The spine journal : official journal of the North American Spine Society
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Patient satisfaction is and will continue to become an important metric in the American health care system. To our knowledge, there is no current literature exploring the factors that impact patient satisfaction in outpatient orthopedic spine surgery clinic. ⋯ Two patient variables that have a statistical significance on Press Ganey patient satisfaction scores were pain score and "provider spent enough time with you."
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Coexisting Parkinson's disease (PD) and cervical spondylotic myelopathy (CSM) presents a diagnostic and therapeutic challenge due to symptomatic similarities between the diseases. Whereas CSM patients are routinely treated with surgery, PD patients face poorer outcomes following spine surgery. No studies have investigated the quality of life (QOL) outcomes following decompression in coexisting PD and CSM. ⋯ This is the first study to characterize QOL outcomes following cervical decompression for patients with coexisting PD and CSM. Although myelopathy may have been less severe among PD patients, a significant reduction in pain-related disability was observed following decompression. However, PD predicted diminished improvement in overall QOL measured by the EQ-5D.
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Multicenter Study Comparative Study
Anterior decompression with fusion versus posterior decompression with fusion for massive cervical ossification of the posterior longitudinal ligament with a ≥50% canal occupying ratio: a multicenter retrospective study.
Previous studies have shown that compared with laminoplasty, anterior decompression with fusion (ADF) is superior for postoperative neurologic improvement in patients with massive cervical ossification of the posterior longitudinal ligament (OPLL) with a ≥50% canal occupying ratio. However, it is unknown which method, ADF or posterior decompression with fusion (PDF), is more effective for the treatment of massive OPLL. ⋯ The present study demonstrated that the postoperative recovery rate was similar in the ADF and PDF group. In patients with massive OPLL with kyphotic alignment, neurologic recovery rate in the ADF was superior to that in the PDF (in situ fusion). Additionally, postoperative neck pain was less severe in the ADF group. However, the occurrence of perioperative complications was more common in the ADF group.
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Frailty is defined as a state of decreased reserve and susceptibility to stressors. The relationship between frailty and postoperative outcomes after degenerative spine surgery has not been studied. ⋯ Frailty is an important predictor of postoperative outcomes following degenerative spine surgery. Preoperative recognition of frailty may be useful for perioperative optimization, risk stratification, and patient counseling.
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The value of continuity of care in preventing 30-day readmissions after surgical procedures remains an issue of debate. ⋯ Using a comprehensive all-payer cohort of patients in New York State, who were evaluated in the ER after spine surgery, we identified an association of assessment in the hospital where the original procedure was performed with lower rate of 30-day readmissions. This underscores the potential importance of continuity of care in readmission prevention for these patients.