Ambulatory surgery center ownership models.

Outpatient spine surgery performed in ambulatory surgery centers (ASCs) has grown dramatically over the last decade because of significant clinical and economic advantages to patients, physicians and the health care industry. Physicians benefit from the efficiencies of the outpatient setting and potential profit from ownership. There are various ownership models which differ primarily on the amount of ownership attributed to physicians, management companies and hospital systems, the key players in the space.

Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF).

Degenerative spondylolisthesis with or without spondylolysis, multiply recurrent disk herniation, and degenerative disk disease commonly presents as back and leg pain, weakness and paresthesias. Surgical intervention, to include lumbar decompression with instrumented fusion with or without interbody fusion, is recommended to patients who are refractory to at least six weeks of nonoperative treatment, or patients with severe or progressive neurological deficits. This paper reviews the pre- and post-operative considerations, as well as the surgical technique, for a minimally invasive transforaminal lumbar interbody fusion for the above conditions.

Minimally Invasive/Less Invasive Microdiscectomy.

Herniated disks in the lumbar spine typically present with the sudden onset of back and leg pain in a myodermatomal distribution. Symptoms may include radicular pain, paresthesias, and in extreme cases weakness or foot drop. Typically patients are treated conservatively for 6-8 weeks with a combination of steroids, nonsteroidal anti-inflammatory drugs, physical therapy, epidural steroid injections, and rest.

Patient perceptions of physician reimbursement for spine surgery.

Study Design: Anonymous patient survey.

Objective: To determine what patients think surgeons should be paid to perform elective spine surgical procedures, and gauge awareness of actual Medicare reimbursement.

Summary Of Background Data: With increasing transparency, the public may become aware of physician reimbursements and may be a part of the debate regarding appropriate reimbursement.

Subclavian vein thrombosis after application of body cast.

Mehta-Cotrel body casting is a well-recognized and effective technique for the treatment of progressive infantile scoliosis. The treatment can be challenging to execute given the commitment required by the patient's family and treatment team, and is not without complications. In this report, we detail the occurrence of a subclavian vein thrombosis after the placement of a Mehta-Cotrel cast for the treatment of progressive infantile kyphoscoliosis.

Orthopedic specialty hospitals: centers of excellence or greed machines?

Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction.

Effect of light-emitting diode (LED) therapy on the development of osteoarthritis (OA) in a rabbit model.

Objective: The objective of this study was to evaluate whether light-emitting diodes (LEDs) could be effective in a noninvasive, therapeutic device for the treatment of osteoarthritic (OA) knee joints.

Design: Five weeks following the anterior cruciate ligament transection (ACLT) of mature New Zealand White rabbits, the animal knees were exposed to LED stimulation at intervals of 10 min/day, 5 days/week for 5 weeks in the experimental group (n=7). The device used high intensity red and infrared (IR) LEDs with a total amount of energy delivered to the skin of 2.

Use of bone morphogenic protein-7 as a treatment for osteoarthritis.

Osteoarthritis is a degenerative disorder resulting from breakdown of articular cartilage. Previous work has shown bone morphogenic protein-7 has a potential protective effect on cartilage during the development of osteoarthritis. The purpose of this study was to determine whether bone morphogenic protein-7 could decrease the amount of cartilage degradation in preexisting osteoarthritis.

Psoriatic arthritis and arthroplasty: a review of the literature.

Psoriatic arthritis is an inflammatory arthropathy as- sociated with the characteristic dermatologic lesions of psoriasis. The diagnosis of psoriatic arthritis is quite difficult, due to the overlap of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) with concomitant non-associated psoriasis. A nonspecific elevation in inflammatory markers (erythrocyte sedimentation rate, ESR; antinuclear antibodies, ANA; or rheumatoid factor, RF) and characteristic radiographic features are often present in these patients.

Analysis of cartilage tissue on a cellular level in fresh osteochondral allograft retrievals.

Background: Fresh human osteochondral allografting is a biological cartilage replacement technique used to treat articular and osteoarticular defects in the knee. A small number of grafts fail, and we analyzed every retrieved graft during a 4-year period in order to learn more about the potential causes of failure.

Hypothesis: A large percentage of chondrocytes still remain viable many years after fresh osteochondral allografting.

Improvement of muscle healing through enhancement of muscle regeneration and prevention of fibrosis.

Skeletal muscle is able to repair itself through regeneration. However, an injured muscle often does not fully recover its strength because complete muscle regeneration is hindered by the development of fibrosis. Biological approaches to improve muscle healing by enhancing muscle regeneration and reducing the formation of fibrosis are being investigated.