The spine journal : official journal of the North American Spine Society
-
Despite recent advances in gender equity in medicine, the representation of women in orthopedic and neurosurgery remains particularly low. Furthermore, compared with their male colleagues, female faculty members are less likely to publish research, limiting opportunities in the academic promotion process. Understanding disparities in research productivity provides insight into the "gender gap" in the spine surgeon workforce. ⋯ Female representation in academic spine research has doubled over the past 4 decades, although the growth of female representation as senior author has plateaued. Female physician-investigators are half as likely to continue participating in spine-related research longer than 5 years and on average publish half as many articles as senior author. In addition to recruiting more women into research, efforts should be made to identify and address barriers in research advancement and promotion for female physician-investigators.
-
Brace treatment for adolescent idiopathic scoliosis (AIS) is generally prescribed for 18-23 hours per day, but the minimal time of brace wear per day to stop progression of AIS is still unclear. Compliance of patients with AIS with brace treatment is reported to be between 27% and 47% of the prescribed time, brace wear especially at school is often described as embarrassing by adolescent patients. It has been reported that a higher rate of compliance leads to a significantly lower rate of curve progression. Theoretically, prescribing brace treatment 16 hours instead of 23 hours per day (patients are allowed to attend school free of their brace) could lead to a higher rate of compliance, and subsequently reduce progression rate of patients with AIS. ⋯ Twelve to 16 hours of brace wear per day did not lead to a higher progression rate of AIS compared with more than 16 hours in our study group. Our analysis showed that smoking status of parents possibly contributes to the risk of developing AIS; however, we did not find an impact on progression of scoliosis.
-
Elective spine surgery is a commonly performed operative procedure, that requires knowledge of risk-adjusted results to improve outcomes and reduce costs. ⋯ Differences among hospitals defines opportunities for care improvement.
-
Patients with degenerative lumbar stenosis (DLS) adopt a forward flexed posture in an attempt to decompress neural elements. The relationship between sagittal alignment and severity of lumbar stenosis has not previously been studied. ⋯ Severity of central lumbar stenosis as graded on MRI correlates with severity of sagittal malalignment. These findings support theories of sagittal malalignment as a compensatory mechanism for central lumbar stenosis.
-
Current metrics to assess patients' health-related quality of life (HRQOL) may not reflect a true change in the patients' specific perception of what is most important to them. ⋯ The PGI is easy to administer and offers additional information about the patients' perspective not captured in standard HRQOL metrics. Patient Generated Index scores correlated with all of the standard HRQOL scores and were more responsive than ODI, SF-36, and SRS-22r, suggesting that the PGI may be a step closer to one HRQOL measure that better encompasses concerns and goals of the individual patients.