Herniation: A Single-Center Observational Study.

Vangen-Lønne, Vetle / Madsbu, Mattis A / Salvesen, Øyvind / Nygaard, Øystein P / Solberg, Tore K / Gulati, Sasha

World neurosurgery

2020 Volume 137, Page(s) e577–e583

Abstract: Objective: To examine outcomes and complications following first-time lumbar microdiscectomy.: Methods: Prospective data for patients operated on between May 2007 and July 2016 were obtained from the Norwegian Registry for Spine Surgery. The primary ... ...

Abstract	Objective: To examine outcomes and complications following first-time lumbar microdiscectomy. Methods: Prospective data for patients operated on between May 2007 and July 2016 were obtained from the Norwegian Registry for Spine Surgery. The primary outcome was change in Oswestry Disability Index (ODI) score at 1 year. Secondary endpoints were change in quality of life measured with EuroQol 5 Dimensions, back and leg pain measured with numeric rating scales, and perioperative complications within 3 months of surgery. Results: For all enrolled patients (N = 1219) enrolled, mean improvement in ODI at 1 year was 33.3 points (95% confidence interval [CI] 31.7 to 34.9, P < 0.001). Mean improvement in EuroQol 5 Dimensions at 1 year of 0.52 point (95% CI 0.49 to 0.55, P < 0.001) represents a large effect size (Cohen's d = 1.6). Mean improvements in back pain and leg pain numeric rating scales were 3.9 points (95% CI 3.6 to 4.1, P < 0.001) and 5.0 points (95% CI 4.8 to 5.2, P < 0.001), respectively. There were 18 surgical complications in 1219 patients and 63 medical complications in 846 patients. The most common complication was micturition problems at 3 months following surgery (n = 25, 2.1%). In multivariate analysis, ODI scores of 21-40 (hazard ratio [HR] 14.5, 95% CI 1.1 to 27.9, P = 0.035), 41-60 (HR 27.5, 95% CI 13.4 to 41.7, P < 0.001), 61-80 (HR 47.4, 95% CI 33.4 to 61.4, P < 0.001) and >81 (HR 66.7, 95% CI 51.1 to 82.2, P < 0.001) were identified as positive predictors for ODI improvement at 1 year, whereas age ≥65 (HR -0.9, 95% CI -0.3 to -1.5, P = 0.004) was identified as a negative predictor for ODI improvement. Conclusions: Microdiscectomy for lumbar disc herniation is an effective and safe treatment.
MeSH term(s)	Adult ; Back Pain/etiology ; Back Pain/surgery ; Diskectomy/methods ; Female ; Humans ; Intervertebral Disc Displacement/complications ; Intervertebral Disc Displacement/surgery ; Lumbar Vertebrae/surgery ; Male ; Middle Aged ; Pain Measurement ; Prospective Studies ; Quality of Life ; Treatment Outcome
Language	English
Publishing date	2020-02-17
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2020.02.056
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Article: Can a Successful Outcome After Surgery for Lumbar Disc Herniation Be Defined by the Oswestry Disability Index Raw Score?

Werner, David A T / Grotle, Margreth / Gulati, Sasha / Austevoll, Ivar M / Madsbu, Mattis A / Lønne, Greger / Solberg, Tore K

Global spine journal

2019 Volume 10, Issue 1, Page(s) 47–54

Abstract: Study design: Prospective multicenter cohort study.: Objective: To investigate (1) the discriminative ability and cutoff estimates for success 12 months after surgery for lumbar disc herniation on the Oswestry Disability Index (ODI) raw score ... ...

Abstract	Study design: Prospective multicenter cohort study. Objective: To investigate (1) the discriminative ability and cutoff estimates for success 12 months after surgery for lumbar disc herniation on the Oswestry Disability Index (ODI) raw score compared with a change and a percentage change score and (2) to what extent these clinical outcomes depend on the baseline disability. Methods: A total of 6840 patients operated for lumbar disc herniation from the Norwegian Registry for Spine Surgery (NORspine) were included. In receiver operating characteristic (ROC) curve analyses, a global perceived effect (GPE) scale (1-7) was used an external anchor. Success was defined as categories 1-2, "completely recovered" and "much better." Cutoffs for success for subgroups with different preoperative disability were also estimated. Results: When defining success after surgery for lumbar disc herniation, the accuracy (sensitivity, specificity, area under the curve, 95% CI) for the ODI raw score (0.83, 0.87, 0.930, 0.924-0.937) was comparable to the ODI percentage change score (0.85, 0.85, 0.925, 0.918-0.931), and higher than the ODI change score (0.79, 0.73, 0.838, 0.830-0.852). The cutoff for success was highly dependent on the amount of baseline disability (low-high), with cutoffs ranging from 13 to 28 for the ODI raw score and 39% to 66% for ODI percentage change. The ODI change score (points) was not as accurate. Conclusion: The 12-month ODI raw score, like the ODI percentage change score, can define a successful outcome with excellent accuracy. Adjustment for the baseline ODI score should be performed when comparing outcomes across groups, and one should consider using cutoffs according to preoperative disability (low, medium, high ODI scores).
Language	English
Publishing date	2019-06-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2648287-3
ISSN	2192-5690 ; 2192-5682
ISSN (online)	2192-5690
ISSN	2192-5682
DOI	10.1177/2192568219851480
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Article ; Online: Surgery for Herniated Lumbar Disk in Individuals 65 Years of Age or Older: A Multicenter Observational Study.

Madsbu, Mattis A / Solberg, Tore K / Salvesen, Øyvind / Nygaard, Øystein P / Gulati, Sasha

JAMA surgery

2017 Volume 152, Issue 5, Page(s) 503–506

MeSH term(s)	Age Factors ; Aged ; Diskectomy/methods ; Female ; Humans ; Incidence ; Intervertebral Disc Displacement/epidemiology ; Intervertebral Disc Displacement/surgery ; Lumbar Vertebrae ; Male ; Norway/epidemiology ; Registries ; Treatment Outcome
Language	English
Publishing date	2017-02-22
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2701841-6
ISSN	2168-6262 ; 2168-6254
ISSN (online)	2168-6262
ISSN	2168-6254
DOI	10.1001/jamasurg.2016.5557
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Conference proceedings: Surgery for lumbar disc herniation in individuals aged 65 and older – a multicentre observational study

Madsbu, Mattis A. / Solberg, Tore K. / Salvesen, Øyvind / Nygaard, Øystein P. / Gulati, Sasha

2019 , Page(s) JM–SNS03

Event/congress	70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie; Würzburg; Deutsche Gesellschaft für Neurochirurgie; 2019
Keywords	Medizin, Gesundheit
Publishing date	2019-05-08
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/19dgnc065
Database	German Medical Science

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Article ; Online: Validation of intracranial hemorrhage in the Norwegian Patient Registry.

Øie, Lise R / Madsbu, Mattis A / Giannadakis, Charalampis / Vorhaug, Anders / Jensberg, Heidi / Salvesen, Øyvind / Gulati, Sasha

Brain and behavior

2018 Volume 8, Issue 2, Page(s) e00900

Abstract: Objectives: Administrative health registries need to have accurate diagnoses and sufficient coverage in the population they serve in order to be useful in research. In this study, we investigated the proportion of discharge diagnoses of intracranial ... ...

Abstract	Objectives: Administrative health registries need to have accurate diagnoses and sufficient coverage in the population they serve in order to be useful in research. In this study, we investigated the proportion of discharge diagnoses of intracranial hemorrhage (ICH) that were coded correctly in the Norwegian Patient Registry (NPR). Materials and methods: We reviewed the electronic medical records and diagnostic imaging of all admissions to St. Olavs University Hospital, Trondheim, Norway, between January 1, 2008, to December 31, 2014, with a discharge diagnosis of ICH in the NPR, and estimated positive predictive values (PPVs) for primary and secondary diagnoses. Separate calculations were made for inpatient and outpatient admissions. Results: In total, 1,419 patients with 1,458 discharge diagnoses of ICH were included in our study. Overall, 1,333 (91.4%) discharge diagnoses were coded correctly. For inpatient admissions, the PPVs for primary discharge codes were 96.9% for hemorrhagic stroke, 95.3% for subarachnoid hemorrhage, and 97.9% for subdural hemorrhage. The most common cause of incorrect diagnosis was previous stroke that should have been coded as rehabilitation or sequela after stroke. There were more false-positive diagnoses among outpatient consultations and secondary diagnoses. Conclusion: Coding of ICH discharge diagnoses in the NPR is of high quality, showing that data from this registry can safely be used for medical research.
MeSH term(s)	Aged ; Clinical Coding/standards ; Data Accuracy ; Diagnostic Errors/prevention & control ; Diagnostic Errors/statistics & numerical data ; Electronic Health Records/statistics & numerical data ; Female ; Hematoma, Subdural/diagnosis ; Hematoma, Subdural/epidemiology ; Humans ; Intracranial Hemorrhages/diagnosis ; Intracranial Hemorrhages/epidemiology ; Male ; Middle Aged ; Norway/epidemiology ; Patient Discharge/statistics & numerical data ; Predictive Value of Tests ; Registries/standards ; Registries/statistics & numerical data ; Stroke/diagnosis ; Stroke/epidemiology ; Subarachnoid Hemorrhage/diagnosis ; Subarachnoid Hemorrhage/epidemiology
Language	English
Publishing date	2018-01-23
Publishing country	United States
Document type	Journal Article ; Validation Study
ZDB-ID	2623587-0
ISSN	2162-3279 ; 2162-3279
ISSN (online)	2162-3279
ISSN	2162-3279
DOI	10.1002/brb3.900
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Article ; Online: Lumbar Microdiscectomy in Obese Patients: A Multicenter Observational Study.

Madsbu, Mattis A / Øie, Lise R / Salvesen, Øyvind / Vangen-Lønne, Vetle / Nygaard, Øystein P / Solberg, Tore K / Gulati, Sasha

World neurosurgery

2018 Volume 110, Page(s) e1004–e1010

Abstract: Objective: To evaluate the association between obesity and outcomes after microdiscectomy for lumbar disc herniation.: Methods: The primary outcome measure was change in Oswestry Disability Index (ODI) at 1 year after surgery. Obesity was defined as ... ...

Abstract	Objective: To evaluate the association between obesity and outcomes after microdiscectomy for lumbar disc herniation. Methods: The primary outcome measure was change in Oswestry Disability Index (ODI) at 1 year after surgery. Obesity was defined as body mass index (BMI) ≥30. Prospective data were retrieved from the Norwegian Registry for Spine Surgery. Results: We enrolled 4932 patients, 4018 nonobese and 914 obese. For patients with complete 1-year follow-up (n = 3381) the mean improvement in ODI was 31.2 points (95% confidence interval 30.4-31.9, P < 0.001). Improvement in ODI was 31.4 points in nonobese and 30.1 points in obese patients (P = 0.182). Obese and nonobese patients were as likely to achieve a minimal clinically important difference (84.2 vs. 82.7%, P = 0.336) in ODI (≥10 points improvement). Obesity was identified as a negative predictor for ODI improvement in a multiple regression analysis (BMI 30-34.99; P < 0.001, BMI ≥35; P = 0.029). Obese and nonobese patients experienced similar improvement in Euro-Qol-5 scores (0.48 vs. 0.49 points, P = 0.441) as well as back pain (3.7 vs. 3.5 points, P = 0.167) and leg pain (4.7 vs. 4.8 points, P = 0.654), as measured by the Numeric Rating Scale. Duration of surgery was shorter for nonobese patients (55.7 vs. 65.3 minutes, P ≤ 0.001). Nonobese patients experienced fewer complications compared with obese patients (6.1% vs. 8.3%, P = 0.017). Obese patients had slightly longer hospital stays (2.0 vs. 1.8 days, P = 0.004). Conclusions: Although they had more minor complications, obese individuals experienced improvement after lumbar microdiscectomy for lumbar disc herniation similar to that of nonobese individuals.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration/epidemiology ; Intervertebral Disc Degeneration/etiology ; Intervertebral Disc Degeneration/surgery ; Intervertebral Disc Displacement/epidemiology ; Intervertebral Disc Displacement/etiology ; Intervertebral Disc Displacement/surgery ; Lumbar Vertebrae/surgery ; Male ; Microdissection/methods ; Middle Aged ; Norway/epidemiology ; Obesity/complications ; Obesity/epidemiology ; Retrospective Studies ; Treatment Outcome ; Young Adult
Language	English
Publishing date	2018-02
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Observational Study
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2017.11.156
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Article ; Online: Accuracy and complication rates of external ventricular drain placement with twist drill and bolt system versus standard trephine and tunnelation: a retrospective population-based study.

Mansoor, Nadia / Madsbu, Mattis A / Mansoor, Nina M / Trønnes, Andreas N / Fredriksli, Oddrun A / Salvesen, Øyvind / Jakola, Asgeir S / Solheim, Ole / Gulati, Sasha

Acta neurochirurgica

2020 Volume 162, Issue 4, Page(s) 755–761

Abstract: Background: An external ventricular drain (EVD) is typically indicated in the presence of hydrocephalus and increased intracranial pressure (ICP). Procedural challenges have prompted the development of different methods to improve accuracy, safety, and ... ...

Abstract	Background: An external ventricular drain (EVD) is typically indicated in the presence of hydrocephalus and increased intracranial pressure (ICP). Procedural challenges have prompted the development of different methods to improve accuracy, safety, and logistics. Objectives: EVD placement and complications rates were compared using two surgical techniques; the standard method (using a 14-mm trephine burrhole with the EVD tunnelated through the skin) was compared to a less invasive method (EVD placed through a 2.7-3.3-mm twist drill burrhole and fixed to the bone with a bolt system). Methods: Retrospective observational study in a single-centre setting between 2008 and 2018. EVD placement was assessed using the Kakarla scoring system. We registered postoperative complications, surgery duration and number of attempts to place the EVD. Results: Two hundred seventy-two patients received an EVD (61 bolt EVDs, 211 standard EVDs) in the study period. Significant differences between the bolt system and the standard method were observed in terms of revision surgeries (8.2% vs. 21.5%, p = 0.020), surgery duration (mean 16.5 vs. 28.8 min, 95% CI 7.64, 16.8, p < 0.001) and number of attempts to successfully place the first EVD (mean 1.72 ± 1.2 vs. 1.32 ± 0.8, p = 0.017). There were no differences in accuracy of placement or complication rates. Conclusions: The two methods show similar accuracy and postoperative complication rates. Observed differences in both need for revisions and surgery duration favoured the bolt group. Slightly, more attempts were needed to place the initial EVD in the bolt group, perhaps reflecting lower flexibility for angle correction with a twist drill approach.
MeSH term(s)	Adult ; Aged ; Cerebral Ventricles/surgery ; Drainage/adverse effects ; Drainage/methods ; Female ; Humans ; Hydrocephalus/surgery ; Male ; Middle Aged ; Operative Time ; Patient Safety ; Postoperative Complications/epidemiology ; Reoperation/statistics & numerical data ; Retrospective Studies ; Treatment Outcome ; Trephining/adverse effects ; Trephining/methods ; Ventriculostomy
Language	English
Publishing date	2020-02-04
Publishing country	Austria
Document type	Journal Article ; Observational Study
ZDB-ID	80010-7
ISSN	0942-0940 ; 0001-6268
ISSN (online)	0942-0940
ISSN	0001-6268
DOI	10.1007/s00701-020-04247-3
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