Publications by authors named "Federico Girardi"

Background/context: The assessment of disc degeneration remains a significant challenge in clinical research. Pfirrmann grade is a frequently used classification for lumbar disc degeneration on MRI. However, there has been no gold standard for cervical spine disc degeneration.

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  • The study analyzed untreated osteoporosis prevalence in patients undergoing lumbar spinal fusion surgery and its effects on bone health.
  • A total of 445 patients participated; 31% had osteoporosis, with about 48% of them untreated, mostly due to being male.
  • Untreated osteoporosis was linked to lower bone mineral density and higher bone turnover markers, highlighting the need for better preoperative screening and treatment strategies.
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Purpose: To evaluate the impact of bilateral ultrasound-guided erector spinae plane blocks (ESPBs) on pain and opioid-related outcomes in a surgical population with chronic pain.

Methods: A retrospective, observational cohort study. Clinical data were extracted from the electronic medical records of patients who underwent lumbar fusion (February 2018 - July 2020).

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Study Design: Secondary analysis of prospective study.

Objective: To analyze the impact of prior total knee arthroplasty (TKA), total hip arthroplasty (THA), or both on the Oswestry Disability Index (ODI) two years after elective lumbar surgery.

Background: Degenerative conditions that cause pain and mobility loss significantly reduce quality of life.

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Study Design: Review of cohort studies.

Objective: To ascertain if previous hip (THA) or knee (TKA) arthroplasty was associated with patients' outcomes assessments of subsequent lumbar surgery, specifically overall satisfaction, less disability due to pain, and an affective appraisal reflecting emotional assessment of results.

Background: Hip, knee, and lumbar symptoms often co-exist and increasingly are managed with surgery.

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Background: The modified frailty index (mFI-5) has been shown to be a reliable risk stratification tool in different spine procedures. Its usefulness to predict complications after 1-level or 2-level anterior cervical decompression and fusion (ACDF) has not been studied extensively.

Purpose: We aimed to assess the usefulness of the mFI-5 in 1-level or 2-level ACDF surgery by asking the following questions: (1) Is the mFI-5 a reliable tool to predict complications after 1-level or 2-level ACDF? (2) Is the mFI-5 useful in predicting prolonged hospital stay after 1-level or 2-level ACDF? (3) Is the mFI-5 useful in predicting readmission after 1-level or 2-level ACDF?

Methods: We performed a retrospective analysis of the medical records of patients who underwent 1-level or 2-level ACDF at our institution.

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Study Design: Retrospective cohort study.

Objectives: To identify imaging predictors on pre- and perioperative imaging that are associated with a future revision surgery for adjacent segment disease (ASD) following lumbar fusion.

Methods: Patients undergoing open posterior lumbar fusion between 2014-2022 were followed-up for >2-year.

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Although the coexistence of cervical and lumbar spinal conditions is fairly common, surgical treatments are usually staged, even though simultaneous fusion of the cervical and lumbar spine may be a viable option for appropriate candidates. We sought to investigate the outcomes of staged vs simultaneous cervical and lumbar fusions in terms of differences in postoperative complications and resource use. We performed a retrospective cohort study using claims data from the 2006 to 2020 all-payer Premier Health Database.

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Study Design: Retrospective review of cohort studies.

Objective: To analyze how different ODI subsections and their improvement affect patient satisfaction 2 years after elective lumbar surgery for degenerative lumbar spondylolisthesis (DLS).

Background: The Oswestry Disability Index (ODI) is crucial in evaluating outcomes of spinal disorders and provides valuable insights into a patient's preoperative status.

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  • The study examines the relationship between prior hip or knee arthroplasty and patient satisfaction after lumbar spine surgery, focusing on whether patients' expectations are met post-surgery.
  • It pooled data from three prospective studies, evaluating preoperative and postoperative expectations using a survey that measured expected versus actual improvements in symptoms and function.
  • Results showed that while patients with prior arthroplasty had similar high expectations compared to those without, they experienced a lower fulfillment rate of those expectations, with various factors influencing this outcome, including preoperative expectations and psychological factors.
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Study Design: Secondary analysis of prospective study.

Objective: To investigate the impact of fatty infiltration (FI) in the paraspinal muscles (PM) on postoperative Oswestry Disability Index (ODI) subsection-scores in patients undergoing elective lumbar surgery for degenerative lumbar spondylolisthesis (DLS).

Background: DLS can increase FI in the PM like the multifidus (MF), erector spinae (ES), and psoas (PS), leading to greater spinal disability and higher ODI-scores.

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Background Context: Concurrent degeneration of the lumbar spine, hip, and knee can cause significant disability and lower quality of life. Osteoarthritis in the lower extremities can lead to movement limitations, possibly requiring total knee arthroplasty (TKA) or total hip arthroplasty (THA). These procedures often impact spinal posture, causing alterations in spinopelvic alignment and lumbar spine degeneration.

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Article Synopsis
  • - The Oswestry Disability Index (ODI) is a crucial tool for assessing the functional status of patients with lumbar spine issues and is used by surgeons to track progress post-surgery and compare different surgical methods.
  • - This study aimed to evaluate the baseline characteristics and changes in ODI scores and their subsections over a 2-year period following elective surgery for degenerative lumbar spondylolisthesis, involving a retrospective analysis of 265 patients.
  • - The analysis used statistical methods to assess changes in ODI scores before and after surgery, excluding patients without follow-up data, while also considering factors like age and BMI to understand their impact on outcomes.
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Purpose: Spinal and lower extremity degeneration often causes pain and disability. Lower extremity osteoarthritis, eventually leading to total knee- (TKA) and -hip arthroplasty (THA), can alter posture through compensatory mechanisms, potentially causing spinal misalignment and paraspinal muscle (PM) atrophy. This study aims to evaluate the association between prior THA or TKA and PM-degeneration in patients undergoing elective lumbar surgery for degenerative conditions.

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Study Design: Retrospective cross-sectional study.

Objective: To evaluate the relationship between lumbar foraminal stenosis (LFS) and multifidus muscle atrophy.

Background: The multifidus muscle is an important stabilizer of the lumbar spine.

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Purpose: The literature is scarce in exploring the role of imaging parameters like ultrasound (US) as a biomarker for surgical outcomes. The purpose of this study is to investigate the associations between skin US parameters and revision surgery following spine lumbar fusion.

Methods: Posterior lumbar fusion patients with 2-years follow-up were assessed.

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Purpose: Surgeons' preoperative expectations of lumbar surgery may be associated with patient-reported postoperative outcomes.

Methods: Preoperatively spine surgeons completed a validated Expectations Survey for each patient estimating amount of improvement expected (range 0-100). Preoperative variables were clinical characteristics, spine-specific disability (ODI), and general health (RAND-12).

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Study Design: Retrospective review of a prospective cohort study.

Objective: To identify the association between Oswestry Disability Index (ODI) subsections and overall improvement 2 years after lumbar surgery for degenerative lumbar spondylolisthesis (DLS).

Background: DLS often necessitates lumbar surgery.

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Objective: The paraspinal muscles play an essential role in the stabilization of the lumbar spine. Lumbar paraspinal muscle atrophy has been linked to chronic back pain and degenerative processes within the spinal motion segment. However, the relationship between the different paraspinal muscle groups and facet joint osteoarthritis (FJOA) has not been fully explored.

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Background Only a few studies have examined the impact of the coronavirus disease 2019 pandemic on spine ambulatory surgeries and changes in trends. Therefore, we investigated trends during the pre-pandemic period and three pandemic stages in patients undergoing lumbar decompression procedures in the ambulatory surgery (AMS) setting. Methodology A total of 2,670 adult patients undergoing one- or two-level lumbar decompression surgery were retrospectively reviewed.

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Objective: There are limited data about the influence of the lumbar paraspinal muscles on the maintenance of sagittal alignment after pedicle subtraction osteotomy (PSO) and the risk factors for sagittal realignment failure. The authors aimed to investigate the influence of preoperative lumbar paraspinal muscle quality on the postoperative maintenance of sagittal alignment after lumbar PSO.

Methods: Patients who underwent lumbar PSO with preoperative lumbar MRI and pre- and postoperative whole-spine radiography in the standing position were included.

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Purpose: This study aimed to investigate the impact of sarcopenia and lumbar paraspinal muscle composition (PMC) on patient-reported outcomes (PROs) after lumbar fusion surgery with 12-month follow-up (12 M-FU).

Methods: A prospective investigation of patients undergoing elective lumbar fusion was conducted. Preoperative MRI-based evaluation of the cross-sectional area (CSA), the functional CSA (fCSA), and the fat infiltration(FI) of the posterior paraspinal muscles (PPM) and the psoas muscle at level L3 was performed.

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Study Design: Retrospective review of cohort studies.

Objective: To clarify the necessary Oswestry Disability Index (ODI) improvement for patient satisfaction 2 years after lumbar surgery.

Background: Evaluating elective lumbar surgery care often involves patient-reported outcomes.

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Study Design: Retrospective cohort study.

Objective: To analyze the relationship of abdominal aortic calcification (AAC) and a reduction in the cross-sectional area (CSA) and the fatty infiltration (FI) of the paravertebral muscles in patients undergoing lumbar fusion surgery.

Background: Both AAC and paraspinal muscle degeneration have been shown to be associated with poorer outcomes after surgical treatment of degenerative diseases of the lumbar spine.

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