The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Dec 2019
Deep Infections After Pediatric Spinal Arthrodesis: Differences Exist with Idiopathic, Neuromuscular, or Genetic and Syndromic Cause of Deformity.
Little is known about the rates, timing, and causative microorganisms of deep surgical site infections after spinal arthrodesis in patients with genetic and syndromic scoliosis compared with patients with adolescent idiopathic scoliosis and kyphosis or patients with neuromuscular scoliosis. ⋯ Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Dec 2019
Natural Language Processing for the Identification of Surgical Site Infections in Orthopaedics.
The identification of surgical site infections for infection surveillance in hospitals depends on the manual abstraction of medical records and, for research purposes, depends mainly on the use of administrative or claims data. The objective of this study was to determine whether automating the abstraction process with natural language processing (NLP)-based models that analyze the free-text notes of the medical record can identify surgical site infections with predictive abilities that match the manual abstraction process and that surpass surgical site infection identification from administrative data. ⋯ This study examines NLP's potential to automate the identification of surgical site infections. This automation can potentially aid the prevention and early identification of these surgical complications, thereby reducing their adverse clinical and economic impact.
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J Bone Joint Surg Am · Dec 2019
Establishing Safe Zones to Avoid Nerve Injury in the Approach to the Humerus in Pediatric Patients: A Magnetic Resonance Imaging Study.
The surgical anatomy of upper-extremity peripheral nerves in adults has been well described as "safe zones" or specific distances from osseous landmarks. In pediatrics, relationships between nerves and osseous landmarks remain ambiguous. The goal of our study was to develop a model to accurately predict the location of the radial and axillary nerves in children to avoid iatrogenic injury when approaching the humerus in this population. ⋯ Knowing the locations of upper-extremity peripheral nerves as a proportion of arm length in skeletally immature patients may help to avoid iatrogenic injuries during surgical approaches to the humerus.
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J Bone Joint Surg Am · Dec 2019
Multicenter Study Comparative StudyArtificial Intelligence Distinguishes Surgical Training Levels in a Virtual Reality Spinal Task.
With the emergence of competency-based training, the current evaluation scheme of surgical skills is evolving to include newer methods of assessment and training. Artificial intelligence through machine learning algorithms can utilize extensive data sets to analyze operator performance. This study aimed to address 3 questions: (1) Can artificial intelligence uncover novel metrics of surgical performance? (2) Can support vector machine algorithms be trained to differentiate "senior" and "junior" participants who are executing a virtual reality hemilaminectomy? (3) Can other algorithms achieve a good classification performance? ⋯ The significance of these results lies in the potential of artificial intelligence to complement current educational paradigms and better prepare residents for surgical procedures.
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J Bone Joint Surg Am · Nov 2019
Randomized Controlled TrialThe Effects of Perioperative Corticosteroids on Dysphagia Following Surgical Procedures Involving the Anterior Cervical Spine: A Prospective, Randomized, Controlled, Double-Blinded Clinical Trial.
Dysphagia is one of the most common complications of surgical procedures in the anterior cervical spine, and can persist up to 2 years postoperatively. Corticosteroids are relatively safe and inexpensive for treating various inflammatory conditions. Perioperative corticosteroid administration for anterior cervical spine procedures may effectively minimize postoperative dysphagia, potentially leading to better outcomes, decreased readmission rates, and improved patient satisfaction. The purpose of this study was to determine the efficacy of perioperative corticosteroids in decreasing the severity and duration of dysphagia following single-level and multilevel anterior cervical spine procedures. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.