The Impact of Comorbidities on the Change in Short-Form 36 and Oswestry Scores Following Lumbar Spine Surgery

Spine ◽  
2006 ◽  
Vol 31 (17) ◽  
pp. 1974-1980 ◽  
Author(s):  
James Slover ◽  
William A. Abdu ◽  
Brett Hanscom ◽  
James N. Weinstein
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Short Form ◽  
Lumbar Spine Surgery ◽  
Short Form 36 ◽  
The Impact

scholarly journals Impact of the Economic Downturn on Elective Lumbar Spine Surgery in the United States: A National Trend Analysis, 2003 to 2013

2017 ◽  
Vol 7 (3) ◽  
pp. 213-219 ◽  
Author(s):  
David N. Bernstein ◽  
David Brodell ◽  
Yue Li ◽  
Paul T. Rubery ◽  
Addisu Mesfin
Keyword(s):  
United States ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
International Classification Of Diseases ◽  
The United States ◽  
Lumbar Spine Surgery ◽  
Economic Downturn ◽  
Classification Of Diseases ◽  
Lumbar Spinal ◽  
The Impact

Study Design: Retrospective database analysis. Objective: The impact of the 2008-2009 economic downtown on elective lumbar spine surgery is unknown. Our objective was to investigate the effect of the economic downturn on the overall trends of elective lumbar spine surgery in the United States. Methods: The Nationwide Inpatient Sample (NIS) was used in conjunction with US Census and macroeconomic data to determine historical trends. The economic downturn was defined as 2008 to 2009. Codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), were used in order to identify appropriate procedures. Confidence intervals were determined using subgroup analysis techniques. Results: From 2003 to 2012, there was a 19.8% and 26.1% decrease in the number of lumbar discectomies and laminectomies, respectively. Over the same time period, there was a 56.4% increase in the number of lumbar spinal fusions. The trend of elective lumbar spine surgeries per 100 000 persons in the US population remained consistent from 2008 to 2009. The number of procedures decreased by 4.5% from 2010 to 2011, 7.6% from 2011 to 2012, and 3.1% from 2012 to 2013. The R2 value between the number of surgeries and the S&P 500 Index was statistically significant ( P ≤ .05). Conclusions: The economic downturn did not affect elective lumbar fusions, which increased in total from 2003 to 2013. The relationship between the S&P 500 Index and surgical trends suggests that during recessions, individuals may utilize other means, such as insurance, to cover procedural costs and reduce out-of-pocket expenditures, accounting for no impact of the economic downturn on surgical trends. These findings can assist multiple stakeholders in better understanding the interconnectedness of macroeconomics, policy, and elective lumbar spine surgery trends.

scholarly journals The Impact of Corticosteroid Injection Timing on Infection Rates Following Spine Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 219256822110266
Author(s):  
Gregory S. Kazarian ◽  
Michael E. Steinhaus ◽  
Han Jo Kim
Keyword(s):  
Systematic Review ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Postoperative Infection ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Significant Risk ◽  
Lumbar Spine Surgery ◽  
Injection Timing ◽  
The Impact

Study Design/Setting: Systematic review/meta-analysis. Objectives: The objective of this review was to assess how the risk of infection following lumbar spine surgery varies as a function of the timing of preoperative corticosteroid spinal injections (CSIs). Methods: A systematic review and meta-analysis was performed in accordance with the PRISMA guidelines. PubMed and EMBASE databases were searched and data was pooled for meta-analysis. Results: Six studies were identified for inclusion. Two (33.3%) demonstrated a significant relationship between the timing of preoperative CSIs and the risk of postoperative infection, while 4 (66.7%) demonstrated no impact. A total of 2.5% (110/4,448) of patients who underwent CSI <1 month before surgery experienced a postoperative infection, as compared to 1.2% (1,466/120, 943) of controls, which was statistically significant (RR = 1.986 95% CI 1.202-3.282 P = 0.007). A total of 1.6% (25/1,600) of patients who underwent CSI 0-3 months before surgery experienced a postoperative infection, as compared to 1.6% (201/12, 845) of controls (RR = 0.887 95% CI 0.586-1.341, P = 0.569). A total of 1.1% (199/17 870) of patients who underwent CSI 3-6 months before surgery experienced a postoperative infection, as compared to 1.3% (1,382/102, 572) of controls (RR = 1.053 95% CI 0.704-1.575, P = 0.802). Differences in infection risk for 0-3 months and 3-6 months were not statistically significant. Conclusions: CSIs <1 month prior to lumbar spine surgery are a significant risk factor for infection, while CSIs beyond that point showed no such association. Surgeons should consider avoiding CSIs <1 month of the use of CSIs of the spine.

Correlation between the Oswestry Disability Index and the 4-item short forms for physical function and pain interference from PROMIS

2019 ◽  
Vol 31 (5) ◽  
pp. 691-696 ◽  
Author(s):  
Timothy J. Yee ◽  
Brandon W. Smith ◽  
Jacob R. Joseph ◽  
Yamaan S. Saadeh ◽  
Jay K. Nathan ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Physical Function ◽  
Spine Surgery ◽  
Oswestry Disability Index ◽  
Short Form ◽  
Pearson Correlation ◽  
Pain Interference ◽  
Lumbar Spine Surgery ◽  
Time Points ◽  
Patient Reported

OBJECTIVEThe Oswestry Disability Index (ODI) is one of the most commonly used patient-reported outcome instruments, but completion of this 10-question survey can be cumbersome. Tools from the Patient-Reported Outcomes Measurement Information System (PROMIS) are an alternative, and potentially more efficient, means of assessing physical, mental, and social outcomes in spine surgery. Authors of this retrospective study assessed whether scores on the 4-item surveys of function and pain from the PROMIS initiative correlate with those on the ODI in lumbar spine surgery.METHODSPatients evaluated in the adult neurosurgery spine clinic at a single institution completed the ODI, PROMIS Short Form v2.0 Physical Function 4a (PROMIS PF), and PROMIS Short Form v1.0 Pain Interference 4a (PROMIS PI) at various time points in their care. Score data were retrospectively analyzed using linear regressions with calculation of the Pearson correlation coefficient.RESULTSThree hundred forty-three sets of surveys (ODI, PROMIS PF, and PROMIS PI) were obtained from patients across initial visits (n = 147), 3-month follow-ups (n = 107), 12-month follow-ups (n = 52), and 24-month follow-ups (n = 37). ODI scores strongly correlated with PROMIS PF t-scores at baseline (r = −0.72, p < 0.0001), 3 months (r = −0.79, p < 0.0001), 12 months (r = −0.85, p < 0.0001), and 24 months (r = −0.89, p < 0.0001). ODI scores also correlated strongly with PROMIS PI t-scores at baseline (r = 0.71, p < 0.0001), at 3 months (r = 0.82, p < 0.0001), at 12 months (r = 0.86, p < 0.0001), and at 24 months (r = 0.88, p < 0.0001). Changes in ODI scores moderately correlated with changes in PROMIS PF t-scores (r = −0.68, p = 0.0003) and changes in PROMIS PI t-scores (r = 0.57, p = 0.0047) at 3 months postoperatively.CONCLUSIONSA strong correlation was found between the ODI and the 4-item PROMIS PF/PI at isolated time points for patients undergoing lumbar spine surgery. Large cohort studies are needed to determine longitudinal accuracy and precision and to assess possible benefits of time savings and improved rates of survey completion.

scholarly journals Is the Hospital Anxiety and Depression Scale Associated With Outcomes After Lumbar Spine Surgery?

2019 ◽  
Vol 10 (3) ◽  
pp. 266-271 ◽  
Author(s):  
Leah Y. Carreon ◽  
Annette B. Jespersen ◽  
Christian C. Støttrup ◽  
Karen H. Hansen ◽  
Mikkel O. Andersen
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Short Form ◽  
Depression Scale ◽  
Leg Pain ◽  
Anxiety And Depression ◽  
Lumbar Spine Surgery ◽  
Consecutive Series ◽  
Medical Patients ◽  
Hospital Anxiety

Study Design:Longitudinal cohort.Objectives:The Hospital Anxiety and Depression Scale (HADS) was developed to provide clinicians a reliable, valid, and practical tool to identify and quantify the anxiety and depression in medical patients. Several studies have shown that patients with chronic low back pain may have subclinical depression and impairments in mental health and that these in turn may lead to less than optimal results after lumbar spine surgery. The purpose of this study is to determine if there are associations between preoperative HADS and differences in pre- and postoperative health-related quality-of-life (HRQOLs) scores after spine surgery.Methods:From a single center, a consecutive series of patients completed the HADS, Oswestry Disability Index (ODI), Short Form-36 (SF-36), EuroQOL-5D (EQ-5D), and Visual Analog Scale (VAS) for back and leg pain. Except for HADS, the patients completed the same HRQOLs 1 year after surgery.Results:Of 308 eligible cases, 208 (68%) had follow-up data available and were included in the analysis. Patients in the HADS-Anxiety (HADS-A) Abnormal category had the worst preoperative HRQOLs but had the greatest improvement in 1-year postoperative scores. Except for VAS Leg Pain, preoperative HRQOLs were better in patients in the HADS-Depressed (HADS-D) Normal category. Patients in the HADS-D Abnormal category had statistically significantly greater improvement in 1-year postoperative EQ-5D and ODI scores when compared with the other cohorts.Conclusion:Worse HADS-A and HADS-D scores are associated with worse preoperative HRQOL scores in patients with lumbar degenerative disorders scheduled for spine surgery. However, similar improvements in HRQOLs can be expected 1 year postoperative regardless of the patients’ HADS scores.

The Impact of Current Smoking and Smoking Cessation on Short-Term Morbidity Risk After Lumbar Spine Surgery

Spine ◽  
2016 ◽  
Vol 41 (7) ◽  
pp. 577-584 ◽  
Author(s):  
Christopher T. Martin ◽  
Yubo Gao ◽  
Kyle R. Duchman ◽  
Andrew J. Pugely
Keyword(s):  
Smoking Cessation ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Short Term ◽  
Current Smoking ◽  
Morbidity Risk ◽  
The Impact

scholarly journals Use of Fondaparinux Following Elective Lumbar Spine Surgery Is Associated With a Reduction in Symptomatic Venous Thromboembolism

2019 ◽  
Vol 10 (7) ◽  
pp. 844-850
Author(s):  
Mitchell S. Fourman ◽  
Jeremy D. Shaw ◽  
Chinedu O. Nwasike ◽  
Lorraine A. T. Boakye ◽  
Malcolm E. Dombrowski ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Lumbar Spine ◽  
Spine Surgery ◽  
Lumbar Spine Surgery ◽  
Wound Drainage ◽  
Vte Prophylaxis ◽  
Vein Thrombosis ◽  
Potential Safety ◽  
Risk Patients ◽  
The Impact

Study Design: Retrospective cohort study. Objective: To assess the impact of fondaparinux on venous thromboembolism (VTE) following elective lumbar spine surgery in high-risk patients. Methods: Matched patient cohorts who did or did not receive inpatient fondaparinux starting postoperative day 2 following elective lumbar spine surgery were compared. All patients received 1 month of acetyl salicylic acid 325 mg following discharge. The primary outcome was a symptomatic DVT (deep vein thrombosis) or PE (pulmonary embolus) within 30 days of surgery. Secondary outcomes included prolonged wound drainage, epidural hematoma, and transfusion. Results: A significantly higher number of DVTs were diagnosed in the group that did not receive inpatient VTE prophylaxis (3/102, 2.9%) compared with the fondaparinux group (0/275, 0%, P = .02). Increased wound drainage was seen in 18.5% of patients administered fondaparinux, compared with 25.5% of untreated patients ( P = .15). Deep infections were equivalent (2.2% with fondaparinux vs 4.9% control, P = .18). No epidural hematomas were noted, and the number of transfusions after postoperative day 2 and 90-day return to operating room rates were equivalent. Conclusions: Patients receiving fondaparinux had lower rates of symptomatic DVT and PE and a favorable complication profile when compared with matched controls. The retrospective nature of this work limits the safety and efficacy claims that can be made about the use of fondaparinux to prevent VTE in elective lumbar spine surgery patients. Importantly, this work highlights the potential safety of this regimen, permitting future high-quality trials.

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