Publications by authors named "Christy Daniels"
Study Design: This study was a retrospective propensity-matched study of patients receiving opioid sparing anesthesia (OSA) and those who did not receive an opioid sparing anesthesia regimen.
Objectives: To determine whether patients undergoing spine fusion for deformity fared better with an OSA regimen than those not having an OSA regimen.
Summary Of Background Data: There has been a tremendous focus on opioid overuse.
Article Synopsis
- The study compares the outcomes of transforaminal interbody fusion (TLIF) and anterior lumbar interbody fusion (ALIF) combined with posterior fusion (AP) regarding post-operative complications and pain management in patients.
- Results show that TLIF patients experienced shorter operative times and hospital stays compared to AP patients, but there was no significant difference in residual leg or back pain between the two approaches.
- Overall, both surgical methods had similar complication rates, except for constipation, which was more prevalent in the AP group, suggesting that the choice of surgical approach should consider these factors.
Article Synopsis
- * Patients showed significant improvements in incision color, hypertrophy, and overall appearance over two years, with no cases of incisional hernia or bulging.
- * The study concluded that anterior lumbar surgeries are safe and result in acceptable cosmetic outcomes, contrasting with prior reports of higher morbidity linked to these procedures.
Study Design: Retrospective observational cohort.
Objectives: This study explores the impact of Intraoperative hypotension (IOH) on postoperative complications for major thoracolumbar spine fusion procedures.
Summary Of Background Data: IOH with mean arterial pressure (MAP) <65 mm Hg is associated with postoperative acute kidney injury (AKI) in general surgery.
Article Synopsis
- - The study examined the frequency and risk factors associated with medial breaches of the pedicle wall during robotic-assisted cortical bone trajectory (RA-CBT) screw placements in 145 adult patients from January 2019 to July 2022.
- - Out of 784 screws analyzed, 30 (3.8%) exhibited a medial breach, with a notable correlation to lower bone quality (measured by Hounsfield units), the placement of screws on the right side, and screws in the upper instrumented vertebra.
- - Despite these breaches, no patients required additional surgery for screw repositioning, and there were no significant differences in clinical outcomes between patients with or without a medial breach.
Article Synopsis
- - The study aimed to explore the relationship between Hounsfield units (HU) from CT scans and bone mineral density (BMD) assessed through DEXA scans in children and adolescents, as previous research primarily focused on adults.
- - Researchers analyzed patients under 18 years who had both a lumbar spine CT scan and a DEXA scan within six months, finding a moderate correlation between DEXA Z-scores and HU values.
- - Results showed that children with a DEXA Z-score of ≤-2.0 had significantly lower HU values compared to healthy peers, indicating that HU measurements on CT scans might effectively estimate BMD in the pediatric population.
Article Synopsis
- - The study examined intraoperative screw malposition during robot-assisted cortical bone trajectory (RA-CBT) surgeries, focusing on two types of malposition: skive and shift, which occur due to instrument deflection or registration changes, respectively.
- - A total of 1344 screws were placed in 256 patients, with a malposition rate of 2.4%, linked to higher body mass index (BMI) and specific vertebral characteristics at the insertion points.
- - No screw revisions were necessary post-surgery, highlighting that while malpositions occurred, they did not require further intervention, with factors such as obesity and specific bone properties influencing the likelihood of these errors.
Staged circumferential lumbar fusions have less intraoperative complications and shorter operative time with no difference in 30-, 90-, and 1-year complications: a propensity-matched cohort analysis of 190 patients.
Spine J
January 2024
Article Synopsis
- Circumferential lumbar fusions (cLFs) are becoming more popular due to new minimally invasive techniques, leading to a study comparing staged versus single-anesthetic approaches.
- The study used a matched sample of patients who had cLFs for lumbar degenerative disease to evaluate various complications within different time frames post-surgery.
- Results indicated that while the single-anesthetic surgeries took longer overall, they had more intraoperative complications, but there were no significant differences in hospital stays or long-term outcomes between the two methods.
Opioid-sparing Anesthesia Decreases In-hospital and 1-year Postoperative Opioid Consumption Compared With Traditional Anesthesia: A Propensity-matched Cohort Study.
Spine (Phila Pa 1976)
January 2024
Study Design: Propensity-matched cohort.
Objective: The aim of this study was to determine if opioid-sparing anesthesia (OSA) reduces in-hospital and 1-year postoperative opioid consumption.
Summary Of Background Data: The recent opioid crisis highlights the need to reduce opioid exposure.
Study Design: Retrospective chart review.
Objective: To provide reference values for Hounsfield unit (HU) measured on computed tomography (CT) scans of children and adolescents.
Summary Of Background Data: Spine surgeons increasingly use HU on spine CT as a measure of bone mineral density (BMD).
Background: Cost, efficiency, patient preference, and safety have driven utilization of wide awake, local anesthesia, no tourniquet (WALANT) in hand surgery. This is not well documented in adolescents. We hypothesize that the use of WALANT with adolescents reduced time spent in the operating room (OR) and in the hospital when compared with patients who underwent surgery with traditional anesthesia (TA).
View Article and Find Full Text PDFStudy Design: Retrospective single center propensity-matched observational cohort study that included patients who underwent 1- to 3-level lumbar fusion surgery for degenerative conditions.
Objective: To compare 90-day complication rates between robotic-assisted and non-robotic-assisted lumbar spinal fusions in propensity-matched cohorts.
Summary Of Background Data: A recent administrative database (PearlDiver) study reported increased 30-day complications with the utilization of robotic-assisted enabling technology.
Background Context: Surgical decision making for cervical spondylotic myelopathy (CSM) relies on evaluation of symptoms and physical examination. The Romberg test is a clinical exam used to identify balance issues with CSM. However, the Romberg test has a subjective interpretation and has a binary (positive or negative) result.
View Article and Find Full Text PDFBackground: With the current opioid crisis, as many as 38% of patients are still on opioids one year after elective spine surgery. Identifying drivers of in-hospital opioid consumption may decrease subsequent opioid dependence. We aimed to identify the drivers of in-hospital opioid consumption in patients undergoing 1-2-level instrumented lumbar fusions.
View Article and Find Full Text PDFBackground: The opioid epidemic is at epic proportions currently in the United States. Exposure to opioids for surgery and subsequent postoperative pain management is a known risk factor for opioid dependence. In addition, opioids can have a negative impact on multiple aspects including clinical outcomes, length of hospital stay, and overall cost of care.
View Article and Find Full Text PDFObjective: Unexpected nonhome discharge causes additional costs in the current reimbursement models, especially to the payor. Nonhome discharge is also related to longer length of hospital stay and therefore higher healthcare costs to society. With increasing demand for spine surgery, it is important to minimize costs by streamlining discharges and reducing length of hospital stay.
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