The spine journal : official journal of the North American Spine Society
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Prior studies have suggested no significant differences in functional status and postoperative complications of elderly versus nonelderly patients undergoing posterior lumbar interbody fusion; however, similar studies have not been comprehensively investigated in the setting of anterior lumbar interbody fusion (ALIF). ⋯ In summary, high mFI scores were found to be independently associated with any complication and pulmonary complications in patients who underwent ALIF. The use of mFI together with traditional risk factors may help better identify high-surgical risk patients, which may be useful for preoperative and postoperative care optimization.
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There is limited research investigating educational attainment as a risk factor for low back pain (LBP), with the influence of gender commonly being neglected. Furthermore, genetics and early shared environment explain a substantial proportion of LBP cases and need to be controlled for when investigating risk factors for LBP. ⋯ Educational attainment affects LBP differently in men and women, with higher levels of education only decreasing the risk of developing LBP in women. After adjusting for genetics and early shared environment, the relationship between educational attainment and LBP in women disappears. This suggests that genetics and early shared environment are confounding the relationship between educational attainment and LBP in women.
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Waddell et al. identified a set of eight non-organic signs in 1980. There has been controversy about their meaning, particularly with respect to their use as validity indicators. ⋯ Our results found significant evidence of an association between Waddell signs and somatic over-reporting. Elevated scores on the Waddell signs (particularly scores higher than 2 and 3) were associated with increased odds of exhibiting somatic over-reporting.
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Higher American Society of Anesthesiologists (ASA) classification is a known predictor of postoperative complication in diverse surgical settings. However, its predictive value is not established in single-level elective anterior cervical discectomy and fusion (SLE-ACDF). ⋯ Although we did not detect associations between ASA class >II and adverse 30-day outcomes following SLE-ACDF, imprecision of estimates precludes definitive inferences. Although ASA classification allows simple assessment of patients' physiological status, their overall perioperativerisk factors need to be considered collectively for adequate optimization and improved outcomes in SLE-ACDF.
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Although most cadaveric studies of the Recurrent Laryngeal Nerve (RLN) have focused on course variations, they have usually been done on preserved (fixed and embalmed) cadavers, which renders the RLN immobile and of less surgical landmark value. ⋯ We found that the most reliable anatomical landmark for the RLN bilaterally was the ITA and Berry's ligament, both of which would be encountered as readily identifiable structures in anterior cervical spinal exposure before the nerve itself. We believe this will help spinal surgeons to refine their surgical technique to identify RLN where necessary, thus preventing iatrogenic injury. Our landmark protocol of FEEL-LOOK-AVOID can serve as an easy aide-mémoire for intraoperative surgical anatomy of the RLN during ACDF regardless of side.