Journal of spinal disorders & techniques
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J Spinal Disord Tech · Mar 2016
Increased Preoperative Narcotic Use and Its Association With Postoperative Complications and Length of Hospital Stay in Patients Undergoing Spine Surgery.
Prospective cohort analysis. ⋯ Increased preoperative narcotic use and depression are associated with increased LOS in patients undergoing spine surgery. We calculated that for every 100 morphine equivalents a patient is taking preoperatively; their stay is extended 1.1 days. Narcotic use was not associated with 30- or 90-day postoperative complications. As reimbursement is bundled before surgery, providing interventions for patients with treatable causes for increased length of stay can save cost overall.
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J Spinal Disord Tech · Mar 2016
Radiographic Restoration of Sagittal Spinopelvic Alignment After Posterior Lumbar Interbody Fusion in Degenerative Spondylolisthesis.
A retrospective study. ⋯ Surgical correction of degenerative spondylolisthesis with posterior lumbar interbody fusion and posterior instrumentation resulted in relief of back pain, which may be associated with improvement of sagittal spinopelvic alignment. Surgeons should consider deformity parameters, especially the SA, in the surgical treatment of degenerative spondylolisthesis.
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J Spinal Disord Tech · Feb 2016
Randomized Controlled TrialRadiographic Analysis of One-level Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF) With Unilateral Pedicle Screw Fixation for Lumbar Degenerative Diseases.
A prospective randomized study was conducted. ⋯ One-level unilateral pedicle screw instrumented MI-TLIF provided similar radiologic and clinical outcomes to bilateral pedicle screw instrumented MI-TLIF. This study showed that MIS-TLIF with unilateral pedicle screw fixation would be sufficient in the management of preoperatively stable patients with lumbar degenerative disease.
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J Spinal Disord Tech · Feb 2016
Cost-utility Analysis of One and Two-level Dorsal Lumbar Fusions With and Without Recombinant Human Bone Morphogenic Protein-2 at 1-year Follow-up.
A retrospective 1-year cost-utility analysis. ⋯ Statistically significant and clinically relevant improvements (through minimum clinically important differences) were seen for both cohorts. In the ICER analysis, the control cohort dominated the rhBMP-2 group. Assuming durable per year gains in QALY, by 2 years fusion with autograft but without rhBMP-2 would be considered cost-effective ($71,625/QALY gained), whereas fusion with both autograft and rhBMP-2 would not be cost-effective ($136,207/QALY gained).
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J Spinal Disord Tech · Feb 2016
Factors Affecting Length of Stay and Complications After Elective Anterior Cervical Discectomy and Fusion: A Study of 2164 Patients From The American College of Surgeons National Surgical Quality Improvement Project Database (ACS NSQIP).
Retrospective review of the prospective American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) database with 30-day follow-up of 2164 patients undergoing elective anterior cervical discectomy and fusion (ACDF). ⋯ Extended LOS after ACDF is associated with factors including age, anemia, and diabetes, as well as the development of postoperative complications. One in 33 patients develops a major complication postoperatively, which are associated with an increased LOS of 5 days.