Study Design: Retrospective Cohort.
Objective: To evaluate the effect of computer-assisted navigation (NAV) on rates of complications and reoperations after spinal fusion (SF) for adolescent idiopathic scoliosis (AIS) using a nationally representative claims database.
Summary Of Background Data: Significant controversy surrounds the reported benefits of NAV in SF for AIS. Previous studies have demonstrated decreased rates of pedicle screw breaches with NAV compared to free-hand methods but no impact on complication rates. Thus, the clinical utility of NAV remains uncertain.
Methods: Analyses were performed using the IBM MarketScan databases. Patients aged 10 to 18 undergoing SF for AIS were grouped by use of NAV. Patients with nonidiopathic scoliosis were excluded. Univariate and risk-adjusted multivariate analyses were performed. Primary outcomes were neurological complications, any medical complications, and reoperations. Secondary outcomes included adjusted total reimbursements and length of stay.
Results: A total of 12,046 patients undergoing SF for AIS were identified, and 8640 had 90-day follow-up. NAV was used in 467 patients (5.4%), increasing from 2007 to 2015. After risk adjustment, the odds for any complication within 90 days were lower with NAV (OR = 0.61, P = 0.025), but neurological complications were unrelated to NAV (P = 0.742). NAV was not associated with reoperation within 90 days (P = 0.757) or 2 years (P = 0.095). We observed a $25,038 increase in adjusted total reimbursements (P < 0.001) and a 0.32-day decrease in length of stay (P = 0.022) with use of NAV.
Conclusion: In this national sample, NAV was associated with a lower rate of total complications but no change in rates of neurological complications or reoperations. In addition, NAV was associated with a large increase in total payments, despite a modest decrease in hospital stay. Considering the increasing popularity of NAV, this study provides important context regarding the utility of NAV for AIS.Level of Evidence: 3.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BRS.0000000000004037 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Dehydroxylated Polyvinyl Alcohol Separator Enables Fast Kinetics in Zinc-Metal Batteries.
Small
January 2025
Helmholtz Institute Ulm (HIU), Helmholtzstrasse 11, 89081, Ulm, Germany.
Separators are critical components of zinc-metal batteries (ZMBs). Despite their high ionic conductivity and excellent electrolyte retention, the widely used glass fiber (GF) membranes suffer from poor mechanical stability and cannot suppress dendrite growth, leading to rapid battery failure. Contrarily, polymer-based separators offer superior mechanical strength and facilitate more homogeneous zinc (Zn) deposition.
View Article and Find Full Text PDFCardiovascular disease essential medicines listing by countries: changes over time and association with health outcomes.
BMC Cardiovasc Disord
January 2025
MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 80 Bond Street, Toronto, ON, M5B 1X2, Canada.
Background: Since national essential medicine lists guide the procurement of medicines for populations in many countries, and cardiovascular diseases are the leading cause of death globally, including cardiovascular medicines on these lists can significantly impact healthcare outcomes.
Methods: In this cross-sectional study, national essential medicines' lists from 158 countries were analysed on whether or not they included medicines to treat ischemic heart disease, cerebrovascular disease, and hypertensive heart disease. A linear regression model was used to evaluate the association between countries' coverage scores and amenable mortality.
Clinical relevance of macromolecular complexes involving integrins, potassium and sodium ion channels and the sodium/proton antiporter in human breast cancer.
Cancer Cell Int
January 2025
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Background: Mounting evidence underline the relevance of macromolecular complexes in cancer. Integrins frequently recruit ion channels and transporters within complexes which behave as signaling hubs. A complex composed by β1 integrin, hERG1 K channel, the neonatal form of the Na channel Na 1.
View Article and Find Full Text PDFGlobal, regional, and national burden of esophageal cancer using the 2019 global burden of disease study.
Sci Rep
January 2025
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, Jinan, China.
Esophageal cancer, with its aggressive nature and high mortality, poses diverse epidemiological challenges worldwide. Over the past three decades, esophageal cancer has exhibited a substantial global burden, marked by a significant increase in absolute numbers, contrasting with a decline in age-standardized metrics. Prevalence nearly doubled, reaching 0.
View Article and Find Full Text PDFModulation of Stemness and Differentiation Regulators by Valproic Acid in Medulloblastoma Neurospheres.
Cells
January 2025
Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), Federal University of Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil.
Changes in epigenetic processes such as histone acetylation are proposed as key events influencing cancer cell function and the initiation and progression of pediatric brain tumors. Valproic acid (VPA) is an antiepileptic drug that acts partially by inhibiting histone deacetylases (HDACs) and could be repurposed as an epigenetic anticancer therapy. Here, we show that VPA reduced medulloblastoma (MB) cell viability and led to cell cycle arrest.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!