Spine surgeons facing second opinions: a qualitative study.

Background Context: The social and technological mutation of our contemporary period disrupts the traditional dyad that prevails in the relationship between physicians and patients.

Purpose: The solicitation of a second opinion by the patient may potentially alter this dyad and degrade the mutual trust between the stakeholders concerned. The doctor-patient relationship has often been studied from the patient's perspective, but data are scarce from the spine surgeon's point of view.

Functional outcomes following surgery for spastic hip adductor muscles in ambulatory and non-ambulatory adults.

Objective: To evaluate functional outcomes of surgery of spastic hip adductor muscles (obturator neurotomy with or without adductor longus tenotomy) in ambulatory and non-ambulatory patients, using preoperatively defined personalized goals.

Design: Retrospective observational descriptive study.

Patients: Twenty-three patients with adductor spasticity who underwent obturator neurotomy between May 2016 and May 2021 at the Clinique des Cèdres, Cornebarrieu, France, were included.

Enhancing the referral process for surgical management of spinal metastases: insights from a 12-year, bi-institutional study of 533 patients.

Introduction: Delayed surgical management of spinal metastases (SMs) can have detrimental effects on patient survival and quality of life, leading to pain and potential neurological impairment. This study aimed to assess the impact of delayed referral for SMs on clinical outcomes by analyzing patients managed in emergency situations.

Methods: We retrospectively reviewed the data of all patients admitted on either emergency or elective basis who underwent surgery for the treatment of neoplastic spine lesions at our two institutions (tertiary referral neurosurgical units) between January 2008 and December 2019.

[Teeth and oral cavity at the heart of systemic health].

Research into the interrelationships between oral and systemic diseases has been growing exponentially for over 20 years. Teeth and their supporting tissues can be affected by pathologies, particularly infectious ones, the consequences of which are felt locally in the oral cavity and at a distance in the body. Oral diseases frequently lead to the maintenance of an inflammatory state in oral bones and mucosa, which complicates the treatment of systemic inflammatory pathologies.

[The hopes and stakes of a public health reform. The example of New Caledonia].

At a time when many of us desire fundamental reform of our health system, we return to the case of the New Caledonian Do-Kamo project. The proposed model provides interesting elements of reflection, due to it being person-centered and favoring a cultural approach to disease.

Becoming a neurosurgeon in France: A qualitative study from the trainees' perspective.

Introduction: The training of neurosurgeons is evolving in a world of socio-professional changes, including the technological revolution, administrative pressure on stakeholders, reduced working hours, geographical heterogeneity, generational changes, to name but a few.

Research Question: This qualitative study aimed to explore experiences and feedback of French neurosurgical trainees concerning their training.

Material And Methods: The grounded theory approach was used with 23 neurosurgical trainees' interviews.

Results of a French pilot database of standard of care of chronic subdural hematoma.

Background: A registry of chronic subdural hematoma does not exist in France yet.

Objective: To present a monocentric pilot project of a French registry of surgical management of chronic subdural hematoma.

Method: A monocentric pseudonymized formal database was created.

Security and reliability of CUSTOMBONE cranioplasties: A prospective multicentric study.

Background: Repairing bone defects generated by craniectomy is a major therapeutic challenge in terms of bone consolidation as well as functional and cognitive recovery. Furthermore, these surgical procedures are often grafted with complications such as infections, breaches, displacements and rejections leading to failure and thus explantation of the prosthesis.

Objective: To evaluate cumulative explantation and infection rates following the implantation of a tailored cranioplasty CUSTOMBONE prosthesis made of porous hydroxyapatite.

Impact of malpractice liability among spine surgeons: A national survey of French private neurosurgeons.

Purpose: In the general context of medical judicialization, spine surgeons are impacted by the part that medical responsibility and the risk of malpractice play in their actions and decisions. Our aim was to evaluate possible shifts in practices among private neurosurgeons who are highly exposed to this judicial risk and detect alterations in their pleasure in exercising their profession. We present the first national survey on French physicians' perception of surgical judicialization and consequences on their practice.

French Spine Surgery Society guidelines for management of spinal surgeries during COVID-19 pandemic.

Since the outbreak of coronavirus disease 2019 (COVID-19) in December 2019 in China, various measures have been adopted in order to attenuate the impact of the virus on the population. With regard to spine surgery, French physicians are devoted to take place in the national plan against COVID-19, the French Spine Surgery Society therefore decided to elaborate specific guidelines for management of spinal disorders during COVID-19 pandemic in order to prioritize management of patients. A three levels stratification was elaborated with Level I: Urgent surgical indications, Level II: Surgical indications associated to a potential loss of chance for the patient and Level III: Non-urgent surgical indications.

Implementation of enhanced recovery after surgery (ERAS) protocol for anterior cervical discectomy and fusion: a propensity score-matched analysis.

Purpose: Enhanced recovery after surgery (ERAS), still emerging for the spine, proposes a multimodal approach of perioperative care involving the optimization of every procedural step, with the patient in a proactive position regarding his/her management. We aimed to demonstrate a reduction in the length of hospital stay for ACDF without increasing the risk for patients by comparing 2 groups before and after ERAS implementation using propensity score (PS)-matched analysis.

Methods: We selected 2 periods of 1 year, before (n = 268 patients) and after ERAS implementation (n = 271 patients).

Spine neurosurgeons facing the judicialization of their profession: disenchantment and alteration of daily practice-a qualitative study.

Background: The judicialization of medicine can lead to professional disenchantment and defensive attitudes among surgeons. Some quantitative studies have investigated this topic in spine surgery, but none has provided direct thematic feedback from physicians. This qualitative study aimed to identify the impact of this phenomenon in the practice of spine neurosurgeons.

The "Friday peak" in surgical referrals for spinal metastases: lessons not learned. A retrospective analysis of 201 consecutive cases at a tertiary center.

Background: Spinal cord compression and fracture are potential complications of spine metastasis (SM). Rapid management by an expert team can reduce these adverse developments. Delays in seeking therapeutic advices, which lead to the need for sub-optimal emergency procedures, were already demonstrated nearly 20 years ago.

Benefits of Enhanced Recovery After Surgery for fusion in degenerative spine surgery: impact on outcome, length of stay, and patient satisfaction.

OBJECTIVEEnhanced Recovery After Surgery (ERAS) proposes a multimodal, evidence-based approach to perioperative care. Thanks to the improvement in care protocols and the fluidity of the patient pathway, the first goal of ERAS is the improvement of surgical outcomes and patient experience, with a final impact on a reduction in the hospital length of stay (LOS). The implementation of ERAS in spinal surgery is in the early stages.

Vibrio parahaemolyticus risk assessment in the Pacific Northwest: it's not what's in the water.

The Gram-negative bacterium Vibrio parahaemolyticus (Vp) is a major cause of illness associated with the consumption of raw or undercooked seafood, primarily oysters. This species is a natural member of the bacterial community in brackish waters and is bioaccumulated by oysters through filter feeding. Only a subset of strains is thought to be pathogenic.

Obstacles to comprehensive dental care in patients with sustained limitations of their decision-making abilities: findings from a Delphi study.

The objective of this study was to explore the therapeutic limitations experienced by a panel of special-care dentists in France when treating patients with sustained limitations of their decision-making abilities. We used a Delphi technique conducted in three rounds from 01 June 2014 to 30 September 2015. A first questionnaire comprising open-ended questions was addressed to 72 panellists.

Morphometric study of the posterior longitudinal ligament at the lumbar spine.

Purpose: There are only two descriptions of posterior longitudinal ligament (PLL) at the lumbar spine level but its morphologic characteristics are different to cervical and thoracic levels.

Method: Spine explantation (from Th12 to L5) followed by resection of the neural arch and the dural sheath in 13 fresh cadavers was performed. The PLL was isolated from other epidural structures and its width was measured and compared to the vertebral body width at each vertebral levels.

Spinal cord injury associated with cervical spinal canal stenosis: Outcomes and prognostic factors.

Objectives: To specify outcomes and identify prognostic factors of neurologic and functional recovery in patients with an acute traumatic spinal cord injury (SCI) associated with cervical spinal canal stenosis (SCS), without spinal instability.

Methods: A retrospective study was conducted using data from a Regional Department for SCI rehabilitation in France. A description of the population characteristics, clinical data and neurological and functional outcomes of all patients treated for acute SCI due to cervical trauma associated with SCS was performed.

Managing spine surgery referrals: The consultation of neurosurgery and its nuances.

Introduction: Spinal disorders, particularly low back pain, are among the most common reasons for general practitioner (GP) consultation and can sometimes be a source of professional friction. Despite their frequency and published guidelines, many patients are still mistakenly referred by their GP to specialists for spinal surgery consultation which can create colleague relationship problems, suboptimal or unnessary delayed care, as well as the financial implications for patients.

Purpose: To assess the management of GP lumbar spine referrals made to 4 neurosurgeons from 3 neurosurgical teams specialized in spinal surgery.

Non neurologic burst thoracolumbar fractures fixation: Case-control study.

Study Design: Burst fractures not associated with any neurological deficits are frequent but not therapeutic agreement on their management is available to date. This case-control study was conducted to try to help guide therapeutic decision in the treatment of such fractures.

Materials And Methods: This case-control study includes consecutive retrospective evaluation of 25 case-patients treated by posterior short-segment fixation associated with kyphoplasty (SFK) in the treatment of A3 thoracolumbar unstable fractures, as compared to a control-group composed of 82 patients treated by long-segment (LF) pedicle screws.

Outpatient Lumbar Microdiscectomy in France: From an Economic Imperative to a Clinical Standard-An Observational Study of 201 Cases.

Purpose: The outpatient lumbar discectomy procedures have been established for more than 2 decades. However, especially in Europe, there are still obstacles to the development of these procedures, which may be related to medicoeconomic imperatives, and to several factors concerning both surgeons and patients. We describe our initial experience in introducing this method in our institution.

Indication Variability in Degenerative Lumbar Spine Surgery: A Four-nation Survey.

Study Design: Electronic survey.

Objective: The aim of this study was to identify the international nuances in surgical treatment patterns for severals lumbar degenerative conditions, specifically, to identify differences in responses in each country groupand different treatment trends across countries.

Summary Of Background Data: Significant variations in treatment of lumbar degenerative conditions exist among spine surgeons, related to the lack of established consensus in the literature.

Neurotomy of the rectus femoris nerve: Short-term effectiveness for spastic stiff knee gait: Clinical assessment and quantitative gait analysis.

Background: Stiff knee gait is a troublesome gait disturbance related to spastic paresis, frequently associated with overactivity of the rectus femoris muscle in the swing phase of gait.

Objective: The aim of this study was to assess the short-term effects of rectus femoris neurotomy for the treatment of spastic stiff-knee gait in patients with hemiparesis.

Patients And Methods: An Intervention study (before-after trial) with an observational design was carried out in a university hospital.