Pub Date : 2020-01-20DOI: 10.34371/JSPINERES.2019-0005
孝宜 諸澄, 民世 金, 純久 折田, Trevor A. Lentz, 拓史 橋川, 義信 萩原, S. George, 精司 大鳥, 淳 寺門
Introduction: In recent years, it has been reported that psychosocial factors of patients with orthopedic disorders are involved in pain chronicity. Thus, it is effective to attend to psychosocial aspects as early as possible. The “Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF)” assessment tool collects patient-reported outcomes for 17 items, which can comprehensively evaluate multiple psychological factors. We developed the Japanese version of OSPROYF (OSPRO-YF-J) and verified its reliability and validity. Methods: First, after obtaining permission to develop the Japanese version, we translated OSPRO-YF according to international guidelines. In the preliminary analysis (n = 21; average age, 49.1±20.4 years; 5 males and 16 females), we evaluated the cross-cultural understanding of item expressions and time required to complete the questionnaire. In addition, we verified its reliability. We statistically analyzed reliability in terms of reproducibility, internal consistency, and absolute reliability. We then verified the external validity of OSPRO-YF-J in a separate sample (n = 251; average age, 65.3±13.4 years; 70 males and 181 females). We summarized the obtained data descriptively and confirmed the presence of the ceiling and floor effects. Results: The average time required to complete OSPRO-YF-J was 4.4±2.4 minutes, and the average score was 36.6±10.3 points. No ceiling or floor effect was observed. For reproducibility (Intraclass correlation coefficient = 0.86), Cronbach’s α was 0.84, correlation coefficients for each item ranged from 0.4 to 0.7. Furthermore, in Bland-Altman analysis, no systematic errors (fixed or proportional errors) but only accidental errors were recognized in OSPRO-YF-J. Conclusions: OSPRO-YF-J was confirmed to show good reliability and validity. OSPRO-YF-J is a comprehensive psychological evaluation scale and can be easily implemented in the clinical setting. Therefore, we think that it is a practical questionnaire for evaluating psychological factors.
{"title":"日本語版Optimal Screening for Prediction of Referral and Outcome Yellow Flag Assessment Toolの作成―その信頼性と妥当性の検討―","authors":"孝宜 諸澄, 民世 金, 純久 折田, Trevor A. Lentz, 拓史 橋川, 義信 萩原, S. George, 精司 大鳥, 淳 寺門","doi":"10.34371/JSPINERES.2019-0005","DOIUrl":"https://doi.org/10.34371/JSPINERES.2019-0005","url":null,"abstract":"Introduction: In recent years, it has been reported that psychosocial factors of patients with orthopedic disorders are involved in pain chronicity. Thus, it is effective to attend to psychosocial aspects as early as possible. The “Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF)” assessment tool collects patient-reported outcomes for 17 items, which can comprehensively evaluate multiple psychological factors. We developed the Japanese version of OSPROYF (OSPRO-YF-J) and verified its reliability and validity. Methods: First, after obtaining permission to develop the Japanese version, we translated OSPRO-YF according to international guidelines. In the preliminary analysis (n = 21; average age, 49.1±20.4 years; 5 males and 16 females), we evaluated the cross-cultural understanding of item expressions and time required to complete the questionnaire. In addition, we verified its reliability. We statistically analyzed reliability in terms of reproducibility, internal consistency, and absolute reliability. We then verified the external validity of OSPRO-YF-J in a separate sample (n = 251; average age, 65.3±13.4 years; 70 males and 181 females). We summarized the obtained data descriptively and confirmed the presence of the ceiling and floor effects. Results: The average time required to complete OSPRO-YF-J was 4.4±2.4 minutes, and the average score was 36.6±10.3 points. No ceiling or floor effect was observed. For reproducibility (Intraclass correlation coefficient = 0.86), Cronbach’s α was 0.84, correlation coefficients for each item ranged from 0.4 to 0.7. Furthermore, in Bland-Altman analysis, no systematic errors (fixed or proportional errors) but only accidental errors were recognized in OSPRO-YF-J. Conclusions: OSPRO-YF-J was confirmed to show good reliability and validity. OSPRO-YF-J is a comprehensive psychological evaluation scale and can be easily implemented in the clinical setting. Therefore, we think that it is a practical questionnaire for evaluating psychological factors.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74955880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Vu, Riet Ngoc Do, Thanh Dang Le, Vien Chi Tieu, Tram Thi Bao Nguyen, Khai Dang Tran, Lan Hoang Bui, Tuan Duc Ha, Long Thanh Ngo, Phuc Nghia Diep, Tin Trong Nguyen
Introduction: It is generally accepted that laminoplasty is a safe and reliable surgical treatment for cervical spine myelopathy (CSM) due to spinal canal stenosis. There are multiple techniques of laminoplasty for spinal cord decompression and most of them require expensive instruments to stabilize the laminae. From 2005 to 2015, we applied the modified Z-plasty (Sakou's technique) for CSM patients in an attempt to reduce the cost of treatment. Materials and methods: This is a retrospective study. CSM patients treated by modified Z-plasty technique were selected. We applied the Sakou’s technique, according to which the laminae will be opened in different directions alternatively. We use the JOA score and recovery rate of Hirabayashi to assess the neurological recovery and the Neck Disability Index (NDI) for the cervical functional outcome. Results: There were 42 patients with the mean follow-up duration of 10 years (5-15 years), male: female ratio of 3:1 and mean age of 61. The mean operating time and blood loss per lamina were 40 minutes and 45ml, respectively. The canal expanding index was 4.2mm (3-5 mm). The mean pre- and postoperative JOA score were 11.1 and 14.7, respectively (p<0.05). For the axial pain, the mean NDI was 18 point with 88% of cases having as good and very good cervical function. For complications, there were 3 cases of C5 palsy with full recovery after one year. Conclusion: Being considered as an old-fashioned surgery, the modified Z-plasty can still provide good clinical and radiological outcomes to cervical myelopathic patients. The absence of hardware such as titanium plates or hydroxyapatite spacers reduces the risk of infection and the cost of treatment. Considering the risk-benefit and cost-benefit ratio, this operation is suitable for low-income patients in developing countries.
{"title":"Modified Z-Plasty for Cervical Spine Myelopathy: A Not-So-Obsolete Method of Laminoplasty","authors":"T. Vu, Riet Ngoc Do, Thanh Dang Le, Vien Chi Tieu, Tram Thi Bao Nguyen, Khai Dang Tran, Lan Hoang Bui, Tuan Duc Ha, Long Thanh Ngo, Phuc Nghia Diep, Tin Trong Nguyen","doi":"10.26502/fjsrs0016","DOIUrl":"https://doi.org/10.26502/fjsrs0016","url":null,"abstract":"Introduction: It is generally accepted that laminoplasty is a safe and reliable surgical treatment for cervical spine myelopathy (CSM) due to spinal canal stenosis. There are multiple techniques of laminoplasty for spinal cord decompression and most of them require expensive instruments to stabilize the laminae. From 2005 to 2015, we applied the modified Z-plasty (Sakou's technique) for CSM patients in an attempt to reduce the cost of treatment. Materials and methods: This is a retrospective study. CSM patients treated by modified Z-plasty technique were selected. We applied the Sakou’s technique, according to which the laminae will be opened in different directions alternatively. We use the JOA score and recovery rate of Hirabayashi to assess the neurological recovery and the Neck Disability Index (NDI) for the cervical functional outcome. Results: There were 42 patients with the mean follow-up duration of 10 years (5-15 years), male: female ratio of 3:1 and mean age of 61. The mean operating time and blood loss per lamina were 40 minutes and 45ml, respectively. The canal expanding index was 4.2mm (3-5 mm). The mean pre- and postoperative JOA score were 11.1 and 14.7, respectively (p<0.05). For the axial pain, the mean NDI was 18 point with 88% of cases having as good and very good cervical function. For complications, there were 3 cases of C5 palsy with full recovery after one year. Conclusion: Being considered as an old-fashioned surgery, the modified Z-plasty can still provide good clinical and radiological outcomes to cervical myelopathic patients. The absence of hardware such as titanium plates or hydroxyapatite spacers reduces the risk of infection and the cost of treatment. Considering the risk-benefit and cost-benefit ratio, this operation is suitable for low-income patients in developing countries.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69348008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/fjsrs.2687-8046005
I. Arrotegui
{"title":"Surgical Stabilization in Unstable Vertebral Fractures","authors":"I. Arrotegui","doi":"10.26502/fjsrs.2687-8046005","DOIUrl":"https://doi.org/10.26502/fjsrs.2687-8046005","url":null,"abstract":"","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/fjsrs.2687-8046004
I. Arrotegui
{"title":"Motor Injury by Compression of Spinal Cord at Cervical Level During Surgery","authors":"I. Arrotegui","doi":"10.26502/fjsrs.2687-8046004","DOIUrl":"https://doi.org/10.26502/fjsrs.2687-8046004","url":null,"abstract":"","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/fjsrs.2687-8046006
I. Arrotegui
{"title":"Extraforaminal Lumbar Disc Herniation-How to Approach","authors":"I. Arrotegui","doi":"10.26502/fjsrs.2687-8046006","DOIUrl":"https://doi.org/10.26502/fjsrs.2687-8046006","url":null,"abstract":"","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/fjsrs.2687-8046003
Micah W. Smith, D. R. Romano
Atlantoaxial instability (AAI) is a common deformity in Down syndrome (DS). Although often inconsequential, AAI can progress to atlantoaxial rotatory subluxation (AARS). In patients with DS, concomitant AAI often necessitate surgical fusion, but successful stabilization in this population can be challenging due to high complication rates. A 14-year-old male with DS presented with a 3-month history of spontaneous AARS. After failed closed reduction, the parents consented to surgical stabilization. Preoperative planning revealed a high-riding vertebral artery and thin C2 lamina; therefore, C1-C4 segmental posterior instrumented fusion was performed, resulting in a successful reduction maintained at 12 months’ follow-up. The development of rigid fixation for the treatment of AARS has improved fusion rates in children with DS. However, vascular and osseous anomalies in this population often dictate extension of the fusion constructs beyond C1 and C2. Careful preoperative planning is a prerequisite to safe and solid fixation.
{"title":"Atlantoaxial Rotatory Instability in a Down Syndrome Patient with Aberrant Vertebral Artery Anatomy","authors":"Micah W. Smith, D. R. Romano","doi":"10.26502/fjsrs.2687-8046003","DOIUrl":"https://doi.org/10.26502/fjsrs.2687-8046003","url":null,"abstract":"Atlantoaxial instability (AAI) is a common deformity in Down syndrome (DS). Although often inconsequential, AAI can progress to atlantoaxial rotatory subluxation (AARS). In patients with DS, concomitant AAI often necessitate surgical fusion, but successful stabilization in this population can be challenging due to high complication rates. A 14-year-old male with DS presented with a 3-month history of spontaneous AARS. After failed closed reduction, the parents consented to surgical stabilization. Preoperative planning revealed a high-riding vertebral artery and thin C2 lamina; therefore, C1-C4 segmental posterior instrumented fusion was performed, resulting in a successful reduction maintained at 12 months’ follow-up. The development of rigid fixation for the treatment of AARS has improved fusion rates in children with DS. However, vascular and osseous anomalies in this population often dictate extension of the fusion constructs beyond C1 and C2. Careful preoperative planning is a prerequisite to safe and solid fixation.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zachary Sanford, A. Broda, E. Keller, Justin J. Turcotte, C. Patton
Introduction: The following is a study of the impact of comorbid conditions on hospital length of stay following spinal fusion. Methods: Surgeries were identified from the 2016 Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-US-NIS) by Medicare Severity Diagnosis Related Group (MS-DRG) codes and subdivided for analysis by fusion location and procedure approach. Length of stay was evaluated in relation to comorbid disease status, fusion location, and surgical technique. Comorbidities of interest included hypothyroidism, diabetes mellitus, hypertension, hyperlipidemia, anxiety, obesity, chronic obstructive pulmonary disease, osteoarthritis, rheumatoid arthritis, major depression, coronary atherosclerosis, arrhythmia, congestive heart failure, osteoporosis, stroke, and transient ischemic attack. Patients hospitalized longer than two months were excluded from this analysis. Results: 185,216 patients undergoing an inpatient spinal fusion were identified (Cervical 32,753, Cervicothoracic 2,633, Thoracic 2,817, Thoracolumbar 4,761, Lumbar 32,316, Lumbosacral 17,326). Each comorbid disease was found to significantly increase the length of hospital stay for at least one procedure location (p<.05), with transient ischemic attack (8.5 days in cervicothoracic cases), arrhythmia (5.4 days in thoracic cases), and chronic heart failure (4.8 days in cervicothoracic cases) associated with substantially increased duration of hospitalization. Chronic heart failure (β 2.85, SE 0.11, p <.001), stroke (β 3.05, SE 0.08, p <.001), and osteoarthritis (β 2.12, SE 0.41, p <.001) demonstrated strong positive association with increases in length of peroperative hospitalization. J Spine Res Surg 2019; 1 (2): 048-059 DOI: 10.26502/fjsrs008 Journal of Spine Research and Surgery 49 Conclusion: Preoperative comorbidities contribute variably to the length of post-spinal fusion hospital stay. With increasing trends towards predictive modeling in healthcare outcomes these conditions represent important factors for consideration in surgical planning.
简介:以下是一项关于合并症对脊柱融合术后住院时间影响的研究。方法:根据医疗保险严重程度诊断相关组(MS-DRG)代码从2016年医疗成本和利用项目国家住院患者样本(HCUP-US-NIS)中识别手术，并按融合位置和手术方法进行细分分析。住院时间与合并症状态、融合位置和手术技术有关。合并症包括甲状腺功能减退、糖尿病、高血压、高脂血症、焦虑、肥胖、慢性阻塞性肺病、骨关节炎、类风湿关节炎、重度抑郁症、冠状动脉粥样硬化、心律失常、充血性心力衰竭、骨质疏松症、中风和短暂性脑缺血发作。住院时间超过两个月的患者被排除在本分析之外。结果:185216例患者接受了住院脊柱融合术(颈32753例，颈胸2633例，胸2817例，胸腰椎4761例，腰椎32316例，腰骶17326例)。每一种合并症均显著增加至少一个手术部位的住院时间(p< 0.05)，短暂性脑缺血发作(颈胸病例8.5天)、心律失常(胸胸病例5.4天)和慢性心力衰竭(颈胸病例4.8天)与住院时间显著增加相关。慢性心力衰竭(β 2.85, SE 0.11, p <.001)、中风(β 3.05, SE 0.08, p <.001)和骨关节炎(β 2.12, SE 0.41, p <.001)与手术住院时间的增加呈显著正相关。中华外科杂志2019;结论:术前合并症对脊柱融合术后住院时间长短有不同的影响。随着医疗保健结果预测建模趋势的增加，这些条件代表了手术计划中需要考虑的重要因素。
{"title":"Impact of Comorbid Disease on Length of Hospitalization in Spine Fusion Patients: An HCUP-US-NIS Study","authors":"Zachary Sanford, A. Broda, E. Keller, Justin J. Turcotte, C. Patton","doi":"10.26502/fjsrs008","DOIUrl":"https://doi.org/10.26502/fjsrs008","url":null,"abstract":"Introduction: The following is a study of the impact of comorbid conditions on hospital length of stay following spinal fusion. Methods: Surgeries were identified from the 2016 Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-US-NIS) by Medicare Severity Diagnosis Related Group (MS-DRG) codes and subdivided for analysis by fusion location and procedure approach. Length of stay was evaluated in relation to comorbid disease status, fusion location, and surgical technique. Comorbidities of interest included hypothyroidism, diabetes mellitus, hypertension, hyperlipidemia, anxiety, obesity, chronic obstructive pulmonary disease, osteoarthritis, rheumatoid arthritis, major depression, coronary atherosclerosis, arrhythmia, congestive heart failure, osteoporosis, stroke, and transient ischemic attack. Patients hospitalized longer than two months were excluded from this analysis. Results: 185,216 patients undergoing an inpatient spinal fusion were identified (Cervical 32,753, Cervicothoracic 2,633, Thoracic 2,817, Thoracolumbar 4,761, Lumbar 32,316, Lumbosacral 17,326). Each comorbid disease was found to significantly increase the length of hospital stay for at least one procedure location (p<.05), with transient ischemic attack (8.5 days in cervicothoracic cases), arrhythmia (5.4 days in thoracic cases), and chronic heart failure (4.8 days in cervicothoracic cases) associated with substantially increased duration of hospitalization. Chronic heart failure (β 2.85, SE 0.11, p <.001), stroke (β 3.05, SE 0.08, p <.001), and osteoarthritis (β 2.12, SE 0.41, p <.001) demonstrated strong positive association with increases in length of peroperative hospitalization. J Spine Res Surg 2019; 1 (2): 048-059 DOI: 10.26502/fjsrs008 Journal of Spine Research and Surgery 49 Conclusion: Preoperative comorbidities contribute variably to the length of post-spinal fusion hospital stay. With increasing trends towards predictive modeling in healthcare outcomes these conditions represent important factors for consideration in surgical planning.","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69348290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.26502/fjsrs.2687-8046001
M. Greenberg
{"title":"Preventing Alzheimer's","authors":"M. Greenberg","doi":"10.26502/fjsrs.2687-8046001","DOIUrl":"https://doi.org/10.26502/fjsrs.2687-8046001","url":null,"abstract":"","PeriodicalId":73951,"journal":{"name":"Journal of spine research and surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69347911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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