The initial CT blend sign is not associated with poor patient outcomes after stereotactic minimally invasive surgery

xloma.fota13 shared this article with you from Inoreader The initial CT blend sign is not associated with poor patient outcomes after stereotactic minimally invasive surgery Via BMC Neurology - Latest Articles The initial CT blend sign is an imaging marker that has been used to predict haematoma expansion and poor outcomes in patients with small-volume intracerebral haemorrhage (ICH). However, the association of the... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute motor and sensory axonal neuropathy in association with primary Sjögren’s syndrome: a case report

xloma.fota13 shared this article with you from Inoreader Acute motor and sensory axonal neuropathy in association with primary Sjögren's syndrome: a case report Via BMC Neurology - Latest Articles Primary Sjögren's syndrome is a chronic, autoimmune, connective tissue disorder that results from the infiltration of exocrine glands, especially the lacrimal and salivary glands, by autoantibodies. Patients w... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association Between Text Neck and Neck Pain in Adults

xloma.fota13 shared this article with you from Inoreader Association Between Text Neck and Neck Pain in Adults Via Spine - Featured Articles - Featured Articles Study Design. Observational cross-sectional study. Objective. The aim of this study was to investigate the association between text neck and neck pain (NP) in adults. Summary of Background Data. It has been hypothesized that the inappropriate neck posture adopted when texting and reading on a smartphone, called text neck, is related to the increased prevalence of NP. Methods. The sample was composed of 582 volunteers aged between 18 and 65 years. Sociodemographics, anthropometrics, lifestyle, psychosocial, NP, and smartphone use-related questions were assessed by a self-reported questionnaire. Text neck was assessed by measuring the cervical flexion angle of the participants standing and sitting while typing a text on their smartphones, using the Cervical Range of Motion (CROM) device. Results. Multiple logistic regression analysis and linear regression analysis showed the cervical flexion angle of the standing participant using a smartphone did not associate with the prevalence of NP (odds ratio [OR] = 1.00; 95% confidence interval [CI]: 0.98–1.02; P = 0.66), NP frequency (OR = 1.01; 95% CI: 1.00–1.03; P = 0.056), or maximum NP intensity (beta coefficient = −5.195 × 10−5; 95% CI: −0.02 to 0.02; P = 0.99). Also, the cervical flexion angle of the sitting participant using the smartphone did not associate with NP (OR = 0.99; 95% CI: 0.98–1.01; P = 0.93), NP frequency (OR = 1.01; 95% CI: 0.99–1.02; P = 0.13), or maximum NP intensity (beta coefficient = 0.002; 95% CI: −0.002 to 0.02; P = 0.71). Conclusion. Text neck was not associated with prevalence of NP, NP frequency, or maximum NP intensity in adults. Level of Evidence: 4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Machine Learning Predicts the 3D Outcomes of Adolescent Idiopathic Scoliosis Surgery Using Patient–Surgeon Specific Parameters

xloma.fota13 shared this article with you from Inoreader Machine Learning Predicts the 3D Outcomes of Adolescent Idiopathic Scoliosis Surgery Using Patient–Surgeon Specific Parameters Via Spine - Featured Articles - Featured Articles Study Design. Retrospective descriptive, multicenter study. Objective. The aim of this study was to predict the three-dimensional (3D) radiographic outcomes of the spinal surgery in a cohort of adolescent idiopathic scoliosis (AIS) as a function preoperative spinal parameters and surgeon modifiable factors. Summary of Background Data. Current guidelines for posterior spinal fusion surgery (PSF) in AIS patients are based on two-dimensional classification of the spinal curves. Despite the high success rate, the prediction of the 3D spinal alignment at the follow-ups remains inconclusive. A data-driven surgical decision-making method that determines the combination of the surgical procedures and preoperative patient specific parameters that leads to a specific 3D global spinal alignment outcomes at the follow-ups can lessen the burden of surgical planning and improve patient satisfaction by setting expectations prior to surgery. Methods. A dataset of 371 AIS patients who underwent a PSF with two-year follow-up were included. Demographics, 2D radiographic spinal and pelvic measurements, clinical measurements of the trunk shape, and the surgical procedures were collected prospectively. A previously developed classification of the preoperative global 3D spinal alignment was used as an additional predictor. The 3D spinal alignment (vertebral positions and rotations) at two-year follow-up was used as the predicted outcome. An ensemble learner was used to predict the 3D spinal alignment at two-year follow-up as a function of the preoperative parameters with and without considering the surgeon modifiable factors. Results. The preoperative and surgical factors predicted three clusters of 3D surgical outcomes with an accuracy of 75%. The prediction accuracy decreased to 64% when only preoperative factors, without the surgical factors, were used in the model. Predictor importance analysis determined that preoperative distal junctional kyphosis, pelvic sagittal parameters, end-instrumented vertebra (EIV) angulation and translation, and the preoperative 3D clusters are the most important patient-specific predictors of the outcomes. Three surgical factors, upper and lower instrumented vertebrae, and the operating surgeon, were important surgical predictors. The role of surgeon in achieving a certain outcome clusters for specific ranges of preoperative T10-L2 kyphosis, EIV angulation and translation, thoracic and lumbar flexibilities, and patient's height was significant. Conclusion. Both preoperative patient-specific and surgeon modifiable parameters predicted the 3D global spinal alignment at two-year post PSF. Surgeon was determined as a predictor of the outcomes despite including 20 factors in the analysis that described the surgical moves. Methods to quantify the differences between the implemented surgeon modifiable factors are essential to improve outcome prediction in AIS spinal surgery. Level of Evidence: 3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Alcohol Abuse and Alcohol Withdrawal Are Associated with Adverse Perioperative Outcomes Following Elective Spine Fusion Surgery

xloma.fota13 shared this article with you from Inoreader Alcohol Abuse and Alcohol Withdrawal Are Associated with Adverse Perioperative Outcomes Following Elective Spine Fusion Surgery Via Spine - Featured Articles - Featured Articles Study Design. Cross-sectional study. Objective. Alcohol abuse (AA) and alcohol withdrawal (AW), both belonging to alcohol use disorders, bring about vast health consequences, social issues, and financial burden in United States. This study aims to explore the relationship of AA and AW with perioperative outcomes following elective spine fusion surgery. Summary of Background Data. Large studies evaluating the outcomes of spine surgery in patients with AA or AW are lacking. Methods. We used the National Inpatient Sample (NIS) from 2006 to 2014 to extract records with a primary procedure of spinal fusion surgery. Multivariable regression analysis was used to assess the association of AA and AW with in-hospital mortality, perioperative complications, cost and length of stay (LOS). Results. Among 3,132,192 patients undergoing elective spinal fusion surgery, the prevalence of AA and AW was 1.14% (35,833) and 0.15% (4623), respectively. Among the AA admissions, 12.90% of patients developed AW. The incidence of overall complications was 6.14%, 10.15%, and 33.73% in patients without AA, with AA and with AW, respectively. After multivariable adjustment, AW was associated with elevated risk of overall complications (odds ratio [OR]: 4.51; 95% confidence interval [CI]: 3.86–5.27), neurologic (OR: 2.58; 95% CI: 1.62–4.12), respiratory (OR: 8.04; 95% CI: 6.62–9.77), cardiac (OR: 3.58; 95% CI: 2.60–4.93), gastrointestinal (OR: 2.31; 95%CI: 1.68–3.17), urinary and renal (OR: 2.68; 95% CI: 2.11–3.39), venous thromboembolism (OR: 3.06; 95% CI: 1.94–4.82), wound-related complications (OR: 3.84; 95% CI: 2.96–4.98) and in-hospital mortality (OR: 5.95; 95% CI: 3.25–10.90). AW was also linked to 40% higher cost and 85% longer LOS. Conclusion. Both AA and AW are associated with adverse outcomes in patients undergoing spinal fusion surgery with more pronounced risks for AW. Aggressive management in perioperative period is required to improve outcomes in these patients. Level of Evidence: 3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Minimum Clinically Important Difference for Patient Health Questionnaire-9 in Minimally Invasive Transforaminal Interbody Fusion

xloma.fota13 shared this article with you from Inoreader The Minimum Clinically Important Difference for Patient Health Questionnaire-9 in Minimally Invasive Transforaminal Interbody Fusion Via Spine - Featured Articles - Featured Articles Study Design. Retrospective cohort. Objective. To investigate and establish minimum clinically important differences (MCID) for Patient Health Questionnaire-9 (PHQ-9) among patients undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Summary of Background. Spine surgery is linked to postoperative improvements in anxiety, depression, and mental health. These improvements have been documented using patient-reported outcome measures such as PHQ-9. Few studies evaluated the clinical significance of PHQ-9 for lumbar spine surgery. Methods. Patients who underwent single-level, primary MIS TLIF from 2015 to 2017 were retrospectively reviewed in a prospective database. Patients with incomplete preoperative and 2-year postoperative PHQ-9 surveys were excluded. Demographic and perioperative characteristics were recorded. PHQ-9, 12-Item Short Form (SF-12), and Veterans RAND 12-Item Health Survey (VR-12) Mental Component Summary (MCS) were collected at preoperative, 6-week, 12-week, 6-month, 1-year, and 2-year intervals. MCID was calculated using anchor and distribution-based methods. SF-12 served as an anchor. MCID was assessed using mean change methodology, four receiver operating characteristic curve assessments, and standard error measurement. Cutoff values were selected from receiver operating characteristic curve analysis. MCID achievement rates for all patient-reported outcome measures were calculated. Results. A total of 139 patients met inclusion criteria, with a mean age of 55 years and 39% females. The most common spinal pathology was radiculopathy (92%). MCID analysis revealed the following ranges of values: 2.0 to 4.8 (PHQ-9), 6.7 to 12.1 (SF-12 MCS), and 7.5 to 15.9 (VR-12 MCS). Final MCID thresholds were 3.0 (PHQ-9), 9.1 (SF-12 MCS), and 8.1 (VR-12 MCS). MCID achievement at 2-years for PHQ-9, SF-12 MCS, and VR-12 MCS was 89.2%, 85.6%, and 84.9% respectively. Conclusion. Our 2-year postoperative MCID analysis is the first mental health calculation from an MIS TLIF cohort. We report a 2-year MCID value for PHQ-9 of 3.0 (2.0–4.8). MCID values for mental health instruments are important for determining overall success of lumbar spine surgery. Level of Evidence: 3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of the Yoruba Version of the Pain Self-Efficacy Questionnaire in Patients with Chronic Low Back Pain

xloma.fota13 shared this article with you from Inoreader Validation of the Yoruba Version of the Pain Self-Efficacy Questionnaire in Patients with Chronic Low Back Pain Via Spine - Featured Articles - Featured Articles Study Design. Cultural adaptation and psychometric analysis. Objective. This study determined the test–retest reliability, acceptability, internal consistency, divergent validity of the Yoruba pain self-efficacy questionnaire (PSEQ-Y). It also examined the ceiling and floor effects and the small detectable change (SDC) of the PSEQ-Y among patients with chronic low back pain (LBP). Summary of Background Data. There are various indigenous language translations of the PSEQ and none adapted to African language. However, translations of the PSEQ into Nigerian languages are not readily available. Methods. The validity testing phase of the study involved 131 patients with LBP, while 83 patients with LBP took part in the reliability phase. Following the Beaton recommendation for cultural adaptation of instruments, the PSEQ was adapted into the Yoruba language. The psychometric properties of the PSEQ-Y determined comprised: internal consistency, divergent validity, test–retest reliability, and SDC. Results. The mean age of the participants was 52.96 ± 17.3 years. The PSEQ-Y did not correlate with the Yoruba version of Visual Analogue Scale (VAS-Y) scores (r = –0.05; P = 0.59). The values for the internal consistency and the test–retest reliability of the PSEQ-Y were 0.79 and 0.86, with the 95% confidence interval of the test–retest reliability ranging between 0.82 and 0.90. The standard error of measurement (SEM) and the SDC of the PSEQ-Y were 1.2 and 3.3, respectively. The PSEQ-Y had no floor or ceiling effect, as none of the respondents scored either the minimal or maximal scores. Conclusion. This is the first study in Nigeria to culturally adapt PSEQ. The PSEQ-Y showed adequate psychometric properties similar to existing versions. Therefore, the tool can be used to assess pain self-efficacy in clinical and research settings and help to improve the health outcomes of patients chronic LBP. Level of Evidence: 3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.