Outcomes and Cost-Effectiveness of Hospital Outpatient Versus Ambulatory Surgery Center Lumbar Decompression Surgery.

Study Design: Retrospective Chart Review.

Objectives: Outpatient spinal surgeries in Ambulatory Surgery Centers (ASCs) have gained traction due to their potential cost efficiencies and improved perioperative processes. This study aims to compare the cost-effectiveness and patient outcomes of lumbar laminectomies performed in hospital settings vs ASCs.

Addressing the Challenge of Spine Patient Triage: Development of a Simple Algorithm for Identification of Potential Surgical Candidates.

Introduction: Given that most spine conditions do not require surgical intervention, using surgeons to manage the subset of patients potentially requiring surgery is the most efficient resource allocation strategy. The purpose of this study was to develop a simple algorithm for identifying patients most likely to require spine surgery that could be used to appropriately triage this population to surgeons.

Methods: A retrospective review of 5,886 consecutive new patients presenting to a multidisciplinary spine clinic from March 2021 to September 2022 was conducted.

Effect of Lower Extremity Osteoarthritis on Outcomes of Lumbar Decompression.

Background: The purpose of this study is to evaluate how hip or knee osteoarthritis (OA) and total joint arthroplasty impact the outcomes of patients undergoing lumbar decompression.

Methods: A retrospective review of 342 patients undergoing lumbar decompression without fusion from January 2019 and June 2021 at a single institution was performed. Univariate and multivariate analyses were used to compare outcomes between patients with and without concomitant hip or knee OA.

The Effect of Preoperative, Low-Dose Intrathecal Morphine on Patient Outcomes Following Lumbar Fusion Surgery: Can We Teach an Old Dog New Tricks?

Background: Early pain control after lumbar fusion presents a challenge to patients and providers. Intrathecal morphine (ITM) has been used at the end of these procedures with limited benefit, but recent data suggest low-dose ITM at case initiation may be effective. This study aims to evaluate the use of preoperative ITM during lumbar fusion to determine whether there is a benefit for these patients.

Are We Considering the Whole Patient? The Impact of Physical and Mental Health on the Outcomes of Spine Care.

Study Design: Retrospective, observational.

Objective: To evaluate the influence of baseline health status on the physical and mental health (MH) outcomes of spine patients.

Summary Of Background Data: Spine conditions can have a significant burden on both the physical and MH of patients.

Postoperative Outcomes in Patients Undergoing Orthopaedic Surgery Within 90 Days of Coronavirus Disease 2019.

Introduction: Coronavirus disease 2019 (COVID-19) has resulted in a global pandemic with several hundred million infections worldwide. COVID-19 causes systemic complications that last beyond the initial infection. It is not known whether patients who undergo elective orthopaedic surgeries after COVID-19 are at increased risk of complications.

Development and validation of a risk-based algorithm for preoperative type and screen testing in spine surgery.

Background Context: With improvements in surgical techniques and perioperative management, transfusion rates after spine surgery have decreased over time. Given this trend, routine preoperative ABO/Rh type and antibody screen (T&S) laboratory testing may not be warranted in all patients undergoing spine surgery.

Purpose: The aim of the current study is to evaluate risk factors for intra/postoperative transfusion in patients undergoing a variety of spine procedures and to develop an algorithm for selectively ordering preoperative T&S testing in appropriate patients.

Lower Extremity Osteoarthritis: A Risk Factor for Mental Health Disorders, Prolonged Opioid Use, and Increased Resource Utilization After Single-Level Lumbar Spinal Fusion.

Introduction: Few studies have examined the effect of hip or knee osteoarthritis, together described as lower extremity osteoarthritis (LEOA) on patient outcomes after lumbar fusion. The purpose of this study was to evaluate the effect of LEOA on postoperative outcomes and resource utilization in patients undergoing single-level lumbar fusion.

Methods: Using a national deidentified database, TriNetX, a retrospective observational study of 17,289 patients undergoing single-level lumbar fusion with or without a history of LEOA before September 1, 2019, was conducted.

Wrist Fractures in Skiers and Snowboarders: Incidence, Severity, and Risk Factors Over 40 Seasons.

Purpose: To determine and compare the incidence and severity of wrist fractures in skiers and snowboarders.

Methods: A university-run orthopedic clinic at the base of a major ski resort has maintained an injury database spanning the years 1972 to 2012. Demographic information, equipment type, ability level, trail type and conditions, number of falls, circumstances surrounding the injury, and radiographs were collected on participants sustaining wrist fractures and compared with uninjured control participants asked the same questions, but in reference to their last fall where no injury resulted.

Cortical bone trajectory instrumentation provides favorable perioperative outcomes compared to pedicle screws for single-level lumbar spinal stenosis and degenerative spondylolisthesis.

Objective: To compare perioperative outcomes between cortical bone trajectory (CBT) instrumentation with pedicle screws (PS) in patients undergoing laminectomy and posterolateral fusion for single-level lumbar spinal stenosis, and degenerative grade I spondylolisthesis.

Methods: A consecutive series of 91 patients from a single institution between January 2017 and July 2019 were retrospectively reviewed.

Results: Patients in CBT group had significantly shorter operative time, lower blood loss and shorter length of stay.

Predictive Risk Factors Associated With Increased Opioid Use Among Patients Undergoing Elective Spine Surgery.

Background: Opioids are commonly used for postoperative pain management in spine surgery. However, few guidelines exist for appropriate prescribing in the acute postoperative phase of care. We identify risk factors for inpatient (IP) opioid use and examine relationships between IP requirements and discharge (DC) opioid prescriptions.

Predictors of Postoperative Complications After Surgery for Lumbar Spinal Stenosis and Degenerative Lumbar Spondylolisthesis.

Introduction: The aim of this study was to determine the predictors of 30-day postoperative complications for surgical treatment of lumbar spinal stenosis with degenerative spondylolisthesis (LSSDS) in patients undergoing decompression and fusion or decompression alone.

Methods: A retrospective review of 253 unique patients undergoing surgical intervention for LSSDS in the American College of Surgeons National Surgical Quality Improvement Program database was conducted.

Results: The overall 30-day postoperative complication rate for the population was 16.

Vitamin D in orthopaedics.

Vitamin D is an important component in musculoskeletal development, maintenance, and function. Adequate levels of vitamin D correlate with greater bone mineral density, lower rates of osteoporotic fractures, and improved neuromuscular function. Debate exists about both adequate levels required and intake requirements needed to prevent deficiency of vitamin D.

Psychological distress in a Department of Veterans Affairs spine patient population.

Background Context: The veteran population presents a unique confluence of biopsychosocial factors in the treatment of spinal conditions. In addition to poorer health status and higher numbers of chronic medical conditions compared with the general population, previous reports have highlighted the high prevalence of psychological disorders within the Department of Veterans Affairs (VA) health system. To our knowledge, no study has specifically evaluated psychological distress in patients with a spinal disorder within the VA health system.