Degenerative lumbar spondylosis is a common indication for patients undergoing spine surgery. As healthcare costs rise, measuring quality of life (QOL) gains after surgical procedures is critical in assessing value. We set out to: 1) compare baseline and postoperative EuroQol-5D (EQ-5D) scores for lumbar spine surgery and common surgical procedures to obtain post-operative quality-adjusted life year (QALY) gain, and 2) establish the relative utility of lumbar spine surgery as compared to other commonly performed surgical procedures. A systematic literature review was conducted to identify all studies reporting preoperative/baseline and postoperative EQ-5D scores for common surgical procedures. For each study, the number of patients included and baseline/preoperative and follow-up mean EQ-5D scores were recorded, and mean QALY gained for each intervention was calculated. A total of 67 studies comprising 95,014 patients were identified. Patients with lumbar spondylosis had the worst reported QOL at baseline compared to other surgical cohorts. The greatest QALY gain was seen in patients undergoing hip arthroplasty (0.38), knee arthroplasty (0.35) and lumbar spine surgery (0.32), nearly 2.5-fold greater QALY gained than for all other procedures. The low preoperative QOL, coupled with the improvements offered with surgery, highlight the utility and value of lumbar spine surgery compared to other common surgical procedures.
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http://dx.doi.org/10.1016/j.jocn.2021.09.003 | DOI Listing |
Sci Rep
January 2025
Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8#, Chaoyang District, Beijing, 100020, China.
We aimed to analyze the cervical sagittal alignment change following the growing rod treatment in early-onset scoliosis (EOS) and identify the risk factors of sagittal cervical imbalance after growing-rod surgery of machine learning. EOS patients from our centre between 2007 and 2019 were retrospectively reviewed. Radiographic parameters include the cervical lordosis (CL), T1 slope, C2-C7 sagittal vertical axis (C2-7 SVA), primary curve Cobb angle, thoracic kyphosis (TK), C7-S1 sagittal vertical axis (C7-S1 SVA) and proximal junctional angle (PJA) were evaluated preoperatively, postoperatively and at the final follow-up.
View Article and Find Full Text PDFSci Rep
January 2025
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, UAE.
The first cervical vertebra (C1) is atypical in shape and bears a complex relationship with important neurovascular structures such as the vertebral artery and cervical spinal cord which are at risk of injury during misplaced screw fixation of C1. Placement of screws into the lateral mass of C1 vertebra is performed for stabilization of the craniovertebral junction. The objective of this study was to describe ideal screw dimensions, precise entry points, safe bony corridors, and ideal trajectories for placement of lateral mass screws in the Emirati population.
View Article and Find Full Text PDFSpine J
January 2025
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address:
Background: The vertebral column is the most common site of bony metastasis. When indicated, surgical resection of hypervascular metastatic lesions may be complicated by significant blood loss, the need for blood transfusion, and incomplete tumor resection due to poor visualization and premature abortion of the operation. In select cases, preoperative arterial embolization of hypervascular metastatic tumors may help minimize intraoperative bleeding and reduce operative times.
View Article and Find Full Text PDFSpine J
January 2025
Medical University of South Carolina, Charleston, SC, USA. Electronic address:
Background Context: Clinical outcomes are directly related to patient selection and treatment indications for improved quality of life. With emphasis on quality and value, it is essential that treatment recommendations are optimized.
Purpose: The purpose of the North American Spine Society (NASS) Appropriate Use Criteria (AUC) is to determine the appropriate (ie, reasonable) multidisciplinary treatment recommendations for patients with metastatic neoplastic vertebral fractures across a spectrum of more common clinical scenarios.
Spine J
January 2025
Department of Orthopedic Surgery, Haeundae Bumin Hospital, Busan, South Korea.
Background Context: Stiffness-related functional disability (SRFD) is a well-known complication after long-segment fusion surgery. However, SRFD following decompression with short-segment fusion (1 or 2 levels) compared with decompression alone surgery in the lower lumbar region, which accounts for a significant portion of lumbar range of motion, is poorly documented.
Purpose: This study aimed to compare SRFD after decompression alone (D-A) surgery and decompression with short-segment fusion (D+F) surgery in the lower lumbar region.
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