Gender differences in spine surgery for degenerative lumbar disease: prospective cohort study.

Objective: Despite efforts toward achieving gender-based equality in clinical trial enrollment, females are frequently underrepresented and gender-specific data analysis is lacking. Identifying and addressing gender bias in medical decision-making and outcome reporting may facilitate more equitable healthcare delivery. This study aimed to determine if gender differences exist in the clinical evaluation and surgical management of patients with degenerative lumbar conditions.

Satisfaction in surgically treated patients with degenerative cervical myelopathy: an observational study from the canadian spine outcomes and research network.

Background Context: Healthcare reimbursement is evolving towards a value-based model, entwined and emphasizing patient satisfaction. Factors associated with satisfaction after degenerative cervical myelopathy (DCM) surgery have not been previously established.

Purpose: Our primary objective was to ascertain satisfaction rates and satisfaction predictors at 3 and 12 months following surgical treatment for DCM.

Advanced MRI metrics improve the prediction of baseline disease severity for individuals with degenerative cervical myelopathy.

Background Context: Degenerative cervical myelopathy (DCM) is the most common form of atraumatic spinal cord injury globally. Degeneration of spinal discs, bony osteophyte growth and ligament pathology results in physical compression of the spinal cord contributing to damage of white matter tracts and grey matter cellular populations. This results in an insidious neurological and functional decline in patients which can lead to paralysis.

Preoperative expectations of patients with degenerative cervical myelopathy: an observational study from the Canadian Spine Outcomes and Research Network.

Background: Despite an abundance of literature on degenerative cervical myelopathy (DCM), little is known about preoperative expectations of these patients.

Purpose: The primary objective was to describe patient preoperative expectations. Secondary objectives included identifying patient characteristics associated with high preoperative expectations and to determine if expectations varied depending on myelopathy severity.

The Effects of Peri-Operative Adverse Events on Clinical and Patient-Reported Outcomes After Surgery for Degenerative Cervical Myelopathy: An Observational Cohort Study from the Canadian Spine Outcomes and Research Network.

Background And Objectives: There is a lack of data examining the effects of perioperative adverse events (AEs) on long-term outcomes for patients undergoing surgery for degenerative cervical myelopathy. We aimed to investigate associations between the occurrence of perioperative AEs and coprimary outcomes: (1) modified Japanese Orthopaedic Association (mJOA) score and (2) Neck Disability Index (NDI) score.

Methods: We analyzed data from 800 patients prospectively enrolled in the Canadian Spine Outcomes and Research Network multicenter observational study.

Anterior vs Posterior Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network.

Background And Objectives: The advantages and disadvantages of anterior vs posterior surgical approaches for patients with progressive degenerative cervical myelopathy (DCM) remain uncertain. Our primary objective was to evaluate patient-reported disability at 1 year after surgery. Our secondary objectives were to evaluate differences in patient profiles selected for each approach in routine clinical practice and to compare neurological function, neck and arm pain, health-related quality of life, adverse events, and rates of reoperations.

Accuracy of imaging grading in comparison to open laminectomy to evaluate pedicle screws positioning.

Study Design: Prospective experimental study.

Objective: To compare the accuracy of O-Arm-acquired radiographic and computed tomography (CT) evaluation of thoracic pedicle screw placement with open laminectomy in a simulation laboratory.

Summary Of Background Data: Improving surgical safety and procedural efficiency during thoracic posterior spine instrumentation is essential for decreasing complication rates and possible related risks.

Development of the cervical myelopathy severity index: a new patient reported outcome measure to quantify impairments and functional limitations.

Background Context: Existing degenerative cervical myelopathy (DCM) severity scales have significant shortcomings, creating a strong impetus for the development of a practical measurement tool with sound psychometric properties.

Purpose: This work reports the item generation and reduction of the Cervical Myelopathy Severity Index (CMSI), a new DCM patient-reported outcome measure of symptoms and functional limitations.

Design: Prospective observational study.

Stand-Alone Anchored Spacer vs Anterior Plate Construct in the Management of Adjacent Segment Disease after Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis of Comparative Studies.

Study Design: Systematic Review and Meta-Analysis.

Objectives: This study aimed to evaluate the clinical and radiological outcomes of surgically treated adjacent segment disease (ASDis) following ACDF with either anterior plate construct (APC) or stand-alone anchored spacers (SAAS).

Method: Multiple databases were searched until December 2022 for pertinent studies.

Beneficial Effects of Preoperative Exercise on the Outcomes of Lumbar Fusion Spinal Surgery.

To determine whether there was an association between self-reported preoperative exercise and postoperative outcomes after lumbar fusion spinal surgery. We performed a retrospective multivariable analysis of the prospective Canadian Spine Outcomes and Research Network (CSORN) database of 2,203 patients who had elective single-level lumbar fusion spinal surgeries. We compared adverse events and hospital length of stay between patients who reported regular exercise (twice or more per week) prior to surgery ("Regular Exercise") to those exercising infrequently (once or less per week) ("Infrequent Exercise") or those who did no exercise ("No Exercise").

Determining minimal clinically important difference estimates following surgery for degenerative conditions of the lumbar spine: analysis of the Canadian Spine Outcomes and Research Network (CSORN) registry.

Background Context: There is significant variability in minimal clinically important difference (MCID) criteria for lumbar spine surgery that suggests population and primary pathology specific thresholds may be required to help determine surgical success when using patient reported outcome measures (PROMs).

Purpose: The purpose of this study was to estimate MCID thresholds for 3 commonly used PROMs after surgical intervention for each of 4 common lumbar spine pathologies.

Study Design/setting: Observational longitudinal study of patients from the Canadian Spine Outcomes and Research Network (CSORN) national registry.

Patient, clinical, surgical, and institutional factors associated with length of stay in scheduled degenerative thoracolumbar spine surgery: National Multicenter Cohort Analysis from the Canadian Spine Outcomes and Research Network.

Objective: Length of stay (LOS) is a contributor to costs and resource utilization. The primary goal of this study was to identify patient, clinical, surgical, and institutional variables that influence LOS after elective surgery for thoracolumbar degenerative pathology. The secondary objective was to examine variability in LOS and institutional strategies used to decrease LOS.

Timing of Recovery After Surgery for Patients With Degenerative Cervical Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network.

Background: The time course over which postoperative neurological recovery occurs after surgery for degenerative cervical myelopathy occurs is poorly understood.

Objective: To determine the time point at which patients experience significant neurological improvement.

Methods: We reviewed data from an ongoing prospective multicenter cohort study.

Unexpected intraoperative positive culture (UIPC) in presumed aseptic revision spine surgery: a systematic review and meta-analysis.

Background Context: Unexpected intraoperative positive culture (UIPC) has recently become increasingly common in revision spine surgery, being implicated as an etiological factor in revision spine surgery indications such as implant failure or pseudoarthrosis.

Purpose: Utilizing the available literature, this study aimed to investigate the prevalence of UIPC, and its clinical importance in patients following presumed aseptic revision spine surgery.

Study Design: Meta-analysis and systematic review.

Postoperative recovery patterns following discectomy surgery in patients with lumbar radiculopathy.

This retrospective study of prospectively collected data aimed to identify unique pain and disability trajectories in patients following lumbar discectomy surgery. Patients of this study population presented chiefly with lumbar radiculopathy and underwent discectomy surgery from thirteen sites enrolled in the CSORN registry. Outcome variables of interest included numeric rating scales for leg/back pain and modified Oswestry disability index scores at baseline, 3, 12, and 24 months post-operatively.

Outcome of spine surgery in patients with depressed mental states: a Canadian spine outcome research network study.

Background Context: Depression is higher among spine patients than among the general population. Some small studies, but not others, have suggested that depression may be a predictor of worse outcome after surgery.

Purpose: Determination whether there is an association between depression and worse response to surgery among spine patients.

Does extending a posterior cervical fusion construct into the upper thoracic spine impact patient-reported outcomes as long as 2 years after surgery in patients with degenerative cervical myelopathy?

Objective: In multilevel posterior cervical instrumented fusion, extension of fusion across the cervicothoracic junction (CTJ) at T1 or T2 has been associated with decreased rates of reoperation and pseudarthrosis but with longer surgical time and increased blood loss. The impact on patient-reported outcomes (PROs) remains unclear. The primary objective was to determine whether extension of fusion through the CTJ influenced PROs at 3, 12, and 24 months after surgery.

Fulfillment of Patient Expectations After Spine Surgery is Critical to Patient Satisfaction: A Cohort Study of Spine Surgery Patients.

Background: Patient satisfaction is an important indicator used to monitor quality of care and outcomes after spine surgery.

Objective: To examine the complex relationship between preoperative expectations, fulfillment of expectations, postsurgical outcomes, and satisfaction after spine surgery.

Methods: In this national study of patients undergoing elective surgery for degenerative spinal conditions from the Canadian Spine Outcomes and Research Network Registry, we used logistic regression to examine the relationships between patient satisfaction with surgery (1-5 scale), preoperative expectation score (0 = none to 100 = highest), fulfillment of expectations, and disability and pain improvement.

Predictors of home discharge after scheduled surgery for degenerative cervical myelopathy.

Objective: Degenerative cervical myelopathy (DCM) is an important public health issue. Surgery is the mainstay of treatment for moderate and severe DCM. Delayed discharge of patients after DCM surgery is associated with increased healthcare costs.

Surgical outcomes of patients who fail to reach minimal clinically important differences: comparison of minimally invasive versus open transforaminal lumbar interbody fusion.

Objective: Treatment of degenerative lumbar diseases has been shown to be clinically effective with open transforaminal lumbar interbody fusion (O-TLIF) or minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Despite this, a substantial proportion of patients do not meet minimal clinically important differences (MCIDs) in patient-reported outcomes (PROs). The objectives of this study were to compare the proportions of patients who did not meet MCIDs after O-TLIF and MIS-TLIF and to determine potential clinical factors associated with failure to achieve MCID.

Differentiation of pain-related functional limitations in surgical patients with lumbar spinal stenosis (LSS) using the Oswestry Disability Index: a Canadian Spine Outcomes and Research Network (CSORN) study.

Background Context: The Oswestry Disability Index (ODI) is the most commonly used outcome measure of functional outcome in spine surgery. The ability of the ODI to differentiate pain related functional limitation specifically related to degenerative lumbar spinal stenosis (LSS) is unclear.

Purpose: The purpose of this study was to determine the ability of the functional subsections of the ODI to differentiate the specific patient limitation(s) from symptomatic LSS and the functional impact of surgery.

Patient-Reported Outcomes Following Surgery for Lumbar Disc Herniation: Comparison of a Universal and Multitier Health Care System.

Study Design: Ambispective cohort study.

Objective: Canada has a government-funded universal health care system. The United States utilizes a multitier public and private system.