Publications by authors named "Vincent Federico"
Background: Ambulatory Surgery Centers (ASCs) have been shown to deliver high-quality care to patients at major cost savings to the healthcare system. The objective of this investigation was to examine trends in the Medicare facility and surgeon professional fee payments for hip and knee arthroplasty.
Methods: Publicly available Medicare data was analyzed to determine professional and facility fee payments for unicompartmental knee arthroplasty (UKA), total knee arthroplasty (TKA), and total hip arthroplasty (THA) to ASCs and hospitals between 2018 and 2024.
Study Design: Retrospective review.
Objective: To validate using patient-reported outcome measurement information system-pain interference (PROMIS-PI) to assess outcomes in patients undergoing lumbar decompression surgery compared with well-established pain and disability measures.
Summary Of Background Data: PROMIS outcomes provide valuable information, but the PROMIS-PI measure has not been validated in lumbar decompression.
Study Design: Retrospective review.
Objective: This study aims to compare postoperative patient-reported outcome measures (PROMs) in predominant back pain (PBP) versus predominant leg pain (PLP) patients following lumbar fusion for degenerative spondylolisthesis (DS).
Summary Of Background Data: Prior studies comparing PROMs in patients undergoing lumbar fusion with PBP versus PLP symptoms have included heterogeneous spinal pathology and restricted analysis to posterior fusion techniques.
Study Design: Retrospective review.
Objective: To evaluate how preoperative disability influences patient-reported outcomes (PROs) following primary surgical intervention for cervical herniated disc.
Summary Of Background Data: The effect of baseline disability has been evaluated for various spinal surgeries, but not specifically for primary cervical herniated disc.
Background: As lateral lumbar interbody fusions (LLIF) are increasingly performed, our understanding of postoperative clinical trajectories is important in informing preoperative patient expectations. While minimum clinically important difference (MCID) rates are widely utilized in spine surgery literature, there is less published on how long it takes for patients to achieve MCID following LLIF.
Objective: To evaluate the length of time it takes for patients to report MCID achievement for back pain, leg pain, disability, and physical function and evaluate predictors of time to achieve MCID.
Article Synopsis
- The study investigates the trends in Medicare reimbursements for professional fees versus facility fees in ambulatory surgery centers (ASCs) specifically for shoulder procedures from 2018 to 2024, highlighting cost-saving benefits of ASCs despite decreasing professional fees.
- Researchers analyzed data from 33 common shoulder procedures, finding that facility fees have consistently outperformed professional fees, remaining higher and aligned with inflation.
- The results underscore a troubling trend: while facility fees have stabilized, professional fees have steadily decreased over time, potentially impacting the viability of ASCs for practitioners.
Study Design: Retrospective study.
Objective: To determine whether there are significant differences in postoperative dysphagia when using table-mounted versus self-retaining retractor tools.
Summary Of Background Data: Retraction of prevertebral structures during anterior cervical spine surgery (ACSS) is commonly associated with postoperative dysphagia or dysphonia.
Purpose: To evaluate the influence of preoperative VR-12 physical component scores (PCS) on outcomes following cervical disc replacement (CDR).
Methods: Patients undergoing elective CDR were retrospectively identified. Patient-reported outcomes (PROs) of interest included VR-12 PCS/VR-12 Mental Component Score (MCS)/9-Item Patient Health Questionnaire (PHQ-9)/Short Form-12 (SF-12) PCS and MCS/Patient-Reported Outcome Measurement Information System-Physical Function (PROMIS-PF)/Visual Analog Scale-Neck Pain (VAS-NP)/VAS-Arm Pain (VAS-AP)/Neck Disability Index (NDI).
Purpose: To evaluate the effect of baseline back pain severity on PROMIS mental health outcomes following minimally invasive lumbar decompression (LD).
Methods: Patients undergoing elective, primary, single-level LD were retrospectively reviewed from a prospective single spine surgeon registry. Perioperative characteristics, demographics, and the following patient-reported outcomes (PROs) were extracted: Oswestry Disability Index (ODI)/Patient-Health Questionnaire-9 /PROMIS-Physical Function/Anxiety/Pain Interference/Sleep Disturbance (PROMIS-PF/A/PI/SD).
Background: Patients with lumbar spinal pathology often suffer from anxiety and sleep disturbance, but correlations between anxiety and sleep disturbance and other patient-reported outcome measures (PROMs) before and after surgical intervention have not been explored. The purpose of this study is to analyze the correlations between patient-reported anxiety, sleep disturbance, and PROMs before and after lumbar decompression.
Methods: All patients undergoing elective, primary, lumbar decompression were retrospectively queried from a prospectively-maintained single spine surgeon database.
Study Design: This is a retrospective review.
Objective: To examine the effect of preoperative motor weakness on clinical outcomes in patients undergoing cervical disk replacement (CDR).
Summary Of Background Data: Studies examining the effect of preoperative motor weakness on postoperative clinical outcomes in CDR are limited.
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: Evaluate the influence of the 12-Item veterans Rand (VR-12) physical component score (PCS) on patient-reported outcome measures (PROMs) in an outpatient lumbar decompression (LD) cohort.
Summary Of Background Data: The influence of baseline VR-12 PCS on postoperative clinical outcomes has not been evaluated in patients undergoing outpatient LD.
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.
Background And Objectives: Severe facet arthropathy is generally a contraindication to undergoing cervical disc replacement (CDR) due to associated instability and potentially limited improvement in neck pain caused by arthropathy. This study evaluates the influence of facet arthropathy on radiographic/early clinical outcomes after CDR.
Methods: One/two-level CDR patients from a single surgeon's prospectively maintained database created 2 cohorts based on facet arthropathy: grade 0-1 or 2-3 (milder/moderate arthropathy).
Article Synopsis
- This study focuses on how preoperative motor weakness (MW) influences Patient-Reported Outcome Measures (PROMs) in patients undergoing lateral lumbar interbody fusion (LLIF).
- It includes data from 214 patients, with 149 experiencing MW, and analyzes various outcomes like physical function, pain levels, and quality of life before and after surgery.
- The findings indicate that while there were some demographic and perioperative differences between patients with and without MW, MW did not have a significant impact on overall PROM outcomes or minimum clinically important differences, except for one measure related to disability scores.
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.
Study Design: Case report and literature review.
Objective: To report the relatively rare complication of delayed infection after cervical disc arthroplasty (CDA).
Background: Delayed infection of the M6 device has been a rarely reported complication, with all cases described outside of the United States.
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 PDFArticle Synopsis
- Little research has explored how short-term postoperative patient-reported outcomes (PROs) predict long-term outcomes after lumbar decompression (LD), prompting a study to evaluate this relationship over two years.
- The study analyzed data from 277 patients, focusing on various PRO measures, such as pain scales and disability indexes, assessed at multiple time points, including 6 weeks, 6 months, 1 year, and 2 years post-surgery.
- Findings showed that 6-week PROs are strong predictors for outcomes at 6 months, with certain measures remaining predictive through 1 or even 2 years, aiding in understanding patient recovery trajectories and setting expectations.
Objective: Mental health disorders (MHDs) have been linked to worse postoperative outcomes after various surgical procedures. Past studies have also demonstrated a higher prevalence of dysphagia in both acute and community mental health settings. Dysphagia is among the most common complications following anterior cervical spine surgery (ACSS); however, current literature describing the association between an established diagnosis of an MHD and the rate of dysphagia after ACSS is sparse.
View Article and Find Full Text PDFIntroduction: Lumbar facet cysts represent a potential source of nerve root compression in elderly patients. Isolated decompression without fusion has proven to be a reasonable treatment option in properly indicated patients. However, the risk of lumbar fusion after isolated decompression and facet cyst excision has yet to be elucidated.
View Article and Find Full Text PDFObjective: To evaluate preoperative disability's influence on patient-reported outcomes (PROs) following surgery for degenerative spondylolisthesis (DS).
Methods: DS patients who underwent surgical intervention were retrospectively identified from a single-surgeon spine registry. Cohorts based on Oswestry Disability Index (ODI) < 41 (milder disability) and ≥ 41 (severe disability) were created.