Publications by authors named "Timothy J Hartman"
Study Design: Retrospective review.
Objective: To compare perioperative and postoperative clinical outcomes between minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and lateral lumbar interbody fusion (LLIF) in patients presenting with predominant back pain.
Background: Two popular techniques utilized for lumbar arthrodesis are MIS-TLIF and LLIF.
Background: Direct-acting oral anticoagulants (DOACs) are recommended to reduce risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). However, DOAC dosing inconsistent with FDA-approved product labels is common and associated with poor clinical outcomes.
Objectives: Identify DOAC dosing inconsistent with FDA-approved product labels in ambulatory care patients with NVAF; identify variables associated with dosing lower and higher than label.
Article Synopsis
- - The study aimed to analyze how preoperative pain and disability affect patient-reported outcomes after minimally invasive lumbar fusion surgery for degenerative spondylolisthesis, focusing on symptom severity classifications: Mild, Moderate, and Severe.
- - A total of 177 patients were examined, revealing that those in the Severe group experienced the highest levels of postoperative pain and the worst pre- and post-operative outcomes, while all groups saw improvements over time.
- - The findings indicated that patients with more severe preoperative symptoms had greater improvements and better rates of achieving clinically significant outcomes compared to those with milder symptoms.
Study Design: Retrospective review.
Objective: To evaluate mental health influence on minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) patients.
Summary Of Background Data: Poor mental health has been postulated to indicate inferior patient perceptions of surgical outcomes in spine literature.
No study has examined the prognostic value of the Veterans RAND-12 (VR-12) Mental Component Score (MCS) on postoperative outcomes in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) patients. This study examines the effect of preoperative VR-12 MCS on postoperative patient-reported outcome measures (PROMs) in MIS-TLIF patients. Patients were separated into 2 cohorts: VR-12 MCS < 50 and VR-12 MCS ≥ 50.
View Article and Find Full Text PDFIntroduction: Patients with a prolonged preoperative symptom duration (PSD) in the setting of cervical disk herniation (DH) may suffer inferior outcomes after surgical intervention. Comparison between anterior cervical diskectomy and fusion (ACDF) versus cervical disk arthroplasty (CDA) in this at-risk population has not yet been conducted.
Methods: Patients undergoing ACDF or CDA for DH with a PSD > 180 days were selected.
No study has evaluated the preoperative impact of Veterans RAND-12 Physical Composite Score (VR-12 PCS) on anterior lumbar interbody fusion (ALIF) patients. This study examines its influence on physical function, mental health, pain, and disability outcomes. Two cohorts of ALIF patients with preoperative VR-12 PCS scores were formed using a single-surgeon registry: VR-12 PCS < 30 and VR-12 PCS ≥ 30.
View Article and Find Full Text PDFStudy Design: Retrospective review.
Objective: To assess the impact of Body Mass Index (BMI) on patient-reported outcome measures (PROMs) after cervical disc replacement (CDR).
Background: BMI may affect PROMs after spine surgery.
Study Design: Retrospective cohort study.
Objective: To assess the impact of preoperative symptom duration (PSD) on patient-reported outcome measures (PROMs) after minimally invasive (MIS) transforaminal lumbar interbody fusion (TLIF) for degenerative spondylolisthesis (DSpond).
Background: A prolonged duration of preoperative symptoms may implicate inferior long-term outcomes postsurgery.
Article Synopsis
- The study conducted a retrospective review to evaluate the postoperative outcomes of patients who underwent minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for isthmic spondylolisthesis (IS).
- Researchers divided participants into two groups based on their preoperative back pain levels using a Visual Analog Scale (VAS) to assess clinical outcomes through various patient-reported metrics both preoperatively and up to two years post-surgery.
- Findings indicated that both patient groups experienced significant improvements in physical function, mental health, pain, and disability, with the lower pain cohort achieving better outcomes across most metrics, while those with higher pain levels showed noteworthy improvements as well.
Study Design: Retrospective review.
Objective: To examine the effect of baseline Veterans RAND-12 (VR-12) Mental Composite Score (MCS) on clinical outcomes in patients undergoing cervical disk replacement (CDR) for herniated disk.
Background: Few studies in spine surgery have evaluated the impact of preoperative VR-12 MCS on postoperative outcomes in patients undergoing CDR.
Study Design: Retrospective cohort.
Objective: The aim was to compare patient-reported outcomes (PROMs), minimum clinically important difference (MCID) achievement, and postoperative satisfaction following minimally invasive lumbar decompression in patients stratified by American Society of Anesthesiologists (ASA) classification.
Summary Of Background Data: Some guidelines recommend against performing elective procedures for patients with an ASA score of 3 or greater; however, long-term postoperative outcomes are not well described.
Objective: Multiple studies have demonstrated the safety of outpatient spine surgery, with reports of equivalent to improved patient outcomes compared with inpatient procedures. This has resulted in the increased use of outpatient surgery over time. However, there remains a paucity of literature evaluating the difference in costs between ambulatory surgery center (ASC)- and hospital outpatient department (HOPD)-based procedures for Medicare beneficiaries.
View Article and Find Full Text PDFObjective: To examine the use of local anesthesia and/or conscious sedation in endoscopic spine procedures within the past decade.
Methods: This systematic review abided by PRISMA guidelines. Embase, PubMed, Google Scholar, and Cochrane databases were searched for post-2011 articles with patients >18 years old, lumbar/cervical percutaneous endoscopic spine procedures using local/awake anesthesia, and patient/surgical outcomes.
Article Synopsis
- The study investigates the link between patient-reported mental health and self-reported physical outcomes (like function, pain, and disability) in patients who underwent cervical disc replacement (CDR) at different recovery stages.
- A total of 151 patients were analyzed using various mental health and physical function measures, showing that lower mental health scores correlate with higher levels of pain and disability.
- The findings suggest that improving mental health in these patients might also help reduce their perception of pain and disability post-surgery.
Purpose: To determine the prognostic value of preoperative Veterans RAND-12 (VR-12) Physical Composite Score (PCS) scores on postoperative clinical outcomes in patients undergoing lateral lumbar interbody fusion (LLIF).
Methods: LLIF patients were separated into 2 cohorts based on preoperative VR-12 PCS scores: VR-12 PCS < 30 (lesser physical function) and VR-12 PCS ≥ 30 (greater physical function). Patient-reported outcome measures (PROMs) of VR-12 PCS, VR-12 Mental Composite Score (MCS), Short Form-12 (SF-12) PCS, SF-12 MCS, Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF), Patient Health Questionnaire-9 (PHQ-9), Visual Analog Scale (VAS) Back Pain (VAS-BP), VAS Leg Pain (VAS-LP), and Oswestry Disability Index (ODI) were collected at preoperative and up to 2-year postoperative time points.
Study Design: Retrospective study.
Objective: To characterize an experienced single surgeon learning curve for cervical disk replacement (CDR).
Summary Of Background Data: A single surgeon learning curve has not been established for CDR.
Article Synopsis
- The study aims to identify factors that influence how long it takes for patients to reach the minimum clinically important difference (MCID) after lumbar decompression surgery, using various Patient-Reported Outcomes (PROs) like ODI and VAS scores.
- A retrospective review of 343 patients showed that 67-68% achieved MCID within an average of about 22 weeks, with certain factors like smoking and preoperative scores predicting faster achievement while others like ethnicity and type of insurance indicated slower progress.
- The findings suggest that most patients see noticeable improvements within six months post-surgery, and understanding these predictive factors can help surgeons tailor their approach for different patients.
Study Design: Retrospective study.
Objective: To evaluate the effect of the coronavirus disease 2019 (COVID-19) shutdown in a large metropolitan area on mental health scores of spine patients undergoing lumbar decompression in the preoperative and early postoperative phases.
Summary Of Background Data: Global mental health has been demonstrated to be negatively affected by COVID-19 shutdowns.
Objective: We sought to assess correlational relationship between mental health and outcomes following lateral lumbar interbody fusion (LLIF).
Methods: Patients who had undergone LLIF were identified. Patients with indications for surgery including infection, trauma, or malignancy were excluded.
Article Synopsis
- * Researchers analyzed data from 240 patients, identifying significant predictors of a postoperative length of stay (LOS) of 48 hours or more, including age, the extent of fusion, and preoperative disability scores.
- * Additional findings highlighted that patients with certain complications and longer operative times experienced even longer hospitalizations, indicating the complexity of their recovery process.
Purpose: Few studies examine the clinical outcomes in patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) versus lateral lumbar interbody fusion (LLIF) for adjacent segment disease (ASD). We aim to compare the postoperative clinical trajectory through patient-reported outcome measures (PROMs) and minimum clinically important difference (MCID) in patients undergoing MIS-TLIF versus LLIF for ASD.
Methods: Patients were stratified into two cohorts based on surgical technique for ASD: MIS-TLIF versus LLIF.
Article Synopsis
- The study compares the time and factors affecting the achievement of the minimum clinically important difference (MCID) in patients undergoing anterior cervical discectomy and fusion (ACDF) versus cervical disc replacement (CDR) for various patient-reported outcomes (PROs).
- Results show that CDR patients achieved MCID faster in physical function compared to those undergoing ACDF, with early predictors including the type of procedure, Asian ethnicity, and higher preoperative pain levels.
- The findings suggest that most patients reach significant improvement in outcomes within 2 years, and understanding these predictors could help in setting realistic expectations for recovery.
Objective: To evaluate the effect of early depressive burden on PROMs in the setting of cervical disc replacement (CDR).
Methods: Patients who had undergone primary elective CDR with recorded preoperative and 6-week postoperative 9-item Patient Health Questionnaire (PHQ-9) scores were identified. Early depressive burden was calculated via addition of the preoperative and 6-week PHQ-9 scores.
Purpose: Patients with preoperative depressive symptoms may demonstrate inferior patient-reported outcomes (PROs). The effect of preoperative symptom duration (SD) on PROs in this population has not been well-studied. We aim to assess the influence of preoperative SD on PROs in patients with low mental health scores prior to minimally invasive transforaminal interbody fusion (MIS-TLIF).
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