Journal of neurosurgery. Spine
-
Vertebral compression fractures (VCFs) result in severe and disabling pain, diminished quality of life, and substantial medical costs. There exists no standard instrument with which to measure pain and functional status before and after treatment of VCFs. ⋯ The Vertebral Compression Fracture Pain and Functional Disability Questionnaire appears to be a reliable and valid instrument for assessing back pain and functional ability in patients before and after treatment for VCFs.
-
Epidural spinal cord stimulation (SCS) is effective at treating refractory pain. The failure modes of the implanted hardware, however, have not been well studied. A better understanding of this could aid in improving the current procedure or designing future devices. ⋯ The results of this analysis of SCS hardware failures may be used as a basis for refining surgical technique and designing the next generation of SCS hardware.
-
This study was undertaken to determine whether a clinically useful rule could be formulated for identifying the presence of traumatic brain injury (TBI) in patients who are at exceptionally low risk of cervical spine injury. ⋯ This analysis identified no acceptable rule to justify relaxing vigilance in the search for cervical injury in patients with severe TBI. Provider vigilance and consequent rates of overlooked cervical injury can be affected by environmental cues and presumably by other behavioral and organizational factors.
-
Cost-utility analysis is currently the preferred method with which to compare the cost-effectiveness of various interventions. The authors conducted a study to establish the cost-utility results of routine neurosurgery-based spinal interventions by examining patient-derived values. ⋯ Spinal surgery led to a statistically significant and clinically important improvement in HRQOL. The cost per QALY gained was reasonable, less than half of that observed, for example, for hip replacement surgery or angioplasty treatment of coronary artery disease; however, a prolonged delay in surgical intervention led to an approximate doubling of the cost per QALY gained by the treatment.
-
The aim of this study was to evaluate the efficacy of anterior lumbar interbody fusion (ALIF) augmented by percutaneous pedicle screw fixation (PSF) for revision surgery in the lumbar spine and to determine the prognostic factors affecting surgical outcomes. ⋯ The results demonstrate that ALIF followed by PSF can be an effective alternative in revision surgery of the lumbosacral spine in selected cases. Not only can solid fusion be achieved, sagittal alignment can also be restored in the majority of patients.