Spine
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Observational Study
Factors Associated with Progression to Surgical Intervention for Lumbar Disc Herniation in the Military Health System.
Retrospective cohort. ⋯ LDH compromises military readiness and negatively impacts healthcare costs. MHS beneficiaries with LDH have a good prognosis with approximately 88% of patients successfully completing conservative management. However, strategies to improve outcomes of conservative management in LDH should address risks associated with both patient and facility characteristics.Level of Evidence: 4.
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Observational Study
The Association of "U.S. News & World Report" Hospital Rankings and Outcomes Following Anterior Cervical Fusions: Do Rankings Even Matter?
Retrospective observational study. ⋯ Despite the higher charges and costs of care at ranked hospitals, these facilities appear to have similar outcomes as compared to unranked hospitals following elective ACFs.Level of Evidence: 3.
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Retrospective cohort study. ⋯ Addition of the CPT-based categorization method to MS-DRG coding provides an enhanced method to evaluate the association between predicted and actual cost when using linear regression analysis to assess cost variation in spine surgery.Level of Evidence: 3.
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A retrospective study of 84 patients with spinal metastasis from prostate cancer (SMPCa) was performed. ⋯ The overall performance of the CNSP model was satisfactory and could be used to estimate the survival outcome of individual patients more precisely and thus help clinicians design more specific and individualized therapeutic regimens.Level of Evidence: 4.
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Biomechanical spine model. Comparison of stress in the implant and the adjacent cranial segment was done with conventional rigid versus dynamic stabilization system (DS) fixation. ⋯ Long spinal fixation using rigid rods produces maximum stress at the proximal end screw and increases adjacent disc pressure, possibly leading to PJF. Dynamic stabilization at the cranial end segment may prevent PJF by reducing these factors.Level of Evidence: N/A.