Publications by authors named "Brodke D"
Objective: To determine whether bone transport or Masquelet results in higher rates of major unplanned reoperations for the treatment of segmental tibial bone defects ≥4 cm in length.
Methods: Design: Retrospective cohort.
Setting: Level I trauma center.
Article Synopsis
- * The objective is to explore the relationship between patient-reported physical function scores and HRU in non-surgical CLBP patients within a university health system from 2015 to 2020.
- * By categorizing patients into Low Physical Function (Low-PF) and High Physical Function (High-PF) groups based on their PROMIS-PF scores, the study uses regression analyses to evaluate differences in HRU between these cohorts.
Article Synopsis
- This study evaluated modified Radiographic Union Scale for Tibia (mRUST) scores over time in patients with distal femur fractures treated with intramedullary nails, to identify factors influencing healing and possible reoperation.
- Conducted in ten Level I Trauma Centers, the research included 155 fractures from 152 patients, focusing on mRUST scores at 3, 6, and 12 months post-surgery, with the primary goal of finding predictors for union timing.
- Results showed that a 3-month mRUST score of ≤8 indicated a higher chance of reoperation, and factors such as tobacco use and open fractures correlated with delayed healing times.
How Do Functional Comorbidities Affect PROMIS-PF Scores Following Lumbar Fusion Surgery?
Spine (Phila Pa 1976)
September 2024
Article Synopsis
- This study reviews how physical function (PROMIS PF scores) changes over time after lumbar fusion surgery, particularly focusing on the impact of functional comorbidities like heart failure or COPD on recovery.
- Researchers analyzed data from 1,893 patients who underwent lumbar fusion from 2014 to 2022, comparing outcomes between those with and without comorbidities at regular intervals over two years.
- Findings suggest that patients with functional comorbidities had different recovery trends, potentially highlighting the need for tailored rehabilitation strategies in post-surgical care.
We systematically review literature regarding the contribution of transthyretin amyloidosis to spinal stenosis. Amyloidosis is a protein misfolding condition that causes systemic deposition of amyloid and commonly leads to heart failure and nephropathy. A growing body of literature suggests that amyloid deposits within the ligamentum flavum are frequently associated with spinal stenosis with subsequent myelopathy.
View Article and Find Full Text PDFIntroduction: Distal femur fractures are complex injuries that often present with multiple fragments, posing notable challenges to fixation. This study aimed to (1) use preoperative CT scans to graphically display fracture lines in intra-articular distal femur fractures and (2) identify common fracture patterns in these injuries.
Methods: All skeletally mature patients that underwent surgical fixation of Orthopaedic Trauma Association type 33C distal femur fractures between 2012 and 2022 were identified across two level 1 trauma centers (n = 63).
Factors Related to Clinical Performance in Spine Surgery Fellowship: Can We Predict Success.
J Am Acad Orthop Surg
September 2024
Introduction: The factors most important in the spine fellowship match may not ultimately correlate with quality of performance during fellowship. This study examined the spine fellow applicant metrics correlated with high application rank compared with the metrics associated with the strongest clinical performance during fellowship.
Methods: Spine fellow applications at three academic institutions were retrieved from the San Francisco Match database (first available to 2021) and deidentified for application review.
Objectives: To assess the biomechanical differences between linked and unlinked constructs in young and osteoporotic cadavers in addition to osteoporotic sawbones.
Methods: Intraarticular distal femur fractures with comminuted metaphyseal regions were created in three young matched pair cadavers, three osteoporotic matched pair cadavers, and six osteoporotic sawbones. Precontoured distal femur locking plates were placed in addition to a standardized retrograde nail, with unitized constructs having one 4.
Article Synopsis
- The modified Japanese Orthopaedic Association (mJOA) scale is commonly used for evaluating outcomes in degenerative cervical myelopathy (DCM) but doesn't account for neck pain or the full recovery process post-surgery.
- The study aimed to reassess the effectiveness of riluzole in patients undergoing surgery for DCM using a comprehensive statistical approach that considers multiple outcome measures.
- Results showed that patients taking riluzole had a significantly better chance of overall improvement compared to those on a placebo after one year, indicating riluzole's potential benefit in surgical outcomes for DCM patients.
Article Synopsis
- This study analyzed a large set of data to assess the risk of C5 palsy following two different surgical approaches (anterior vs posterior) for treating degenerative cervical myelopathy (DCM).
- Out of 283 patients, those who had posterior decompression showed a significantly higher incidence of postoperative C5 palsy (11.26%) compared to those who underwent anterior decompression (3.03%).
- The findings suggest that choosing the posterior approach increases the likelihood of C5 palsy by more than four times, which could impact surgical decision-making for DCM treatment.
Background: The management of elderly acetabular fractures is complex, with high rates of conversion total hip arthroplasty (THA) after open reduction and internal fixation (ORIF), but potentially higher rates of complications after acute THA.
Methods: The California Office of Statewide Health Planning and Development database was queried between 2010 and 2017 for all patients aged 60 years or older who sustained a closed, isolated acetabular fracture and underwent ORIF, THA, or a combination. Chi-square tests and Student t tests were used to identify demographic differences between groups.
Study Design: Prospective multicenter cohort study.
Objective: To explore the association between operative level and postoperative dysphagia after anterior cervical discectomy and fusion (ACDF).
Background: Dysphagia is common after ACDF and has several risk factors, including soft tissue edema.
Article Synopsis
- - The study aimed to identify risk factors for unplanned reoperations related to union promotion or deep surgical-site infections (DSSI) in patients with periprosthetic distal femur fractures treated with lateral distal femoral locking plates (LDFLPs).
- - Conducted across ten level-I trauma centers, the retrospective cohort study focused on patients diagnosed with specific fracture types between January 2012 and December 2019 while excluding those with pathological fractures or less than three months of follow-up.
- - Results showed an 8.3% reoperation rate for union promotion linked to factors like higher body mass index and more screws in the distal segment, while no significant factors were identified for DSSI-related reoperations.
Article Synopsis
- Researchers developed a sheep model to study implant-associated spine infections using biofilm, a factor that complicates these infections clinically.
- Five sheep underwent surgeries where they received either bioblog-covered or sterile implants, allowing researchers to compare infection rates and visual indicators of infection.
- The study showed that infected tissues could be effectively visualized with methylene blue staining, and the infected sites displayed characteristics of severe spine infections, proving the model's relevance for further research.
Article Synopsis
- - The study aimed to evaluate the clinical and functional outcomes of nail-plate fixation (NPF) for distal femur fractures and to compare these outcomes with those of patients treated with single lateral locking plates.
- - Conducted at ten trauma centers, the retrospective cohort study found that NPF resulted in significantly lower rates of unplanned reoperations and varus collapse compared to the lateral locking plate treatment group.
- - The researchers concluded that NPF is a promising option for complex fractures, with larger studies recommended to further identify which patients benefit most from this treatment.
Study Design: Prospective Cohort Study.
Objectives: The purpose of this study was to prospectively evaluate the impact of preoperative dysphagia on the postoperative incidence and severity of dysphagia in patients undergoing ACDF at multiple institutions.
Methods: After IRB approval, patients over 18 years of age who underwent an elective ACDF for degenerative conditions were prospectively enrolled at two academic centers from 2018 to 2021.
Purpose: Structured visual gait assessment is essential for the evaluation of pediatric patients with neuromuscular conditions. The purpose of this study was to evaluate the benefit of slow-motion video recorded on a standard smartphone to augment visual gait assessment.
Methods: Coronal and sagittal plane videos of the gait of five pediatric subjects were recorded on a smartphone, including four subjects with ambulatory cerebral palsy and one subject without gait pathology.
Objective: To identify technical factors associated with nonunion after operative treatment with lateral locked plating.
Design: Retrospective cohort study.
Setting: Ten Level I trauma centers.
Technical Tips for Reduction and Stable Fixation of Proximal Humerus Fractures.
J Am Acad Orthop Surg
September 2023
The surgical treatment of proximal humerus fractures, though common, is associated with surprisingly high complication rates upward of 34%. Obtaining a reduction and placing a stable fixation can be challenging because many fractures treated surgically are comminuted and occur in osteoporotic bone. Nevertheless, innovations in technique and implant design are mitigating some failures.
View Article and Find Full Text PDFArticle Synopsis
- Riluzole, a sodium-glutamate antagonist, is being studied for its effects on acute cervical traumatic spinal cord injuries (tSCI) following promising results in earlier trials and pre-clinical models.
- In a global Phase III trial, patients with cervical tSCI were randomized to receive either riluzole or a placebo, focusing on changes in Upper Extremity Motor (UEM) scores over 180 days.
- Although the trial was halted due to COVID-19, riluzole showed potential benefits for certain patient groups, with no serious drug-related side effects reported.
Objective: Clear diagnostic delineation is necessary for the development of a strong evidence base in lumbar spinal surgery. Experience with existing national databases suggests that International Classification of Diseases, Tenth Edition (ICD-10) coding is insufficient to support that need. The purpose of this study was to assess agreement between surgeon-specified diagnostic indication and hospital-reported ICD-10 codes for lumbar spine surgery.
View Article and Find Full Text PDFObjective: The American Spine Registry (ASR) is a collaborative effort between the American Academy of Orthopaedic Surgeons and the American Association of Neurological Surgeons. The goal of this study was to evaluate how representative the ASR is of the national practice with spinal procedures, as recorded in the National Inpatient Sample (NIS).
Methods: The authors queried the NIS and the ASR for cervical and lumbar arthrodesis cases performed during 2017-2019.
Study Design: Retrospective cohort study.
Objective: The decision to pursue operative intervention for patients with isthmic spondylolisthesis is complex. Although steroid injections are a well-accepted therapeutic modality that may delay or obviate surgery, little is known regarding their ability to predict surgical outcomes.
Article Synopsis
- This study focused on the link between preoperative albumin levels and outcomes in lumbar spine surgery, specifically looking at mortality and morbidity.
- Hypoalbuminemia, or low albumin levels, was found to be a significant risk factor, with patients showing a much higher risk of death after surgery compared to those with normal levels.
- Although hypoalbuminemic patients had worse disability scores before surgery, their rates of hospital readmission post-surgery were similar to those with normal albumin levels.
Objectives: To evaluate the initial complications and short-term readmissions and reoperations after open reduction internal fixation (ORIF) versus acute total hip arthroplasty (THA) for elderly acetabular fractures.
Design: Retrospective database review.
Setting: All hospitalizations in the National Readmissions Database and National Inpatient Sample.