Spine
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Multicenter Study
Transcranial Motor-evoked Potentials for Intraoperative Nerve Root Monitoring during Adult Spinal Deformity Surgery: A Prospective Multicenter Study.
A prospective, multicenter study. ⋯ Nerve root injuries in our ASD cohort were partially predictable using multichannel Tc-MEPs with a 70% decrease in amplitude as an alarm threshold. We propose that future research should evaluate the efficacy of an idealized warning threshold (e.g., 50%) and a more detailed evoked muscle selection, in reducing false negatives.
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Retrospective case series. ⋯ Bundled payment models utilize wage index and diagnosis-related groups to determine reimbursement of ACDF. However, machine learning algorithms identified additional variables, such as hospital volume, readmission, and patient age, that are also important for determining the cost of care. Machine learning can improve cost-effectiveness and reduce the financial burden placed upon physicians and hospitals by implementing patient-specific reimbursement.
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Retrospective cohort study. ⋯ Despite a population with greater comorbidity and associated risk, outcomes remained consistent between early and later time periods, indicating general improvements in care. The later cohort demonstrated fewer three-column osteotomies, less suboptimal realignments, and concomitant reductions in adverse events and neurological complications. This may suggest a greater facility with less invasive techniques.
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Randomized Controlled Trial
Abaloparatide Enhances Fusion and Bone Formation in a Rabbit Spinal Arthrodesis Model.
Prospective randomized placebo controlled animal trial. ⋯ Abaloparatide significantly increased the fusion rate in a rabbit posterolateral fusion model as assessed by manual palpation. In addition, there were marked increases in the radiographic evaluation of fusion.