scholarly journals Sexual and reproductive function in spinal cord injury and spinal surgery patients

2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Theodore H. Albright ◽  
Zachary Grabel ◽  
J. Mason DePasse ◽  
Mark A. Palumbo ◽  
Alan H. Daniels
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Spinal Injury ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Reproductive Function ◽  
Current Data ◽  
Cord Injury ◽  
Spine Pathology ◽  
The Impact

Sexual and reproductive health is important quality of life outcomes, which can have a major impact on patient satisfaction. Spinal pathology arising from trauma, deformity, and degenerative disease processes may be detrimental to sexual and reproductive function. Furthermore, spine surgery may impact sexual and reproductive function due to post-surgical mechanical, neurologic, and psychological factors. The aim of this paper is to provide a concise evidence-based review on the impact that spine surgery and pathology can have on sexual and reproductive function. A review of published literature regarding sexual and reproductive function in spinal injury and spinal surgery patients was performed. We have found that sexual and reproductive dysfunction can occur due to numerous etiological factors associated with spinal pathology. Numerous treatment options are available for those patients, depending on the degree of dysfunction. Spine surgeons and non-operative healthcare providers should be aware of the issues surrounding sexual and reproductive function as related to spine pathology and spine surgery. It is important for spine surgeons to educate their patients on the operative risks that spine surgery encompasses with regard to sexual dysfunction, although current data examining these topics largely consists of level IV data.

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

scholarly journals The impact of the SARS-CoV-2 pandemic on referral characteristics in a national tertiary spinal injuries unit

2021 ◽  
Author(s):  
Louis O’Halloran ◽  
Daniel P. Ahern ◽  
Jake M. McDonnell ◽  
Gráinne M. Cunniffe ◽  
Michael K. Dodds ◽  
...  
Keyword(s):  
Road Traffic ◽  
Spinal Injury ◽  
Disc Disease ◽  
Tertiary Referral Centre ◽  
Period 2 ◽  
Spine Pathology ◽  
Social Restriction ◽  
Notable Increase ◽  
Almost All ◽  
The Impact

Abstract Background The SARS-CoV-2 pandemic has had profound implications on healthcare institutions. Aims This study aims to assess and compare referral patterns during COVID-19 to corresponding dates for the preceding 3 years (2017–2019), in order to preemptively coordinate the logistics of the surgical unit for similar future experiences. Methods Retrospective review for our institution, a national tertiary referral centre for spine pathology. Two distinct time-points were chosen to represent the varied levels of social restriction during the current pandemic: (i) study period 1 (SP1) from 11 November 2020 to 08 June 2020 represents a national lockdown, and (ii) study period 2 (SP2) from 09 June 2020 to 09 September 2020 indicates an easing of restrictions. Both periods were compared to corresponding dates (CP1: 11 March–08 June and CP2 09 June–09 September) for the preceding 3 years (2017–2019). Data collected included age, gender, and mechanism of injury (MOI) for descriptive analyses. MOIs were categorised into disc disease, cyclist, road-traffic-accident (RTA), falls < 2 m, falls > 2 m, malignancy, sporting injuries, and miscellaneous. Results All MOI categories witnessed a reduction in referral numbers during SP1: disc disease (−29%), cyclist (−5%), RTAs (−66%), falls < 2 m (−39%), falls > 2 m (−17%), malignancy (−33%), sporting injuries (−100%), and miscellaneous (−58%). Four of 8 categories (RTAs, falls < 2 m, malignancy, miscellaneous) showed a trend towards return of pre-lockdown values during SP2. Two categories (disc disease, falls > 2 m) showed a further reduction (−34%, −27%) during SP2. One category (sporting injuries) portrayed a complete return to normal values during SP2 while a notable increase in cyclist-related referrals was witnessed (+ 63%) when compared with corresponding dates of previous years. Conclusion Spinal injury continues to occur across almost all categories, albeit at considerably reduced numbers. RTAs and falls remained the most common MOI. Awareness needs to be drawn to the reduction of malignancy-related referrals to dissuade people with such symptoms from avoiding presentation to hospital over periods of social restrictions.

scholarly journals COVID-19 and Acute Coronary Syndromes: Current Data and Future Implications

2021 ◽  
Vol 7 ◽  
Author(s):  
Matteo Cameli ◽  
Maria Concetta Pastore ◽  
Giulia Elena Mandoli ◽  
Flavio D'Ascenzi ◽  
Marta Focardi ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Healthcare Providers ◽  
Current Data ◽  
Hospital Environment ◽  
Healthcare Personnel ◽  
Clinical Approach ◽  
Mortality And Morbidity ◽  
The World ◽  
Coronary Syndromes ◽  
The Impact

Coronavirus disease-2019 (COVID-19) pandemic is a global healthcare burden, characterized by high mortality and morbidity rates all over the world. During the outbreak period, the topic of acute coronary syndromes (ACS) has raised several clinical issues, due to the risks of COVID-19 induced myocardial injury and to the uncertainties about the management of these cardiologic emergency conditions, which should be organized optimizing the diagnostic and therapeutic resources and ensuring the maximum protection to healthcare personnel and hospital environment. COVID-19 status should be assessed as soon as possible. Moreover, considerably lower rates of hospitalization for ACS have been reported all over the world, due to patients' hesitations to refer to hospital and to missed diagnosis. As a result, short- and long-term complications of myocardial infarction are expected in the near future; therefore, great efforts of healthcare providers will be required to limit the effects of this issue. In the present review we discuss the impact of COVID-19 pandemic on ACS diagnosis and management, with possible incoming consequences, providing an overview of the available evidence and suggesting future changes in social and clinical approach to ACS.

scholarly journals Parachute Canada/ThinkFirst Hockey Spinal Injuries Registry update

2015 ◽  
Vol 42 (S1) ◽  
pp. S19-S19
Author(s):  
CH Tator ◽  
C Provvidenza
Keyword(s):  
Injury Risk ◽  
Spinal Injury ◽  
Prevention Programs ◽  
Spinal Injuries ◽  
Ice Hockey ◽  
Injury Rates ◽  
Prevention Education ◽  
Cord Injury ◽  
Media Reports ◽  
The Impact

Background: The Registry has collected data on spinal injuries in hockey for 30 years. This paper identifies the nature and incidence of spinal injuries in Canadian ice hockey and the impact of prevention programs. Methods: Data about spinal injuries with and without spinal cord injury in ice hockey have been collected by Parachute Canada/ThinkFirst’s Canadian Ice Hockey Spinal Injury Registry since 1981 through retrospective questionnaires from practitioners, ice hockey organizations and media reports. Injury risk factors assessed include age, gender, location, and injury mechanism. Results: From 1943-2011, 355 cases have been documented. Injuries were primarily sustained by males (97.7%), and were cervical (78.9%)in location, resulting mainly from impact with the boards (64.2%). Checking/pushing from behind (36.0%) was the most common cause of injury, although slightly lower during 2006-2011. Major differences between provinces continue; Ontario and Quebec, continue to show markedly different injury rates, with Ontario’s more than twice that of Quebec. Conclusions: Spinal injuries in hockey continue to occur, although at lower rates than in the peak years from 1981-2000. Injury prevention education and rules reinforcement (e.g. no checking/pushing from behind). Data indicate that multifaceted prevention programs have reduced the risk of injury.

scholarly journals Is Golf a Contact Sport? Protection of the Spine and Return to Play After Lumbar Surgery

2021 ◽  
pp. 219256822098329
Author(s):  
Ram Haddas ◽  
William Pipkin ◽  
Dan Hellman ◽  
Leonard Voronov ◽  
Young-Hoo Kwon ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Treatment Options ◽  
High Impact ◽  
Return To Play ◽  
Lumbar Spine Surgery ◽  
Contact Sport ◽  
Contact Sports ◽  
Spine Pathology ◽  
Modern Era

Study Design: Narrative review. Objective: To address the gap in the literature on specific return to play protocols and rehabilitation regimens for golfers undergoing lumbar spine surgery with a high impact swing. Methods: This review did not involve patient care or any clinical prospective or retrospective review of patient information and thus did not warrant institutional review board approval. The available literature of PubMed, Medline, and OVID was utilized to review the existing literature. Results: Studies have shown that the forces through the lumbar spine in the modern-era golf swing are like other contact sports. Methods of protecting the lumbar spine include proper swing mechanics, abdominal and paraspinal musculature strengthening and flexibility as well as physical fitness. There are a variety of treatment options available to treat lumbar spine pathology each with a different return to play recommendations from doctors in the field. Conclusions: With the introduction of a high impact, modern-era swing to the game of golf, the pathology is seen in the lumbar spine of both young, old, professional, and amateur golfers with low back pain are similar to other athletes in contact sports. Surgery is effective in returning athletes to a similar level of play even though no protocols exist for an effective and safe return. There have been many studies conducted to determine appropriate treatment and return to play for these injuries, but there is a gap in the literature on specific return to play protocols and rehabilitation regimens for golfers undergoing lumbar spine surgery with a high impact swing. As return to competitive play is important, especially with professional golfers, studies combining the use of swing mechanics changes, rehabilitation regimens and the type of surgery performed would be able to provide some insight into this topic now that golf may begin to be considered a contact sport.

scholarly journals The Impact of NSAID Use After Lumbar Fusion Surgery on Fusion Rate and Complications: A Meta-Analysis

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Yahya Othman ◽  
Avani Vaishnav ◽  
Steven Mcanany ◽  
Sravisht Iyer ◽  
Todd Albert ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Spine Surgery ◽  
Spinal Surgery ◽  
Meta Analysis ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Opioid Use ◽  
Pain Scores ◽  
Patient Reported ◽  
The Impact

Abstract INTRODUCTION The purpose of this study is to compile data presented in literature regarding the efficacy of incorporating NSAIDs in the postoperative course for patients undergoing spine surgery, in particular its impact on pain levels, opioid use, complications, and hospital length of stay METHODS This is a meta-analysis and systematic review. A literature search was conducted using the backbone search [spinal surgery] [Nsaid] [complications]. Criteria for inclusion are as follows: use of NSAIDs for postoperative pain management of spinal surgery, comparison between NSAID and NSAID-free cohort, and reporting on any of pain scores, hospital opioid use, hospital length of stay, complications rate, and operative outcomes. RESULTS Out of 799 studies, 19 studies met the inclusion criteria. A total of 1522 patient were included in this analysis. The studies included randomized controlled trials, Prospective and retrospective cohorts. Operations included discectomies, laminectomies, and fusions. Most commonly regimens included the NSAID Ketorelac, as in injection given immediately postoperatively. Patients that received NSAID analgesia postoperatively had significantly lower VAS pain scores at 1 and 12 h postoperatively. This group also had a significantly lower opioid consumption and shorter hospital length of stay. A total of 7 fusion studies reported on arthrodesis, showing a significantly lower odds of fusion after NSAIDs use, however after subgrouping according to smoking, this difference proves to be no longer significant. CONCLUSION Incorporation of NSAIDs into the postoperative regimen for analgesia in patients undergoing spine surgery is an effective approach in reducing hospital length of stay, patient reported pain scores, hospital opioid use, and has no increased risk of complications. Furthermore, use of NSAIDs in the nonsmoking population does not seem to affect arthrodesis rates in patients undergoing spine surgery.

scholarly journals Second opinion in spine surgery: A scoping review

2021 ◽  
Vol 12 ◽  
pp. 436
Author(s):  
Sandra Gattas ◽  
Gianna M. Fote ◽  
Nolan J. Brown ◽  
Brian V. Lien ◽  
Elliot H. Choi ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Economic Value ◽  
Second Opinion ◽  
Inclusion Criteria ◽  
Substantial Impact ◽  
The Past ◽  
Number Of Patients ◽  
Extent Of Surgery ◽  
The Impact

Background: As a growing number of patients seek consultations for increasingly complex and costly spinal surgery, it is of both clinical and economic value to investigate the role for second opinions (SOs). Here, we summarized and focused on the shortcomings of 14 studies regarding the role and value of SOs before proceeding with spine surgery. Methods: Utilizing PubMed, Google Scholar, and Scopus, we identified 14 studies that met the inclusion criteria that included: English, primary articles, and studies published in the past 20 years. Results: We identified the following findings regarding SO for spine surgery: (1) about 40.6% of spine consultations are SO cases; (2) 61.3% of those received a discordant SO; (3) 75% of discordant SOs recommended conservative management; and (4) SO discordance applied to a variety of procedures. Conclusion: The 14 studies reviewed regarding SOs in spine surgery showed that half of the SOs differed from those given in the initial consultation and that SOs in spine surgery can have a substantial impact on patient care. Absent are prospective studies investigating the impact of following a first versus second opinion. These studies are needed to inform the potential benefit of universal implementation of SOs before major spine operations to potentially reduce the frequency and type/extent of surgery.

Complications in spine surgery

2010 ◽  
Vol 13 (2) ◽  
pp. 144-157 ◽  
Author(s):  
Rani Nasser ◽  
Sanjay Yadla ◽  
Mitchell G. Maltenfort ◽  
James S. Harrop ◽  
D. Greg Anderson ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Prospective Studies ◽  
Spinal Surgery ◽  
Retrospective Studies ◽  
Perioperative Complications ◽  
Thoracolumbar Spine ◽  
Healthcare Providers ◽  
Exclusion Process ◽  
Complication Rates

Object The overall incidence of complications or adverse events in spinal surgery is unknown. Both prospective and retrospective analyses have been performed, but the results have not been critically assessed. Procedures for different regions of the spine (cervical and thoracolumbar) and the incidence of complications for each have been reported but not compared. Authors of previous reports have concentrated on complications in terms of their incidence relevant to healthcare providers: medical versus surgical etiology and the relevance of perioperative complications to perioperative events. Few authors have assessed complication incidence from the patient's perspective. In this report the authors summarize the spine surgery complications literature and address the effect of study design on reported complication incidence. Methods A systematic evidence-based review was completed to identify within the published literature complication rates in spinal surgery. The MEDLINE database was queried using the key words “spine surgery” and “complications.” This initial search revealed more than 700 articles, which were further limited through an exclusion process. Each abstract was reviewed and papers were obtained. The authors gathered 105 relevant articles detailing 80 thoracolumbar and 25 cervical studies. Among the 105 articles were 84 retrospective studies and 21 prospective studies. The authors evaluated the study designs and compared cervical, thoracolumbar, prospective, and retrospective studies as well as the durations of follow-up for each study. Results In the 105 articles reviewed, there were 79,471 patients with 13,067 reported complications for an overall complication incidence of 16.4% per patient. Complications were more common in thoracolumbar (17.8%) than cervical procedures (8.9%; p < 0.0001, OR 2.23). Prospective studies yielded a higher incidence of complications (19.9%) than retrospective studies (16.1%; p < 0.0001, OR 1.3). The complication incidence for prospective thoracolumbar studies (20.4%) was greater than that for retrospective series (17.5%; p < 0.0001). This difference between prospective and retrospective reviews was not found in the cervical studies. The year of study publication did not correlate with the complication incidence, although the duration of follow-up did correlate with the complication incidence (p = 0.001). Conclusions Retrospective reviews significantly underestimate the overall incidence of complications in spine surgery. This analysis is the first to critically assess differing complication incidences reported in prospective and retrospective cervical and thoracolumbar spine surgery studies.

scholarly journals Muscle Invasive Bladder Cancer: From Diagnosis to Survivorship

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
N. E. Mohamed ◽  
M. A. Diefenbach ◽  
H. H. Goltz ◽  
C. T. Lee ◽  
D. Latini ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
The Usa ◽  
Muscle Invasive ◽  
The Impact

Bladder cancer is the fifth most commonly diagnosed cancer and the most expensive adult cancer in average healthcare costs incurred per patient in the USA. However, little is known about factors influencing patients' treatment decisions, quality of life, and responses to treatment impairments. The main focus of this paper is to better understand the impact of muscle invasive bladder cancer on patient quality of life and its added implications for primary caregivers and healthcare providers. In this paper, we discuss treatment options, side effects, and challenges that patients and family caregivers face in different phases along the disease trajectory and further identify crucial areas of needed research.

scholarly journals Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland

2020 ◽  
Vol 196 (12) ◽  
pp. 1068-1079 ◽  
Author(s):  
Christiane Matuschek ◽  
Johannes C. Fischer ◽  
Stephanie E. Combs ◽  
Rainer Fietkau ◽  
Stefanie Corradini ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Radiation Oncology ◽  
Radiation Treatment ◽  
Screening Program ◽  
Disease Incidence ◽  
Treatment Options ◽  
Healthcare Providers ◽  
Office Work ◽  
Protective Measures ◽  
The Impact

Abstract Purpose COVID-19 infection has manifested as a major threat to both patients and healthcare providers around the world. Radiation oncology institutions (ROI) deliver a major component of cancer treatment, with protocols that might span over several weeks, with the result of increasing susceptibility to COVID-19 infection and presenting with a more severe clinical course when compared with the general population. The aim of this manuscript is to investigate the impact of ROI protocols and performance on daily practice in the high-risk cancer patients during this pandemic. Methods We addressed the incidence of positive COVID-19 cases in both patients and health care workers (HCW), in addition to the protective measures adopted in ROIs in Germany, Austria and Switzerland using a specific questionnaire. Results The results of the questionnaire showed that a noteworthy number of ROIs were able to complete treatment in SARS-CoV‑2 positive cancer patients, with only a short interruption. The ROIs reported a significant decrease in patient volume that was not impacted by the circumambient disease incidence, the type of ROI or the occurrence of positive cases. Of the ROIs 16.5% also reported infected HCWs. About half of the ROIs (50.5%) adopted a screening program for patients whereas only 23.3% also screened their HCWs. The range of protective measures included the creation of working groups, instituting home office work and protection with face masks. Regarding the therapeutic options offered, curative procedures were performed with either unchanged or moderately decreased schedules, whereas palliative or benign radiotherapy procedures were more often shortened. Most ROIs postponed or cancelled radiation treatment for benign indications (88.1%). The occurrence of SARS-CoV‑2 infections did not affect the treatment options for curative procedures. Non-university-based ROIs seemed to be more willing to change their treatment options for curative and palliative cases than university-based ROIs. Conclusion Most ROIs reported a deep impact of SARS-CoV‑2 infections on their work routine. Modification and prioritization of treatment regimens and the application of protective measures preserved a well-functioning radiation oncology service and patient care.

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