Fallesenmorin8635

001. The median duration that patients used opioids postoperatively was 211 days in 2010 (interquartile range [IQR], 29-356 days), and decreased significantly to 44 days (IQR, 10-294 days) in 2015. The strongest factors associated with chronic opioid use were preoperative opioid use (odds ratio [OR], 4.0), drug abuse (OR, 2.6), depression (OR, 1.6), surgery in the west (OR, 1.6) or south (OR, 1.6), anxiety (OR, 1.5), or 30-day readmission (OR, 1.4).

Chronic opioid use following primary lumbar discectomy has declined from 2010-2015. A variety of factors are associated with chronic opioid use. Preoperative recognition of some of these risk factors may aid in perioperative management and counseling.

Chronic opioid use following primary lumbar discectomy has declined from 2010-2015. A variety of factors are associated with chronic opioid use. Preoperative recognition of some of these risk factors may aid in perioperative management and counseling.

To compare the perioperative morbidity of 2-level anterior cervical discectomy and fusion (ACDF) with that of 1-level anterior cervical corpectomy and fusion (ACCF) for the treatment of cervical degenerative conditions.

A retrospective study of the 2005-2016 National Surgical Quality Improvement Program database for patients undergoing 2-level ACDF and 1-level ACCF was performed. Patient data included age, sex, body mass index (BMI), functional status, and American Society of Anesthesiologists (ASA) physical status (PS) classification. Hospital data included operative time and length of hospital stay (LOS). Thirty-day outcome data included any, serious, and minor adverse events, return to the operating room, readmission, and mortality. After propensity matching for age, sex, ASA PS classification, functional status, and BMI, multivariate logistic regression analysis was used to compare outcomes between the 2 propensity-matched subcohorts. Finally, multivariate logistic regression that additionally controlt best accomplishes the surgical objectives.

While visual analogue score (VAS) metrics are among the most universally adopted patient-reported outcome measures (PROMs), there is limited research on the influence of back and leg pain on the Patient-Reported Outcomes Measurement Information System (PROMIS) physical function (PF) scores. Here we assess the association of VAS back and VAS leg scores with PROMIS PF in the setting of minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). Secondarily, we determine if PROMIS PF is more influenced by back or leg pain.

A prospective surgical registry was reviewed from May 2015 to November 2018. Inclusion criteria were primary, single-level MIS TLIFs. We excluded multilevel procedures and patients without preoperative PROMs. Pre- and postoperative PROMIS PF, VAS back, and VAS leg scores were recorded at 6 weeks, 12 weeks, 6 months, and 1 year. A Pearson correlation evaluated PROMIS PF association with VAS back and VAS leg scores. A Fisher z-test compared correlations. Linear regression evaluated PROMIS with VAS back and VAS leg scores.

Our cohort was comprised of 146 subjects. 40.4% were female and the average age of 51 years. VAS back demonstrated a stronger correlation than VAS leg with PROMIS PF at all timepoints. PROMIS PF scores were negatively associated with both VAS back and VAS leg at all timepoints. Fisher z-test revealed VAS back to have a stronger correlation with PROMIS PF (p = 0.025) than VAS leg.

In the setting of MIS TLIF, physical function as evaluated by PROMIS PF, had a stronger correlation with VAS back than VAS leg at 6 months. This suggests that postoperative PROMIS PF scores may be more influenced by back pain than with leg pain.

In the setting of MIS TLIF, physical function as evaluated by PROMIS PF, had a stronger correlation with VAS back than VAS leg at 6 months. This suggests that postoperative PROMIS PF scores may be more influenced by back pain than with leg pain.

Developmental bony craniovertebral junction (CVJ) anomalies seem to have a genetic basis and also abnormal joint morphology causing atlantoaxial dislocation (AAD) and basilar invagination (BI).

DNA extracted polymerase chain reaction single-stranded conformation polymorphism (SSCP) performed for mutation screening of FBN1 gene (n = 50 cases+ 50 age/sex-matched normal; total 100). Samples with a deviated pattern of bands in SSCP were sequenced to detect the type of variation. buy Vorinostat Computed tomography (CT) scans of 100 patients (15-45 years old) compared with an equal number of age/sex-matched controls (21.9 ± 8.2 years). Joint parameters studied sagittal joint inclination (SI), craniocervical tilt (CCT), coronal joint inclination (CI).

Thirty-nine samples (78%) showed sequence variants. Exon 25, 26, 27, and 28 showed variable patterns of DNA bands in SSCP, which on sequencing gives various types of DNA sequence variations in intronic region of the FBN1 gene in 14%, 14%, 6%, and 44% respectively. CT radiologySI and CCT correlated with both BI and AAD (p < 0.01). The mean SI value in controls 83.35° ± 8.65°, and in patients with BI and AAD129° ± 24.05°. Mean CCT in controls 60.2° ± 9.2°, and in patients with BI and AAD 86.0° ± 18.1°. Mean CI in controls110.3° ± 4.23°, and in cases 125.15° ± 16.4°.

The study showed mutations in FBN1 gene (reported in Marfan syndrome). There is also an alteration of joint morphology, correlating with AAD and BI severity. Hence, we propose a double-hit hypothesis the presence of weak ligaments (due to FB1 gene alterations) and abnormal joint morphology may contribute to AAD and BI.

The study showed mutations in FBN1 gene (reported in Marfan syndrome). There is also an alteration of joint morphology, correlating with AAD and BI severity. Hence, we propose a double-hit hypothesis the presence of weak ligaments (due to FB1 gene alterations) and abnormal joint morphology may contribute to AAD and BI.Cervical deformity is a challenging condition to treat and requires complex decision-making. Apart from a thorough history and physical examination, a thoughtful and quantitative analysis of multiple imaging modalities is critical for understanding the nature and driver of the cervical deformity. A few classification schemes have emerged, and it is now clear that dynamic films are invaluable as they capture the extension reserve that patients can use to compensate for malalignment. These classification systems can help guide surgical planning, because the various subgroups have different properties that lend themselves to specific treatment paradigms. Here we review the clinical and radiographic evaluation, classification, and surgical planning for cervical deformity.