Subjects -> MEDICAL SCIENCES (Total: 8690 journals)
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MEDICAL SCIENCES (2415 journals)            First | 3 4 5 6 7 8 9 10 | Last

Showing 1201 - 1400 of 3562 Journals sorted alphabetically
Journal of Evaluation In Clinical Practice     Hybrid Journal   (Followers: 6)
Journal of Evidence-Based Healthcare     Open Access   (Followers: 1)
Journal of Evidence-Based Integrative Medicine     Open Access   (Followers: 18)
Journal of Evidence-Based Medicine     Partially Free   (Followers: 4)
Journal of Exercise Science & Fitness     Open Access   (Followers: 29)
Journal of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
Journal of Family and Community Medicine     Open Access   (Followers: 3)
Journal of Family Medicine and Primary Care     Open Access   (Followers: 11)
Journal of Foot and Ankle Research     Open Access   (Followers: 6)
Journal of Forensic Science and Research     Open Access   (Followers: 2)
Journal of Gandaki Medical College-Nepal     Open Access  
Journal of Generic Medicines     Hybrid Journal   (Followers: 2)
Journal of Geographical Sciences     Hybrid Journal   (Followers: 1)
Journal of Global Antimicrobial Resistance     Hybrid Journal   (Followers: 3)
Journal of Hand Therapy     Hybrid Journal   (Followers: 19)
Journal of Head & Neck Physicians and Surgeons     Open Access   (Followers: 2)
Journal of Health & Medical Informatics     Open Access   (Followers: 62)
Journal of Health and Biological Sciences     Open Access   (Followers: 1)
Journal of Health Design     Open Access   (Followers: 1)
Journal of Health Economics and Outcomes Research     Open Access   (Followers: 1)
Journal of Health Promotion and Behavior     Open Access  
Journal of Health Research and Reviews     Open Access  
Journal of Health Science and Medical Research     Open Access  
Journal of Health Science Research     Open Access  
Journal of Health Sciences     Open Access   (Followers: 1)
Journal of health sciences     Open Access  
Journal of Health Sciences / Sağlık Bilimleri Dergisi     Open Access  
Journal of Health Sciences and Medicine     Open Access  
Journal of Health Sciences and Medicine     Open Access   (Followers: 6)
Journal of Health Sciences and Surveillance System     Open Access  
Journal of Health Sciences Scholarship     Open Access  
Journal of Health Specialties     Open Access  
Journal of Health Studies     Open Access  
Journal of Healthcare Informatics Research     Hybrid Journal   (Followers: 1)
Journal of Heavy Metal Toxicity and Diseases     Open Access  
Journal of Helminthology     Hybrid Journal   (Followers: 2)
Journal of Herbs Spices & Medicinal Plants     Hybrid Journal  
Journal of HIV for Clinical and Scientific Research     Open Access   (Followers: 2)
Journal of Hospital Medicine     Hybrid Journal   (Followers: 11)
Journal of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal  
Journal of Human Hypertension     Hybrid Journal   (Followers: 3)
Journal of Human Rhythm     Open Access  
Journal of Human Transcriptome     Open Access  
Journal of Ideas in Health     Open Access  
Journal of Inflammation     Open Access   (Followers: 2)
Journal of Inflammation Research     Open Access  
Journal of Injury and Violence Research     Open Access   (Followers: 6)
Journal of Innovation in Health Informatics     Open Access   (Followers: 17)
Journal of Institute of Medicine     Open Access  
Journal of Insulin Resistance     Open Access   (Followers: 1)
Journal of Interactional Research in Communication Disorders     Hybrid Journal   (Followers: 5)
Journal of Interferon & Cytokine Research     Hybrid Journal   (Followers: 3)
Journal of International Medical Research     Open Access   (Followers: 3)
Journal of Interventional Medicine     Open Access   (Followers: 1)
Journal of Investigative Medicine     Hybrid Journal   (Followers: 3)
Journal of Islamabad Medical & Dental College     Open Access   (Followers: 2)
Journal of Istanbul Faculty of Medicine     Open Access  
Journal of Karnali Academy of Health Sciences     Open Access   (Followers: 1)
Journal of Kathmandu Medical College     Open Access   (Followers: 1)
Journal of King Abdulaziz University : Medical Sciences     Open Access   (Followers: 2)
Journal of Laboratory Medicine     Hybrid Journal   (Followers: 27)
Journal of Laryngology and Voice     Open Access   (Followers: 11)
Journal of Lasers in Medical Sciences     Open Access  
Journal of Law, Medicine & Ethics     Hybrid Journal   (Followers: 28)
Journal of Legal Medicine     Hybrid Journal   (Followers: 7)
Journal of Limb Lengthening & Reconstruction     Open Access  
Journal of Lumbini Medical College     Open Access   (Followers: 1)
Journal of Mahatma Gandhi Institute of Medical Sciences     Open Access  
Journal of Manipulative and Physiological Therapeutics     Hybrid Journal   (Followers: 6)
Journal of Manmohan Memorial Institute of Health Sciences     Open Access   (Followers: 1)
Journal of Marine Medical Society     Open Access  
Journal of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
Journal of Maternal and Child Health     Open Access  
Journal of Mechanics in Medicine and Biology     Hybrid Journal  
Journal of Medical and Biological Engineering     Hybrid Journal   (Followers: 4)
Journal of Medical and Biomedical Sciences     Open Access   (Followers: 2)
Journal of Medical Case Reports     Open Access   (Followers: 1)
Journal of Medical Cases     Open Access   (Followers: 6)
Journal of Medical Colleges of PLA     Full-text available via subscription  
Journal of Medical Disorders     Open Access  
Journal of Medical Economics     Hybrid Journal   (Followers: 8)
Journal of Medical Education and Curricular Development     Open Access   (Followers: 6)
Journal of Medical Ethics     Partially Free   (Followers: 27)
Journal of Medical Ethics and History of Medicine     Open Access   (Followers: 19)
Journal of Medical Humanities     Hybrid Journal   (Followers: 21)
Journal of Medical Hypotheses and Ideas     Open Access  
Journal of Medical Imaging and Health Informatics     Full-text available via subscription   (Followers: 1)
Journal of Medical Investigation and Practice     Open Access  
Journal of Medical Laboratory and Diagnosis     Open Access  
Journal of Medical Law and Ethics     Full-text available via subscription   (Followers: 17)
Journal of Medical Microbiology     Full-text available via subscription   (Followers: 6)
Journal of Medical Sciences     Open Access  
Journal of Medical Sciences     Open Access  
Journal of Medical Screening     Hybrid Journal   (Followers: 6)
Journal of Medical Signals and Sensors     Open Access   (Followers: 3)
Journal of Medical Society     Open Access  
Journal of Medical Systems     Hybrid Journal  
Journal of Medical Toxicology     Hybrid Journal   (Followers: 6)
Journal of Medical Ultrasound     Open Access   (Followers: 2)
Journal of Medicinal Botany     Open Access  
Journal of Medicinal Chemistry     Hybrid Journal   (Followers: 207)
Journal of Medicine     Open Access   (Followers: 1)
Journal of Medicine and Biomedical Research     Open Access   (Followers: 1)
Journal of Medicine and Philosophy     Hybrid Journal   (Followers: 9)
Journal of Medicine and the Person     Hybrid Journal  
Journal of Medicine in Scientific Research     Open Access  
Journal of Medicine in the Tropics     Open Access  
Journal of Medicine Research and Development     Open Access   (Followers: 3)
Journal of Medicine, Physiology and Biophysics     Open Access   (Followers: 5)
Journal of Medicines Development Sciences     Open Access   (Followers: 1)
Journal of Metabolomics & Systems Biology     Open Access   (Followers: 2)
Journal of Mind and Medical Sciences     Open Access   (Followers: 1)
Journal of Molecular Medicine     Hybrid Journal   (Followers: 11)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Multidisciplinary Research in Healthcare     Open Access   (Followers: 2)
Journal of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1)
Journal of Nanotechnology in Engineering and Medicine     Full-text available via subscription   (Followers: 6)
Journal of Nanotheranostics     Open Access   (Followers: 1)
Journal of Natural Medicines     Hybrid Journal  
Journal of Natural Science, Biology and Medicine     Open Access   (Followers: 3)
Journal of Nature and Science of Medicine     Open Access   (Followers: 4)
Journal of Negative and No Positive Results     Open Access  
Journal of Nepalgunj Medical College     Open Access  
Journal of Neurocritical Care     Open Access  
Journal of Neurodegenerative Diseases     Open Access   (Followers: 2)
Journal of Neurorestoratology     Open Access  
Journal of Neuroscience and Neurological Disorders     Open Access  
Journal of Nobel Medical College     Open Access  
Journal of Obesity and Bariatrics     Open Access   (Followers: 2)
Journal of Occupational Health     Open Access  
Journal of Occupational Therapy Education     Open Access   (Followers: 12)
Journal of Ocular Biology, Diseases, and Informatics     Hybrid Journal  
Journal of Oral Biology and Craniofacial Research     Full-text available via subscription  
Journal of Oral Health and Craniofacial Science     Open Access  
Journal of Orofacial Sciences     Open Access  
Journal of Otorhinolaryngology, Hearing and Balance Medicine     Open Access   (Followers: 1)
Journal of Ovarian Research     Open Access  
Journal of Ozone Therapy     Open Access  
Journal of Palliative Medicine     Hybrid Journal   (Followers: 47)
Journal of Paramedical Sciences & Rehabilitation     Open Access  
Journal of Parkinsonism and Restless Legs Syndrome     Open Access   (Followers: 2)
Journal of Parkinson’s Disease and Alzheimer’s Disease     Open Access   (Followers: 1)
Journal of Participatory Medicine     Open Access  
Journal of Patan Academy of Health Sciences     Open Access  
Journal of Pathogens     Open Access   (Followers: 1)
Journal of Patient Experience     Open Access  
Journal of Patient Safety and Risk Management     Hybrid Journal   (Followers: 2)
Journal of Patient-Centered Research and Reviews     Open Access  
Journal of Patient-Reported Outcomes     Open Access  
Journal of Periodontal Research     Hybrid Journal  
Journal of Personalized Medicine     Open Access   (Followers: 3)
Journal of Pest Science     Hybrid Journal   (Followers: 1)
Journal of Pharmaceutical Policy and Practice     Open Access   (Followers: 4)
Journal of Physiobiochemical Metabolism     Hybrid Journal   (Followers: 2)
Journal of Physiology-Paris     Hybrid Journal   (Followers: 2)
Journal of Pioneering Medical Sciences     Open Access  
Journal of Postgraduate Medicine     Open Access  
Journal of Pregnancy     Open Access   (Followers: 4)
Journal of Prevention & Intervention Community     Hybrid Journal   (Followers: 7)
Journal of Preventive Medicine and Public Health     Open Access  
Journal of Primary Prevention     Hybrid Journal   (Followers: 7)
Journal of Prosthodontic Research     Full-text available via subscription   (Followers: 1)
Journal of Prosthodontics     Hybrid Journal   (Followers: 2)
Journal of Receptor, Ligand and Channel Research     Open Access   (Followers: 1)
Journal of Regenerative Medicine     Partially Free   (Followers: 4)
Journal of Research in Medical Sciences     Open Access   (Followers: 2)
Journal of Science and Applications : Biomedicine     Open Access   (Followers: 1)
Journal of Science and Technology (Ghana)     Open Access   (Followers: 3)
Journal of Scientific Innovation in Medicine     Open Access  
Journal of Scientific Perspectives     Open Access   (Followers: 1)
Journal of Sensory Studies     Hybrid Journal   (Followers: 4)
Journal of Shaheed Suhrawardy Medical College     Open Access  
Journal of Shoulder and Elbow Arthroplasty     Open Access  
Journal of Sleep Disorders : Treatment & Care     Hybrid Journal   (Followers: 10)
Journal of South American Earth Sciences     Hybrid Journal   (Followers: 5)
Journal of Spinal Cord Medicine     Hybrid Journal   (Followers: 5)
Journal of Spinal Disorders & Techniques     Hybrid Journal   (Followers: 2)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of Stem Cell Therapy and Transplantation     Open Access   (Followers: 1)
Journal of Stomal Therapy Australia     Full-text available via subscription   (Followers: 1)
Journal of Strength and Conditioning Research     Hybrid Journal   (Followers: 77)
Journal of Substance Use     Hybrid Journal   (Followers: 15)
Journal of Surgical Academia     Open Access   (Followers: 1)
Journal of Surgical and Clinical Research     Open Access  
Journal of Surgical Case Reports     Open Access  
Journal of Surgical Education     Full-text available via subscription   (Followers: 3)
Journal of Surgical Technique and Case Report     Open Access  
Journal of Systemic Therapies     Full-text available via subscription   (Followers: 3)
Journal of Taibah University Medical Sciences     Open Access  
Journal of Telemedicine and Telecare     Hybrid Journal   (Followers: 12)
Journal of The Academy of Clinical Microbiologists     Open Access  
Journal of the American Association for Laboratory Animal Science     Full-text available via subscription   (Followers: 9)
Journal of the American College of Certified Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American College of Clinical Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American Medical Directors Association     Hybrid Journal   (Followers: 5)
Journal of the American Medical Informatics Association : JAMIA     Hybrid Journal   (Followers: 36)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 7)
Journal of the Anatomical Society of India     Full-text available via subscription  
Journal of the Anus, Rectum and Colon     Open Access  
Journal of The Arab Society for Medical Research     Open Access  

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Similar Journals
Journal Cover
Journal of Spinal Disorders & Techniques
Journal Prestige (SJR): 1.115
Citation Impact (citeScore): 2
Number of Followers: 2  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1536-0652 - ISSN (Online) 1539-2465
Published by LWW Wolters Kluwer Homepage  [301 journals]
  • Pulsed Electromagnetic Field Stimulation Is a Practical Adjunctive Therapy
           for Fusion in Spine Surgery
    • Authors: Wade; Sean M.; Clark, DesRaj M.; Fredericks, Donald R. Jr; Wagner, Scott C.
      Abstract: No abstract available
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Update on Spinal Cord Injury Management
    • Authors: Russo; Glenn S.; Mangan, John J.; Galetta, Matthew S.; Boody, Barrett; Bronson, Wesley; Segar, Anand; Kepler, Christopher K.; Kurd, Mark F.; Hilibrand, Alan S.; Vaccaro, Alexander R.; Schroeder, Gregory D.
      Abstract: imageThe management of acute spinal cord injury requires a multidisciplinary approach to maximize patient outcomes and potential. Treatment of this injury involves both surgical and medical intervention. Medical intervention in acute spinal cord injury is aimed at decreasing the neurotoxic environment that occurs as part of the secondary injury. New neuroregenerative therapies are being developed.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Interlaminar Endoscopic Lumbar Discectomy Using a New 8.4-mm Endoscope and
           Nerve Root Retractor
    • Authors: Shim; Hyeong-Ki; Choi, Kyung-Chul; Cha, Kyung Han; Lee, Dong Chan; Park, Choon-Keun
      Abstract: imageStudy Design: Surgical technique.Objective: Using an 8.4-mm endoscope and endoscopic nerve root retractor, the interlaminar endoscopic lumbar discectomy (IELD) technique is introduced for lumbosacral levels.Summary of Background Data: Although spine surgeons are familiar with IELD, this technique is only used for L5–S1 disk herniations and requires a wide interlaminar space.Methods: Using an 8.4 mm-endoscope, high-speed drill, and endoscopic Kerrison punches, a nerve-root retractor facilitated the simultaneous medial retraction of the nerve root and removal of the disk fragment by the instrument’s cannula. Clinical parameters such the visual analog scale scores for back and leg pain, modified Macnab criteria, and Oswestry Disability Index were analyzed.Results: A total of 101 patients were enrolled. The visual analog scale scores for back and leg pain significantly decreased from 6.8±2.1 and 7.8±1.5 to 2.0±0.6 and 1.78±1.1, respectively, at the 1-year follow up (P
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • A Comparison of Complications and Clinical and Radiologic Outcome Between
           the Mini-open Prepsoas and Mini-open Transpsoas Approaches for Lumbar
           Interbody Fusion: A Meta-Analysis
    • Authors: Spiessberger; Alexander; Arvind, Varun; Dietz, Nicholas; Grueter, Basil; Huber, Florian; Guggenberger, Roman; Moriggl, Bernhard; Varma, Vikas; Cho, Samuel K.
      Abstract: imageStudy Design: Systematic review and meta-analysis.Objective: To compare complication rates and clinical and radiologic outcome between the mini-open prepsoas and mini-open transpsoas approaches for lateral lumbar interbody fusion.Summary of Background Data: Both approaches are believed to be safe with similar complication rates. Previous studies suggest that the rate of neurological injury might be higher in the transpsoas group, whereas visceral or vascular injury might be more frequent in the prepsoas group.Methods: A systematic review of the literature was performed. Data were extracted from original publications up until December 26, 2018. Evidence was extracted from well-designed case-control or cohort studies and sorted in 2 groups, the prepsoas and transpsoas approaches. A meta-analysis was performed using a random-effects model (I2 statistic>50% for all analyses).Results: A total of 115 studies included data of 13,260 patients, 2450 in the prepsoas group and 10,810 in the transpsoas group. Demographics for prepsoas versus transpsoas group were (N-weighted means): age 61.9 versus 60.9 years; %female sex 53% versus 63%, levels fused 1.4 versus 2.6, blood loss 52.4 versus 122.3 mL, and operating time 125.1 versus 200.7 min. The following statistically significant differences in complication rates between prepsoas and transpsoas approaches were found: transient psoas weakness or thigh/groin numbness 4% versus 26% [95% confidence interval (CI): 11%–17%], motor neural injury 0.4% versus 1.3% (95% CI: 16%–62.3%); no statistically significant differences were found for: major vascular injury 2% versus 1% (95% CI: 1.04%–2.31%), kidney or ureter injury 0.04% versus 0.08% (95% CI: 0.057%–5.2%), injury pleural/peritoneal structures 0.6% versus 0.2% (95% CI: 0.89%–6.58%), cage subsidence 5% versus 4% (95% CI: 0.9%–1.97%), surgical site infection 1% versus 1% (95% CI: 0.57%–1.66%), abdominal wall pseudohernia 1% versus 1% (95% CI: 0.07%–21.22%), sympathetic chain injury 5% versus 0% (95% CI: 0.34%–97.86%), and directly procedure-related death 0.04% versus 0% (95% CI: 0.127%–76.8%). Pooled mean perioperative changes between prepsoas and transpsoas approaches were: segmental sagittal Cobb angle 3.07 versus 1.99 degrees; foraminal height 2 versus 6.96 mm.Conclusions: The prepsoas had fewer complications than the transpsoas approach. Furthermore, the prepsoas approach showed superior restoration of segmental lordosis, whereas foraminal height restoration was superior with the transpsoas approach. This could be explained by the differences in location of the interbody device placement in relation to the center of rotation of the spine between the 2 surgical techniques.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Worker’s Compensation Terminology
    • Authors: Galetta; Matthew; Radcliff, Kristen E.; Hilibrand, Alan S.; Vaccaro, Alexander R.; Yeon, Howard B.
      Abstract: imageInjuries to the spine comprise a high percentage of workplace injuries. Spine surgeons’ evaluation of injured workers requires attention to facts specific to worker’s compensation claims including whether the injury occurred in the scope of employment, whether a work incident was causally related to the injury, and whether the injury contributed to a significant degree to the patient’s overall medical condition. An injured worker’s compensation is subject to state-specific guidelines and is largely dependent on the degree of disability and whether the disability is temporary or permanent. Here, we review the background, organization, and key terms used in the worker’s compensation system.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Are the Outcomes of Minimally Invasive Transforaminal/Posterior Lumbar
           Fusion Influenced by the Patient’s Age or BMI'
    • Authors: Manson; Neil; Hubbe, Ulrich; Pereira, Paulo; Lam, Khai; Fuster, Salvador; Senker, Wolfgang
      Abstract: imageStudy Design: A retrospective subgroup analysis of a prospective observational study was carried out.Summary of Background Data: Patients’ baseline characteristics may influence the clinical outcomes after minimally invasive lumbar interbody fusion (MILIF).Objective: This study aimed to investigate the influence of patient’s age and body mass index (BMI) on the clinical outcomes of MILIF for degenerative lumbar disorder.Materials and Methods: A total of 252 patients underwent MILIF. The clinical outcomes, including time to first ambulation, time to postsurgical recovery, back/leg pain in visual analog scale, Oswestry Disability Index, and EuroQol-5 Dimension, were collected at baseline, 4 weeks, 6, and 12 months. Patients were subgrouped by age (50 y and below: N=102; 51–64 y: N=102; 65 y and above: N=48) and BMI (≤25.0: N=79; 25.1–29.9: N=104; ≥30.0: N=69). Data from baseline to 12 months were compared for all clinical outcomes within age/BMI subgroups. Adverse events (AEs) and serious adverse events (SAEs) were summarized by age and BMI subgroups.Results: All age and BMI subgroups showed significant improvements in clinical outcomes at 12 months compared with the baseline. The median time to first ambulation was similar for all subgroups (age groups: P=0.8707; BMI: P=0.1013); older people show a trend of having longer time to postsurgical recovery (age groups: P=0.0662; BMI: P=0.1591). Oswestry Disability Index, back, and leg pain visual analog scale, and EuroQol-5 Dimension were similar in all subgroups at every timepoint. A total of 50 AEs (N=39) were reported, 9 of which were SAEs; 3 AEs and 1 SAE were considered to be related to surgical procedure. No differences were observed in safety by age groups and BMI groups.Conclusion: MILIF appears to be safe and effective, independent of age or weight in the treatment of degenerative lumbar disorder.Level of Evidence: Level II.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • A Novel Reconstruction Using a Combined Anterior and Posterior Approach
           After Axis Tumor Spondylectomy
    • Authors: Yang; Jian; Yang, Xing-Hai; He, Shao-Hui; Jiao, Jian; Jia, Qi; Hu, Jin-Bo; Xiao, Jian-Ru
      Abstract: imageStudy Design: This was a retrospective study.Objective: To describe a novel reconstruction strategy using a T-shaped titanium mesh cage with posterior cervical screw-rod fixation after total spondylectomy of axis tumors.Summary of Background Data: Instability of the upper cervical spine because of tumors in axis (C2) often results in devastating complications. Surgical resection and reconstruction after spondylectomy of C2 remain a technical challenge because of the intricate anatomies, vital adjacent tissues, and the unique spinal biomechanics in this special region.Materials and Methods: The novel reconstruction mode included the construction of the anterior aspect conducted with a specially made titanium mesh cage and the posterior cervical fixation only. Patients who received total C2 tumors spondylectomy and reconstruction with this novel mode in our center between January 2009 and December 2017 were retrospectively analyzed to evaluate the efficacy of this novel reconstruction method.Results: A total of 24 patients with C2 tumor received total spondylectomy and the new mode of local reconstruction. The neurological deficits recovered well and local pain relieved significantly (P
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Diabetes Does Not Increase Complications, Length of Stay, or Hospital
           Costs After Minimally Invasive Transforaminal Lumbar Interbody Fusion
    • Authors: Narain; Ankur S.; Haws, Brittany E.; Jenkins, Nathaniel W.; Parrish, James M.; Block, Andrew M.; Lamoutte, Eric H.; Karmarkar, Sailee S.; Singh, Kern
      Abstract: imageStudy Design: Retrospective cohort.Objective: To determine if the presence of diabetes mellitus as comorbidity is associated with complications, inpatient length of stay, or direct hospital costs after minimally invasive transforaminal lumbar interbody fusion (MIS TLIF).Summary of Background Data: Very few studies have investigated the effect of diabetes on complications, length of stay, or costs in minimally invasive lumbar surgeries.Methods: Patients undergoing primary, single-level MIS TLIF were retrospectively reviewed. Diabetic and nondiabetic patients were propensity matched in a 1:1 manner for age, sex, and comorbidity burden. An association between diabetic status and preoperative demographic or perioperative variables, including inpatient length of stay, was tested for using Student t test or χ2 analysis. Multivariate linear regression was used to test for an association between diabetic status and direct hospital costs.Results: After 1:1 propensity matching, 100 patients were included in this analysis. There were no significant differences in age, sex, body mass index, smoking status, or Charlson Comorbidity Index between propensity-matched patients with and without diabetes. In regards to the length of stay, no significant differences existed between diabetic and nondiabetic groups (68.7 vs. 58.3 h, P=0.218). No other significant differences existed in other perioperative variables including operative time, intraoperative blood loss, or complication rate (P≥0.05 for each). Multivariate analysis indicated that diabetic status was not associated with differences in total direct hospital costs (US$20,428 vs. US$20,429, P=0.792) or cost subcategories after MIS TLIF (P≥0.05 for each).Conclusions: In this investigation, diabetes was not associated with postoperative complication rates, inpatient length of stay, or direct hospital costs after primary, single-level MIS TLIF. The reduced extent of operative exposure and tissue trauma in MIS TLIF may mitigate the risk of complications in diabetic patients, possibly preventing extensions in hospital stay length and associated hospital costs.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • PROMIS PF in the Evaluation of Postoperative Outcomes in Workers’
           Compensation Patients Following Anterior Cervical Discectomy and Fusion
    • Authors: Yoo; Joon S.; Parrish, James M.; Jenkins, Nathaniel W.; Brundage, Thomas S.; Hrynewycz, Nadia M.; Patel, Dillon S.; Singh, Kern
      Abstract: imageStudy Design: This was a retrospective cohort study.Objective: To determine the improvement of clinical outcomes in Workers’ Compensation (WC) patients compared with non-WC patients utilizing Patient-reported Outcome Measurement Information System Physical Function (PROMIS PF) following anterior cervical discectomy and fusion (ACDF).Summary of Background Data: To our knowledge, there has not been a study to evaluate clinical outcomes of WC patients utilizing the PROMIS PF survey.Methods and Materials: Patients undergoing a primary, 1 to 3-level ACDF were retrospectively reviewed and stratified according to insurance (WC and non-WC). Demographic and perioperative characteristics were compared using χ2 test and independent t tests. Change in PROMIS PF scores was calculated using paired t tests. Differences in postoperative PROMIS PF scores and changes in PROMIS PF from baseline were compared using linear regression.Results: In total, 124 1 to 3-level ACDF patients were included: 36 had WC insurance and 88 had non-WC insurance. WC patients were younger and more likely to be obese. WC patients reported significantly lower PROMIS PF scores preoperatively and at 6 weeks, 12 weeks, and 6 months timepoints. However, both cohorts reported comparable PROMIS PF scores at the 1-year timepoint. WC patients demonstrated similar improvements from baseline through 1-year postoperatively compared with non-WC patients. For both non-WC and WC cohort, the change in the postoperative PROMIS PF score from baseline was significant at 3 months, 6 months, and 1 year. However, in both cohorts, the change in the postoperative PROMIS PF score from baseline was not significantly different at 6 weeks.Conclusions: In our study, WC patients had worse baseline physical function as indicated by lower preoperative PROMIS PF scores and reported lower PROMIS PF scores postoperatively. However, there were no significant differences when comparing the postoperative change from baseline between the cohorts. Both cohorts experienced significant postoperative improvements from baseline. This study established that PROMIS PF is an effective tool to evaluate recovery of WC patients following ACDF.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Retrospective Review of Revision Surgery After Image-guided Instrumented
           Spinal Surgery Compared With Traditional Instrumented Spinal Surgery
    • Authors: Towner; James E.; Li, Yan Icy; Singla, Amit; Moquin, Ross; Li, Yan Michael
      Abstract: imageStudy Design: Retrospective cohort series.Objective: The objective of this study was to determine if the use of image-guided navigation offers a clinically significant advantage over fluoroscopy-assisted pedicle screw and non-navigated screw placement in reducing the risk of revision surgery for malpositioned screws in instrumented spinal surgery.Summary of Background Data: Use image-guided navigation has become increasingly commonplace in instrumented spine surgery, but there is a lack of information regarding differences in the rates of clinically relevant screw malposition with image-guided compared with non-navigated screw placement.Materials and Methods: This is a retrospective cohort series of consecutive patients who underwent instrumented spinal surgery by the senior authors at 2 academic tertiary care centers in New York.Results: A total of 663 instrumented spinal surgeries were analyzed, including 271 instances with image-guided navigation. For the image-guided navigation cohort, 110 of the patients underwent screw placement using O-Arm image-guidance, yielding data on 1115 screws. The remaining 161 surgeries utilizing image-guided screw placement were performed using Brainlab Spine Navigation, for a total of 1001 screws. A fluoroscopy-assisted technique or freehand technique was used in 419 instances, with a total of 3689 screws. Of the non-navigated cohort, 10 patients required a surgical revision of screw placement, for a total of 15 malpositioned screws. Amongst the image-guided navigation cohort, 1 patient in the O-Arm group and 2 in the Brainlab group required revision surgery, with 3 malpositioned screws in total. The rate of revision surgery for a malpositioned screw placed via non-navigated techniques was 2.39%. This risk was decreased to 1.11% with the use of the intraoperative image-guided navigation. However, no comparisons between non-navigated and image-guided screw placement reached statistical significance.Conclusion: Although not reaching statistical significance, these data suggest there may be an advantage offered by image-guided screw placement in instrumented spinal surgery.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • A Long-Term Follow-up, Multicenter, Comparative Study of the Radiologic,
           and Clinical Results Between a CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramics
           (BGS-7) Intervertebral Spacer and Titanium Cage in 1-Level Posterior
           Lumbar Interbody Fusion
    • Authors: Lee; Jae Hyup; Kim, Sun Ki; Kang, Sung Shik; Han, Seung Jung; Lee, Choon-Ki; Chang, Bong-Soon
      Abstract: imageStudy Design: This is a prospective, stratified randomized, multicenter, 4-year follow-up study.Objective: The authors aimed to evaluate the long-term clinical efficacy and safety of CaO-SiO2-P2O5-B2O3 glass ceramics (BGS-7) spacers in 1-level posterior lumbar interbody fusion (PLIF) at a 4-year follow-up.Summary of Background Data: According to 1-year follow-up results, BGS-7 spacer showed similar fusion rates and clinical outcomes compared with titanium cage. A long-term follow-up study beyond 2 years is necessary to investigate the status of intervertebral bone graft volumes. Moreover, longer follow-up is mandatory to also evaluate the safety and efficacy of BGS-7 spacers, because they remain in the intervertebral space for a long time.Materials and Methods: In this prospective, randomized, multicenter, 4-year follow-up study, we evaluated 62 of the 74 patients who underwent 1-level PLIF. During 1-level PLIF, titanium cages filled with autologous local bone were inserted into the control group patients and BGS-7 spacers were inserted to the experimental group patients. Bone fusion was evaluated by plain radiography and thin-section computed tomography. Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), Short Form-36 Health Survey (SF-36), and evaluation of safety were conducted after 48 months.Results: Computed tomography scan showed a bone fusion rate of 90.6% in the BGS-7 spacer group and 93.3% in the control group, with no significant differences between groups. The BGS-7 spacer group showed a significantly larger area directly fused to the endplate than the control group (P
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Physician Decision-making in Return to Play After Cervical Spine Injury: A
           Descriptive Analysis of Survey Data
    • Authors: Ukogu; Chierika; Bienstock, Dennis; Ferrer, Christopher; Zubizarreta, Nicole; McAnany, Steven; Chaudhary, Saad B.; Iatridis, James C.; Hecht, Andrew C.
      Abstract: imageSummary of Background Data: Cervical spine injuries commonly occur during athletic play, and such injuries carry significant risk for adverse sequelae if not properly managed. Although guidelines for managing return to play exist, adherence among spine surgeons has not been thoroughly examined.Study Design: Prospective analysis of survey data collected from surgeon members of the Cervical Spine Research Society (CSRS) and the International Society for the Advancement of Spine Surgery (ISASS).Objective: The objective of this study was to characterize consensus among spine surgeons regarding decision-making on return to competitive sports and level of impact following significant cervical spine injuries from real-life scenarios.Materials and Methods: Return to play decisions for 15 clinical cervical spine injury scenarios were compared with current guidelines. Surgeon demographic information such as orthopedic board certification status and years in practice were also analyzed. Weighted kappa analysis was utilized to determine interrater reliability in survey responses.Results: Survey respondents had a poor agreement with both Watkins and Torg guidelines (average weighted κ of 0.027 and 0.066, respectively). Additional kappa analysis of surgeon agreement regarding the “Types of Play” and “Level of Play” for return was still remained poor (Kendall W of 0.312 and 0.200, respectively). Responses were also significantly influenced by surgeon demographics.Conclusions: There is poor consensus among spine surgeons for return to play following cervical spine injury. These results support the concept that given the gravity of cervical spine injuries, a more standardized approach to decision-making regarding return to play after cervical spine injury is necessary.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Predictors and Clinical Importance of Postoperative Coronal Malalignment
           After Surgery to Correct Adult Spinal Deformity
    • Authors: Tanaka; Nobuki; Ebata, Shigeto; Oda, Kotaro; Oba, Hiroki; Haro, Hirotaka; Ohba, Tetsuro
      Abstract: imageStudy Design: A retrospective observational study of a cohort of consecutive patients.Objective: The objective of this study was to determine the correlations between clinical outcomes of spinal surgery to correct adult spinal deformity (ASD) including mechanical complications and coronal malalignment and clarify the risk factors for postoperative coronal malalignment.Summary of Background Data: Despite the coronal malalignment seen regularly in adult patients who have undergone spinal surgery to correct spinal deformity, the associations between coronal malalignment, and clinical outcomes including mechanical complications after the surgery have remained unclear until now. To understand the associations between coronal malalignment and outcomes of surgery to correct ASD, and risk factors for postoperative coronal malalignment has substantial clinical importance.Materials and Methods: We included data from 121 consecutive patients who had undergone spinal surgery to correct ASD and were followed up for a minimum of 2 years. Iliac screws were used for pelvic fixation in all cases. The coronal balance was defined as the horizontal distance between the midpoint of C7 and the center of the sacrum on the coronal plane, and coronal malalignment was defined as when the absolute coronal balance was>20 mm. Preoperative radiographic parameters, surgical features, and clinical outcomes including mechanical complications were compared between groups of patients with coronal balance and those with malalignment. Univariate and multivariate regression analysis were used to clarify risk factors for postoperative coronal malalignment.Results: Postoperative coronal malalignment had no significant association with the clinical outcome as evaluated by a Roland-Morris Disability Questionnaire and Oswestry Disability Index but had a significant association with the frequency of rod fracture. A large preoperative coronal imbalance (malalignment), L5 coronal tilt angle, and use of lateral lumbar interbody fusion were found as risk factors for postoperative coronal malalignment.Conclusion: Postoperative coronal malalignment had no significant association with the clinical outcome as evaluated by the Oswestry Disability Index and Roland-Morris Disability Questionnaire but was significantly associated with the frequency of rod fracture.Level of Evidence: Level III.
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Is it Suitable to Fix the Occipito-C2 Angle and the Posterior
           Occipitocervical Angle in a Normal Range During Occipitocervical
           Fusion'
    • Authors: Tang; Chao; Li, Guang Zhou; Kang, Min; Liao, Ye Hui; Tang, Qiang; Zhong, De Jun
      Abstract: imageStudy Design: This is a retrospective study.Objectives: The objective of this study was (1) to measure the occipito-C2 angle (OC2A) and the posterior occipitocervical angle (POCA) in a normal population, and (2) to observe the effects of OC2A and POCA selection on postoperative clinical efficacy and lower cervical curvature after occipitocervical fusion (OCF) in patients with basilar invagination (BI) and atlantoaxial fracture and dislocation (AAFD).Summary of Background Data: OC2A has received special attention with respect to the clinical efficacy during OCF. However, none of studies have focused on the relationship between OC2A and POCA and have assessed their impact on clinical outcomes in patients with different occipiocervical diseases.Materials and Methods: One hundred fifty healthy subjects without any cervical disease (healthy group) were randomly selected based on sex and age. Three spine surgeons measured the OC2A and POCA in the healthy group and averaged the values. Forty-two patients with BI (BI group) and 32 patients with AAFD (AAFD group) who underwent OCF between January 2012 and January 2017 were reviewed. OC2A, POCA, and cervical spinal angle (CSA) were measured preoperatively, postoperatively immediately after surgery and ambulation, and at the final follow-up visit. The preoperative and final follow-up visual analog scale (VAS), Japanese Orthopaedic Association score (JOA), neck disability index (NDI), and the change of CSA from postoperatively immediately after surgery and ambulation to the final follow-up (dCSA) were recorded.Results: The values of OC2A and POCA were 14.5±3.7 and 108.2±8.1 degrees in the healthy group, respectively, and the respective 95% confidence intervals were 7.2–21.8 and 92.3–124.0 degrees as the normal range. There was a negative correlation between OC2A and POCA (r=−0.386, P
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
  • Analysis of the Change Patterns of Sagittal Alignment Values After
           Selective Thoracic Fusion in Lenke 1 Adolescent Idiopathic Scoliosis
           According to Preoperative Thoracic Kyphosis Status
    • Authors: Park; Se-Jun; Lee, Chong-Suh; Lee, Kyung-Joon; Lee, Ji-Woon; Park, Jin-Sung
      Abstract: imageStudy Design: This was a retrospective study.Objective: The objective of this study was to demonstrate the different change patterns in reciprocal sagittal alignment values after selective thoracic fusion (STF) in Lenke type 1 adolescent idiopathic scoliosis (AIS) according to preoperative thoracic kyphosis (TK).Summary of Background Data: Several studies have found significant increase in TK after STF, while other studies have reported decrease in TK postoperatively. Similar inconclusive results on changes in lumbar lordosis (LL) have been reported, showing LL increase, decrease, or no change.Materials and Methods: Ninety-three patients presenting with Lenke type 1 AIS treated by posterior STF with a minimum follow-up of 2 years were included in this study. Using whole spine radiographs, sagittal parameters including TK, LL, and upper lumbar lordosis (ULL) were compared preoperatively and at the last follow-up between a hypokyphosis group (preoperative TK
      PubDate: Sat, 01 Aug 2020 00:00:00 GMT-
       
 
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