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Mashup Score: 2Impact of Frailty and Cervical Radiographic Parameters on... : Spine - 2 month(s) ago
a. There is a growing body of literature indicating an association between frailty and increased postoperative complications following various surgeries. However, few studies have investigated the relationship between frailty and postoperative dysphagia after anterior cervical spine surgery. Materials and Methods. Patients who underwent anterior cervical spine surgery for the treatment of degenerative cervical pathology were included. Frailty and dysphagia were assessed by the modified Frailty Index-11 (mFI-11) and Eat Assessment Tool 10 (EAT-10), respectively. We also collected clinical demographics and cervical alignment parameters previously reported as risk factors for postoperative dysphagia. Multivariable logistic regression was performed to identify the odds ratio (OR) of postoperative dysphagia at early (2–6 weeks) and late postoperative time points (1–2 years). Results. Ninety-five patients who underwent ACSS were included in the study. Postoperative dysphagia occurred in 31 p
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Mashup Score: 8
minimizing opioid use after lumbar spinal fusion is an important area of study. Patients and Methods. Patients aged 18 to 75 years undergoing 1 to 2 level lumbar fusions between April 2016 and December 2019 were included. Patients with chronic opioid use, smokers, and those on systemic glucocorticoids or contraindications to study medications were excluded. A block randomization scheme was used, and study personnel, hospital staff, and subjects were blinded to the assignment. Patients were randomized postoperatively. The IV-K group received 15 mg (age > 65) or 30 mg (age < 65) every six hours (q6h) for 48 hours, IV-A received 1000 mg q6h, and IV-P received normal saline q6h for 48 hours. Demographic and surgical details, opioid use in morphine milliequivalents, opioid-related adverse events, and length of stay (LOS) were recorded. The primary outcome was in-hospital opioid use up to 72 hours. Results. A total of 171 patients were included (58 IV-K, 55 IV-A, and 58 IV-P) in the intent-t
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Mashup Score: 4Pain Medication Use Two Years After Adolescent Idiopathic... : Spine - 3 month(s) ago
Studies of opiate use have reported that up to 80% of users began their addiction with misuse of prescription opioids. Identifying opioid use and those at risk in the AIS population is critical for optimal outcomes. Materials and Methods. A query of a multicenter prospective AIS surgical fusion registry was performed to identify patients of all curve types with responses to question 11 on the Scoliosis Research Society-22 questionnaire at two years postoperative. Question 11 asks about pain medication usage for the patient’s back with five specific responses: narcotics daily, narcotics weekly or less, non-narcotics daily, non-narcotics weekly/less, or none. Ordinal regression was used to evaluate the association between preoperative Scoliosis Research Society-22 Mental Health (MH) domain scores and two-year postoperative pain medication usage. Results. A total of 2595 patients who underwent surgery from 2002 to 2019 met inclusion. The average primary curve was 56±12°, average age 14.7±
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Mashup Score: 2
k on perioperative outcomes and its safety in MI-TLIF. Materials and Methods. Patients who underwent 1-level MI-TLIF and received the ESP block (group E) were included. An age and sex-matched control group was selected from a historical cohort that received the standard-of-care (group NE). The primary outcome of this study was 24-hour opioid consumption in morphine milligram equivalents. Secondary outcomes were pain severity measured by a numeric rating scale, opioid-related side effects, and hospital length of stay. Outcomes were compared between the two groups. Results. Ninety-eight and 55 patients were included in the E and NE groups, respectively. There were no significant differences between the two cohorts in patient demographics. Group E had lower 24-hour postoperative opioid consumption (P = 0.117, not significant), reduced opioid consumption on a postoperative day (POD) 0 (P = 0.016), and lower first pain scores postsurgery (P < 0.001). Group E had lower intraoperative opioid
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Mashup Score: 6
development of CDA. Materials and Methods. Forty-seven patients with single-level cervical radiculopathy were randomized to either BRYAN CDA or ACDF for a Food and Drug Administration Investigational Device Exemption trial. At 20 years, patient-reported outcomes, including visual analog scales (VAS) for neck and arm pain, neck disability index (NDI), and reoperation rates, were analyzed. Results. Follow-up rate was 91.3%. Both groups showed significantly better NDI, VAS arm pain, and VAS neck pain scores at 20 years versus preoperative scores. Comparing CDA versus ACDF, there was no difference at 20 years in mean scores for NDI [11.1 (SD 14.1) vs. 19.9 (SD 17.2), P=0.087], mean VAS arm pain [0.9 (SD 2.4) vs. 2.3 (SD 2.8), P=0.095], or mean VAS neck pain [1.2 (SD 2.5) vs. 2.9 (3.3), P=0.073]. There was a significant difference between CDA versus ACDF groups in the change in VAS neck pain score between 10 and 20 years [respectively, −0.4 (SD 2.5) vs. 1.5 (SD 2.5), P=0.030]. Reoperations
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Mashup Score: 2
) positively associated with skeletal maturity using Risser grade, scoliosis severity using the Cobb angle, and chronological age in years. Summary of Background Data: AIS is a three-dimensional deformity of the spine which occurs in 2.5% to 3.7% of the Australian population. There is some evidence of asymmetry in paraspinal muscle activation and morphology in AIS. Asymmetric paraspinal muscle forces may facilitate asymmetric vertebral growth during adolescence. Methods: An asymmetryindex [Ln(concave/convex volume)] of deep and superficial paraspinal muscle volumes, at the level of the major curve apex (Thoracic 8-9th vertebral level) and lower-end vertebrae (LEV, Thoracic 10-12th vertebral level), was determined from three-dimensional Magnetic Resonance Imaging of 25 adolescents with AIS (all right thoracic curves), and 22 healthy controls (convex=left); all female, 10 to 16 years. Results: Asymmetryindex of deep paraspinal muscle volumes was greater in AIS (0.16±0.20) than healthy sp
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Mashup Score: 4Recovery Kinetics After Cervical Spine Surgery : Spine - 4 month(s) ago
is a big gap in the literature, as preoperative counseling and expectations before surgery are important. Materials and Methods. Patients who underwent either anterior cervical discectomy and fusion (ACDF) or cervical disk replacement (CDR) were included. Data collected included preoperative patient-reported outcome measures, return to driving, return to working, and discontinuation of opioids data. A multivariable regression was conducted to identify the factors associated with return to driving by 15 days, return to working by 15 days, and discontinuing opioids by 30 days. Results. Seventy ACDF patients and 70 CDR patients were included. Overall, 98.2% of ACDF patients and 98% of CDR patients returned to driving in 16 and 12 days, respectively; 85.7% of ACDF patients and 90.9% of CDR patients returned to work in 16 and 14 days; and 98.3% of ACDF patients and 98.3% of CDR patients discontinued opioids in a median of seven and six days. Though not significant, minimal (odds ratio (OR)=
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Mashup Score: 10Longitudinal Relationship Between Reduced Modic Change... : Spine - 4 month(s) ago
not clear whether or not reduced MC edema implies improved clinical outcomes. Patients and Methods. Linear regression was conducted separately in 2 subgroups with MC edema at baseline on short tau inversion recovery (STIR) or T1/T2-weighted magnetic resonance imaging, respectively. Independent variable: reduced edema (yes/no) at 1 year on STIR or T1/T2-series, respectively. Dependent variable: 1-year score on the Roland-Morris Disability Questionnaire (RMDQ), Oswestry Disability Index (ODI), or 0 to 10 numeric rating scale for LBP intensity, adjusted for the baseline score, age, smoking, body mass index, physical workload, and baseline edema on STIR (STIR analysis only). Post hoc, we, in addition, adjusted all analyses for baseline edema on STIR, treatment group (amoxicillin/placebo), and prior disc surgery—or for disc degeneration. Results. Among patients with MC edema on STIR at baseline (n = 162), reduced edema on STIR was not significantly related to the RMDQ (B: −1.0, 95% CI: −2.8
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Mashup Score: 3Quantifying Typical Progression of Adolescent Idiopathic... : Spine - 4 month(s) ago
rogressive deforming condition that occurs in three dimensions of the scoliotic spine during periods of growth. However, there remains a gap for multiple timepoint segmental deformity analysis in AIS cohorts during development. Materials and Methods. Thirty-six female patients with Lenke 1 AIS curves underwent two to six sequential magnetic resonance images. Scans were reformatted to produce images in orthogonal dimensions. Wedging angles and rotatory values were measured for segmental elements within the major curve. Two-tailed, paired t tests compared morphologic differences between sequential scans. Rates of change were calculated for variables given the actual time between successive scans. Pearson correlation coefficients were determined for multidimensional deformity measurements. Results. Vertebral bodies were typically coronally convexly wedged, locally lordotic, convexly axially rotated, and demonstrated evidence of local mechanical torsion. Between the first and final scans,
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Mashup Score: 18Vertebral Bone Quality Score as a Predictor of Pedicle... : Spine - 4 month(s) ago
unit (HU) value, is more predictive of pedicle screw loosening. Summary of Background Data. In clinical work, we found that patients with screw loosening had higher VBQ scores. In addition, some studies have found a correlation between VBQ scores and osteoporosis. Patients and Methods. Patients who were treated with lumbar pedicle screw fixation were reviewed. The VBQ score was measured using magnetic resonance imaging scans. The HU value for L1 to L4 lumbar bone mineral density was measured with computed tomography scans. Logistic regression analysis was used to identify factors associated with pedicle screw loosening. Receiver-operating characteristic curve analysis was used to evaluate the value of VBQ scores in predicting pedicle screw loosening. Results. A total of 156 patients were included in the final analysis. The pedicle screw loosening rate was 35% (55 of 156 patients). The postoperative low-back pain visual analog scale score was higher in the loosening group (3.0 ± 2.0 vs.
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✨Featured Article✨ ICYMI: In patients undergoing anterior cervical #spine surgery, the following is associated w/ postoperative dysphagia 1. Frailty 2. Overcorrection of TS–CL 3. Surgery at C3/C4 #OrthoTwitter #NSGY https://t.co/qEUiQjNhYW