Why Orthopaedic Residents Must Be Exposed to and Taught Value-Based Care: AOA Critical Issues.

The shift to value-based care is changing the practice of medicine. In order to prepare our orthopaedic trainees to survive in a value-based health-care environment, we must expose them to and educate them about value-based programs. This creates both challenges and opportunities for training programs.

A RCT comparing 7-year clinical outcomes of one level symptomatic cervical disc disease (SCDD) following ProDisc-C total disc arthroplasty (TDA) versus anterior cervical discectomy and fusion (ACDF).

Purpose: The objective of this trial was to compare the safety and efficacy of TDA using the ProDisc-C implant to ACDF in patients with single-level SCDD between C3 and C7.

Methods: We report on the single-site results from a larger multicenter trial of 13 sites using an approved US Food and Drug Administration protocol (prospective, randomized controlled non-inferiority design). Patients were randomized one-to-one to either the ProDisc-C device or ACDF.

Single-center results at 7 years of prospective, randomized ProDisc-C total disc arthroplasty versus anterior cervical discectomy and fusion for treatment of one level symptomatic cervical disc disease.

Consistent with EBSJ's commitment to fostering quality research, we are pleased to feature some of the most highly rated abstracts from the 10th Annual AOSpine North America Fellows Forum in Banff, Canada. Enhancing the quality of evidence in spine care means acknowledging and supporting the efforts of young researchers within our AOSpine North America network. We look forward to seeing more from these promising researchers in the future.

Results at 24 months from the prospective, randomized, multicenter Investigational Device Exemption trial of ProDisc-C versus anterior cervical discectomy and fusion with 4-year follow-up and continued access patients.

Background: Cervical total disk replacement (TDR) is intended to address pain and preserve motion between vertebral bodies in patients with symptomatic cervical disk disease. Two-year follow-up for the ProDisc-C (Synthes USA Products, LLC, West Chester, Pennsylvania) TDR clinical trial showed non-inferiority versus anterior cervical discectomy and fusion (ACDF), showing superiority in many clinical outcomes. We present the 4-year interim follow-up results.

Incidence of dysphagia comparing cervical arthroplasty and ACDF.

Study Design: Retrospective cohort from randomized prospective clinical trial.

Objective: Evaluate incidence of dysphagia between instrumented ACDF and a no-profile cervical disc arthroplasty.

Summary Of Background Data: Dysphagia is a well-known complication following anterior cervical discectomy and fusion (ACDF) and the etiology is multifactorial.

Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease.

Background Context: Cervical total disc replacement (TDR) is intended to address radicular pain and preserve functional motion between two vertebral bodies in patients with symptomatic cervical disc disease (SCDD).

Purpose: The purpose of this trial is to compare the safety and efficacy of cervical TDR, ProDisc-C (Synthes Spine Company, L.P.

Two-Year Results of a Randomized Controlled Clinical Trial Comparing ProDisc-C and Anterior Cervical Discectomy and Fusion.

Background: Anterior cervical discectomy and fusion (ACDF) is a well-accepted procedure for the treatment of cervical radiculopathy. Hilibrand et al. reported that adjacent segment disease is known to occur at a rate of 2.

Adjacent segment disc pressures following two-level cervical disc replacement versus simulated anterior cervical fusion.

Anterior cervical fusion (ACF) has been shown to alter the biomechanics of adjacent segments of the cervical spine. The goal of total disc replacement is to address pathology at a given disc with minimal disruption of the operated or adjacent segments. This study compares the pressure within discs adjacent to either a two-level simulated ACDF or a two-level total disc replacement with the ProDisc-C.

Acute neurologic deficit associated with a posterior cervical drain: a case report.

Study Design: Descriptive.

Objectives: To document a rare complication involving the use of a wound drain after cervical laminectomy.

Summary Of The Background Data: No previous reports describe spinal cord compression by a surgical drain resulting in a neurologic deficit.

Transpedicular decompression and pedicle subtraction osteotomy (eggshell procedure): a retrospective review of 59 patients.

Study Design: Outcomes of transpedicular decompression and/or osteotomy were analyzed retrospectively.

Objectives: To determine the effectiveness of decompression and correction, fusion stability, procedural safety, neurologic outcome, complication rates, and overall patient outcomes.

Summary Of Background Information: The "eggshell" procedure is reserved for complex reconstructive problems in the treatment of acute trauma, deformity, tumor, or infection.

Chronic lumbar spine and radicular pain: pathophysiology and treatment.

The lumbar spine forms the foundation and infrastructure of an organic skyscraper equipped with the physiologic capacity to act as a crane for lifting and a crankshaft for walking. Subjected to aging like other "human machinery," the lumbar spine adapts to the wear and tear of gravity and biomechanical loading through structural and neurochemical changes. Many of the changes are maladaptive, resulting in pain, physical and functional disability, and altered neurophysiologic circuitry.