Perioperative Visual Loss in Spine Fusion Surgery: Ischemic Optic Neuropathy in the United States from 1998 to 2012 in the Nationwide Inpatient Sample.
Background:Perioperative ischemic optic neuropathy (ION) causes visual loss in spinal fusion. Previous case–control studies are limited by study size and lack of a random sample. The purpose of this study was to study trends in ION incidence in spinal fusion and risk factors in a large nationwide ad
Abstract Historical perspective abstract: From the 90׳s to now: a historical perspective on more than two decades of estrogen neuroprotection: In the early 90׳s, estrogens were known to exert organizational and activational effects on reproductive tissues and sexual behavior. As well, the role of sex and gonadal hormones in altering the risk for developing Alzheimer׳s Disease (AD) was only beginning to be elucidated. Preliminary investigations suggested that estrogen-containing therapies typical...
Purpose While open TLIF (O-TLIF) remains the mainstay approach, minimally invasive TLIF (MI-TLIF) may offer potential advantages of reduced trauma to paraspinal muscles, minimized perioperative blood loss, quicker recovery and reduced risk of infection at surgical sites. This meta-analysis was conducted to provide an updated assessment of the relative benefits and risks of MI-TLIF versus O-TLIF.
#2Seth S. Leopold(Clinical Orthopaedics and Related Research)H-Index: 34
Most clinicians have come to imagine that scientific evidence has levels, and at the top of the pyramid are randomized clinical trials (RCTs) and meta-analyses [12]. But we all have read some poorly designed randomized trials, and sometimes a humble case series can substantially influence thought about a technique or implant, particularly if it describes failures of treatment. Nevertheless, as the Centre for Evidence-Based Medicine analogizes [6], if clinical evidence were stored in boxes marked...
Last. David W. Polly(UMN: University of Minnesota)H-Index: 70
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Background Minimally invasive sacroiliac joint fusion is increasing significantly. Starting January 1, 2015, it has a category I CPT code. The current RVU for this procedure is not equal to the amount of work involved. There is not a published RUC validated survey to establish the work effort of MI SI fusion. Our hospital system has been doing this procedure for 4 years and has been tracking surgeon time through a commercial tracking system (Navicare). Our study looks at time utilization for per...
The terms multivariate and multivariable are often used interchangeably in the public health literature. However, these terms actually represent 2 very distinct types of analyses. We define the 2 types of analysis and assess the prevalence of use of the statistical term multivariate in a 1-year span of articles published in the American Journal of Public Health. Our goal is to make a clear distinction and to identify the nuances that make these types of analyses so distinct from one another.
Minimally invasive spine surgery (MISS) was developed to minimize the morbidity associated with large, open surgical approaches, but questions over its benefits and safety. Smith and Fessler review the evidence to support MISS over open approaches for decompression of lumbar stenosis, and highlight new applications of these minimally invasive techniques. Issues with the adoption of MISS, criteria for acceptance of these procedures, and the need for better training and education on MISS are also ...
Purpose To evaluate the effects of age and race on optic disc, retinal nerve fiber layer (RNFL), and macular measurements with spectral-domain optical coherence tomography (SD OCT). Design Cross-sectional observational study. Participants Three hundred fifty adult subjects without ocular disease. Methods Data from SD OCT imaging of the optic nerve head, peripapillary RNFL, and macula of 632 eyes from 350 subjects without ocular disease were imaged with SD OCT. Multivariate models were used to de...
Context In recent decades, the fastest growth in lumbar surgery occurred in older patients with spinal stenosis. Trials indicate that for selected patients, decompressive surgery offers an advantage over nonoperative treatment, but surgeons often recommend more invasive fusion procedures. Comorbidity is common in older patients, so benefits and risks must be carefully weighed in the choice of surgical procedure. Objective To examine trends in use of different types of stenosis operations and the...
The utilization of large-scale databases for research in medical fields, including anesthesiology, has increased in popularity over the last decade, likely due to their structured content and relative ease of access. These databases have been used in a variety of perioperative studies, including analyses of risk stratification, preoperative testing, complications, and cost. While these databases contain a wealth of information that allows for an abundance of research opportunities, there are uni...
Last. Steven Roth(UIC: University of Illinois at Chicago)H-Index: 40
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Abstract BACKGROUND CONTEXT Perioperative ischemic optic neuropathy (ION) is a devastating complication of spinal fusion surgery. PURPOSE To develop predictive models of this blinding condition using a longitudinal medical administrative claims database, which provides temporal sequence of perioperative ischemic optic neuropathy and potential risk factors. DESIGN Nested case control study. PATIENT SAMPLE Participants in Cliniformatics Data Mart medical claims database (2007–2017) with hospitaliz...
Abstract Objective: This study evaluated the incidence and risk factors for ischemic optic neuropathy (ION) as a complication of cardiac surgery requiring cardiopulmonary bypass (CPB). Design: Retrospective chart review of prospectively collected data at a tertiary care center Setting: Single tertiary academic referral center Participants: This study comprised of 44,568 cardiac surgery patients with CPB between January 1, 1995 and January 5, 2017 using the Society of Thoracic Surgeons’ (STS) dat...
BACKGROUND Administrative health claims data have been used for research in neuro-ophthalmology, but the validity of International Classification of Diseases (ICD) codes for identifying neuro-ophthalmic conditions is unclear. EVIDENCE ACQUISITION We performed a systematic literature review to assess the validity of administrative claims data for identifying patients with neuro-ophthalmic disorders. Two reviewers independently reviewed all eligible full-length articles and used a standardized abs...
Fluid management has been widely recognized as an important component of the perioperative care in patients undergoing major procedures including spine surgeries. Patient- and surgery-related factors such as age, length of the surgery, massive intraoperative blood loss, and prone positioning, may impact the intraoperative administration of fluids. In addition, the type and volume of fluid administered may also affect postoperative outcomes. Published literature describing intraoperative fluid ma...
Abstract Objective The extradural neural axis compartment (EDNAC) is an adipovenous zone located between the meningeal and endosteal layers of dura and has been minimally investigated. It runs along the neuraxis from the orbits down to the coccyx and contains fat, valveless veins, arteries and nerves. This review aims to outline the current knowledge regarding the structural and functional significance of the EDNAC. Methods A narrative review of EDNAC literature was conducted. Results The EDNAC ...
A 76-year-old male whose brain MRI demonstrated an anterior right frontal broad dural based homogenously enhancing mass measuring 6.0x3.1x6.3cm. after presenting with a one year progressive cognitive dysfunction. A right sided pterional craniotomy and resection of mass was performed under general anesthesia with an uncomplicated intraoperative course. Postoperatively, the right eye was noted to have an afferent pupillary defect, complete ophthalmoplegia, ptosis, and significant resistance to ret...
Last. Steven Roth(UIUC: University of Illinois at Urbana–Champaign)H-Index: 40
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PURPOSE: We sought to identify the national incidence of acute kidney injury (AKI) associated with pediatric posterior spinal fusion (PSF) surgery for scoliosis, and to determine factors that increase risk. METHODS: The 1998-2014 National Inpatient Sample (NIS), a large United States hospital discharge database, was queried for discharges aged 0-17 years with International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for scoliosis undergoing PSF for the outc...