The spine journal : official journal of the North American Spine Society
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The impact of surgical site infection (SSI) is substantial. Although previous study has determined relative risk and odds ratio (OR) values to quantify risk factors, these values may be difficult to translate to the patient during counseling of surgical options. Ideally, a model that predicts absolute risk of SSI, rather than relative risk or OR values, would greatly enhance the discussion of safety of spine surgery. To date, there is no risk stratification model that specifically predicts the risk of medical complication. ⋯ We present a validated model for predicting SSI after spine surgery. The value in this model is that it gives the user an absolute percent likelihood of SSI after spine surgery based on the patient's comorbidity profile and invasiveness of surgery. Patients are far more likely to understand an absolute percentage, rather than relative risk and confidence interval values. A model such as this is of paramount importance in counseling patients and enhancing the safety of spine surgery. In addition, a tool such as this can be of great use particularly as health care trends toward pay for performance, quality metrics (such as SSI), and risk adjustment. To facilitate the use of this model, we have created a Web site (SpineSage.com) where users can enter patient data to determine likelihood for SSI.
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Comparative Study Clinical Trial
Oswestry Disability Index is a better indicator of lumbar motion than the Visual Analogue Scale.
Lumbar pathology is often associated with axial pain or neurologic complaints. It is often presumed that such pain is associated with decreased lumbar motion; however, this correlation is not well established. The utility of various outcome measures that are used in both research and clinical practice have been studied, but the connection with range of motion (ROM) has not been well documented. ⋯ Extremes of lumbar motion and motions associated with ADLs are of increasing clinical interest. Although the ODI and VAS are associated with each other, the ODI appears to be a better predictor of these motion parameters than the VAS (axial extremity, lower extremity, or combined) and may be more useful in the clinical setting when considering functional movement parameters.
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Walking capacity is a primary outcome indicator for individuals with lumbar spinal stenosis (LSS). Therefore, there is a demand for psychometrically sound measures of walking that are responsive to change. ⋯ The PF Scale, ODI, and walking capacity change score are able to detect changes in walking capacity in people with LSS. The individual walking capacity item from the ODI appears to be the most valid and responsive to changes in measured walking and may be a reasonable alternative for measuring walking when an objective test such as the SPWT is not feasible.
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Previous studies on the risk and prevalence of diabetes among spinal cord injury (SCI) patients are limited and controversial. ⋯ Our findings may facilitate the prioritizing of preventive health strategies and planning of long-term care for SCI patients.