Comparative analysis of clinical factors associated with pedicle screw pull-out between intraoperative cone-beam computed tomography and postoperative computed tomography

Abstract Background No studies to date have elucidated the clinical factors associated with pedicle screw pull-out. The aim of this study was to assess the frequency of pedicle screw pull-out by comparing intraoperative scans obtained using cone-beam computed tomography (CBCT) with scans acquired postoperatively using computed tomography (CT). We also sought to determine the incidence of pedicle screw pull-out and identify relevant risk factors. Methods This was a retrospective analysis of prospectively collected data for 636 pedicle screws placed in 66 consecutive patients who underwent at least triple-level posterior fixation of the thoracic or lumbar spine between April 2014 and March 2020. Pedicle screw pull-out distance in the axial and sagittal planes was compared between CT scans obtained 2 days postoperatively and CBCT images acquired intraoperatively. The risk factors associated with pedicle screw pull-out were investigated by multivariate logistic regression analysis. Results Pedicle screw pull-out was seen with 17 pedicle screws (2.7%) in 13 (19.7%) patients. There were significant differences in age, number of fused segments, frequency of diffuse idiopathic skeletal hyperostosis (DISH), presence of osteoporosis, and advanced elderly medical service system insurance for pedicle screw pull-out. Risk factors for pedicle screw pull-out were older age (odds ratio 1.15, 95% confidence interval 1.04–1.272) and a diagnosis of DISH (odds ratio 6.10, 95% confidence interval, 1.23–30.20). Conclusions Several cases of intraoperative pedicle screw pull-out may be caused by use of connecting rods. Older age and DISH are risk factors for pedicle screw pull-out.

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Comparative analysis of clinical factors associated with pedicle screw pull-out between intraoperative cone-beam computed tomography and postoperative computed tomography

10.21203/rs.3.rs-52538/v2 ◽

2020 ◽

Author(s):

Satoshi Sumiya ◽

Kazuyuki Fukushima ◽

Yoshiro Kurosa ◽

Takashi Hirai ◽

Hiroyuki Inose ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Confidence Interval ◽

Pedicle Screw ◽

Odds Ratio ◽

Pedicle Screws ◽

Cone Beam ◽

Clinical Factors ◽

Factors Associated ◽

Pull Out

Abstract Background: No studies to date have elucidated the clinical factors associated with pedicle screw pull-out. The aim of this study was to assess the frequency of pedicle screw pull-out by comparing intraoperative scans obtained using cone-beam computed tomography (CBCT) with scans acquired postoperatively using computed tomography (CT). We also sought to determine the incidence of pedicle screw pull-out and identify relevant risk factors.Methods: This was a retrospective analysis of prospectively collected data for 742 pedicle screws placed in 76 consecutive patients who underwent at least triple-level posterior fixation for thoracic or lumbar spinal injury, spinal metastasis, or pyogenic spondylitis between April 2014 and July 2020. Pedicle screw pull-out distance in the axial and sagittal planes was compared between CT scans obtained 2 days postoperatively and CBCT images acquired intraoperatively. Risk factors associated with pedicle screw pull-out were investigated by multivariate logistic regression analysis.Results: Pedicle screw pull-out was seen with 58 pedicle screws (7.8%) in 26 (34.2%) patients. There were significant differences in age, number of fused segments, frequency of diffuse idiopathic skeletal hyperostosis (DISH), and medical history of osteoporosis for pedicle screw pull-out. Risk factors for pedicle screw pull-out were older age (odds ratio 1.07, 95% confidence interval 1.02–1.130) and a diagnosis of DISH (odds ratio 3.35, 95% confidence interval, 1.12–10.00).Conclusions: Several cases of intraoperative pedicle screw pull-out may be caused by use of connecting rods. Older age and DISH are risk factors for pedicle screw pull-out.

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Comparative analysis of clinical factors associated with pedicle screw pull-out during or immediately after surgery between intraoperative cone-beam computed tomography and postoperative computed tomography

10.21203/rs.3.rs-52538/v5 ◽

2021 ◽

Author(s):

Satoshi Sumiya ◽

Kazuyuki Fukushima ◽

Yoshiro Kurosa ◽

Takashi Hirai ◽

Hiroyuki Inose ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Pedicle Screw ◽

Odds Ratio ◽

Pedicle Screws ◽

Cone Beam ◽

Clinical Factors ◽

Factors Associated ◽

Pull Out ◽

History Of

Abstract Background No studies to date have elucidated the clinical factors associated with pedicle screw pull-out during or immediately after surgery. The aim of this study was to assess the frequency of pedicle screw pull-out by comparing intraoperative scans obtained using cone-beam computed tomography (CBCT) with postoperative scans obtained using computed tomography (CT). We also sought to determine the incidence of pedicle screw pull-out and identify relevant risk factors. Methods This was a retrospective analysis of prospectively collected data for 742 pedicle screws placed in 76 consecutive patients who underwent at least triple-level posterior fixation for thoracic or lumbar spinal injury, spinal metastasis, or pyogenic spondylitis between April 2014 and July 2020. Pedicle screw pull-out distance in the axial and sagittal planes was compared between CT scans obtained 2 days postoperatively and CBCT images acquired intraoperatively. Risk factors associated with pedicle screw pull-out were investigated by multivariate logistic regression analysis. Results Pedicle screw pull-out was seen with 58 pedicle screws (7.8%) in 26 patients (34.2%). There were significant differences in age, number of fused segments, frequency of diffuse idiopathic skeletal hyperostosis (DISH), and medical history of osteoporosis for pedicle screw pull-out. Risk factors for pedicle screw pull-out were older age (odds ratio 1.07, 95% confidence interval 1.02–1.130) and a diagnosis of DISH (odds ratio 3.35, 95% confidence interval 1.12–10.00). Several cases suggest that use of connecting rods was an important factor in intraoperative pedicle screw pull-out. Conclusions Our findings suggest that age, number of fused segments, presence of DISH, and medical history of osteoporosis are risk factors for pedicle screw pull-out, with the greatest being older age and DISH.

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Comparative analysis of clinical factors associated with pedicle screw pull-out during or immediately after surgery between intraoperative cone-beam computed tomography and postoperative computed tomography

10.21203/rs.3.rs-52538/v3 ◽

2020 ◽

Author(s):

Satoshi Sumiya ◽

Kazuyuki Fukushima ◽

Yoshiro Kurosa ◽

Takashi Hirai ◽

Hiroyuki Inose ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Pedicle Screw ◽

Odds Ratio ◽

Pedicle Screws ◽

Cone Beam ◽

Clinical Factors ◽

Factors Associated ◽

Pull Out ◽

History Of

Abstract Background No studies to date have elucidated the clinical factors associated with pedicle screw pull-out during or immediately after surgery. The aim of this study was to assess the frequency of pedicle screw pull-out by comparing intraoperative scans obtained using cone-beam computed tomography (CBCT) with postoperative scans obtained using computed tomography (CT). We also sought to determine the incidence of pedicle screw pull-out and identify relevant risk factors.Methods This was a retrospective analysis of prospectively collected data for 742 pedicle screws placed in 76 consecutive patients who underwent at least triple-level posterior fixation for thoracic or lumbar spinal injury, spinal metastasis, or pyogenic spondylitis between April 2014 and July 2020. Pedicle screw pull-out distance in the axial and sagittal planes was compared between CT scans obtained 2 days postoperatively and CBCT images acquired intraoperatively. Risk factors associated with pedicle screw pull-out were investigated by multivariate logistic regression analysis.Results Pedicle screw pull-out was seen with 58 pedicle screws (7.8%) in 26 patients (34.2%). There were significant differences in age, number of fused segments, frequency of diffuse idiopathic skeletal hyperostosis (DISH), and medical history of osteoporosis for pedicle screw pull-out. Risk factors for pedicle screw pull-out were older age (odds ratio 1.07, 95% confidence interval 1.02–1.130) and a diagnosis of DISH (odds ratio 3.35, 95% confidence interval, 1.12–10.00). Several cases suggest that use of connecting rods was an important factor in intraoperative pedicle screw pull-out.Conclusions Our findings suggest that age, number of fused segments, the presence of DISH, and medical history of osteoporosis are risk factors for pedicle screw pull-out, with the greatest being older age and DISH.

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Comparative analysis of clinical factors associated with pedicle screw pull-out during or immediately after surgery between intraoperative cone-beam computed tomography and postoperative computed tomography

10.21203/rs.3.rs-52538/v4 ◽

2020 ◽

Author(s):

Satoshi Sumiya ◽

Kazuyuki Fukushima ◽

Yoshiro Kurosa ◽

Takashi Hirai ◽

Hiroyuki Inose ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Pedicle Screw ◽

Odds Ratio ◽

Pedicle Screws ◽

Cone Beam ◽

Clinical Factors ◽

Factors Associated ◽

Pull Out ◽

History Of

Abstract Background No studies to date have elucidated the clinical factors associated with pedicle screw pull-out during or immediately after surgery. The aim of this study was to assess the frequency of pedicle screw pull-out by comparing intraoperative scans obtained using cone-beam computed tomography (CBCT) with postoperative scans obtained using computed tomography (CT). We also sought to determine the incidence of pedicle screw pull-out and identify relevant risk factors.Methods This was a retrospective analysis of prospectively collected data for 742 pedicle screws placed in 76 consecutive patients who underwent at least triple-level posterior fixation for thoracic or lumbar spinal injury, spinal metastasis, or pyogenic spondylitis between April 2014 and July 2020. Pedicle screw pull-out distance in the axial and sagittal planes was compared between CT scans obtained 2 days postoperatively and CBCT images acquired intraoperatively. Risk factors associated with pedicle screw pull-out were investigated by multivariate logistic regression analysis.Results Pedicle screw pull-out was seen with 58 pedicle screws (7.8%) in 26 patients (34.2%). There were significant differences in age, number of fused segments, frequency of diffuse idiopathic skeletal hyperostosis (DISH), and medical history of osteoporosis for pedicle screw pull-out. Risk factors for pedicle screw pull-out were older age (odds ratio 1.07, 95% confidence interval 1.02–1.130) and a diagnosis of DISH (odds ratio 3.35, 95% confidence interval 1.12–10.00). Several cases suggest that use of connecting rods was an important factor in intraoperative pedicle screw pull-out.Conclusions Our findings suggest that age, number of fused segments, presence of DISH, and medical history of osteoporosis are risk factors for pedicle screw pull-out, with the greatest being older age and DISH.

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Comparative analysis of clinical factors associated with pedicle screw pull‐out during or immediately after surgery between intraoperative cone‐beam computed tomography and postoperative computed tomography

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03916-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Satoshi Sumiya ◽

Kazuyuki Fukushima ◽

Yoshiro Kurosa ◽

Takashi Hirai ◽

Hiroyuki Inose ◽

...

Keyword(s):

Risk Factors ◽

Computed Tomography ◽

Pedicle Screw ◽

Odds Ratio ◽

Pedicle Screws ◽

Cone Beam ◽

Clinical Factors ◽

Factors Associated ◽

Pull Out ◽

History Of

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Epidemiological investigation of euthanasia in an Ontario animal shelter

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x17715152 ◽

2017 ◽

Vol 20 (6) ◽

pp. 479-486 ◽

Cited By ~ 3

Author(s):

Rachael Mozes ◽

David L Pearl ◽

Lee Niel ◽

J Scott Weese

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Odds Ratio ◽

Age Groups ◽

Quadratic Term ◽

Epidemiological Investigation ◽

Animal Shelter ◽

Factors Associated

Objectives The objective was to evaluate factors associated with euthanasia in an animal shelter in Kitchener-Waterloo, Ontario, Canada. Methods Data from 3737 cats admitted to the shelter between January and December 2011 were evaluated. Results Overall, 1989/3737 (53%) of admitted cats were euthanized. Male cats had greater odds of being euthanized than females (odds ratio [OR] 1.63, 95% confidence interval [CI] 1.29–2.05; P <0.001) and surrendered cats were more likely to be euthanized than strays (OR 38.0, 95% CI 14.8–97.69; P <0.001). Black cats were more likely to be euthanized than cats of another color (OR 1.45, 95% CI 1.16–1.80; P <0.001). Cats that spent >5 days in the shelter were more likely to be euthanized than those that spent <5 days in the shelter (OR 1.57, 95% CI 1.25–1.97; P <0.001). Cats that spent >20 days in the shelter were less likely to be euthanized than those that spent <5 days in the shelter (OR 0.26, 95% CI 0.19–0.34; P <0.001). Age, an age quadratic term, neuter status and interactions among these variables were statistically significant; the odds of unneutered animals being euthanized was high and relatively stable across age groups, but in neutered animals the odds of being euthanized increased with age before plateauing in older cats. Conclusions and relevance With >50% of the cats admitted to the shelter in 2011 euthanized, it is important to understand the contributing risk factors that predispose shelter cats to euthanasia and what changes can be made to the shelter system and in owner education to lower the incidence of euthanasia.

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Correlation between the Computed Tomography Values of the Screw Path and Pedicle Screw Pullout Strength: An Experimental Study in Porcine Vertebrae

Asian Spine Journal ◽

10.31616/asj.2019.0170 ◽

2020 ◽

Vol 14 (3) ◽

pp. 265-272

Author(s):

Atsushi Ikeura ◽

Taketoshi Kushida ◽

Kenichi Oe ◽

Yoshihisa Kotani ◽

Muneharu Ando ◽

...

Keyword(s):

Computed Tomography ◽

Bone Mineral Density ◽

Pedicle Screw ◽

Bone Mineral ◽

Lumbar Vertebrae ◽

Pedicle Screws ◽

Mineral Density ◽

Screw Insertion ◽

Pull Out ◽

Pull Out Strength

Study Design: Biomechanical study.Purpose: To assess the correlation between the computed tomography (CT) values of the pedicle screw path and screw pull-out strength.Overview of Literature: The correlation between pedicle screw pull-out strength and bone mineral density has been well established. In addition, several reports have demonstrated a correlation between bone mineral density and CT values. However, no previous biomechanical studies investigated the correlation between CT values and pedicle screw pull-out strength.Methods: Sixty fresh-frozen lumbar vertebrae from 6-month-old pigs were used. Before screw insertion, the CT values of the screw path were obtained for each sample. Specimens were then randomly divided into three equal groups. Each group had one of three pedicle screws inserted: 4.0-mm LEGACY (4.0-LEG), 4.5-mm LEGACY (4.5-LEG), or 4.5-mm SOLERA (4.5-SOL) (all from Medtronic Sofamor Danek Inc., Memphis, TN, USA). Each screw had a consistent 30-mm thread length. Axial pull-out testing was performed at a rate of 1.0 mm/min. Correlations between the CT values and pedicle screw pull-out strength were evaluated using Pearson’s correlation coefficient analysis.Results: The correlation coefficients between the CT values of the screw path and pedicle screw pull-out strength for the 4.0-LEG, 4.5-LEG, and 4.5-SOL groups were 0.836 (p <0.001), 0.780 (p <0.001), and 0.873 (p <0.001), respectively. Greater CT values were associated with greater screw pull-out strength.Conclusions: The CT values of the screw path were strongly positively correlated with pedicle screw pull-out strength, regardless of the screw type and diameter, suggesting that the CT values could be clinically useful for predicting pedicle screw pull-out strength.

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Perioperative Risk Factors Associated With Morbidity and Mortality Following Pediatric Inpatient Sinus Surgery

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489418805504 ◽

2018 ◽

Vol 128 (1) ◽

pp. 13-21 ◽

Cited By ~ 2

Author(s):

Brittany N. Burton ◽

Sapideh Gilani ◽

Milli Desai ◽

Robert Saddawi-Konefka ◽

Lindia Willies-Jacobo ◽

...

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Confidence Interval ◽

Odds Ratio ◽

Acute Sinusitis ◽

Morbidity And Mortality ◽

Sinus Surgery ◽

Factors Associated ◽

Wide Range ◽

Comorbidity Burden

Objectives: Pediatric sinus surgery is indicated for a wide range of sinonasal and skull base pathologies, but it is most commonly performed for recalcitrant chronic rhinosinusitis or complicated acute sinusitis. The authors aim to report medical risk factors of morbidity and mortality following inpatient sinus surgery in the pediatric population. Methods: Using data from the Kids’ Inpatient Database from 2003 to 2012, patients with International Classification of Diseases, Ninth Revision, procedure codes for primary sinus surgery were identified. Mixed-effect multivariable logistic regression was used to identify risk factors of inpatient postoperative morbidity and mortality. Results: The final sample included a weighted estimate of 4965 pediatric patients. The rates of inpatient morbidity and mortality were 6% and 1%, respectively. Respiratory complications (2.5%) were the most prevalent postoperative adverse events. The most prevalent comorbidities were chronic sinusitis (59.8%), acute sinusitis (27.8%), and cystic fibrosis (26.4%). Compared with patients who did not experience any morbidity, patients with inpatient morbidity had higher rates of pneumonia, mycoses, and nasal or paranasal benign neoplasm ( P < .05). The odds of inpatient morbidity and mortality were highest for patients with leukemia (odds ratio, 2.74; 95% confidence interval, 1.59-4.72; P < .001) and mycoses (odds ratio, 15.84; 95% confidence interval, 6.45-38.89; P < .001), respectively. Conclusions: This study is the first to report the national comorbidity burden and risk factors for postoperative adverse events following inpatient sinus surgery. Knowledge of the comorbidities and independent factors associated with morbidity and mortality will help in directing preoperative optimization and counseling. Level of Evidence: 2c

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Epidemiological, Morphological, and Morphometric Study on Haemonchus spp. Recovered From Goats in Egypt

Frontiers in Veterinary Science ◽

10.3389/fvets.2021.705619 ◽

2021 ◽

Vol 8 ◽

Author(s):

Ahmed Gareh ◽

Nagwa M. Elhawary ◽

Amin Tahoun ◽

Amany M. Ramez ◽

Dina M. M. EL-shewehy ◽

...

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Infection Rate ◽

Odds Ratio ◽

Significant Risk ◽

Morphological Characterization ◽

Economic Losses ◽

Morphometric Study ◽

Factors Associated ◽

Epidemiological Pattern

Goats can be infected by multiple groups of external and internal parasites. Haemonchus spp. are among abomasal parasites that can result in higher mortality and several considerable economic losses in goats. Early detection of parasites and better understanding of the major risk factors associated with infection are among the main strategies for controlling the infection. Considering this, information on hemonchosis in goats from Egypt, and the contribution of goats in the maintenance of the epidemiological foci of the disease is limited. This study investigated the prevalence of Haemonchus species among 240 abomasum samples collected during postmortem examination of goat carcasses from Assiut Governorate, Egypt. Moreover, the association of the major risk factors to describe the epidemiological pattern of the disease was explored. This study demonstrated that 16.66% of abomasa samples harbored Haemonchus species. Additionally, age, sex, and sampling season were the most significant risk factors associated with infection. Following the variable factors under study, goats aged 1 year or older were at higher risk, with an infection rate of 22.14% (31 of 140), than those younger than 1 year (9%) [p = 0.008; odds ratio (OR) = 2.87; 95% confidence interval (CI), 1.30–6.35]. The infection rate was 25% (19 of 76) in males and 12.8% (21 of 164) in females [p = 0.024; odds ratio (OR) = 2.26; 95% confidence interval (CI), 1.13–4.53]. Moreover, the exposure to infection was higher in summer (22.22%) than in winter (8.33%) (p = 0.007; odds ratio (OR) = 0.318; 95% confidence interval (CI), 0.139–0.725). More importantly, three species of the parasite—Haemonchus contortus, Haemonchus placei, and Haemonchus longistipes—were identified for the first time, and the confirmation of the identification and morphological characterization of the worms was performed using light microscopy and SEM. Collectively, this study reveals interesting epidemiological, morphological, and morphometric findings associated with the occurrence of hemonchosis among goats in Egypt. This study suggests further research for exploring the major circulating species of the parasite in Egypt, which is mandatory for controlling the disease.

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Factors associated with non-vaccination against measles among 12-23 months old children in Yirgachefe district of SNNPR, Ethiopia, 2016

10.21203/rs.2.10399/v1 ◽

2019 ◽

Author(s):

Luna Habtamu Degife ◽

Yoseph Worku ◽

Muse Tadesse

Keyword(s):

Risk Factors ◽

Confidence Interval ◽

Odds Ratio ◽

Statistical Significance ◽

Southern Ethiopia ◽

Effective Vaccine ◽

Age Group ◽

Factors Associated ◽

Lack Of Knowledge

Abstract Immunization is an effective and proven tool for controlling and eliminating life-threatening vaccine preventable infectious diseases. In Ethiopia 5% of childhood mortalities are due to measles. In 2015, 85% of children had received 1 dose of measles vaccine by their second birthday. Despite the availability of a safe and effective vaccine, measles outbreaks secondary to non-vaccination are occurring in southern Ethiopia especially in Yirgachefe district.This study was done to assess the risk factors associated with non-vaccination against measles. A Community-based unmatched case control study was conducted in Yirgachefe district from December 1-31, 2016.Cases were defined as children in the age group of 12- 23 months of age who did not take measles vaccination. The study was done in 6 randomly selected kebeles and cases and controls were selected randomly by probability proportional to size sampling. A structured questionnaire was used for data collection and data was analyzed by using Epi info version 7 and SPSS version 20. Statistical significance was interpreted using Odds ratio with 95% confidence interval and P value <0.05. A total of 320 individuals (107 cases and 214 controls) were approached for interview with a response rate of 93.75%. Of the cases, 57% were males and more than half fall in the 12-18 months age group. Lack of Ante Natal Care follow up (Adjusted Odds Ratio (AOR) =3.57; 95% Confidence Interval (CI): 1.22-10.44), lack of knowledge on the importance of vaccination, who should be vaccinated and if measles is contagious with an AOR and CI of (AOR=6.81; 95% CI: 1.56-29.64), (AOR=4.29; 95% CI: 1.83-10.04) and (AOR=8.97; 95%CI: 3.15-25.58) respectively were independent risk factors. Lack of ANC follow up, lack of knowledge about who should get vaccinated, the importance of vaccination and contagiousness of the disease were identified as risk factors for non-vaccination against measles. Education and awareness about measles and its immunization should be given to the community. Additionally, ANC follow up should also be strengthened.

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