Study Design: Survey of neurosurgical and orthopedic spine surgeons.
Objective: To define the "complications of spinal surgery," we surveyed a large group of practicing spine surgeons to establish a preliminary definition of perioperative complications.
Summary Of Background Data: Although the risk of complications following spinal procedures plays an important role in determining the appropriateness of surgical intervention, there is little consensus among spine surgeons regarding the definition of complications in spine surgery. The relevance of medical complications is also not clearly defined.
Methods: We surveyed a cohort of practicing spine surgeons via email and a commercially maintained website. Surgeons were presented with various complication scenarios, and asked to assess the presence or absence of a complication, as well as complication severity, with responses limited to "major complication" and "minor complication/adverse event."
Results: The survey was sent to approximately 2000 practicing surgeons; complete responses were received from 229, giving a response rate of 11.4%. Orthopedic surgeons comprised the majority of respondents (73%); most surgeons reported being in practice for greater than 5 years (83%). Greater than 75% of surgeons agreed on complication presence or absence in 10 of 11 scenarios assessed (91%, P<0.05). Consensus (≥70% agreement, P<0.05) as to type of complication was found in 7 of 11 scenarios presented (64%). Events deemed major complications involved either severe medical adverse events with permanent sequela or events requiring return to the operating room. Surgeons consistently considered medical adverse events, whether or not directly related to surgery, relevant to complication assessment.
Conclusions: We present a practical binary definition of complications in spine surgery based upon a survey of over 200 practicing spine surgeons. Further work is required in critically assessing spine surgery complications.
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http://dx.doi.org/10.1097/BSD.0b013e3181c11f89 | DOI Listing |
Radiol Med
January 2025
Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Purpose: To develop an artificial intelligence (AI) algorithm for automated measurements of spinopelvic parameters on lateral radiographs and compare its performance to multiple experienced radiologists and surgeons.
Methods: On lateral full-spine radiographs of 295 consecutive patients, a two-staged region-based convolutional neural network (R-CNN) was trained to detect anatomical landmarks and calculate thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), and sagittal vertical axis (SVA). Performance was evaluated on 65 radiographs not used for training, which were measured independently by 6 readers (3 radiologists, 3 surgeons), and the median per measurement was set as the reference standard.
Background: There has been an increase in both primary anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA) over the last decade, with rates peaking for patients aged 75 years and older. Despite aTSA being the mainstay of treatment for patients with glenohumeral arthritis in the absence of rotator cuff insufficiency, there has been an upward trend of rTSA utilization in the elderly due to concerns about rotator cuff integrity, regardless of deformity. The purpose of this study is to evaluate outcomes including pain, function, range of motion, satisfaction, and complications in patients 80 years or older following primary anatomic and reverse total shoulder arthroplasty for osteoarthritis without full thickness rotator cuff tears.
View Article and Find Full Text PDFWorld Neurosurg
January 2025
Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Objective: In recent decades, many physicians have chosen to opt out of Medicare, allowing them to set their own pricing models for their patients. Characterization of Medicare opt-outs has not been thoroughly studied in any surgical specialty, including Neurosurgery. Our study characterizes the factors that may influence a neurosurgeon's decision to opt out of Medicare acceptance and contextualizes them both within the field and across various surgical specialties.
View Article and Find Full Text PDFClin Neurol Neurosurg
January 2025
Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, NY, United States.
Background: Malnutrition is a predictor of poor surgical outcomes, but its specific effects in spinal epidural abscess (SEA) are understudied. This study aims to assess the association between nutritional status and post-operative outcomes.
Methods: We conducted a retrospective cohort study using the 2011-2022 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database to identify adult SEA patients who underwent spinal surgery.
Study Design: Retrospective cohort study.
Objective: Frailty is defined as a state of minimal "physiologic reserve." The modified 5 factor frailty index (mFI-5) is a recently proposed metric for assessing frailty and has been previously studied as a predictor of morbidity and mortality.
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