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Aspects associated with non-adoption of wholesome habits amid people who have diabetes mellitus: the population-based examine throughout Brazilian.
Background context Pre-existing comorbid psychiatric mood disorders are a known risk factor for impaired health-related quality of life and poor long-term outcomes after spine surgery. Cell Cycle inhibitor Purpose The purpose of this study was to investigate the effect of pre-existing mood disorders on (1) pre- and post-operative patient-reported outcomes, (2) complications, and (3) pre- and post-operative opioid consumption in patients undergoing elective cervical or lumbar spine surgery. Study design/setting Retrospective review at a single academic institution from 2014-2017. Patient sample Consecutive adult patients who underwent cervical or lumbar surgery. Outcome measures Quantitative measurements of pain (visual analog scale [VAS]) and spinal region-specific disability scores (Neck Disability Index [NDI] and Oswestry Disability Index [ODI]). Methods This is a retrospective review of 435 consecutive patients (179 cervical, 256 lumbar) who underwent elective spine surgery at a single academic institution from 2014-2017. Pati0.01) and illicit-drug abusers (p=0.03). There were no differences regarding surgical complications or opioid consumption. Tobacco use (p less then 0.001) was the sole contributor to postoperative VAS pain scores. Patients with mood disorders had significantly higher VAS values both prior to and 3 months following surgery (p=0.01), but there was no difference in ODI scores. Conclusion Patients with pre-operative psychiatric mood disorders undergoing elective cervical surgery had worse NDI scores and received more opioid prescriptions, despite similar VAS scores as those without mood disorders. Lumbar surgery patients with mood disorders were demographically different than those without mood disorders and had worse pain before and after surgery, though ODI scores were not different. Tobacco use was the sole contributor to post-operative VAS pain scores. This information can be useful in counseling patients with mood disorders prior to elective spinal surgery.Importance Defining clinically meaningful success criteria from patient-reported outcome measures (PROMs) is crucial for clinical audits, research and decision-making. Purpose We aimed to define criteria for a successful outcome 3 and 12 months after surgery for cervical degenerative radiculopathy (CDR) on recommended PROMs. Study design Prospective cohort study with 12 months follow-up. Patient sample Patients operated at one or two levels for cervical radiculopathy included in the Norwegian Registry for Spine Surgery (NORspine) from 2011 to 2016. Outcome measures Neck Disability Index (NDI), Numeric Rating Scale for neck pain (NRS-NP) and arm pain (NRS-AP), health-related quality-of-life EuroQol 3L (EQ-5D), general health status (EQ-VAS). Methods We included 2868 consecutive CDR patients operated for cervical radiculopathy in one or two levels and included in the Norwegian Registry for Spine Surgery (NORspine). External criterion to determine accuracy and optimal cut-off values for success in the PROMs was d for use in research and clinical practice.Background context Long thoracolumbar fixation and fusion have become a consolidated treatment for severe spinal disorders. Concomitant sacropelvic fixation with S2 alar-iliac (S2AI) screws is frequently performed to limit instrumentation failure and pseudarthrosis at the lumbosacral junction. Purpose This study explored the use of triangular titanium implants in different configurations in which the implants supplemented standard sacropelvic fixation with S2AI screws in order to further increase the stability of S2AI fixation. Study design Finite element study. Methods Four T10-pelvis instrumented models were built pedicle screws and rods in T10-S1 (PED); pedicle screws and rods in T10-S1, and bilateral S2 alar-iliac screws (S2AI); pedicle screws and rods in T10-S1, bilateral S2AI screws, and triangular implants inserted bilaterally in a sacral alar-iliac trajectory (Tri-SAI); pedicle screws and rods in T10-S1, bilateral S2AI screws and two bilateral triangular titanium implants inserted in a lateral trajecteded to determine if these in vitro effects translate into clinically important differences.Background context While several models for predicting independent ambulation early after traumatic spinal cord injury (SCI) based upon age and specific motor and sensory level findings have been published and validated, their accuracy, especially in individual American Spinal Injury Association [ASIA] Impairment Scale (AIS) classifications, has been questioned. Further, although age is widely used in prediction rules, its role and possible modifications have not been adequately evaluated until now. Purpose To evaluate the predictive accuracy of existing clinical prediction rules for independent ambulation among individuals at spinal cord injury model systems (SCIMS) Centers as well as the effect of modifying the age parameter from a cutoff of 65 years to 50 years. Study design Retrospective analysis of a longitudinal database. Patient sample Adult individuals with traumatic SCI. Outcome measures The FIM locomotor score was used to assess independent walking ability at the 1-year follow-up. Methods In all, 63n age, with statistically significant improvement of AUC when age-cut off was reduced to 50. Conclusions We confirmed previous results that former prediction models achieve strong prognostic accuracy by combining AIS subgroups, yet prognostication of the separate AIS groups is less accurate. Further, prognostication of persons with AIS B+C, for whom a clinical prediction model has arguably greater clinical utility, is less accurate than those with AIS A+D. Our findings emphasize that age is an important factor in prognosticating ambulation following SCI. Prediction accuracy declines for older individuals compared with younger ones. To improve prediction of independent ambulation, the age of 50 years may be a better cutoff instead of age of 65.Background context Rod fractures (RF) and pseudarthrosis are a frequent occurrence after adult spinal deformity (ASD) surgery and may be problematic. However, not all rod fractures signal nonunion and cause clinical concern. An improved understanding of the sequelae after rod fracture occurrence is valuable for further management. Purpose To characterize the radiographic findings, clinical outcomes, and revision rates between patients who developed unilateral rod fracture (URF) and bilateral rod fracture (BRF) following thoracolumbar posterior spinal fusions to the sacrum for ASD and identify patient characteristics associated with clinically significant rod fracture that lead to subsequent revision surgeries and detection of nonunion. Study design/setting A retrospective single-center cohort study was performed. Patient sample Patients undergoing long-construct posterior spinal fusions to the sacrum performed at a single institution from 2004 to 2014 and developed a rod fracture postoperatively were included.
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