Navigated Spinal Fusion

2019 ◽  
pp. 355-374
Author(s):  
Ana Luís ◽  
Rodrigo Navarro-Ramirez ◽  
Sertac Kirnaz ◽  
Jonathan Nakhla ◽  
Roger Härtl
Keyword(s):  
Spinal Fusion

Low Confidence in Spinal Fusion Not Likely to Affect Coverage

2007 ◽  
Vol 37 (3) ◽  
pp. 57
Author(s):  
ALICIA AULT
Keyword(s):  
Spinal Fusion

The effect of hospital characteristics on pediatric neuromuscular scoliosis fusion cost

2019 ◽  
Vol 24 (6) ◽  
pp. 713-721
Author(s):  
Jonathan Dallas ◽  
Chevis N. Shannon ◽  
Christopher M. Bonfield
Keyword(s):  
Spinal Fusion ◽  
Economies Of Scale ◽  
Hospital Costs ◽  
Neuromuscular Scoliosis ◽  
Teaching Hospitals ◽  
Inclusion Criteria ◽  
Cost Information ◽  
Nonprofit Hospitals ◽  
Disease Etiology ◽  
Hospital Characteristics

OBJECTIVESpinal fusion is used in the treatment of pediatric neuromuscular scoliosis (NMS) to improve spine alignment and delay disease progression. However, patients with NMS are often medically complex and require a higher level of care than those with other types of scoliosis, leading to higher treatment costs. The purpose of this study was to 1) characterize the cost of pediatric NMS fusion in the US and 2) determine hospital characteristics associated with changes in overall cost.METHODSPatients were identified from the National Inpatient Sample (2012 to the first 3 quarters of 2015). Inclusion criteria selected for patients with NMS, spinal fusion of at least 4 vertebral levels, and elective hospitalization. Patients with no cost information were excluded. Sociodemographics, treating hospital characteristics, disease etiology/severity, comorbidities, length of stay, and hospital costs were collected. Univariable analysis and multivariable gamma log-link regression were used to determine hospital characteristics associated with changes in cost.RESULTSA total of 1780 weighted patients met inclusion criteria. The median cost was $68,815. Following multivariable regression, both small (+$11,580, p < 0.001) and medium (+$6329, p < 0.001) hospitals had higher costs than large hospitals. Rural hospitals had higher costs than urban teaching hospitals (+$32,438, p < 0.001). Nonprofit hospitals were more expensive than both government (–$4518, p = 0.030) and investor-owned (–$10,240, p = 0.001) hospitals. There was significant variability by US census division; compared with the South Atlantic, all other divisions except for the Middle Atlantic had significantly higher costs, most notably the West North Central (+$15,203, p < 0.001) and the Pacific (+$22,235, p < 0.001). Hospital fusion volume was not associated with total cost.CONCLUSIONSA number of hospital factors were associated with changes in fusion cost. Larger hospitals may be able to achieve decreased costs due to economies of scale. Regional differences could reflect uncontrolled-for variability in underlying patient populations or systems-level and policy differences. Overall, this analysis identified multiple systemic patterns that could be targets of further cost-related interventions.

Effects of preoperative obesity and psychiatric comorbidities on minimum clinically important differences for lumbar fusion in grade 1 degenerative spondylolisthesis: analysis from the prospective Quality Outcomes Database registry

2020 ◽  
Vol 33 (5) ◽  
pp. 635-642
Author(s):  
Joseph Laratta ◽  
Leah Y. Carreon ◽  
Avery L. Buchholz ◽  
Andrew Y. Yew ◽  
Erica F. Bisson ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Preoperative Diagnosis ◽  
Rating Scale ◽  
Lumbar Fusion ◽  
Degenerative Spondylolisthesis ◽  
Leg Pain ◽  
Quality Outcomes ◽  
Medical Comorbidities ◽  
Fusion Procedure ◽  
Patient Reported

OBJECTIVEMedical comorbidities, particularly preoperatively diagnosed anxiety, depression, and obesity, may influence how patients perceive and measure clinical benefit after a surgical intervention. The current study was performed to define and compare the minimum clinically important difference (MCID) thresholds in patients with and without preoperative diagnoses of anxiety or depression and obesity who underwent spinal fusion for grade 1 degenerative spondylolisthesis.METHODSThe Quality Outcomes Database (QOD) was queried for patients who underwent lumbar fusion for grade 1 degenerative spondylolisthesis during the period from January 2014 to August 2017. Collected patient-reported outcomes (PROs) included the Oswestry Disability Index (ODI), health status (EQ-5D), and numeric rating scale (NRS) scores for back pain (NRS-BP) and leg pain (NRS-LP). Both anchor-based and distribution-based methods for MCID calculation were employed.RESULTSOf 462 patients included in the prospective registry who underwent a decompression and fusion procedure, 356 patients (77.1%) had complete baseline and 12-month PRO data and were included in the study. The MCID values for ODI scores did not significantly differ in patients with and those without a preoperative diagnosis of obesity (20.58 and 20.69, respectively). In addition, the MCID values for ODI scores did not differ in patients with and without a preoperative diagnosis of anxiety or depression (24.72 and 22.56, respectively). Similarly, the threshold MCID values for NRS-BP, NRS-LP, and EQ-5D scores were not statistically different between all groups. Based on both anchor-based and distribution-based methods for determination of MCID thresholds, there were no statistically significant differences between all cohorts.CONCLUSIONSMCID thresholds were similar for ODI, EQ-5D, NRS-BP, and NRS-LP in patients with and without preoperative diagnoses of anxiety or depression and obesity undergoing spinal fusion for grade 1 degenerative spondylolisthesis. Preoperative clinical and shared decision-making may be improved by understanding that preoperative medical comorbidities may not affect the way patients experience and assess important clinical changes postoperatively.

Cell Therapy to Obtain Spinal Fusion

2008 ◽  
Author(s):  
Elizabeth A. Olmsted-Davis ◽  
Alan R. Davis ◽  
Michael Heggeness ◽  
Francis Gannon ◽  
Mary Dickinson ◽  
...  
Keyword(s):  
Cell Therapy ◽  
Spinal Fusion

Emergency Department Visits After Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

2019 ◽  
Vol 40 (7) ◽  
pp. e629-e633
Author(s):  
Andrew B. Harris ◽  
Majd Marrache ◽  
Varun Puvanesarajah ◽  
Micheal Raad ◽  
Richard L. Skolasky ◽  
...  
Keyword(s):  
Emergency Department ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Posterior Spinal Fusion ◽  
Emergency Department Visits

Incidence of Pleural Fluid and Its Associated Risk Factors After Posterior Spinal Fusion in Patients With Adolescent Idiopathic Scoliosis

Spine ◽  
2017 ◽  
Vol 42 (8) ◽  
pp. 603-609 ◽  
Author(s):  
Kazunori Hayashi ◽  
Hidetomi Terai ◽  
Hiromitsu Toyoda ◽  
Akinobu Suzuki ◽  
Masatoshi Hoshino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Spinal Fusion ◽  
Pleural Fluid ◽  
Posterior Spinal Fusion ◽  
Associated Risk Factors

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: Assessment of functional outcome following lumbar fusion

2014 ◽  
Vol 21 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
William C. Watters ◽  
Praveen V. Mummaneni ◽  
Andrew T. Dailey ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Functional Outcome ◽  
Spinal Fusion ◽  
Lumbar Fusion ◽  
Minimum Clinically Important Difference ◽  
Degenerative Disease ◽  
Psychological State ◽  
Lumbar Spinal Fusion ◽  
Patient Reported ◽  
Lumbar Spinal

Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome.

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