The spine journal : official journal of the North American Spine Society
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
Efficacy and safety of urinary catheters with silver alloy coating in patients with spinal cord injury: a multicentric pragmatic randomized controlled trial. The ESCALE trial.
Patients with spinal cord injury (SCI) who carry indwelling urinary catheters have an increased risk of urinary tract infection (UTI). Antiseptic silver alloy-coated (SAC) silicone urinary catheters prove to be a promising intervention to reduce UTIs; however, current evidence cannot be extrapolated to patients with SCI. ⋯ The results of this study do not support the routine use of indwelling antiseptic SAC silicone urinary catheters in patients with SCI. However, UTIs associated to long-term urinary catheter use remain a challenge and further investigations are still needed.
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Prior reports have compared posterior column osteotomies with pedicle subtraction osteotomies in terms of utility for correcting fixed sagittal imbalance in adolescent patients with deformity. No prior reports have described the use of multilevel Smith-Petersen Osteotomies (SPOs) alone for surgical correction in the adult spinal deformity (ASD) population. ⋯ Multilevel SPOs are feasible for restoration of LL as well as sagittal and coronal alignment in the ASD population with or without prior instrumented fusion.
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Despite recent advances in gender equity in medicine, the representation of women in orthopedic and neurosurgery remains particularly low. Furthermore, compared with their male colleagues, female faculty members are less likely to publish research, limiting opportunities in the academic promotion process. Understanding disparities in research productivity provides insight into the "gender gap" in the spine surgeon workforce. ⋯ Female representation in academic spine research has doubled over the past 4 decades, although the growth of female representation as senior author has plateaued. Female physician-investigators are half as likely to continue participating in spine-related research longer than 5 years and on average publish half as many articles as senior author. In addition to recruiting more women into research, efforts should be made to identify and address barriers in research advancement and promotion for female physician-investigators.
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Elective spine surgery is a commonly performed operative procedure, that requires knowledge of risk-adjusted results to improve outcomes and reduce costs. ⋯ Differences among hospitals defines opportunities for care improvement.
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Surgical treatment of lumbar disc herniation (LDH) may lead to different outcomes in young, middle-aged, and elderly patients. However, no study has, by the same data ascertainment, evaluated referral pattern, improvement, and outcome in different age strata. ⋯ In general, older patients referred to LDH surgery have statistically significantly inferior PROM scores, improve less, and reach inferior PROM scores postoperatively. The clinical relevance must however be questioned because most patients reach, independent of age group, the defined level for a successful outcome, and the patient satisfaction rate is high.