Publications by authors named "John Li Tat Chen"

Background: Psychological distress post lumbar spine surgery is associated with poorer outcomes. There is a scarcity of studies devoted to analyzing the risk factors associated with psychological distress in patients who have undergone lumbar fusion surgery. The purpose of this study was to (1) describe the time course and severity of psychological distress using the STarT Back Tool (SBT) and (2) determine the demographic and clinical predictors of SBT score post lumbar spine fusion surgery.

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Background: The factors that affect return to work (RTW) after anterior cervical discectomy and fusion (ACDF) for degenerative cervical myelopathy (DCM) remain unclear, especially in a non-Workers' Compensation setting. We aimed to (1) identify factors that influence RTW in patients undergoing ACDF (2) determine if early RTW plays a role in functional outcomes, quality of life, and satisfaction.

Methods: Prospectively collected data of 103 working adults who underwent primary ACDF for DCM were retrospectively reviewed.

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Study Design: Retrospective longitudinal study.

Objective: To identify the preoperative factors associated with postoperative lumbar fusion recovery in back or leg pain, self-reported walking time, and gait speed over a 6-month period.

Summary Of Background Data: The demand for lumbar fusion surgeries has significantly increased over the years.

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Article Synopsis
  • The study analyzed registry data to evaluate how smoking impacts postoperative outcomes, satisfaction, and fusion rates in nondiabetic patients undergoing minimally invasive spine surgery.
  • Data from 187 patients was reviewed, revealing that while smoking did not significantly affect functional outcomes or fusion rates, it was linked to lower satisfaction scores.
  • Conclusions suggest that smokers may require additional preoperative counseling, as their satisfaction with the surgery is notably lower despite similar functional results compared to nonsmokers.
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Study Design: This is a retrospective study.

Objective: This study aims to determine (1) when shoulder rebalancing occurs after adolescent idiopathic scoliosis (AIS) correction surgery and (2) whether shoulder asymmetry was influenced by the use of pedicle screws or hooks.

Summary Of Background Data: Postoperative shoulder imbalance is an important outcome of AIS correction surgery as it may influence a patient's appearance and satisfaction.

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Study Design: Retrospective review of prospectively collected data.

Objective: The objective of this study was to determine how different combinations of preoperative back pain (BP) and leg pain (LP) may influence functional outcomes, patient satisfaction and return to work (RTW) in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for degenerative spondylolisthesis.

Summary Of Background Data: Surgical decision-making is often based on the traditional assumption that the predominance of lower extremity symptoms is a stronger indication for lumbar spine surgery.

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Study Design: This is a retrospective study.

Objective: To determine (1) the independent risk factors of postoperative shoulder imbalance (PSI) after adolescent idiopathic scoliosis (AIS) correction surgery; and (2) whether the level of upper instrumented vertebrae (UIV) affects postoperative shoulder balance.

Summary Of Background Data: PSI is an important outcome of AIS correction surgery as it influences a patient's appearance and satisfaction.

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Article Synopsis
  • The study conducted a retrospective review of registry data to examine differences in MIS-TLIF outcomes among Chinese, Malays, and Indians.
  • Researchers analyzed data from 753 patients and found demographic differences; Chinese patients were overrepresented while Malays and Indians were underrepresented.
  • While preoperative differences in pain and disability scores existed between races, significant disparities in outcomes diminished by the 2-year mark, with Indians showing lesser results in the Physical Component Summary compared to Chinese.
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  • This study retrospectively analyzed data from 46 patients who underwent 3-level anterior cervical discectomy and fusion (ACDF) to explore the link between cervical sagittal balance and adjacent segment degeneration (ASD) over an average follow-up of 5 years.
  • Results indicated that 58.7% of patients developed ASD, but cervical alignment factors like CSA and T1 slope showed no significant correlation with ASD in this specific group, contrasting with findings from 1-level and 2-level ACDF studies.
  • Ultimately, the presence of ASD did not affect clinical outcomes even after 2 years, suggesting that spinal alignment may not play a critical role in the development of ASD following 3
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Study Design: Retrospective review of prospectively-collected registry data.

Objectives: The aim of this study was to determine how different combinations of preoperative neck pain (NP) and arm pain (AP) influence functional outcomes, patient satisfaction, and return-to-work in patients undergoing anterior cervical discectomy and fusion (ACDF) for degenerative cervical radiculopathy (DCR).

Summary Of Background Data: Surgeons often base decisions on the traditional belief that the predominance of radicular upper extremity symptoms is a stronger indication for cervical spine surgery than axial pain.

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Background Context: The patient acceptable symptom state (PASS) is a valuable tool for interpreting patient-reported outcomes. Previous studies have attempted to define the PASS in a heterogenous cohort with various lumbar spinal disorders and surgical procedures.

Purpose: We aimed to determine the PASS threshold for the Oswestry Disability Index (ODI) specifically for patients undergoing lumbar fusion for spondylolisthesis-associated functional disability.

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Article Synopsis
  • The study is a retrospective cohort analysis aimed at understanding how body mass index (BMI) influences patient-reported outcomes after 1- and 2-level anterior cervical discectomy and fusion (ACDF) surgeries, amidst rising issues of cervical spondylosis and obesity among aging populations.
  • A total of 878 patients were originally studied, but after exclusions (like prior surgeries or missing data), 535 were analyzed using various PRO measures collected at three different time points (preoperative, 6 months, and 2 years post-surgery).
  • Results indicated that despite 48.3% of patients being obese, all groups showed significant improvements in PRO scores without major differences between BMI categories, although the highest reoperation rate
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Study Design: This was a retrospective review of prospectively collected data.

Objectives: Few studies have described the relationship between mental health and patient-reported outcome measures (PROMs) after minimally invasive spine surgery. Prior studies on open surgery included small cohorts with short follow-ups.

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Article Synopsis
  • Young patients under 50 with degenerative lumbar spondylosis are increasingly seeking surgical treatment, but there's limited understanding of their post-surgery outcomes compared to older patients.
  • The study aims to evaluate how many of these younger patients achieve significant improvement in pain and function after transforaminal lumbar interbody fusion, alongside the rates of complications and reoperations, as well as the success of radiographic fusion.
  • A retrospective analysis of 83 patients under 50 years, out of a larger group, assessed their clinical outcomes and complications for at least two years post-surgery, with various pain measurement tools being used to gauge effectiveness.
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Study Design: This was a retrospective study that was carried out using prospectively collected registry data.

Objective: The objective of this study was to identify preoperative predictors of outcomes after anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy.

Summary Of Background Data: Proper patient selection is paramount to achieving good surgical results.

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Background: Although several studies have suggested that minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) may be especially beneficial in the elderly population due to lower operative morbidity and faster postoperative recovery, there are limited studies investigating the functional outcomes, quality of life, and satisfaction in elderly patients after MIS-TLIF. Furthermore, existing studies had substantial clinical, diagnostic, and surgical heterogeneity.

Questions/purposes: We asked if elderly patients could experience comparable (1) patient-reported pain, disability and quality of life, (2) perioperative complications, and (3) radiological fusion rates as their younger counterparts after MIS-TLIF.

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Study Design: A retrospective review of prospectively collected registry data.

Objectives: (1) Examine functional outcomes of patients with postoperative sacral slope (SS)<30 degrees versus SS≥30 degrees after single-level transforaminal lumbar interbody fusion (TLIF) for degenerative spondylolisthesis (DS); (2) determine the factors associated with SS at the last follow-up.

Summary Of Background Data: Few studies have examined the relationship between spinopelvic parameters and functional outcomes in patients with DS undergoing short-segment TLIF.

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Study Design: Retrospective review of prospectively-collected registry data.

Objective: To compare the patient-reported outcomes, satisfaction, and return to work among a large cohort of patients stratified by preoperative myelopathy severity undergoing Anterior Cervical Discectomy and Fusion (ACDF) for Degenerative Cervical Myelopathy.

Summary Of Background Data: Recent clinical practice guidelines noted a lack of studies stratifying their sample based on preoperative disease severity.

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Study Design: A retrospective study using prospectively collected registry data.

Objective: Examine the influence of preoperative mental health on outcomes after Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS-TLIF).

Summary Of Background Data: Prior studies investigating the relationship between mental health and outcomes after lumbar spine surgery included small cohorts with short follow-up and heterogenous fusion techniques.

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Study Design: Retrospective cohort study.

Objectives: This study aims to determine the preoperative predictors of postoperative satisfaction in transforaminal lumbar interbody fusion (TLIF) surgery in order to improve management of patient groups at high risk of dissatisfaction. We retrospectively reviewed prospectively collected data on patients who underwent open TLIF in a tertiary hospital between 2008 and 2012 with 2-year follow-up and performed multivariate analysis for their preoperative variables.

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Compression fractures are the most common vertebral fractures. They involve the anterior column of the spine, and are considered stable fractures due to the presence of intact posterior ligaments that aid in resisting further collapse and deformity. They are thus often managed conservatively.

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Background Context: Comparative studies between open and minimally invasive surgical (MIS) approaches for the treatment of spinal stenosis have mainly investigated immediate postoperative parameters.

Purpose: We aimed to compare the postoperative improvements in functional and pain scores between open versus MIS lumbar laminotomy and to describe the complications of each method.

Study Design/setting: We conducted as retrospective review of prospectively collected data.

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Study Design: We present the case study of a 31-year-old lady who had a spontaneous cervical spinal epidural hematoma in the postpartum period and who presented with sudden onset of neck pain and lower limb weakness for which an emergency decompressive laminectomy was performed with neurological recovery.

Objective: To report on the spontaneous spinal epidural hematoma in the postpartum period, which is a rare complication during pregnancy and requires early recognition and expedient intervention to prevent permanent neurological sequelae.

Summary Of Background Data: This complication has been described only once previously in the postpartum period.

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Study Design: prospective study.

Objective: present results of Prestige LP artificial cervical disc replacement (ADR).

Summary Of Background Data: motion preservation with ADR can potentially reduce adjacent segment degeneration.

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Spontaneous spinal epidural haematomas (SSEHs) are rare causes of spinal cord compression. We present 2 cases of thoracic SSEHs with similar magnetic resonance imaging (MRI) features. Patient 1 was on long-term oral anticoagulants and patient 2 had uncontrolled hypertension.

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