Publications by authors named "Lloyd A Hey"

Purpose: Spine deformity surgery is a complex multi-step procedure that has a relatively high complication rate. The use of surgical safety checklists has been shown to reduce perioperative adverse events, but existing lists are varied and non-specific for spinal deformity surgery. Thus, the purpose of this study was to develop a comprehensive surgical checklist for complex spinal corrective surgery.

View Article and Find Full Text PDF

Introduction: Benefits of increasing screw density in posterior instrumentation used to treat a scoliotic deformity are demonstrated using a three-dimensional finite element model (FEM) of the thoracolumbosacral spine.

Methods: The FEM represents a Lenke 1AN scoliotic deformity with a 50° Cobb angle and 20° apical vertebral rotation. The curve is corrected with bilateral pedicle screw fixation and 75 separate randomized screw distributions.

View Article and Find Full Text PDF

The CHOISSE multi-stage framework for evaluating the effects of electronic checklist applications (e-checklists) on surgical team members' perception of their roles, performance, communication, and understanding of checklists is introduced via a pilot study. A prospective interventional cohort study design was piloted to assess the effectiveness of the framework and the sociotechnical effects of the e-checklist. A Delphi process was used to design the stages of the framework based on literature and expert consensus.

View Article and Find Full Text PDF

Introduction: This study develops and validates an accurate, computationally efficient, 3-dimensional finite element model (FEM) of the human lumbar spine. Advantages of this simplified model are shown by its application to a disc degeneration study that we demonstrate is completed in one-sixth the time required when using more complicated computed tomography (CT) scan-based models.

Methods: An osseoligamentous FEM of the L1-L5 spine is developed using simple shapes based on average anatomical dimensions of key features of the spine rather than CT scan images.

View Article and Find Full Text PDF

When changes occur in neurological responses during a surgical case, it is very important that all staff in the operating room (OR) understand their role in resolving or improving these conditions. Timely interventions are needed, and each personnel team is responsible for very specific tasks. Our intent was to cut down on confusion and delay by implementing a checklist that assigns tasks and designates a coordinator, so we incorporated the use of a checklist developed by Vitale et al.

View Article and Find Full Text PDF

Study Design: An electronic survey administered to Scoliosis Research Society (SRS) membership.

Objective: To characterize surgeon practices and views regarding the use of two attending surgeons for adult spinal deformity (ASD) surgery.

Summary Of Background Data: The use of two experienced attending surgeons can decrease the operative time, estimated blood loss, and perioperative complication rates.

View Article and Find Full Text PDF

Spinal deformity in the adult is a common medical disorder with a significant and measurable impact on health-related quality of life. The ability to measure and quantify patient self-reported health status with disease-specific and general health status measures, and to correlate health status with radiographic and clinical measures of spinal deformity, has enabled significant advances in the assessment of the impact of deformity on our population, and in the evaluation and management of spinal deformity using an evidence-based approach. There has been a significant paradigm shift in the evaluation and management of patients with adult deformity.

View Article and Find Full Text PDF

Study Design: An electronic survey administered to Scoliosis Research Society membership.

Objective: To characterize surgeon views regarding proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) management providing the framework in which a PJK/PJF classification system and treatment guidelines could be established.

Summary Of Background Data: PJK/PJF are common complications of adult spinal deformity surgery.

View Article and Find Full Text PDF

Study Design: Systematic review of literature.

Objective: To perform a comprehensive English language systematic literature review of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF), concentrating on incidence, risk factors, health related quality of life impact, prevention strategy, and classification systems.

Summary Of Background Data: PJK and PJF are well described clinical pathologies and are a frequent cause of revision surgery.

View Article and Find Full Text PDF

Study Design: Secondary analysis of the 2000 Medical Expenditure Panel Survey (MEPS). OBJECTIVE.: To examine national prescription patterns of nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants among individuals with back pain in the United States.

View Article and Find Full Text PDF

Objectives: Emergency department (ED) overcrowding has become a national problem. Children account for nearly 25% of overall ED visits. It has been reported that uninsured and publicly insured children are likely to visit the ED for urgent and nonurgent problems, yet it remains unclear to what extent health insurance status would influence children's overall ED utilization or ED utilization for nonurgent problems at the national level after controlling for other confounding factors.

View Article and Find Full Text PDF