1
|
Alahmari A, Thornley P, Glennie A, Urquhart JC, Al-Jahdali F, Rampersaud R, Fisher C, Siddiqi F, Rasoulinejad P, Bailey CS. Preoperative Disc Angle is an Important Predictor of Segmental Lordosis After Degenerative Spondylolisthesis Fusion. Global Spine J 2024; 14:610-619. [PMID: 35949020 PMCID: PMC10802516 DOI: 10.1177/21925682221118845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective Cohort Study. OBJECTIVES To determine the effect of interbody cages inserted via posterior approach on segmental lordosis in the setting of preoperative lordotic vs kyphotic discs in patients with lumbar degenerative spondylolisthesis (LDS). METHODS Retrospective analysis of prospectively collected data on assessment and management of LDS patients from 2 contributing centres. Patients were analyzed preoperatively and at 12-month follow-up with standing lumbar radiographs. Index level segmental lumbar lordosis (SLL), disc angle and global lumbar lordosis was measured. Patients were stratified into 4 groups based on index level disc angle and procedure: preoperative lordotic posterolateral fusion (group L-PLF); preoperative kyphotic PLF (group K-PLF); preoperative lordotic interbody fusion (IF) (group L-IF); preoperative kyphotic IF (group K-IF). RESULTS A total of 100/111 (90%) patients completed follow-up with 40 in group L-IF and 48 in group K-IF. There were 18 patients in group L-PLF and 5 in group K-PLF. Among patients with preoperatively lordotic disc angles who had a worsening of SLL, group L-IF had worse SLL than group L-PLF patients, with differences persisting at one-year (mean difference 2.30, 95% CI, .3, 4.3, P = .029). Patients in group K-IF achieved improvement in SLL at one-year more frequently than group L-IF (67% vs 44%, P = .046), with similar mean improvement magnitude between groups L-IF and K-IF (-1.1, 95% CI, -3.7, 1.6, P = .415). CONCLUSION Segmental lordosis worsening was greater with preoperative index lordotic disc angles when an interbody cage was used. Patients who have a kyphotic disc preoperatively gain more lordosis with interbody cage use.
Collapse
Affiliation(s)
- Abdulmajeed Alahmari
- Division of Orthopaedics, Department of Surgery, Western University, London, ON, Canada
| | - Patrick Thornley
- Division of Orthopaedics, Department of Surgery, Western University, London, ON, Canada
| | - Andrew Glennie
- Department of Orthopedics and Neurosurgery, Dalhousie University, Halifax, NS, Canada
| | | | - Fares Al-Jahdali
- Department of Orthopedics and Neurosurgery, Dalhousie University, Halifax, NS, Canada
| | - Raja Rampersaud
- University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada; Arthritis Program, Krembil Research Institute, Toronto, Ontario, Canada
| | - Charles Fisher
- University of British Columbia, Vancouver, British Columbia, Canada; Vancouver General Hospital, Vancouver, BC, Canada
| | - Fawaz Siddiqi
- Division of Orthopaedics, Department of Surgery, Western University, London, ON, Canada
| | - Parham Rasoulinejad
- Division of Orthopaedics, Department of Surgery, Western University, London, ON, Canada
| | - Christopher S. Bailey
- Division of Orthopaedics, Department of Surgery, Western University, London, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| |
Collapse
|
2
|
Thornley P, Garner S, Rogers KJ, Yorgova P, Gabos PG, Shah SA. Socioeconomic, Racial, and Insurance Disparities in Clinical Outcomes After Surgery Among Patients With Idiopathic Scoliosis. J Pediatr Orthop 2024; 44:e163-e167. [PMID: 37867376 DOI: 10.1097/bpo.0000000000002551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
BACKGROUND Socioeconomic status (SES), race, and insurance type correlate with initial curve severity for patients with idiopathic scoliosis, but less is known regarding how these variables impact surgical outcomes. The objectives of this study were to determine the influence of SES, race, and insurance on preoperative appointment attendance, likelihood of obtaining a preoperative second opinion, brace prescription, missed 6 or 12-month postsurgical appointments, incidence of emergency department visits 0 to 90 days after surgery, and major complications within a year of surgery. METHODS A review of 421 patients diagnosed with idiopathic scoliosis who underwent surgery at a single high-volume pediatric spinal deformity institution between May 2015 and October 2021 was conducted. Area Deprivation Index, a quantitative measure of SES, was collected. Scores were stratified by quartile; higher scores indicated a lower SES. χ 2 tests for correlation were performed to determine whether clinical outcomes were dependent upon Area Deprivation Index, race, or insurance type; P ≤0.05 was significant. RESULTS The sample was 313 Caucasian (74%), 69 (16%) black, and 39 (9.3%) other patients. More patients had private versus public insurance (80% vs 20%) and were of higher SES. The likelihood of missing preoperative appointments was higher for black patients ( P = 0.037). Those with lower SES missed more postoperative appointments and received less bracing and second opinions ( P = 0.038, P = 0.017, P = 0.008, respectively). Being black and publicly insured correlated with fewer brace prescriptions ( P < 0.001, P = 0.050) and decreased rates of obtaining second opinions ( P = 0.004, P = 0.001). CONCLUSION Patients with idiopathic scoliosis surgery who were Caucasian, privately insured, and of higher SES were more likely to seek preoperative second opinions, be prescribed a brace, and attend postoperative appointments. Recognition of the inherent health care disparities prevalent within each pediatric spine surgery referral region is imperative to better inform local and national institutional level programs to educate and assist patients and families most at risk for disparate access to scoliosis care. LEVEL OF EVIDENCE Level III; retrospective case-control study.
Collapse
Affiliation(s)
- Patrick Thornley
- Department of Orthopaedics, Nemours Children's Health, Wilmington, DE
| | | | | | | | | | | |
Collapse
|
3
|
Thornley P, Urquhart JC, Glennie A, Rampersaud R, Fisher C, Abraham E, Charest-Morin R, Dea N, Kwon BK, Manson N, Hall H, Paquette S, Street J, Siddiqi F, Rasoulinejad P, Bailey CS. Functional outcomes correlate with sagittal spinal balance in degenerative lumbar spondylolisthesis surgery. Spine J 2023; 23:1512-1521. [PMID: 37307882 DOI: 10.1016/j.spinee.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/05/2023] [Accepted: 06/03/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND CONTEXT Degenerative lumbar spondylolisthesis (DLS) is a debilitating condition associated with poor preoperative functional status. Surgical intervention has been shown to improve functional outcomes in this population though the optimal surgical procedure remains controversial. The importance of maintaining and/or improving sagittal and pelvic spinal balance parameters has received increasing interest in the recent DLS literature. However, little is known about the radiographic parameters most associated with improved functional outcomes among patients undergoing surgery for DLS. PURPOSE To identify the effect of postoperative sagittal spinal alignment on functional outcome after DLS surgery. STUDY DESIGN Retrospective cohort study. PATIENT SAMPLE Two-hundred forty-three patients in the Canadian Spine Outcomes and Research Network (CSORN) prospective DLS study database. OUTCOME MEASURES Baseline and 1-year postoperative leg and back pain on the 10-point Numeric Rating Scale and baseline and 1-year postoperative disability on the Oswestry Disability Index (ODI). METHODS All enrolled study patients had a DLS diagnosis and underwent decompression in isolation or with posterolateral or interbody fusion. Global and regional radiographic alignment parameters were measured at baseline and 1-year postoperatively including sagittal vertical axis (SVA), pelvic incidence and lumbar lordosis (LL). Both univariate and multiple linear regression was used to assess for the association between radiographic parameters and patient-reported functional outcomes with adjustment for possible confounding baseline patient factors. RESULTS Two-hundred forty-three patients were available for analysis. Among participants, the mean age was 66 with 63% (153/243) female with the primary surgical indication of neurogenic claudication in 197/243 (81%) of patients. Worse pelvic incidence-LL mismatch was correlated with more severe disability [ODI, 0.134, p<.05), worse leg pain (0.143, p<.05) and worse back pain (0.189, p<.001) 1-year postoperatively. These associations were maintained after adjusting for age, BMI, gender, and preoperative presence of depression (ODI, R2 0.179, β, 0.25, 95% CI 0.08, 0.42, p=.004; back pain R2 0.152 (β, 0.05, 95% CI 0.022, 0.07, p<.001; leg pain score R2 0.059, β, 0.04, 95% CI 0.008, 0.07, p=.014). Likewise, reduction of LL was associated with worse disability (ODI, R2 0.168, β, 0.04, 95% CI -0.39, -0.02, p=.027) and worse back pain (R2 0.135, β, -0.04, 95% CI -0.06, -0.01, p=.007). Worsened SVA correlated with worse patient reported functional outcomes (ODI, R2 0.236, β, 0.12, 95% CI 0.05, 0.20, p=.001). Similarly, an increase (worsening) in SVA resulted in a worse NRS back pain (R2 0.136, β, 0.01, 95% CI .001, 0.02, p=.029) and worse NRS leg pain (R2 0.065, β, 0.02, 95% CI 0.002, 0.02, p=.018) scores regardless of surgery type. CONCLUSIONS Preoperative emphasis on regional and global spinal alignment parameters should be considered in order to optimize functional outcome in lumbar degenerative spondylolisthesis treatment.
Collapse
Affiliation(s)
- Patrick Thornley
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, 1-319, 800 Commissioners Rd, East, London, Ontario N6A 5W9, Canada
| | - Jennifer C Urquhart
- Lawson Health Research Institute, 750 Baseline Road Eat Suite 300, London, Ontario N6C 2R5, Canada
| | - Andrew Glennie
- Department of Orthopedics and Neurosurgery, Dalhousie University, 1796 Summer Street - Room 4558, Halifax, Nova Scotia B3H 3A7, Canada
| | - Raja Rampersaud
- University of Toronto, University Health Network, Arthritis Program, Krembil Research Institute, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada
| | - Charles Fisher
- University of British Columbia, Vancouver General Hospital, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
| | - Edward Abraham
- Canada East Spine Centre, 555 Somerset Street - Suite 200, Saint John, New Brunswick E2K 4X2, Canada
| | - Raphaele Charest-Morin
- University of British Columbia, Vancouver General Hospital, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
| | - Nicolas Dea
- University of British Columbia, Vancouver General Hospital, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
| | - Brian K Kwon
- University of British Columbia, Vancouver General Hospital, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
| | - Neil Manson
- Canada East Spine Centre, 555 Somerset Street - Suite 200, Saint John, New Brunswick E2K 4X2, Canada
| | - Hamilton Hall
- Division of Orthopedic Surgery, University of Toronto, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
| | - Scott Paquette
- University of British Columbia, Vancouver General Hospital, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
| | - John Street
- University of British Columbia, Vancouver General Hospital, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada
| | - Fawaz Siddiqi
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, 1-319, 800 Commissioners Rd, East, London, Ontario N6A 5W9, Canada
| | - Parham Rasoulinejad
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, 1-319, 800 Commissioners Rd, East, London, Ontario N6A 5W9, Canada
| | - Christopher S Bailey
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, 1-319, 800 Commissioners Rd, East, London, Ontario N6A 5W9, Canada.
| |
Collapse
|
4
|
Thornley P, Meade MH, Oitment C, Fernandes RR, Urquhart JC, Singh S, Siddiqi F, Rasoulinejad P, Bailey CS. Sagittal alignment in operative degenerative lumbar spondylolisthesis: a scoping review. J Spine Surg 2023; 9:314-322. [PMID: 37841791 PMCID: PMC10570642 DOI: 10.21037/jss-23-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 07/16/2023] [Indexed: 10/17/2023]
Abstract
Background The benefit of surgical intervention over conservative treatment for degenerative lumbar spondylolisthesis (DLS) patients with neurologic symptoms is well-established. However, it is currently unclear what breadth of available evidence exists on regional and global sagittal alignment in DLS surgery. As such, the purpose of the current study is to conduct a scoping review to map and synthesize the DLS literature regarding the current radiographic assessment of sagittal spinal alignment in DLS surgery. Methods A comprehensive search of the MEDLINE, EMBASE and Cochrane databases from January 1971 to January 2023 was performed for all DLS studies examining sagittal spinal alignment parameters with DLS surgery according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) protocol. Results From 2,222 studies, a total of 109 studies were included, representing 10,730 patients with an average age of 63.0 years old and average follow-up of 35.1 months postoperatively. Among included studies, 93 (85%), were largely published in the last decade and predominantly represented retrospective cohorts 70 (64%) or case series 22 (20%). A common theme among the reporting of radiographic parameters in the included investigations was the assessment of the magnitude and/or maintenance of a radiographic change postoperatively, with 92 (84%) studies reporting these findings. The majority of studies focused on index DLS level [33 (30%) studies] or lumbar spine radiographic imaging [33 (30%) studies] only. Thirty-seven (34%) studies reported spinopelvic parameters, with only 13 (12%) of included studies assessing 36-inch standing lateral radiographs and overall alignment. Conclusions There is increasing prevalence of investigations assessing sagittal spinal alignment parameters in DLS surgery. Although, there is an increasing prevalence of studies investigating sagittal spinal alignment parameters in DLS surgery the quality of the currently available literature on this topic is of overall low evidence and largely retrospective in nature. Additionally, there is limited analysis of global sagittal spinal alignment in DLS suggesting that future investigational emphasis should prioritize longitudinally followed large prospective cohorts or multi-centre randomized controlled trials. Attempts at standardizing the radiographic and functional outcome reporting techniques across multi-centre investigations and prospective cohorts will allow for more robust, reproducible analyses of significance to be conducted on DLS patients.
Collapse
Affiliation(s)
- Patrick Thornley
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | - Matthew H. Meade
- Department of Orthopedic Surgery, Jefferson Health-New Jersey, Stratford, NJ, USA
| | - Colby Oitment
- McMaster University, Hamilton General Hospital, Department of Orthopedic Surgery, Hamilton, Ontario, Canada
| | - Renan Rodrigues Fernandes
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | | | - Supriya Singh
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | - Fawaz Siddiqi
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | - Parham Rasoulinejad
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | - Christopher S. Bailey
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| |
Collapse
|
5
|
Sarraj M, Saidahmed A, Thornley P, Koziarz F, Khamis RA, Jentzsch T, Bhanot K, Oitment C. Secondary Osteoporosis with Normal Bone Mineral Density: A Case of Compression Fracture and Spinal Cord Injury in Cushing's Disease. Spine Surg Relat Res 2023; 7:406-409. [PMID: 37636149 PMCID: PMC10447193 DOI: 10.22603/ssrr.2022-0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/04/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Mohamed Sarraj
- McMaster University, Division of Orthopedic Surgery, Department of Surgery, Hamilton General Hospital, Ontario, Canada
| | - Ahmed Saidahmed
- McMaster University, Division of Orthopedic Surgery, Department of Surgery, Hamilton General Hospital, Ontario, Canada
| | - Patrick Thornley
- Division of Orthopedic Surgery, Western University, Ontario, Canada
| | - Frank Koziarz
- McMaster University, Department of Health Research Methods, Evidence and Impact, Ontario, Canada
| | - Rami Abou Khamis
- McMaster University, Department of Internal Medicine, Hamilton General Hospital, Ontario, Canada
| | - Thorsten Jentzsch
- Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Kunal Bhanot
- Division of Orthopaedic Surgery, St. Michael's Hospital, Ontario, Canada
| | - Colby Oitment
- McMaster University, Division of Orthopedic Surgery, Department of Surgery, Hamilton General Hospital, Ontario, Canada
| |
Collapse
|
6
|
Birk M, Sidhu K, Filezio MR, Singh V, Ferri-de-Barros F, Chan V, Shumilak G, Nataraj A, Langston H, Yee NJ, Iorio C, Shkumat N, Rocos B, Ertl-Wagner B, Lebel D, Camp MW, Dimentberg E, Saran N, Laflamme M, Ouellet JA, Wenghofer J, Livock H, Beaton L, Tice A, Smit K, Graham R, Duarte MP, Roy-Beaudry M, Turgeon I, Joncas J, Mac-Thiong JM, Labelle H, Barchi S, Parent S, Gholamian T, Livock H, Tice A, Smit K, Yoon S, Zulfiqar A, Rocos B, Murphy A, Bath N, Moll S, Sorbara J, Lebel D, Camp MW, Nallet JA, Rocos B, Lebel DE, Zeller R, Dermott JA, Kim DJ, Anthony A, Zeller R, Lebel DE, Wang Z, Shen J, Kamel Y, Liu J, Shedid D, Al-Shakfa F, Yuh SJ, Boubez G, Rizkallah M, Rizkallah M, Shen J, Boubez G, Kamel Y, Liu J, Shedid D, Al-Shakfa F, Lavoie F, Yug SJ, Wang Z, Alavi F, Nielsen C, Rampersaud R, Lewis S, Cheung AM, Cadieux C, Fernandes R, Brzozowski P, Zdero R, Bailey C, Rasoulinejad P, Cherry A, Manoharan R, Xu M, Srikandarajah N, Iorio C, Raj A, Nielsen C, Rampersaud R, Lewis S, Beange K, Graham R, Livock H, Smit K, Manoharan R, Cherry A, Srikandarajah N, Raj A, Xu M, Iorio C, Nielsen CJ, Rampersaud YR, Lewis SJ, Nasrabadi AAM, Moammer G, Phee JM, Walker T, Urquhart JC, Glennie RA, Rampersaud YR, Fisher CG, Bailey CS, Herrington BJ, Fernandes RR, Urquhart JC, Rasoulinejad P, Siddiqi F, Bailey CS, Urquhart J, Fernandes RR, Glennie RA, Rampersaud YR, Fisher CG, Bailey CS, Yang MMH, Riva-Cambrin J, Cunningham J, Casha S, Cadieux CN, Urquhart J, Fernandes R, Glennie A, Fisher C, Rampersaud R, Xu M, Manoharan R, Cherry A, Raj A, Srikandarajah N, Iorio C, Nielsen C, Lewis S, Rampersaud R, Cherry A, Raj A, McIntosh G, Manoharan R, Murray JC, Nielsen C, Xu M, Srikandarajah N, Iorio C, Perruccio A, Canizares M, Rampersaud R, El-Mughayyar D, Bigney E, Richardson E, Manson N, Abraham E, Attabib N, Small C, Kolyvas G, LeRoux A, Outcomes CS, Investigators RN, Hebert J, Baisamy V, Rizkallah M, Shen J, Cresson T, Vazquez C, Wang Z, Boubez G, Lung T, Canizares M, Perruccio A, Rampersaud R, Crawford EJ, Ravinsky RA, Perruccio AV, Rampersaud YR, Coyte PC, Bond M, Street J, Fisher C, Charest-Morin R, Sutherland JM, Bartolozzi AR, Barzilai O, Chou D, Laufer I, Verlaan JJ, Sahgal A, Rhines LD, Scuibba DM, Lazary A, Weber MH, Schuster JM, Boriani S, Bettegowda C, Arnold PM, Clarke MJ, Fehlings MG, Reynolds JJ, Gokaslan ZL, Fisher CG, Dea N, Versteeg AL, Charest-Morin R, Laufer I, Teixeira W, Barzilai O, Gasbarrini A, Fehlings MG, Chou D, Johnson MG, Gokaslan ZL, Dea N, Verlaan JJ, Goldschlager T, Shin JH, O'Toole JE, Sciubba DM, Bettegowda C, Clarke MJ, Weber MH, Mesfin A, Kawahara N, Goodwin R, Disch A, Lazary A, Boriani S, Sahgal A, Rhines L, Fisher CG, Versteeg AL, Gal R, Reich L, Tsang A, Aludino A, Sahgal A, Verlaan JJ, Fisher CG, Verkooijen L, Rizkallah M, Wang Z, Yuh SJ, Shedid D, Shen J, Al-Shakfa F, Belguendouz C, AlKafi R, Boubez G, MacLean MA, Georgiopoulos M, Charest-Morin R, Germscheid N, Goodwin CR, Weber M, International AS, Rizkallah M, Boubez G, Zhang H, Al-Shakfa F, Brindamour P, Boule D, Shen J, Shedid D, Yuh SJ, Wang Z, Correale MR, Soever LJ, Rampersaud R, Malic CC, Dubreuil M, Duke K, Kingwell SP, Lin Z, MacLean MA, Julien LC, Patriquin G, LeBlanc J, Green R, Alant J, Barry S, Glennie RA, Oxney W, Christie SD, Sarraj M, Alqahtani A, Thornley P, Koziarz F, Bailey CS, Freire-Archer M, Bhanot K, Kachur E, Bhandari M, Oitment C, Malhotra AK, Balas M, Jaja BNR, Harrington EM, Hofereiter J, Jaffe RH, He Y, Byrne JP, Wilson JR, Witiw CD, Brittain KCM, Christie S, Pillai S, Dvorak MF, Evaniew N, Chen M, Waheed Z, Rotem-Kohavi N, Fallah N, Noonan VK, Fisher CG, Charest-Morin R, Dea N, Ailon T, Street J, Kwon BK, Sandarage RV, Galuta A, Ghinda D, Kwan JCS, TsaI EC, Hachem LD, Hong J, Velumian A, Mothe AJ, Tator CH, Fehlings MG, Shakil H, Jaja BNR, Zhang P, Jaffe R, Malhotra AK, Wilson JR, Witiw CD, Rotem-Kohavi N, Dvorak MF, Dea N, Evaniew N, Chen M, Waheed Z, Xu J, Fallah N, Noonan V, Kwon B, Dandurand C, Muijs S, Dvorak M, Schnake K, Cumhur, Ouml Ner, Greene R, Furlong B, Smith-Forrester J, Swab M, Christie SD, Hall A, Leck E, Marshall E, Christie S, Dvorak MF, Cumhur F, Ouml Ner, Vaccaro AR, Benneker LM, Rajasekaran S, El-Sharkawi M, Popescu EC, Tee JW, Paquet J, France JC, Allen R, Lavelle WF, Hirschfeld M, Pneumaticos S, Dandurand C, Cumhur, Ouml Ner, Muijs S, Schnake K, Dvorak M, Fernandes RR, Thornley P, Urquhart J, Kelly S, Alenezi N, Alahmari A, Siddiqi F, Singh S, Rasoulinejad P, Bailey C, Evaniew N, Burger LD, Dea N, Cadotte DW, McIntosh G, Jacobs B, St-Laurent-Lebeux L, Bourassa-Moreau É, Sarraj M, Majeed M, Guha D, Pahuta M, Laflamme M, McIntosh G, Dea N, Bak AB, Alvi MA, Moghaddamjou A, Fehlings MG, Silva YGMD, Goulet J, McIntosh G, Bedard S, Pimenta N, Blanchard J, Couture J, LaRue B, Investigators C, Adams T, Cunningham E, El-Mughayyar D, Bigney E, Vandewint A, Manson N, Abraham E, Small C, Attabib N, Richardson E, Hebert J, Bond M, Street J, Fisher C, Charest-Morin R, Sutherland JM, Hillier T, Bailey CS, Fisher C, Rampersaud R, Koto P, Glennie RA, Soroceanu A, Nicholls F, Thomas K, Evaniew N, Lewkonia P, Bouchard J, Jacobs B, Ben-Israel D, Crawford EJ, Fisher C, Dea N, Spackman E, Rampersaud R, Thomas KC, Srikandarajah N, Murray JC, Nielsen C, Manoharan R, Cherry A, Raj A, Xu M, Iorio C, Bailey C, Dea N, Fisher C, Hall H, Manson N, Thomas K, Canizares M, Rampersaud YR, Urquhart J, Fernandes RR, Glennie RA, Rampersaud YR, Fisher CG, Bailey C, Yang MMH, Far R, Sajobi T, Riva-Cambrin J, Casha S, Bond M, Street J, Fisher C, Charest-Morin R, Sutherland JM, Silva Y, Pimenta NG, LaRue B, Bedard S, Oviedo SC, Goulet J, Couture J, Blanchard J, McDonald J, Al-Jahdali F, Urquhart J, Alahmari A, Rampersaud R, Fisher C, Bailey C, Glennie A, Evaniew N, Coyle M, Rampersaud YR, Bailey CS, Jacobs WB, Cadotte DW, Thomas KC, Attabib N, Paquet J, Nataraj A, Christie SD, Weber MH, Phan P, Charest-Morin R, Fisher CG, Hall H, McIntosh G, Dea N, Malhotra AK, Davis AM, He Y, Harrington EM, Jaja BNR, Zhu MP, Shakil H, Dea N, Jacobs WB, Cadotte DW, Paquet J, Weber MH, Phan P, Christie SD, Nataraj A, Bailey CS, Johnson MG, Fisher CG, Manson N, Rampersaud YR, Thomas KC, Hall H, Fehlings MG, Ahn H, Ginsberg HJ, Witiw CD, Wilson JR, Althagafi A, McIntosh G, Charest-Morin R, Rizzuto MA, Ailon T, Dea N, Evaniew N, Jacobs BW, Paquet J, Rampersaud R, Hall H, Bailey CS, Weber M, Johnson MG, Nataraj A, Attabib N, Cadotte DW, Manson N, Stratton A, Christie SD, Thomas KC, Wilson JR, Fisher CG, Charest-Morin R, Bak AB, Alvi MA, Moghaddamjou A, Fehlings MG, Bak AB, Alvi MA, Moghaddamjou A, Fehlings MG, Soroceanu A, Nicholls F, Thomas K, Evaniew N, Salo P, Bouchard J, Jacobs B, Dandurand C, Laghaei PF, Ailon T, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon BK, Paquette S, Street J, Soroceanu A, Nicholls F, Thomas K, Evaniew N, Bouchard J, Salo P, Jacobs B, Varshney VP, Sahjpaul R, Paquette S, Osborn J, Bak AB, Moghaddamjou A, Fehlings MG, Leck E, Marshall E, Christie S, Elkaim LM, Lasry OJ, Raj A, Murray JC, Cherry A, McIntosh G, Nielsen C, Srikandarajah N, Manoharan R, Iorio C, Xu M, Perruccio A, Canizares M, Rampersaud YR, Stratton A, Tierney S, Wai EK, Phan P, Kingwell S, Magnan MC, Soroceanu A, Nicholls F, Thomas K, Evaniew N, Salo P, Bouchard J, Jacobs B, Spanninga B, Hoelen TCA, Johnson S, Arts JJC, Bailey CS, Urquhart JC, Glennie RA, Rampersaud YR, Fisher CG, Levett JJ, Elkaim LM, Alotaibi NM, Weber MH, Dea N, Abd-El-Barr MM, Cherry A, Yee A, Jaber N, Fehlings M, Cunningham E, Adams T, El-Mughayyar D, Bigney E, Vandewint A, Manson N, Abraham E, Small C, Attabib N, Richardson E, Hebert J, Werier J, Smit K, Villeneuve J, Sachs A, Abdelbary H, Al-Mosuli YK, Rakhra K, Phan P, Nagata K, Gum JL, Brown ME, Daniels CL, Carreon LY, Bonello JP, Koucheki R, Abbas A, Lex J, Nucci N, Whyne C, Larouche J, Ahn H, Finkelstein J, Lewis S, Toor J, Lee NJ, Orosz LD, Gum JL, Poulter GT, Jazini E, Haines CM, Good CR, Lehman RA, Crawford EJ, Ravinsky RA, Perruccio AV, Coyte PC, Rampersaud YR, Freire-Archer M, Sarraj M, AlShaalan F, Koziarz A, Thornley P, Alnemari H, Oitment C, Bharadwaj L, El-Mughayyar D, Bigney E, Manson N, Abraham E, Small C, Attabib N, Richardson E, Kearney J, Kundap U, Investigators C, Hebert J, Elkaim LM, Levett JJ, Niazi F, Bokhari R, Alotaibi NM, Lasry OJ, Bissonnette V, Yen D, Muddaluru VS, Gandhi P, Mastrolonardo A, Guha D, Pahuta MA, Christie SD, Vandertuin T, Ritcey G, Rainham D, Alhawsawi M, Mumtaz R, Abdelnour M, Qumquji F, Soroceanu A, Swamy G, Thomas K, Wai E, Phan P, Bhatt FR, Orosz LD, Yamout T, Good CR, Schuler TC, Nguyen T, Jazini E, Haines CM, Oppermann M, Gupta S, Ramjist J, Oppermann PS, Yang VXD, Levett JJ, Elkaim LM, Niazi F, Weber MH, Ioro-Morin C, Bonizzato M, Weil AG, Oppermann M, Ramjist J, Gupta S, Oppermann PS, Yang VXD, Jung Y, Muddalaru V, Gandhi P, Guha D, Koucheki R, Bonello JP, Abbas A, Lex JR, Nucci N, Whyne C, Yee A, Ahn H, Finkelstein J, Larouche J, Lewis S, Toor J, Dhawan A, Dhawan J, Sharma AN, Azzam DB, Cherry A, Fehlings MG, Orosz LD, Lee NJ, Yamout T, Gum JL, Lehman RA, Poulter GT, Haines CM, Jazini E, Good CR, Ridha BB, Persad A, Fourney D, Byers E, Gallagher M, Sugar J, Brown JL, Wang Z, Shen J, Boubez G, Al-Shakfa F, Yuh SJ, Shedid D, Rizkallah M, Singh M, Singh PK, Lawrence PL, Dell S, Goodluck-Tyndall R, Wade K, Morgan M, Bruce C, Silva YGMD, Pimenta N, LaRue B, Aldakhil S, Blanchard J, Couture J, Goulet J, Bednar DA, Raj R, Urquhart J, Bailey C, Christie SD, Greene R, Chaves JPG, Zarrabian M, Sigurdson L, Manoharan R, Cherry A, Iorio C, Srikandarajah N, Xu M, Raj A, Nielsen CJ, Rampersaud YR, Lewis SJ. Canadian Spine Society: 23rd Annual Scientific Conference, Wednesday, March 1 - Saturday, March 4, Fairmont Le Château Frontenac, Québec, Que., Canada. Can J Surg 2023; 66:S1-S53. [PMID: 37567613 DOI: 10.1503/cjs.006523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2023] Open
Affiliation(s)
| | | | | | | | | | - Vivien Chan
- Division of Neurosurgery, University of Alberta, Edmonton, Alta
- UCLA Health, Los Angeles, Calif
| | - Geoffrey Shumilak
- Division of Neurosurgery, University of Alberta, Edmonton, Alta
- Division of Neurosurgery, University of Saskatchewan, Saskatoon, Sask
| | - Andrew Nataraj
- Division of Neurosurgery, University of Alberta, Edmonton, Alta
| | | | - Nicholas J Yee
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Hospital for Sick Children, Toronto, Ont
| | | | | | | | | | - David Lebel
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Hospital for Sick Children, Toronto, Ont
| | - Mark W Camp
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Hospital for Sick Children, Toronto, Ont
| | | | - Neil Saran
- Division of Orthopaedic Surgery, McGill University, Montréal, Que
| | | | - Jean A Ouellet
- Division of Orthopaedic Surgery, McGill University, Montréal, Que
| | | | - Holly Livock
- Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Luke Beaton
- Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Andrew Tice
- Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Kevin Smit
- Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Ryan Graham
- Health Science Department, University of Ottawa, Ottawa, Ont
| | - Matias Pereira Duarte
- Centre hospitalier universitaire Sainte-Justine, Montréal, Que
- Division of Orthopaedic Surgery, Université de Montréal, Montréal, Que
| | | | | | - Julie Joncas
- Centre hospitalier universitaire Sainte-Justine, Montréal, Que
| | - Jean-Marc Mac-Thiong
- Centre hospitalier universitaire Sainte-Justine, Montréal, Que
- Division of Orthopaedic Surgery, Université de Montréal, Montréal, Que
| | - Hubert Labelle
- Centre hospitalier universitaire Sainte-Justine, Montréal, Que
- Division of Orthopaedic Surgery, Université de Montréal, Montréal, Que
| | - Soraya Barchi
- Centre hospitalier universitaire Sainte-Justine, Montréal, Que
| | - Stefan Parent
- Centre hospitalier universitaire Sainte-Justine, Montréal, Que
- Division of Orthopaedic Surgery, Université de Montréal, Montréal, Que
| | - Tara Gholamian
- Faculty of Medicine, University of Ottawa, Ottawa, Ont
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont
| | - Holly Livock
- Department of Orthopaedic Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Andrew Tice
- Department of Orthopaedic Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Kevin Smit
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ont
- Department of Orthopaedic Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Samuel Yoon
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Hospital for Sick Children, Toronto, Ont
| | | | | | | | | | | | | | - David Lebel
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Hospital for Sick Children, Toronto, Ont
| | - Mark W Camp
- Hospital for Sick Children, Toronto, Ont
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chloe Cadieux
- London Health Sciences Centre, London, Ont
- Department of Orthopaedic Surgery, Western University, London, Ont
| | - Renan Fernandes
- London Health Sciences Centre, London, Ont
- Department of Orthopaedic Surgery, Western University, London, Ont
| | | | - Radovan Zdero
- Department of Orthopaedic Surgery, Western University, London, Ont
| | - Chris Bailey
- London Health Sciences Centre, London, Ont
- Department of Orthopaedic Surgery, Western University, London, Ont
| | - Parham Rasoulinejad
- London Health Sciences Centre, London, Ont
- Department of Orthopaedic Surgery, Western University, London, Ont
| | | | | | | | | | | | | | | | | | | | - Kristen Beange
- Department of Systems and Computer Engineering, Carleton University, Ottawa, Ont
- Ottawa-Carleton Institute for Biomedical Engineering, Ottawa, Ont
| | - Ryan Graham
- Ottawa-Carleton Institute for Biomedical Engineering, Ottawa, Ont
- School of Human Kinetics, University of Ottawa, Ottawa, Ont
| | - Holly Livock
- Division of Orthopedic Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - Kevin Smit
- Division of Orthopedic Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ont
| | | | | | | | | | | | | | | | | | | | | | - Gemah Moammer
- Grand River Hospital, Waterloo, Ont
- Department of Orthopaedic Surgery, McMaster University, Hamilton, Ont
| | - John Mc Phee
- Department of Systems Design Engineering, University of Waterloo, Waterloo, Ont
| | - Taryn Walker
- London Health Sciences Centre Combined Neurosurgical and Orthpaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - Jennifer C Urquhart
- London Health Sciences Centre Combined Neurosurgical and Orthpaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - R Andrew Glennie
- Departments of Orthopedics and Neurosurgery, Dalhousie University, Halifax, N.S
| | | | - Charles G Fisher
- Department of Surgery, University of British Columbia, Vancouver, B.C
| | - Chris S Bailey
- London Health Sciences Centre Combined Neurosurgical and Orthpaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - Brandon J Herrington
- London Health Sciences Centre combined Neurosurgical and Orthopaedic spine program, London, Ont
- Schulich School of Medicine and Dentistry, Department of Surgery, Western University, London, Ont
| | - Renan R Fernandes
- London Health Sciences Centre combined Neurosurgical and Orthopaedic spine program, London, Ont
- Schulich School of Medicine and Dentistry, Department of Surgery, Western University, London, Ont
| | - Jennifer C Urquhart
- London Health Sciences Centre combined Neurosurgical and Orthopaedic spine program, London, Ont
- Lawson Health Research Institute, London Health Sciences Centre, London, Ont
| | - Parham Rasoulinejad
- London Health Sciences Centre combined Neurosurgical and Orthopaedic spine program, London, Ont
- Schulich School of Medicine and Dentistry, Department of Surgery, Western University, London, Ont
- Lawson Health Research Institute, London Health Sciences Centre, London, Ont
| | - Fawaz Siddiqi
- London Health Sciences Centre combined Neurosurgical and Orthopaedic spine program, London, Ont
- Schulich School of Medicine and Dentistry, Department of Surgery, Western University, London, Ont
- Lawson Health Research Institute, London Health Sciences Centre, London, Ont
| | - Christopher S Bailey
- London Health Sciences Centre combined Neurosurgical and Orthopaedic spine program, London, Ont
- Schulich School of Medicine and Dentistry, Department of Surgery, Western University, London, Ont
- Lawson Health Research Institute, London Health Sciences Centre, London, Ont
| | - Jennifer Urquhart
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - Renan R Fernandes
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - R Andrew Glennie
- Departments of Orthopedics and Neurosurgery, Dalhousie University, Halifax, N.S
| | | | - Charles G Fisher
- Department of Surgery, University of British Columbia, Vancouver, B.C
| | - Chris S Bailey
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - Michael M H Yang
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
- O'Brien Institute of Public Health, Calgary, Alta
| | - Jay Riva-Cambrin
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | | | - Steven Casha
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Chloe N Cadieux
- Division of Orthopaedic Surgery, Western University, London, Ont
| | | | - Renan Fernandes
- Division of Orthopaedic Surgery, Western University, London, Ont
| | - Andrew Glennie
- Department of Surgery, Dalhousie University, Halifax, N.S
| | - Charles Fisher
- Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Raja Rampersaud
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
| | | | | | | | | | | | | | | | | | | | | | | | - Greg McIntosh
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | | | | | | | - Mark Xu
- Krembil Research Institute Arthritis Institute, Toronto, Ont
| | | | | | | | | | | | - Dana El-Mughayyar
- Canada East Spine Centre, Saint John, N.B
- Department of Kinesiology, University of New Brunswick, Fredericton, N.B
- Horizon Health Network, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
| | - Erin Bigney
- Canada East Spine Centre, Saint John, N.B
- Department of Kinesiology, University of New Brunswick, Fredericton, N.B
- Horizon Health Network, Saint John, N.B
| | - Eden Richardson
- Canada East Spine Centre, Saint John, N.B
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | - Neil Manson
- Canada East Spine Centre, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
- Saint John Orthopaedics, Saint John, N.B
| | - Edward Abraham
- Canada East Spine Centre, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
- Saint John Orthopaedics, Saint John, N.B
| | - Najmedden Attabib
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
| | - Chris Small
- Canada East Spine Centre, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
- Saint John Orthopaedics, Saint John, N.B
| | - George Kolyvas
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
| | - Andre LeRoux
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
| | | | | | - Jeff Hebert
- Department of Kinesiology, University of New Brunswick, Fredericton, N.B
| | | | | | - Jesse Shen
- Centre hospitalier de l'Université de Montréal, Montréal, Que
| | | | | | - Zhi Wang
- Centre hospitalier de l'Université de Montréal, Montréal, Que
| | - Ghassan Boubez
- Centre hospitalier de l'Université de Montréal, Montréal, Que
| | - Tiffany Lung
- Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Mayilee Canizares
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ont
| | - Anthony Perruccio
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ont
| | - Raja Rampersaud
- Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Ont
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Ont
| | - Eric J Crawford
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | - Robert A Ravinsky
- Department of Orthopaedics & Physical Medicine, Medical University of South Carolina, Charleston, S.C
| | - Anthony V Perruccio
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
- Schroeder Arthritis Institute, University Health Network, Toronto, Ont
| | - Y Raja Rampersaud
- Schroeder Arthritis Institute, University Health Network, Toronto, Ont
- Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network & University of Toronto, Toronto, Ont
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | - Michael Bond
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, B.C
| | - John Street
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Charles Fisher
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Raphaele Charest-Morin
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, B.C
| | - Arthur R Bartolozzi
- Combined Neurological and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Ori Barzilai
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | - Dean Chou
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | - Ilya Laufer
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | | | - Arjun Sahgal
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | | | | | - Aron Lazary
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | - Michael H Weber
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | | | - Stefano Boriani
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | | | - Paul M Arnold
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | | | | | | | - Ziya L Gokaslan
- AO Spine Knowledge Forum Tumor, Davos, Graubünden, Switzerland
| | | | - Nicolas Dea
- Combined Neurological and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
- AO Foundation, Davos, Graubünden, Switzerland
| | | | - Raphaele Charest-Morin
- Spine Surgery Institute, Vancouver General Hospital, University of British Columbia, Vancouver, B.C
| | - Ilya Laufer
- Department of Neurosurgery, New York University Langone Health, New York, N.Y
| | - William Teixeira
- Department of Orthopedic, Spine Surgery Division, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - Ori Barzilai
- Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, N.Y
| | | | - Michael G Fehlings
- Division of Neurosurgery and Spine Program, Department of Surgery, University of Toronto, Toronto, Ont
| | - Dean Chou
- Department of Neurosurgery, Division of Spine Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, N.Y
| | | | - Ziya L Gokaslan
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, R.I
| | - Nicolas Dea
- Spine Surgery Institute, Vancouver General Hospital, University of British Columbia, Vancouver, B.C
| | | | - Tony Goldschlager
- Department of Neurosurgery, Monash Health, Melbourne, Victoria, Australia
| | - John H Shin
- Department of Neurosurgery, Massachusetts General Hospital, Harvard University, Boston, Mass
| | - John E O'Toole
- Department of Neurosurgery, Rush University, Chicago, Ill
| | - Daniel M Sciubba
- Department of Neurosurgery, Zucker School of Medicine at Hofstra, Long Island Jewish Medical Center and North Shore University Hospital, Northwell Health, Manhasset, N.Y
| | - Chetan Bettegowda
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Md
| | | | - Michael H Weber
- Spine Surgery Program, Department of Surgery, Montréal General Hospital, McGill University Health Centre, Montréal, Que
| | - Addisu Mesfin
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, N.Y
| | - Norio Kawahara
- Department of Orthopaedic Surgery, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Rory Goodwin
- Department of Neurosurgery, Spine Division, Duke University, Durham, N.C
| | - Alexander Disch
- Department of Orthopaedics, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Saxony, Germany
| | - Aron Lazary
- National Center for Spinal Disorders, Budapest, Hungary
| | | | - Arjun Sahgal
- Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Laurence Rhines
- Department of Neurosurgery, Division of Surgery, The University of Texas MD Anderson Cancer Centre, Houston, Tex
| | - Charles G Fisher
- Spine Surgery Institute, Vancouver General Hospital, University of British Columbia, Vancouver, B.C
| | - Anne L Versteeg
- Division of Surgery, Department of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Division of Imaging and Cancer, University Medical Center Utrecht, Utrecht, Netherlands
| | - Roxanne Gal
- Division of Imaging and Cancer, University Medical Center Utrecht, Utrecht, Netherlands
| | - Leilani Reich
- Division of Spine, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, B.C
| | - Angela Tsang
- Division of Spine, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, B.C
| | - Allan Aludino
- Division of Spine, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, B.C
| | - Arjun Sahgal
- Department of Radiation Oncology, University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Jorrit-Jan Verlaan
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Charles G Fisher
- Division of Spine, Department of Orthopaedics, University of British Columbia and Vancouver General Hospital, Vancouver, B.C
| | - Lenny Verkooijen
- Division of Imaging and Cancer, University Medical Center Utrecht, Utrecht, Netherlands
| | | | | | | | | | | | | | | | | | | | - Mark A MacLean
- Department of Surgery, Dalhousie University, Halifax, N.S
| | | | | | | | - C Rory Goodwin
- Duke University Medical Center, Duke University, Durham, N.C
| | - Michael Weber
- Combined Neurological and Orthopedic Spine Program, McGill University, Montréal, Que
| | | | | | | | | | | | | | | | | | | | | | | | - Marcia Rebecca Correale
- University Health Network, Toronto Western Hospital, Schroeder Arthritis Institute, Toronto, Ont
- Department of Physical Therapy, University of Toronto, Toronto, Ont
| | - Leslie Jayne Soever
- University Health Network, Toronto Western Hospital, Schroeder Arthritis Institute, Toronto, Ont
- Department of Physical Therapy, University of Toronto, Toronto, Ont
| | - Raja Rampersaud
- University Health Network, Toronto Western Hospital, Schroeder Arthritis Institute, Toronto, Ont
- Department of Surgery, University of Toronto, Toronto, Ont
- Krembil Research Institute, Toronto, Ont
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Mohamed Sarraj
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ont
| | | | - Patrick Thornley
- Division of Orthopaedic Surgery, Western University, London, Ont
| | - Frank Koziarz
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ont
| | | | | | | | - Edward Kachur
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ont
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ont
| | - Colby Oitment
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ont
| | - Armaan K Malhotra
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | - Michael Balas
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - Blessing N R Jaja
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - Erin M Harrington
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - Johann Hofereiter
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - Rachael H Jaffe
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | - Yingshi He
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
| | - James P Byrne
- Department of Surgery, Johns Hopkins Hospital, Baltimore, Md
| | - Jefferson R Wilson
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | - Christopher D Witiw
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ont
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | | | | | | | - Marcel F Dvorak
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Nathan Evaniew
- Division of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | | | | | | | | | | | - Charles G Fisher
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Raphaële Charest-Morin
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Tamir Ailon
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - John Street
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Brian K Kwon
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Ryan V Sandarage
- Neurosurgery Division, University of Ottawa, Ottawa, Ont
- The Ottawa Hospital, Ottawa, Ont
| | - Ahmad Galuta
- Neurosurgery Division, University of Ottawa, Ottawa, Ont
| | | | - Jason C S Kwan
- Neurosurgery Division, University of Ottawa, Ottawa, Ont
| | - Eve C TsaI
- Neurosurgery Division, University of Ottawa, Ottawa, Ont
- The Ottawa Hospital, Ottawa, Ont
| | - Laureen D Hachem
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ont
- Krembil Research Institute, University Health Network, Toronto, Ont
| | - James Hong
- Krembil Research Institute, University Health Network, Toronto, Ont
| | - Alexander Velumian
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ont
- Krembil Research Institute, University Health Network, Toronto, Ont
| | - Andrea J Mothe
- Krembil Research Institute, University Health Network, Toronto, Ont
| | - Charles H Tator
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ont
- Krembil Research Institute, University Health Network, Toronto, Ont
| | - Michael G Fehlings
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ont
- Krembil Research Institute, University Health Network, Toronto, Ont
| | - Husain Shakil
- Department of Surgery, Neurosurgery Division, University of Toronto, Toronto, Ont
- Unity Health Toronto, Toronto, Ont
| | | | | | - Rachael Jaffe
- Department of Surgery, Neurosurgery Division, University of Toronto, Toronto, Ont
- Unity Health Toronto, Toronto, Ont
| | - Armaan K Malhotra
- Department of Surgery, Neurosurgery Division, University of Toronto, Toronto, Ont
- Unity Health Toronto, Toronto, Ont
| | - Jefferson R Wilson
- Department of Surgery, Neurosurgery Division, University of Toronto, Toronto, Ont
- Unity Health Toronto, Toronto, Ont
| | - Christopher D Witiw
- Department of Surgery, Neurosurgery Division, University of Toronto, Toronto, Ont
- Unity Health Toronto, Toronto, Ont
| | | | - Marcel F Dvorak
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Nathan Evaniew
- Division of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | - Melody Chen
- Praxis Spinal Cord Institute, Vancouver, B.C
| | | | - Jijie Xu
- Praxis Spinal Cord Institute, Vancouver, B.C
| | | | | | - Brian Kwon
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Charlotte Dandurand
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Sander Muijs
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Marcel Dvorak
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Klaus Schnake
- Malteser Waldkrankenhaus Erlangen, Erlangen, Bavaria, Germany
| | | | - Ouml Ner
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Ryan Greene
- Division of Neurosurgery, Dalhousie University, Halifax, N.S
- Neurosurgery Division, Memorial University of Newfoundland, St. John's, N.L
| | - Bradley Furlong
- Neurosurgery Division, Memorial University of Newfoundland, St. John's, N.L
| | | | - Michelle Swab
- Neurosurgery Division, Memorial University of Newfoundland, St. John's, N.L
| | - Sean D Christie
- Division of Neurosurgery, Dalhousie University, Halifax, N.S
| | - Amanda Hall
- Neurosurgery Division, Memorial University of Newfoundland, St. John's, N.L
| | | | | | | | - Marcel F Dvorak
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | | | - Ouml Ner
- University Medical Centre Utrecht, Utrecht, Netherlands
| | | | | | | | | | | | - Jin Wee Tee
- Alfred Hospital, Melbourne, Victoria, Australia
| | | | - John C France
- Orthopedics, West Virginia University, Morgantown, W.V
| | - Richard Allen
- Department of Orthopaedic Surgery, University of California at San Diego, San Diego, Calif
| | | | | | | | - Charlotte Dandurand
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | | | - Ouml Ner
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Sander Muijs
- University Medical Center Utrecht, Utrecht, Netherlands
| | - Klaus Schnake
- Malteser Waldkrankenhaus Erlangen, Erlangen, Bavaria, Germany
| | - Marcel Dvorak
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | | | | | | | | | | | | | | | | | | | | | | | | | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | | | - Greg McIntosh
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | | | | | | | | | | | | | | | - Mathieu Laflamme
- Centre hospitalier universitaire de Québec, Université Laval, Québec, Que
| | - Greg McIntosh
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | | | | | | | | | | | - Julien Goulet
- Orthopaedic Surgery Division, Université de Sherbrooke, Sherbrooke, Que
| | - Greg McIntosh
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | - Sonia Bedard
- Neurosurgery Division, Université de Sherbrooke, Sherbrooke, Que
| | - Newton Pimenta
- Neurosurgery Division, Université de Sherbrooke, Sherbrooke, Que
| | - Jocelyn Blanchard
- Orthopaedic Surgery Division, Université de Sherbrooke, Sherbrooke, Que
| | - Jerome Couture
- Orthopaedic Surgery Division, Université de Sherbrooke, Sherbrooke, Que
| | - Bernard LaRue
- Orthopaedic Surgery Division, Université de Sherbrooke, Sherbrooke, Que
| | | | - Tyler Adams
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Erin Cunningham
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Dana El-Mughayyar
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Erin Bigney
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Amanda Vandewint
- Canada East Spine Centre, Saint John, N.B
- Faculty of Medicine, Dalhousie University, Saint John, N.B
| | - Niel Manson
- Canada East Spine Centre, Saint John, N.B
- Faculty of Medicine, Dalhousie University, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Edward Abraham
- Canada East Spine Centre, Saint John, N.B
- Faculty of Medicine, Dalhousie University, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Chris Small
- Canada East Spine Centre, Saint John, N.B
- Faculty of Medicine, Dalhousie University, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Najmedden Attabib
- Canada East Spine Centre, Saint John, N.B
- Faculty of Medicine, Dalhousie University, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Eden Richardson
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Jeffery Hebert
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
| | - Michael Bond
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, B.C
| | - John Street
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Charles Fisher
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Raphaele Charest-Morin
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, B.C
| | - Troy Hillier
- Faculty of Medicine, Dalhousie University, Halifax, N.S
| | - Chris S Bailey
- Orthopaedic Surgery Division, Western University, London, Ont
| | - Charles Fisher
- Combined Neurosurgical and Orthopedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Raja Rampersaud
- Orthopaedic Surgery Division, University of Toronto, Toronto, Ont
| | | | - R Andrew Glennie
- Orthopaedic Surgery Division, Dalhousie University, Halifax, N.S
| | | | | | | | | | | | | | | | - David Ben-Israel
- Department of Orthopaedic Surgery and Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Eric J Crawford
- Orthopaedic Surgery Division, University of Toronto, Toronto, Ont
| | - Charles Fisher
- Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Nicolas Dea
- Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Eldon Spackman
- Department of Orthopaedic Surgery and Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Raja Rampersaud
- Orthopaedic Surgery Division, University of Toronto, Toronto, Ont
| | - Kenneth C Thomas
- Department of Orthopaedic Surgery and Clinical Neurosciences, University of Calgary, Calgary, Alta
| | | | | | | | | | - Ahmed Cherry
- Toronto Western Hospital, University Health Network, Toronto, Ont
| | - Aditiya Raj
- Toronto Western Hospital, University Health Network, Toronto, Ont
| | - Mark Xu
- Toronto Western Hospital, University Health Network, Toronto, Ont
| | - Carlo Iorio
- Toronto Western Hospital, University Health Network, Toronto, Ont
| | - Chris Bailey
- London Health Sciences Centre, London, Ont
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | - Nicolas Dea
- Canadian Spine Outcomes and Research Network, Markdale, Ont
- Vancouver Spine Surgery Institute, Vancouver, B.C
| | - Charles Fisher
- Canadian Spine Outcomes and Research Network, Markdale, Ont
- Vancouver Spine Surgery Institute, Vancouver, B.C
| | - Hamilton Hall
- Canadian Spine Outcomes and Research Network, Markdale, Ont
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Neil Manson
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Kenneth Thomas
- Canadian Spine Outcomes and Research Network, Markdale, Ont
- Department of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | - Mayilee Canizares
- Canadian Spine Outcomes and Research Network, Markdale, Ont
- Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ont
| | - Yoga Raja Rampersaud
- Toronto Western Hospital, University Health Network, Toronto, Ont
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | - Jennifer Urquhart
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - Renan R Fernandes
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - R Andrew Glennie
- Departments of Orthopedics and Neurosurgery, Dalhousie University, Halifax, N.S
| | | | - Charles G Fisher
- Department of Surgery, University of British Columbia, Vancouver, B.C
| | - Chris Bailey
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - Michael M H Yang
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
- O'Brien Institute of Public Health, Calgary, Alta
| | - Rena Far
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Tolulope Sajobi
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Jay Riva-Cambrin
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Steven Casha
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Michael Bond
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, B.C
| | - John Street
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Charles Fisher
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Raphaele Charest-Morin
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Jason M Sutherland
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, B.C
| | | | | | | | | | | | | | | | | | - James McDonald
- Division of Orthopaedics, Department of Surgery, Memorial University of Newfoundland, St. John's, N.L
| | | | | | - Abdulmajeed Alahmari
- Division of Orthopaedics, Department of Surgery, Western University, London, Ont
| | - Raja Rampersaud
- Department of Orthopaedic Surgery, Toronto Western Hospital, Toronto, Ont
| | - Charles Fisher
- Combined Neurosurgical and Orthopaedic Spine Program, Vancouver General Hospital and the University of British Columbia, Vancouver, B.C
| | - Chris Bailey
- Division of Orthopaedics, Department of Surgery, Western University, London, Ont
| | - Andrew Glennie
- Division of Orthopedics, Dalhousie University, Halifax, N.S
| | - Nathan Evaniew
- Division of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | - Matthew Coyle
- Division of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | | | | | - W Bradley Jacobs
- Division of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | - David W Cadotte
- Division of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | - Kenneth C Thomas
- Division of Orthopaedic Surgery, University of Calgary, Calgary, Alta
| | | | - Jérôme Paquet
- Department of Surgery, Université de Québec, Québec, Que
| | - Andrew Nataraj
- Neurosurgery Division, University of Alberta, Edmonton, Alta
| | - Sean D Christie
- Division of Neurosurgery, Dalhousie University, Halifax, N.S
| | - Michael H Weber
- Orthopaedic Surgery Division, McGill University, Montréal, Que
| | - Philippe Phan
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
| | - Raphaële Charest-Morin
- Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Charles G Fisher
- Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ont
| | | | - Nicolas Dea
- Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C
| | - Armaan K Malhotra
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ont
| | - Aileen M Davis
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ont
| | - Yingshi He
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
| | - Erin M Harrington
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
| | - Blessing N R Jaja
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
| | - Mary P Zhu
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
| | - Husain Shakil
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ont
| | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - W Bradley Jacobs
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - David W Cadotte
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Jérôme Paquet
- Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, CHU de Québec-Université Laval, Québec, Que
| | - Michael H Weber
- Division of Orthopedic Surgery, McGill University, Montréal, Que
| | | | - Sean D Christie
- Division of Neurosurgery, Dalhousie University, Halifax, N.S
| | - Andrew Nataraj
- Division of Neurosurgery, Department of Surgery, University of Alberta Hospital, Edmonton, Alta
| | - Christopher S Bailey
- Division of Orthopaedics, Western University, London Health Sciences Centre, London, Ont
| | - Michael G Johnson
- Department of Surgery, Section of Orthopaedics and Neurosurgery, University of Manitoba, Winnipeg, Man
| | - Charles G Fisher
- Combined Neurosurgical and Orthopedic Spine Program, Vancouver General Hospital, Vancouver, B.C
| | - Neil Manson
- Canada East Spine Centre, Saint John Orthopedics, Dalhousie University, Saint John, N.B
| | - Y Raja Rampersaud
- Division of Orthopaedic Surgery and Neurosurgery, Toronto Western Hospital, Toronto, Ont
| | - Kenneth C Thomas
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alta
| | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ont
| | - Michael G Fehlings
- Division of Orthopaedic Surgery and Neurosurgery, Toronto Western Hospital, Toronto, Ont
| | - Henry Ahn
- Division of Orthopedic Surgery, St Michael's Hospital, Toronto, Ont
| | - Howard J Ginsberg
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
| | - Christopher D Witiw
- Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, Toronto, Ont
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ont
| | - Jefferson R Wilson
- Canada East Spine Centre, Saint John Orthopedics, Dalhousie University, Saint John, N.B
| | - Alwalaa Althagafi
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, B.C
| | - Greg McIntosh
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | - Raphaële Charest-Morin
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, B.C
| | - Michael A Rizzuto
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedic Surgery, University of British Columbia, Vancouver, B.C
| | - Tamir Ailon
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedic Surgery, University of British Columbia, Vancouver, B.C
| | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedic Surgery, University of British Columbia, Vancouver, B.C
| | - Nathan Evaniew
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | - Bradley W Jacobs
- Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, Calgary, Alta
| | - Jerome Paquet
- Centre de recherche du Centre hospitalier universitaire (CHU) de Québec, CHU de Québec-Université Laval, Québec, Que
| | - Raja Rampersaud
- Divisions of Orthopaedics and Neurosurgery, University of Toronto, Toronto, Ont
| | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ont
| | - Christopher S Bailey
- Department of Orthopedic Surgery, London Health Sciences Centre, Western University, London, Ont
| | - Michael Weber
- Department of Orthopedic Surgery, McGill University Health Centre, Montréal, Que
| | - Michael G Johnson
- Department of Surgery, Section of Orthopedics and Neurosurgery, University of Manitoba, Winnipeg, Man
| | - Andrew Nataraj
- Division of Neurosurgery, Department of Surgery, University of Alberta Hospital, Edmonton, Alta
| | - Najmedden Attabib
- Canada East Spine Centre, Division of Neurosurgery, Zone 2, Horizon Health Network, Saint John, N.B
| | - David W Cadotte
- Combined Neurosurgical and Orthopedic Spine Program, University of Calgary, Calgary, Alta
| | - Neil Manson
- Canada East Spine Centre, Saint John Orthopedics, Dalhousie Medicine New Brunswick, Saint John Campus, Saint John, N.B
| | | | - Sean D Christie
- Division of Neurosurgery, Dalhousie University, Halifax, N.S
| | - Kenneth C Thomas
- Divisions of Orthopaedics and Neurosurgery, University of Toronto, Toronto, Ont
| | | | - Charles G Fisher
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedic Surgery, University of British Columbia, Vancouver, B.C
| | - Raphaele Charest-Morin
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedic Surgery, University of British Columbia, Vancouver, B.C
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Vishal P Varshney
- Department of Anesthesia, Providence Healthcare, Vancouver, B.C
- Department of Anesthesiology, Pharmacology, Therapeutics, University of British Columbia, Vancouver, B.C
| | - Ramesh Sahjpaul
- Department of Anesthesia, Providence Healthcare, Vancouver, B.C
- Department of Anesthesiology, Pharmacology, Therapeutics, University of British Columbia, Vancouver, B.C
- Division of Neurosurgery, University of British Columbia, Vancouver, B.C
| | - Scott Paquette
- Department of Anesthesia, Providence Healthcare, Vancouver, B.C
- Department of Anesthesiology, Pharmacology, Therapeutics, University of British Columbia, Vancouver, B.C
- Division of Neurosurgery, University of British Columbia, Vancouver, B.C
| | - Jill Osborn
- Department of Anesthesia, Providence Healthcare, Vancouver, B.C
- Department of Anesthesiology, Pharmacology, Therapeutics, University of British Columbia, Vancouver, B.C
| | | | | | | | | | | | | | | | | | | | | | | | - Greg McIntosh
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | | | | | | | | | - Mark Xu
- University Health Network, Toronto, Ont
| | | | | | | | - Alexandra Stratton
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
| | - Sarah Tierney
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
| | - Eugene K Wai
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
| | - Philippe Phan
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
| | - Stephen Kingwell
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
| | | | | | | | | | | | | | | | | | - Barend Spanninga
- Laboratory for Experimental Orthopaedics, Department of Orthopaedic Surgery, Maastricht University, Maastricht, Limburg, Netherlands
| | - Thomáy-Claire A Hoelen
- Department of Orthopaedic Surgery, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Limburg, Netherlands
| | | | - Jacobus J C Arts
- Department of Orthopaedic Surgery, Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, Limburg, Netherlands
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, North Brabant, Netherlands
| | - Chris S Bailey
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - Jennifer C Urquhart
- London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, Ont
| | - R Andrew Glennie
- Departments of Orthopedics and Neurosurgery, Dalhousie University, Halifax, N.S
| | | | - Charles G Fisher
- Department of Surgery, University of British Columbia, Vancouver, B.C
| | | | - Lior M Elkaim
- Department of Neurology and Neurosurgery, McGill University, Montréal, Que
| | - Naif M Alotaibi
- Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Michael H Weber
- Department of Orthopaedic Surgery, McGill University, Montréal, Que
| | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopaedic Surgery, University of British Columbia, Vancouver, B.C
| | | | | | - Albert Yee
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Nadia Jaber
- University of Toronto Spine Program, University of Toronto, Toronto, Ont
| | | | - Erin Cunningham
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Tyler Adams
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Dana El-Mughayyar
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Erin Bigney
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
| | - Amanda Vandewint
- Canada East Spine Centre, Saint John, N.B
- Faculty of Medicine, Dalhousie University, Saint John, N.B
| | - Neil Manson
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Edward Abraham
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Chris Small
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | | | | | - Jeffery Hebert
- Faculty of Medicine, University of New Brunswick, Fredericton, N.B
| | - Joel Werier
- Ottawa Hospital, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
| | - Kevin Smit
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
- Children's Hospital of Eastern Ontario, Ottawa, Ont
| | - James Villeneuve
- Ottawa Hospital, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
| | - Adam Sachs
- Ottawa Hospital, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
| | - Hesham Abdelbary
- Ottawa Hospital, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
| | | | - Kawan Rakhra
- Ottawa Hospital, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
| | - Philippe Phan
- Ottawa Hospital, Ottawa, Ont
- Ottawa Hospital Research Institute, Ottawa, Ont
- Orthopaedic Surgery Division, University of Ottawa, Ottawa, Ont
| | | | | | | | | | | | | | - Robert Koucheki
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ont
| | - Aazad Abbas
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Johnathan Lex
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ont
- Division of Orthopedic Surgery, University of Toronto, Toronto, Ont
| | - Nicholas Nucci
- Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont
| | - Cari Whyne
- Holland Musculoskeletal Research Program, Sunnybrook Research Institute, Toronto, Ont
| | - Jeremie Larouche
- Division of Orthopedic Surgery, University of Toronto, Toronto, Ont
- Department of Orthopedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Henry Ahn
- Division of Orthopedic Surgery, University of Toronto, Toronto, Ont
- Department of Orthopedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Joel Finkelstein
- Division of Orthopedic Surgery, University of Toronto, Toronto, Ont
- Department of Orthopedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Stephen Lewis
- Division of Orthopedic Surgery, University of Toronto, Toronto, Ont
- Department of Orthopedic Surgery, Toronto Western Hospital, Toronto, Ont
| | - Jay Toor
- Division of Orthopedic Surgery, University of Toronto, Toronto, Ont
| | - Nathan J Lee
- Columbia University Medical Center, New York, N.Y
| | | | | | | | | | | | | | | | - Eric J Crawford
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | - Robert A Ravinsky
- Department of Orthopaedics & Physical Medicine, Medical University of South Carolina, Charleston, S.C
| | - Anthony V Perruccio
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
- Schroeder Arthritis Institute, University Health Network, Toronto, Ont
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont
| | - Y Raja Rampersaud
- Schroeder Arthritis Institute, University Health Network, Toronto, Ont
- Division of Orthopaedic Surgery, Toronto Western Hospital, University Health Network & University of Toronto, Toronto, Ont
| | | | - Mohamed Sarraj
- Orthopaedic Surgery Division, McMaster University, Hamilton, Ont
| | - Fawaz AlShaalan
- King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Alex Koziarz
- Orthopaedic Surgery Division, McMaster University, Hamilton, Ont
| | | | | | - Colby Oitment
- Orthopaedic Surgery Division, McMaster University, Hamilton, Ont
| | - Lalita Bharadwaj
- Orthopaedic Surgery Division, University of New Brunswick, Fredericton, N.B
| | - Dana El-Mughayyar
- Orthopaedic Surgery Division, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
| | - Erin Bigney
- Orthopaedic Surgery Division, University of New Brunswick, Fredericton, N.B
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
| | - Neil Manson
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
| | - Edward Abraham
- Canada East Spine Centre, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
- Saint John Orthopaedics, Saint John, N.B
| | - Chris Small
- Canada East Spine Centre, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
- Saint John Orthopaedics, Saint John, N.B
| | - Najmedden Attabib
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
- Dalhousie Medicine New Brunswick, Saint John, N.B
| | - Eden Richardson
- Canada East Spine Centre, Saint John, N.B
- Horizon Health Network, Saint John, N.B
- Canadian Spine Outcomes and Research Network, Markdale, Ont
| | | | | | | | - Jeffrey Hebert
- Orthopaedic Surgery Division, University of New Brunswick, Fredericton, N.B
| | - Lior M Elkaim
- Department of Neurology and Neurosurgery, McGill University, Montréal, Que
| | | | - Farbod Niazi
- Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Rakan Bokhari
- Department of Neurology and Neurosurgery, McGill University, Montréal, Que
| | | | - Oliver J Lasry
- Department of Neurology and Neurosurgery, McGill University, Montréal, Que
| | | | | | - Varun S Muddaluru
- Graduate Entry Medicine, Royal College of Surgeons in Ireland, Dublin, Leinster, Ireland
| | - Pranjan Gandhi
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ont
| | | | - Daipayan Guha
- Division of Neurosurgery, McMaster University, Hamilton, Ont
| | - Markian A Pahuta
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ont
| | | | | | | | | | - Mamdoh Alhawsawi
- King Saud Medical City, Riyadh, Saudi Arabia
- Ottawa Civic Hospital, Ottawa, Ont
| | | | | | - Feras Qumquji
- King Saud Medical City, Riyadh, Saudi Arabia
- Ottawa Civic Hospital, Ottawa, Ont
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcelo Oppermann
- Department of Clinical Neurological Science, Schulich School of Medicine & Dentistry, Western University, London, Ont
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | - Shaurya Gupta
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | - Joel Ramjist
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | - Priscila Santos Oppermann
- Department of Clinical Neurological Science, Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Victor X D Yang
- Department of Clinical Neurological Science, Schulich School of Medicine & Dentistry, Western University, London, Ont
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | | | - Lior M Elkaim
- Department of Neurology and Neurosurgery, McGill University, Montréal, Que
| | - Farbod Niazi
- Faculty of Medicine, Université de Montréal, Montréal, Que
| | - Michael H Weber
- Department of Orthopaedic Surgery, McGill University, Montréal, Que
| | - Christian Ioro-Morin
- Service de neurochirurgie, Département de chirurgie, Université de Sherbrooke, Sherbrooke, Que
| | - Marco Bonizzato
- Department of Electrical Engineering and Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, Que
- Department of Neuroscience and Centre interdisciplinaire sur le cerveau et l'apprentissage, Université de Montréal, Montréal, Que
| | - Alexander G Weil
- Division of Neurosurgery, St-Justine University Hospital, Montréal, Que
| | - Marcelo Oppermann
- Department of Clinical Neurological Science, Schulich School of Medicine & Dentistry, Western University, London, Ont
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | - Joel Ramjist
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | - Shaurya Gupta
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | - Priscila S Oppermann
- Department of Clinical Neurological Science, Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Victor X D Yang
- Department of Clinical Neurological Science, Schulich School of Medicine & Dentistry, Western University, London, Ont
- Department of Electrical Computer & Biomedical Engineering, Toronto Metropolitan University, Toronto, Ont
| | - Youngkyung Jung
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ont
| | - Varun Muddalaru
- Royal College of Surgeons in Ireland, Dublin, Leinster, Ireland
| | - Pranjan Gandhi
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ont
| | - Daipayan Guha
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ont
| | | | | | - Aazad Abbas
- Faculty of Medicine, University of Toronto, Toronto, Ont
| | - Johnathan R Lex
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
| | - Nicholas Nucci
- Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont
| | - Cari Whyne
- Sunnybrook Holland Musculoskeletal Research Program, Toronto, Ont
| | - Albert Yee
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Henry Ahn
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- St. Michael's Hospital, Toronto, Ont
| | - Joel Finkelstein
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Jeremie Larouche
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Sunnybrook Health Sciences Centre, Toronto, Ont
| | - Stephen Lewis
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
- Toronto Western Hospital, Toronto, Ont
| | - Jay Toor
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
| | - Alaina Dhawan
- Faculty of Health Sciences, Queen's University, Kingston, Ont
| | - Jillian Dhawan
- Faculty of Health Sciences, Queen's University, Kingston, Ont
| | - Ajay N Sharma
- Faculty of Health Sciences, University of California, Irvine, Calif
| | - Daniel B Azzam
- Faculty of Health Sciences, Tufts University, Boston, Mass
| | - Ahmed Cherry
- Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont
| | | | | | - Nathan J Lee
- Columbia University Medical Center, New York, N.Y
| | | | | | | | | | | | | | | | | | | | | | - Elizabeth Byers
- Biomedical Engineering, Pennsylvania State University, University Park, Pa
| | | | | | - Justin L Brown
- Biomedical Engineering, Pennsylvania State University, University Park, Pa
| | | | | | | | | | | | | | | | | | | | | | - Shevaughn Dell
- University Hospital of the West Indies, Kingston, Jamaica
| | | | - Kevin Wade
- University Hospital of the West Indies, Kingston, Jamaica
| | | | - Carl Bruce
- Department of Surgery, University of the West Indies, Jamaica
| | | | - Newton Pimenta
- Surgery Department, Université de Sherbrooke, Sherbrooke, Que
| | - Bernard LaRue
- Surgery Department, Université de Sherbrooke, Sherbrooke, Que
| | - Salman Aldakhil
- Surgery Department, Université de Sherbrooke, Sherbrooke, Que
| | | | - Jerome Couture
- Surgery Department, Université de Sherbrooke, Sherbrooke, Que
| | - Julien Goulet
- Surgery Department, Université de Sherbrooke, Sherbrooke, Que
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Freire-Archer M, Sarraj M, Koziarz A, Thornley P, Alshaalan F, Alnemari H, Kachur E, Bhandari M, Oitment C. Incidence and Recurrence of Deep Spine Surgical Site Infections: A Systematic Review and meta-analysis. Spine (Phila Pa 1976) 2023:00007632-990000000-00352. [PMID: 37163651 DOI: 10.1097/brs.0000000000004713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/02/2023] [Indexed: 05/12/2023]
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVE To determine a pooled incidence rate for deep SSI, and compare available evidence for deep surgical site infection (SSI) management among instrumented spinal fusions. SUMMARY OF BACKGROUND DATA Deep SSI is a common complication of instrumented spinal surgery associated with patient morbidity, poorer long-term outcomes, and higher healthcare costs. METHODS We systematically searched Medline and Embase, and included studies with an adult patient population undergoing posterior instrumented spinal fusion of the thoracic, lumbar or sacral spine, with a reported outcome of deep SSI. The primary outcome was the incidence of deep SSI. Secondary outcomes included persistent deep SSI following initial debridement, mean number of debridements, and microbiology. Subsequent meta-analysis combined outcomes for surgical-site infection using a random-effects model and quantified heterogeneity using the χ2 test and the I2 statistic. Additionally, qualitative analysis of management strategies was reported. RESULTS Of 9087 potentially eligible studies, we included 54 studies (37 comparative, 17 non-comparative). The pooled SSI incidence rate was 1.5% (95% CI, 1.1% to 1.9%) based on 209,347 index procedures. Up to 25% of patients (95% CI 16.8% to 35.3%), had a persistent infection. These patients require an average of 1.4 (range: 0.8-1.9) additional debridements. Infecting organisms were commonly gram-positive and among them, staphylococcus aureus was the most frequent (46%). Qualitative analysis suggests implant retention, especially for early deep SSI management. Evidence was limited for other management strategies. CONCLUSIONS The pooled incidence rate of deep SSI post-thoracolumbar spinal surgery is 1.5%. The rate of recurrence and repeat debridement is at least 12%, up to 25%. Persistent infection is a significant risk, highlighting the need for standardized treatment protocols. Our review further demonstrates heterogeneity in management strategies. Large-scale prospective studies are needed to develop better evidence around deep SSI incidence and management in the instrumented thoracolumbar adult spinal fusion population.
Collapse
Affiliation(s)
- Millaray Freire-Archer
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Mohamed Sarraj
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Alex Koziarz
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Thornley
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | - Fawaz Alshaalan
- Department of Orthopedic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Haitham Alnemari
- Department of Spine, King Faisal Medical City, Abha, Saudi Arabia
- Department of Spine, McMaster University, Hamilton, Ontario, Canada
| | - Edward Kachur
- McMaster University, Division of Neurosurgery, Hamilton General Hospital, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Colby Oitment
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
8
|
Sidhu K, Kim D, Lebel D, Alshammari A, Photopoulos G, Duarte MP, Provost M, Nielsen C, Oitment C, Cowley R, Dumas E, Dea N, Versteeg A, Eltit F, Rampersaud YR, Dandurand C, Grassner L, Alduwaisan A, Kennedy C, Christie S, Toobaie A, Algarni N, El-Mughayyar D, Pahuta M, Grassner L, Pelletier-Roy R, Bak AB, Singh S, Abbas A, Abbas A, Abbas A, Ajisebutu A, Aldahamsheh O, Martin S, Baron N, Basiratzadeh S, Beresford-Cleary N, Good C, Thomson A, Bhatt F, Bhatt F, Good C, Thomson A, Blake N, Briand MM, Shah V, Chen T, Cherry A, Rocos B, Cherry A, Chua R, Chua R, Cotter T, Coyle MJ, Dandurand C, Dandurand C, Dandurand C, Dauphinee E, Dionne A, El Bojairami I, Duarte MP, Duarte MP, Elahi MT, Ellingwood N, Ells B, Fallah N, Fernandes R, Fernandes R, Fleury C, Flórez-Jiménez S, Li P, Gennari A, Georgiopoulos M, Greene R, Yu C, Werthmann N, Hakimjavadi R, Hakimjavadi R, Heard B, Hutchison C, Kemna C, Kennedy C, Laflamme M, Laskin J, MacLean M, Mac-Thiong JM, Manson N, Manson N, Manson N, Urquhart J, Kuepper E, Pahuta M, Pahuta M, Parker E, Persad A, Phan K, Rachevitz M, Ridha B, Dhaliwal P, Sakoto S, Sarraj M, Sarraj M, Hache P, Singh S, Slosar P, Sun M, Sundararajan K, Sundararajan K, Thornley P, Thornley P, Thornley P, Thornley P, Thorogood N, Toobaie A, Belhouari S, Olotu O, Du JT, Saleh I, Varga A, Varshney V, Versteeg A, Visnjevac O, Wang Z, Wasim A, Wasim A, Wu J, Filezio M, Singh V, Ferri-de-Barros F, Dermott J, Lebel D, Machida M, Bath N, Levin D, Campbell F, Koyle M, Isaac L, Ruskin D, Brennenstuh S, Stinson J, Navarro-Ramirez R, Rabau O, Ouellet JA, Hurry J, Brooks J, Fitzgerald R, Louer C, Murphy J, Shaw KA, Smit K, El-Hawary R, Joncas J, Parent S, Duval M, Chèmaly O, Brassard F, Mac-Thiong JM, Barchi S, Labelle H, Beauséjour M, Ishimo MC, Joncas J, Labelle H, Le May S, Lewis L, Arnold K, Oitment C, Jentzsch T, Lewis S, Rienmuller A, Jentzsch T, Yashuv HS, Martin A, Nielsen C, Berven S, Ludwig T, Coyle M, Asmussen M, Edwards B, Nicholls F, Bigney E, Fleury C, El-Mughayyar D, Cherry A, Vanderwint A, Richardson E, Kerr J, McPhee R, Abraham E, Manson N, Attabib N, Small C, Couture J, Goulet J, Bédard S, Lebel K, LaRue B, Investigators CSORN, Gal R, Verlaan JJ, Charest-Morin R, Fisher CG, Wessels H, Verkooijen L, Ng T, Gokaslan Z, Fisher C, Dea N, Charest-Morin R, Urquhart J, Glennie A, Fisher C, Bailey C, Mcintosh G, Fisher C, Paquet J, Abraham E, Bailey C, Weber M, Johnson M, Nataraj A, Glennie A, Attabib N, Kelly A, Hall H, Rampersaud R, Manson N, Phan P, Thomas K, Dea N, Thomé C, Kögl N, Vo AK, Kramer JLK, Petr O, Visva S, Phan K, Nguyen-Luu T, Stratton A, Kingwell S, Wai E, Phan P, Puskas D, Pahuta M, Marion T, Greene R, Kehler S, Rockwood K, Urquhart J, Thornley P, Rasoulinejad P, Glennie A, Rampersaud R, Manson N, Abraham E, Fisher C, Charest-Morin R, Paquette S, Gélinas-Phaneuf N, Thomas K, Dea N, Dvorak M, Kwon B, Street J, Ailon T, Christie S, Bailey C, McIntosh G, Dea N, Charest-Morin R, Adams T, Bigney E, Cunningham E, Richardson E, Vandewint A, Attabib N, Abraham E, Manson N, Small C, LeRoux A, Kolyvas G, Investigators CSORN, Hebert J, Jiang E, Fisk F, Taliaferro K, Stukas S, Cooper J, Gill J, Fallah N, Skinnider MA, Belanger L, Ritchie L, Tsang A, Dong K, Streijger F, Street J, Paquette S, Ailon T, Dea N, Charest-Morin R, Fisher CG, Dvorak MF, Wellington C, Kwon BK, Dionne A, Richard-Denis A, Briand MM, Bourassa-Moreau É, Mac-Thiong JM, Moghaddamjou A, Fehlings MG, Nadeau M, Fisher C, Toor J, Larouche J, Finkelstein J, Whyne C, Yee A, Toor J, Du JT, Versteeg A, Yee N, Finkelstein J, Abouali J, Nousiainen MT, Kreder H, Whyne C, Larouche J, Toor J, Lewis S, Finkelstein J, Larouche J, Yee A, Whyne C, Dhaliwal P, Hasan M, Berrington N, Johnson M, Burger L, Nicholls F, Evaniew N, Cobetto N, Aubin CE, Larson AN, Cheng Y, Fourney D, Hakimjavadi R, Michalowski W, Viktor H, Baddour N, Wai E, Stratton A, Kingwell S, Phan P, Dandurand C, Mawhinney G, Reynolds J, Orosz L, Thomson A, Bhatt F, Guth M, Allen B, Boyd D, Grigorian J, Schuler T, Jazini E, Haines C, Orosz L, Bhatt F, Allen B, Sabet A, Schuler T, Haines C, Jazini E, Orosz L, Thomson A, Namian S, Bharara N, Jazini E, Good C, Schuler T, Haines C, Orosz L, Tewari A, Roy R, Good C, Schuler T, Haines C, Jazini E, Orosz L, Thomson A, Bhatt F, Grigorian J, Schuler T, Haines C, Merril J, Roy R, Jazini E, Wang M, Orosz L, Haines C, Jazini E, Bhatt F, Sabet A, Roy R, Schuler T, Good C, Greene R, Schmidt M, Christie S, Richard-Denis A, Le MT, Lim V, Mac-Thiong JM, Gallagher M, Cheung A, Brown J, Chaudhry H, Yee C, McIntosh G, Christie S, Fisher C, Jarzem P, Roy JF, Bouchard J, Yee A, Eseonu K, Ahn H, Cherry A, Rampersaud R, Davidson B, Rabinovitch L, Nielsen C, Jiang F, Vaisman A, Lewis S, Canizares M, Rampersaud R, Investigators CSORN, Avila M, Burket A, Aguilar-Salinas P, Mongrain R, Ouellet J, Driscoll M, Schmidt-Braekling T, Dobransky J, Kreviazuk C, Gofton W, Phan P, Beaule P, Grammatopoulos G, Street J, Fisher C, Jacobs B, Johnson M, Paquet J, Wilson J, Hall H, Bailey CS, Christie S, Nataraj A, Manson N, Phan P, Rampersaud R, Thomas K, Mcintosh G, Rasoulinejad P, Charest-Morin R, Hindi M, Farimani PL, Mashayekhi MS, Ailon T, Boyd M, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Urquhart J, Ailon T, Bailey C, Boyd M, Charest-Morin R, Dea N, Dvorak M, Glennie A, Kwon B, Paquette S, Rampersaud R, Street J, Fisher C, Vandewint A, Bigney E, El-Mughayyar D, Richardson E, Edward A, Manson N, Attabib N, Kolyvas G, Small C, Investigators CSORN, Mac-Thiong JM, Barthélémy D, Lim V, Richard-Denis A, Driscoll M, Aubin CE, Cobetto N, Roy-Beaudry M, Bellefleur C, Turgeon I, Labelle H, Barchi S, Parent S, Joncas J, Parent S, Labelle H, Barchi S, Mac-Thiong JM, Lee W, Phan P, Bigney E, Richardson E, El-Mughayyar D, Vandewint A, Abraham E, Manson N, Small C, Alugo T, Leroux A, Kolyvas G, Investigators CSORN, Attabib N, McIntosh G, Oxner W, Dunning PC, Glennie A, Wang D, Humphreys S, Noonan V, Urquhart J, Siddiqi F, Rasoulinejad P, Bailey C, Urquhart J, Thornley P, Rampersaud R, Glennie A, Rasoulinejad P, Fisher C, Bailey C, Investigators CSORN, Bigney E, Dumas E, El-Mughayyar D, Cherry A, Vanderwint A, Richardson E, Kerr J, McPhee R, Abraham E, Manson N, Attabib N, Small C, Couture J, Goulet J, Bédard S, LaRue B, Investigators CSORN, Macthiong JM, Bourassa-Moreau E, Ogden C, Gallagher M, Cheung A, Huong VT, Tarabay B, Al-Shakfa F, Yuh SJ, Shedid D, Boubez G, Wang Z, Gueziri HE, Santaguida C, Collins DL, Hall A, Alant J, Barry S, Weise L, Glennie A, Oxner B, Etchegary H, Christie S, Carreon L, Glassman S, Brown M, Daniels C, Polly D, Gum J, Gum J, Glassman S, Brown M, Daniels C, Carreon L, Hong HA, Fallah N, Humphreys S, Walden K, Noonan VK, Phan P, Basiratzadeh S, Wai EK, Phan P, Salo P, Krawetz R, Hart D, Bains I, Swamy G, Yang Q, Godoy A, Smith S, Lin C, Nataraj A, Puskas D, Pahuta M, Marion T, Dea N, Waheed Z, Thorogood N, Nightingale T, Noonan V, Touchette C, Duda T, Almojuela A, Bergeron D, Aljoghaiman M, Sader N, Kameda-Smith M, Alant J, Christie S, Hresko MT, Alzakri A, Parent S, Sucato DJ, Lenke LG, Marks M, Labelle H, Pereira P, Charles YP, Krutko A, Santos C, Park Y, Arzoglou V, Park SW, Franke J, Fuentes S, He S, Hosszu T, Varanda P, Mlyavykh S, Vanhauwaert D, Senker W, Franke J, Park Y, Charles YP, Santos C, Arzoglou V, Song Y, He S, Bhagat S, Hong JY, Vanhauwaert D, Senker W, Pereira P, Senker W, Charles YP, Pereira P, Santos C, Park Y, Arzoglou V, Park SW, Bordon G, Fuentes S, Song Y, Vialle E, Bhagat S, Krutko A, Franke J, Thornley P, Rampersaud R, Glennie A, Rasoulinejad P, Abraham E, Ailon T, Charest-Morin R, Dea N, Dvorak M, Gélinas-Phaneuf N, Kwon B, Manson N, Paquette S, Street J, Thomas K, Fisher C, Bailey C, Mishreky A, Hurry J, El-Hawary R, Jiang E, Fisk F, Taliaferro K, Dea N, Investigators CSORN, Al Anazi M, El-Hawary R, Kindrachuk M, Noyes E, Wu A, Fourney D, Pratt M, Wai E, Stratton A, Kingwell S, Wang Z, Phan P, Robarts S, Razmjou H, Yee A, Larouche J, Finkelstein J, Persad A, Huschi Z, Cheng Y, Fourney D, Rossong H, Zhang H, Johnson M, Goytan M, Zarrabian M, Berrington N, Zeiler F, Charles A, Roy-Beaudy, Parent S, Duong L, Marion T, Guha D, Pahuta M, Hache P, Oitment C, Guha D, Pahuta M, Sarraj M, Oitment C, Guha D, Pahuta M, Miyanji F, McAnany S, Cheung A, Dewitt D, Street J, Jurisica I, Perruccio AV, Rampersaud YR, Niu Y, Perruccio AV, Jurisica I, Rampersaud YR, Glennie A, Alahmari A, Al-Jahdali F, Fisher C, Rampersaud R, Urquhart J, Bailey C, Urquhart J, Bailey C, Urquhart J, Rampersaud R, Glennie A, Fisher C, Bailey C, Urquhart J, Rampersaud R, Glennie A, Fisher C, Bailey C, Harback K, Akpinar I, Adjetey C, Tindall D, Chernesky J, Noonan V, Fernandes RJR, Bailey C, Siddiqi F, Rasoulinejad P, Toor J, Abbas A, Brooks H, Larouche J, Abbas A, Bhatia A, Selimovic D, Larouche J, Yee A, Lewis S, Finkelstein J, Toor J, Abbas A, Toor J, Versteeg A, Finkelstein J, Toor J, Abbas A, Ahn H, Larouche J, Finkelstein J, Whyne C, Yee A, Slomp F, Thiessen E, Lastivnyak N, Maclean LS, Ritchie V, Hockley A, Osborn J, Paquette S, Sahjpaul R, Gal R, Charest-Morin R, Verlaan JJ, Wessels H, Fisher CG, Verkooijen L, Pastrak M, Truong VT, Liberman M, Al-Shakfa F, Yuh SJ, Soder SA, Wu J, Sunna T, Renaud-Charest É, Boubez G, Shedid D, Balasuberamaniam P, Shrikumar M, Chen T, Anthony T, Phillips A, Nathens A, Chapman M, Crawford E, Stark R, Schwartz C, Finkelstein J, Small C, Rampersaud R. Canadian Spine SocietyAbstract 57. Radiographic reporting in adolescent idiopathic scoliosis: Is there a discrepancy comparing radiologists’ reports and surgeons’ assessments?Abstract 74. How useful is prereferral spine imaging? A quality improvement projectAbstract 82. Early recovery after surgery, predictors of shorter length of stayAbstract 68. Gliding screws on early-onset scoliosis: a 5-year experienceAbstract 66. Reliability of radiographic assessment of growth modulation from anterior vertebral body tethering surgery in pediatric scoliosisAbstract 16. A dangerous curve: impact of the COVID-19 pandemic on brace treatment in adolescent idiopathic scoliosisAbstract 24. Development of a model of interprofessional support interventions to enhance brace adherence in adolescents with idiopathic scoliosisAbstract 94. Recognizing the importance of self-image in adult spinal deformity: results from the Prospective Evaluation of Elderly Deformity Surgery (PEEDS)Abstract 25. Assessing pain as a primary factor in the surgical treatment of adult spinal deformity surgery in patients over 60 years of ageAbstract 72. Application of the Ames-International Spine Study Group (AMES) radiographic modifiers to an asymptomatic population. Are the thresholds for “normal” appropriate?Abstract 109. Exploring the relationship between cannabis and narcotic use on preoperative health considerations in Canadian thoracolumbar patients: a CSORN studyAbstract 36. Metastatic spine disease: Should patients with short life expectancy be denied surgical care? An international retrospective cohort studyAbstract 91. What do patients expect of palliative treatment for symptomatic spinal metastases? A qualitative studyAbstract 44. Denosumab for giant cell tumours of the spine: molecular predictors of clinical response — a pilot studyAbstract 89. Surgical management and outcomes from “stable” degenerative spondylolisthesis (DS) from the CSORN prospective DS study: What the @#$ % are we doing?Abstract 33. Economic consequences of waiting for lumbar disc herniation surgeryAbstract 108. Motor recovery depends on timing of surgery in patients with lumbar disc herniationAbstract 106. Outcomes following revision decompression for lumbar spinal stenosis when compared to primary decompression: a matched cohort analysis using the Canadian Spine Outcomes and Research Network registryAbstract 64. Patient engagement, remote monitoring and virtual care — a pilot project in rural and remote patients undergoing elective lumbar surgeryAbstract 84. Development of a frailty index from the Canadian Spine Outcomes and Research Network (CSORN) to predict long-term success of surgery for patients with degenerative pathologies of the spineAbstract 102. Posterolateral versus posterior interbody fusion for the management of lumbar degenerative spondylolisthesis: analysis from the CSORN prospective LDS propensity score matched studyAbstract 31. Impact on patient-reported outcomes of ending the posterior construct proximally at C2 versus C3 in degenerative cervical myelopathy patientsAbstract 42. Perioperative factors predict 2-year trajectories of pain and disability following anterior cervical discectomy and fusionAbstract 61. Calculating utilities from the modified Japanese Orthopaedic Association score: a prerequisite for quantifying the value of care for cervical myelopathyAbstract 119. Serum neurofilament light (NF-L) and glial fibrillary acidic protein (GFAP) biomarkers and their association with MRI findings in human acute traumatic spinal cord injuryAbstract 95. The Montreal Acute Classification of Spinal Cord Injury (MAC-SCI): a new tool to detect and characterize spinal cord injury in the trauma patientAbstract 118. Mechanism of injury is associated with neurologic outcomes after cervical sensorimotor complete acute traumatic spinal cord injuryAbstract 13. Patient perspective: diagnosis and prognosis of acute spinal cord injuriesAbstract 136. Predictive analytics to improve dedicated spine trauma operating room resource allocationAbstract 138. Machine learning models to predict surgical resident workload at a level 1 trauma centreAbstract 139. Machine learning to predict duration of surgery and length of stay for single-level discectomy proceduresAbstract 9. Outpatient spinal surgery in ManitobaAbstract 131. Unexpected positive culture in presumed aseptic revision spine surgery: a systematic review and meta-analysisAbstract 50. Lumbar anterior vertebral body tethering: biomechanical assessment of the surgical decision factors influencing the immediate and 2 years postoperative correctionAbstract 145. Does prolonged symptom duration influence surgical outcomes for cervical radiculopathy?Abstract 147. A data-driven cluster analysis approach to create homogenous subgroups for traumatic spine injury: toward improving traditional classificationAbstract 41. The use of neo-adjuvant denosumab in treatment of giant cell tumours of the spineAbstract 5. Complications, revision rates and accuracy of robotic-guided S2 alar-iliac screw placementAbstract 6. Opioid use after spine surgery: How much are we over-prescribing?Abstract 7. Intradiscal injection of autologous bone marrow aspirate concentrate improves low back pain at 1 yearAbstract 8. Augmented reality–assisted spine surgery: an early experience demonstrating safety and accuracy with 218 screwsAbstract 22. Comparison of complications, revision rates and fluoroscopy time using the latest technology in robotic-guided surgery with historical fluoroscopic-guided controlsAbstract 23. Robotic-guided thoracolumbar fusion experience: a multi-surgeon, single-centre study of 628 patients and 3874 robotic-guided screws from 2012 to 2020Abstract 86. A province-wide assessment of the appropriateness of lumbar spine MRIAbstract 134. Concomitant traumatic spinal cord injury and brain injury diagnoses are more frequent and impactful than expectedAbstract 45. Spatial and depth mapping of nascent mineralization on Ti6Al4V surfaces demonstrating hierarchical macro-micro-nanoscale surface featuresAbstract 111. Propensity-matched outcomes comparing lumbar interbody fusion and total disk arthroplasty: a Canadian Spine Outcomes and Research Network (CSORN) studyAbstract 30. A Canadian-based pilot study of current surgical practice and implant preferences in lumbar fusion surgeryAbstract 32. Local contamination is a major cause of early deep wound infections following open posterior lumbosacral fusionsAbstract 99. Comparing patient preoperative expectations and postoperative expectation fulfillment between minimally invasive versus open fusion surgeryAbstract 146. Outpatient robotic-assisted lumbar spinal fusion using the Mazor X Stealth EditionAbstract 149. Lessons learned from my first 100 robotic-assisted lumbar fusions using the Mazor X Stealth Edition: surgical synergy with MIS, surgical navigation and roboticsAbstract 151. Freehand biomechanical testing for use in lumbar discectomy trainingAbstract 48. Spinal pathology and outcome post-THA: Does segment of arthrodesis matter?Abstract 27. Patient, surgical and institutional factors associated with length of stay in degenerative lumbar spine surgery: national multicentre cohort analysis from the Canadian Spine Outcomes and Research Network (CSORN)Abstract 28. The impact of the increasing proportion of degenerative spine emergency admissionsAbstract 51. Patient’s expectations of surgery for degenerative spondylolisthesis: analysis by site and type of surgery from the Canadian Spine Outcomes and Research Network (CSORN)Abstract 60. The impact of sex on thoracolumbar surgery outcomes in patients with diabetes — a CSORN studyAbstract 81. The impact of older age on rehabilitation outcomes following functional motor-incomplete traumatic spinal cord injuryAbstract 47. Devise and investigate a novel, intramuscular pressure based, muscle activation strategy in a spine stability modelAbstract 17. 3D radiologic outcomes for patients with moderate idiopathic scoliosis curves treated with internal (anterior vertebral growth modulation) versus external bracing: a 2-year observational studyAbstract 18. Is quality of life affected by concomitant isthmic spondylolisthesis when undergoing surgery for adolescent idiopathic scoliosis and nonsurgical management of the spondylolisthesis?Abstract 128. Toward macrostructural and microstructural investigation of the cervical spinal cord through quantitative analysis of T2-weighted and diffusion-weighted imagingAbstract 26. Minimally invasive versus open thoracolumbar spine surgery for patients who have lumbar spinal stenosis and an ASA score of 3 or above: a CSORN studyAbstract 101. Association between surgeon age and outcomes of spine surgery: a population-based retrospective cohort studyAbstract 77. Utilizing machine learning methodology to create a short form of the Multi-Morbidity Index in spinal cord injuryAbstract 70. Ten-year reoperation rate and clinical outcome in patients treated surgically for lumbar spinal stenosisAbstract 105. Assessing the importance of radiographic and clinical parameters when choosing decompression without fusion for LDS: results from the CSORN prospective DS studyAbstract 104. Preoperative cannabis use in Canadian thoracolumbar spine surgery patients: a CSORN studyAbstract 142. Post-traumatic ascending myelitis, about 2 cases, etiologic analysis and treatmentAbstract 55. NanoLOCK surfaces enhance osteoblast activities at the cellular levelAbstract 76. Which scoring system is the most accurate for predicting survival in patients undergoing surgery for spinal metastases from lung cancer?Abstract 11. Pedicle screw insertion using ultrasound-based navigation without intraoperative radiation: feasibility study on porcine cadaversAbstract 85. What barriers prevent patients being discharged from hospital following elective spine surgery?Abstract 15. Propensity-matched comparison of 90-day complications in robotic-assisted versus non-robotic-assisted lumbar fusionAbstract 56. No-tap (2-step) robotic-assisted cortical bone trajectory (RA-CBT) screw insertion is safe and efficient: comparative analysis of 179 patients and 924 RA-CBT screwsAbstract 124. Developing a Web-based application to promote the adoption of a clinical prediction model for independent walking in people with traumatic spinal cord injury — a protocolAbstract 125. Multivariable prediction models for prognostication after traumatic spinal cord injury — a systematic reviewAbstract 148. Expression of blood serum cytokines in the presentation of acute sciaticaAbstract 150. Do patient-reported outcome scores (PROs) correlate with bundled payment plan performance for elective spine surgeries?Abstract 46. Effects of delayed neurosurgery on anxiety, depression and economic burdenAbstract 69. Care close to home — a retrospective analysis of patients undergoing elective lumbar surgery in a rural satellite hospitalAbstract 110. Surgical adverse events for primary tumours of the spine and their impact on prognosis and outcomes: a PTRON studyAbstract 80. Spinal cord stimulation research in the restoration of function for individuals living with spinal cord injuries: a scoping reviewAbstract 132. Workup and management of asymptomatic extracranial traumatic vertebral artery injury: a Canadian Neurosurgery Resident Research Collaborative studyAbstract 12. A surgical treatment algorithm for restoring pelvic balance and health-related quality of life in high-grade lumbosacral spondylolisthesisAbstract 38. Effectiveness of 6 surgical approaches for minimally invasive lumbar interbody fusion: 1-year follow-up results from a global multicentre studyAbstract 39. Clinical outcomes and fusion success in patients with degenerative lumbar disease without spondylolisthesis: comparing anterolateral to posterior MIS approaches from a global multicentre studyAbstract 40. Anterolateral versus posterior approaches to minimally invasive interbody fusion for patients with spondylolisthesis: results at 1-year follow-up from a global multicentre studyAbstract 73. Benefit of minimally invasive lumbar interbody fusion versus traditional interbody fusion versus posterolateral spinal fusion in lumbar degenerative spondylolisthesis: a propensity-matched analysis from the CSORN prospective LDS studyAbstract 67. The effect of fusionless pediatric scoliosis surgery on 3D radiographic spinopelvic alignmentAbstract 62. Calculating utilities from the Neck Disability Index: a prerequisite for quantifying the value of cervical spine careAbstract 63. The psychometric properties of the mJOA for quality-of-life assessments in cervical myelopathyAbstract 59. Low radius of curvature growth friendly implants increases the risk of developing clinically significant proximal junctional kyphosisAbstract 144. Very long–term outcome of single-level minimally invasive lumbar microdiscectomy with a tubular retractorAbstract 112. Metal implant hypersensitivity in patients undergoing spinal surgery: a literature review and case reportAbstract 43. Diagnostic value of the lumbar spinal stenosis (SSHQ) survey in virtual care provided at a tertiary spine programAbstract 54. Is the Calgary Postoperative Pain After Spine Surgery (CAPPS) score correlated with long-term outcomes after lumbar fusion?Abstract 4. Development of a single-entry referral pathway for patients with spinal conditions in Manitoba: a cross-sectional review of impact and potential way forward for Canadian spine programsAbstract 113. Automatization of bone age calculationAbstract 123. An effectiveness and quality-of-life analysis of conservative care versus surgery for moderate and severe cervical myelopathyAbstract 133. Long-term survivorship of cervical spine procedures: a survivorship meta-analysis and meta-regressionAbstract 137. Natural history of degenerative cervical myelopathy: a meta-analysis and neurologic deterioration survival curve synthesisAbstract 14. Does intraoperative vancomycin powder affect postoperative infections in adolescent idiopathic scoliosis?Abstract 37. The clinical impact of nano-surface technology on postoperative opioid consumption in patients undergoing anterior lumbar interbody fusionAbstract 130. Design and implementation of a comprehensive perioperative complex spine communication toolAbstract 87. Stratifying low back pain patients in an inter-professional education and self-management model of care: results of a latent class analysisAbstract 88. Cohort accuracy versus confidence at the patient level: clinical challenges for AI-based prediction of low back pain outcomesAbstract 96. Preoperative disc angle is an important predictor of segmental lordosis after degenerative spondylolisthesis fusionAbstract 97. Preoperative depression, functional and radiographic outcomes after surgery for degenerative lumbar spondylolisthesisAbstract 116. A CSORN study of functional outcomes after surgery for lumbar degenerative spondylolisthesisAbstract 121. A CSORN study of the effect on radiographic alignment outcomes with different surgery type for degenerative lumbar spondylolisthesisAbstract 79. Spinal cord stimulation to restore neurological function: a costing analysisAbstract 107. Biomechanical properties of a novel morselized bone graft cageAbstract 93. Optimizing spine surgery instrument trays to immediately increase efficiency and reduce costs in the operating roomAbstract 103. Machine learning models can predict subsequent publication of North American Spine Society Annual General Meeting abstractsAbstract 117. The use of primary sacroiliac joint fusion for lower back pain due to sacroiliac joint pathology: a systematic review and meta-analysisAbstract 141. How to make the most of your operative time by optimizing surgical schedulingAbstract 126. Altering physician referral practices remains a challenge: a spine assessment clinic quality improvement studyAbstract 152. Outcomes of workers’ compensation patients undergoing neuromodulation for persistent neuropathic pain conditionsAbstract 90. Expectations of treatment outcomes in patients with spinal metastases: What do we tell our patients? A qualitative studyAbstract 52. Fluoroscopically guided radiofrequency ablation of the superior cluneal nerve: preliminary outcomes data for a minimally invasive approach for treating superior cluneal neuralgiaAbstract 21. Single-stage posterior approach for en bloc resection and spinal reconstruction of T4 Pancoast tumour invading spineAbstract 34. Predictors of sacral ulcers in patients with complete spinal cord injuryAbstract 135. Targeting geographic wait time disparities in Canada: a rapid review of domestic and international strategies to reduce orthopedic wait times in the MaritimesAbstract 143. The influence of coronal plane parameters on patient-reported outcome measures in patients undergoing decompression for lumbar spinal stenosis. Can J Surg 2022. [DOI: 10.1503/cjs.011622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
9
|
Sarraj M, Alqahtani A, Thornley P, Koziarz F, Bailey CS, Freire-Archer M, Bhanot K, Kachur E, Bhandari M, Oitment C. Management of deep surgical site infections of the spine: a Canadian nationwide survey. J Spine Surg 2022; 8:443-452. [PMID: 36606001 PMCID: PMC9808097 DOI: 10.21037/jss-22-47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/07/2022] [Indexed: 01/09/2023]
Abstract
Background Deep surgical site infections after spinal instrumentation represent a significant source of patient morbidity and poorer outcomes. Given lack of evidence or guidelines on the variety of procedural options in the management of deep spine surgical site infections, the purpose of this survey was to document and investigate the use of these techniques across Canada. Methods A 34-question survey evaluating surgical techniques for irrigation and debridement in postoperative thoracolumbar infection was distributed to Canadian adult spine surgeons. Results were analyzed qualitatively, and comparisons by specialty, years of training, and number of cases were completed using Fischer's exact tests. We defined consensus as >70% agreement. Results We received 53 responses (62% response rate) from a comprehensive sample of Canadian adult spine surgeons. There was a consensus to retain hardware (80%) and interbody implants (93%) in acute infection, to retain interbody implants in chronic/recurrent infection (71%), and application of topical antibiotics in recurrent infection (85%). There was consensus on the use of absorbable suture to close fascia in acute (83%) and chronic (87%) infection. Eighty-five percent of surgeons used nonabsorbable materials such as Nylon or staples for skin closure in chronic infection, however, there was no consensus in acute infection. Surgeons varied significantly in type, volume and pressure of fluids, adjuvant solvents, graft management, use of topical antibiotics acutely, and the use of negative pressure wound therapy. Partial hardware exchange was controversial. Additionally, specialty or surgeon experience had no impact on management strategy. Conclusions This survey demonstrates significant heterogeneity amongst Canadian adult spine surgeons regarding key steps in the surgical management of deep instrumented spine infection, concordant with scarce literature addressing these steps.
Collapse
Affiliation(s)
- Mohamed Sarraj
- Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University, Ontario, Canada
| | - Abdullah Alqahtani
- Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University, Ontario, Canada
| | - Patrick Thornley
- Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University, Ontario, Canada;,London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | - Frank Koziarz
- Division of Neurosurgery, Hamilton General Hospital, McMaster University, Ontario, Canada
| | - Christopher S. Bailey
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, Ontario, Canada
| | | | - Kunal Bhanot
- Division of Orthopedic Surgery, Grand River Hospital, McMaster University, Ontario, Canada
| | - Edward Kachur
- Division of Neurosurgery, Hamilton General Hospital, McMaster University, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University, Ontario, Canada
| | - Colby Oitment
- Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University, Ontario, Canada
| |
Collapse
|
10
|
Kruse C, Gouveia K, Thornley P, Yan JR, McCarthy C, Chan T, Kishta W, Khanna V. COVID-19 and the transition to virtual teaching sessions in an orthopaedic surgery training program: a survey of resident perspectives. BMC Med Educ 2022; 22:655. [PMID: 36050706 PMCID: PMC9434512 DOI: 10.1186/s12909-022-03703-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND COVID-19 has had a tremendous impact on medical education. Due to concerns of the virus spreading through gatherings of health professionals, in-person conferences and rounds were largely cancelled. The purpose of this study is the evaluate the implementation of an online educational curriculum by a major Canadian orthopaedic surgery residency program in response to COVID-19. METHODS A survey was distributed to residents of a major Canadian orthopaedic surgery residency program from July 10th to October 24th, 2020. The survey aimed to assess residents' response to this change and to examine the effect that the transition has had on their participation, engagement, and overall educational experience. RESULTS Altogether, 25 of 28 (89%) residents responded. Respondents generally felt the quality of education was superior (72%), their level of engagement improved (64%), and they were able to acquire more knowledge (68%) with the virtual format. Furthermore, 88% felt there was a greater diversity of topics, and 96% felt there was an increased variety of presenters. Overall, 76% of respondents felt that virtual seminars better met their personal learning objectives. Advantages reported were increased accessibility, greater convenience, and a wider breadth of teaching faculty. Disadvantages included that the virtual sessions felt less personal and lacked dynamic feedback to the presenter. CONCLUSIONS Results of this survey reveal generally positive attitudes of orthopaedic surgery residents about the transition to virtual learning in the setting of an ongoing pandemic. This early evaluation and feedback provides valuable guidance on how to grow this novel curriculum and bring the frontier of virtual teaching to orthopaedic education long-term.
Collapse
Affiliation(s)
- Colin Kruse
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, ON, Hamilton, Canada.
| | - Kyle Gouveia
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, ON, Hamilton, Canada
| | - Patrick Thornley
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, ON, Hamilton, Canada
| | - James R Yan
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, ON, Hamilton, Canada
| | - Colm McCarthy
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, ON, Hamilton, Canada
| | - Teresa Chan
- Department of Medicine, Division of Emergency Medicine, McMaster University, ON, Hamilton, Canada
| | - Waleed Kishta
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, ON, Hamilton, Canada
| | - Vickas Khanna
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, ON, Hamilton, Canada
| |
Collapse
|
11
|
Oitment C, Thornley P, Koziarz F, Jentzsch T, Bhanot K. A Review of Strategies to Improve Biomechanical Fixation in the Cervical Spine. Global Spine J 2022; 12:1596-1610. [PMID: 35020520 PMCID: PMC9393983 DOI: 10.1177/21925682211063855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
STUDY DESIGN Systematic review. OBJECTIVES Review the surgical techniques and construct options aimed at improving the biomechanical strength of cervical constructs. METHODS A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of the MEDLINE, Embase, and Cochrane Library databases was performed to identify all studies examining biomechanical strategies utilized in the osteoporotic cervical spine. Screening was performed in duplicate for all stages of the review process. RESULTS An initial search returned 3887 articles. After deletion of duplications and review of abstracts and full text, 39 articles met inclusion criteria. Overall, the surgical techniques reviewed aimed at obtaining rigid fixation in the setting of poor bone quality, or dispersing the forces at the bone-implant interface. We identified 6 key techniques to improve biomechanical fixation. These include bicortical fixation, appropriate screw selection (size and trajectory), PMMA augmentation, load sharing techniques, consideration of ancillary fixation around the occipitocervical junction, and supplementing the construct with post-operative collar or halo. CONCLUSION The summation of the literature highlights a framework of modalities available to surgeons to improve biomechanical fixation in the cervical spine. While these may improve construct strength in the setting of osteoporosis, there is a paucity of evidence available to make recommendations in this patient population.
Collapse
Affiliation(s)
- Colby Oitment
- Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University, Hamilton, ON, Canada,Dr Colby Oitment, MD, McMaster University, Department of Orthopedic Surgery, Hamilton General HospitalAffiliation, McMaster University, 1200 Main St West, Hamilton, ON L8S 4L8, Canada.
| | - Patrick Thornley
- Division of Orthopedic Surgery, Hamilton General Hospital, McMaster University, Hamilton, ON, Canada
| | - Frank Koziarz
- Department of Graduate Studies, Health Research Methodology (HRM), and Epidemiology, McMaster University, Hamilton, ON, Canada
| | - Thorsten Jentzsch
- Division of Orthopaedic Surgery, St Michael’s Hospital, Toronto, ON, Canada,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Kunal Bhanot
- Division of Orthopaedic Surgery, St Michael’s Hospital, Toronto, ON, Canada,Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
12
|
Thornley P, Bishop N, Baker D, Brock J, Arundel P, Burren C, Smithson S, DeVile C, Crowe B, Allgrove J, Saraff V, Shaw N, Balasubramanian M. Non-collagen pathogenic variants resulting in the osteogenesis imperfecta phenotype in children: a single-country observational cohort study. Arch Dis Child 2022; 107:486-490. [PMID: 34750202 DOI: 10.1136/archdischild-2021-322911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/21/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND/OBJECTIVES In England, children (0-18 years) with severe, complex and atypical osteogenesis imperfecta (OI) are managed by four centres (Birmingham, Bristol, London, Sheffield) in a 'Highly Specialised Service' (HSS OI); affected children with a genetic origin for their disease that is not in COL1A1 or COL1A2 form the majority of the 'atypical' group, which has set criteria for entry into the service. We have used the data from the service to assess the range and frequency of non-collagen pathogenic variants resulting in OI in a single country. METHODS Children with atypical OI were identified through the HSS OI service database. All genetic testing for children with OI in the service were undertaken at the Sheffield Diagnostic Genetics Service. Variant data were extracted and matched to individual patients. This study was done as part of a service evaluation project registered with the Sheffield Children's Hospital Clinical Governance Department. RESULTS One hundred of 337 children in the HSS met the 'atypical' criteria. Eighty have had genetic testing undertaken; 72 had genetic changes detected, 67 in 13 genes known to be causative for OI. The most frequently affected genes were IFITM5 (22), P3H1 (12), SERPINF1 (8) and BMP1 (6). CONCLUSION Among children with more severe forms of OI (approximately one-third of all children with OI), around 20% have pathogenic variants in non-collagen genes. IFITM5 was the most commonly affected gene, followed by genes within the P3H1 complex. These data provide additional information regarding the likelihood of different genetic origins of the disease in children with OI, which may influence clinical care.
Collapse
Affiliation(s)
- Patrick Thornley
- The University of Sheffield Faculty of Medicine Dentistry and Health, Sheffield, UK
| | - Nicholas Bishop
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK.,Highly Specialised Osteogenesis Imperfecta Service, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Duncan Baker
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Joanna Brock
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Paul Arundel
- Highly Specialised Osteogenesis Imperfecta Service, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Christine Burren
- Department of Paediatric Endocrinology and Diabetes, Bristol Royal Hospital for Children, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah Smithson
- Department of Clinical Genetics, St Michaels Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Catherine DeVile
- Department of Neurosciences, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Belinda Crowe
- Department of Neurosciences, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jeremy Allgrove
- Department of Endocrinology, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK
| | - Vrinda Saraff
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Nick Shaw
- Department of Endocrinology and Diabetes, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.,Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Meena Balasubramanian
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK .,Highly Specialised Osteogenesis Imperfecta Service, Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK.,Sheffield Clinical Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| |
Collapse
|
13
|
Thornley P, Peterson D, Kishta W. Child Abuse with Thoracolumbar Fracture-Dislocation Treated with Pedicle Screw Fixation in a 2-Year-Old: A Case Report. JBJS Case Connect 2021; 11:01709767-202112000-00081. [PMID: 34937046 DOI: 10.2106/jbjs.cc.21.00129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
CASE A nonverbal 2-year-old boy presented with acute-on-chronic thoracolumbar fracture-subluxation with associated chylothorax and progressive neurologic dysfunction secondary to nonaccidental trauma. We discussed the successful management of this patient with short-segment pedicle screw instrumentation resulting in complete resolution of his chylothoraxes and neurologic impairment. A clinical follow-up is reported out to 12 months after hardware removal. CONCLUSION Thoracolumbar fracture-subluxation with massive chylothorax is a rare and important presentation of nonaccidental trauma that must be recognized. Temporary pedicle screw fixation is a successful treatment option for young children presenting with this difficult spinal pathology.
Collapse
Affiliation(s)
- Patrick Thornley
- Department of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | | | | |
Collapse
|
14
|
Bosakhar B, Liu K, Thornley P, Kishta W. Surgical Technique for the Removal of a Bullet From the Sacroiliac Joint in a Child: A Case Report and Literature Review. JBJS Case Connect 2021; 11:01709767-202109000-00086. [PMID: 34398854 DOI: 10.2106/jbjs.cc.21.00110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE This report presents a logical and effective technique for removing a bullet from the sacroiliac joint (SIJ). The surgery involved a fluoroscopy-guided anterior extraperiosteal lateral window approach. Other than a transient femoral nerve neuropraxia, there were no complications. A literature review identified 3 reports on bullet removal from the SIJ of adult patients. CONCLUSION An anterior extraperiosteal approach for removing bullets from the SIJ in pediatric patients provides satisfactory results. When deciding whether to remove a bullet from the SIJ, the location, joint diastasis, and patient's age should be considered.
Collapse
Affiliation(s)
| | - Kathy Liu
- Royal College of Surgeons, Dublin, Ireland
| | | | - Waleed Kishta
- McMaster University Medical Centre, Hamilton, Canada
| |
Collapse
|
15
|
Missiuna PC, Sarraj M, Bosakhar B, Thornley P, Donnellan J, Kishta W, Darby P, Maizlin ZV. Vertebroplasty for Treatment of Steroid-Induced Osteoporotic Vertebral Compression Fractures in an Adolescent With Duchenne Muscular Dystrophy. HSS J 2021; 17:223-226. [PMID: 34421434 PMCID: PMC8361581 DOI: 10.1177/1556331621990648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Paul C. Missiuna
- Department of Surgery, Division of Orthopedic Surgery, McMaster University Medical Centre, Hamilton, ON, Canada,Paul C. Missiuna, MD, FRCS (C), Department of Surgery, Division of Orthopedic Surgery, McMaster University Medical Centre, Hamilton, ON L8N 3Z5, Canada.
| | - Mohamed Sarraj
- Department of Surgery, Division of Orthopedic Surgery, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Batool Bosakhar
- Department of Surgery, Division of Orthopedic Surgery, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Patrick Thornley
- Department of Surgery, Division of Orthopedic Surgery, McMaster University Medical Centre, Hamilton, ON, Canada
| | - John Donnellan
- Department of Radiology, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Waleed Kishta
- Department of Surgery, Division of Orthopedic Surgery, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Peter Darby
- Department of Anesthesia, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Zeev V. Maizlin
- Department of Radiology, McMaster University Medical Centre, Hamilton, ON, Canada
| |
Collapse
|
16
|
Giglio V, Schneider P, Madden K, Lin B, Multani I, Baldawi H, Thornley P, Naji L, Levin M, Wang P, Bozzo A, Wilson D, Ghert M. Published randomized controlled trials of surveillance in cancer patients - a systematic review. Oncol Rev 2021; 15:522. [PMID: 34267889 PMCID: PMC8256375 DOI: 10.4081/oncol.2021.522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 04/09/2021] [Indexed: 01/14/2023] Open
Abstract
With solid tumor cancer survivorship increasing, the number of patients requiring post-treatment surveillance also continues to increase. This highlights the need for evidence-based cancer surveillance guidelines. Ideally, these guidelines would be based on combined high-quality data from randomized controlled trials (RCTs). We present a systematic review of published cancer surveillance RCTs in which we sought to determine the feasibility of data pooling for guideline development. We carried out a systematic search of medical databases for RCTs in which adult patients with solid tumors that had undergone surgical resection with curative intent and had no metastatic disease at presentation, were randomized to different surveillance regimens that assessed effectiveness on overall survival (OS). We extracted study characteristics and primary and secondary outcomes, and assessed risk of bias and validity of evidence with standardized checklist tools. Our search yielded 32,216 articles for review and 18 distinct RCTs were included in the systematic review. The 18 trials resulted in 23 comparisons of surveillance regimens. There was a highlevel of variation between RCTs, including the study populations evaluated, interventions assessed and follow-up periods for the primary outcome. Most studies evaluated colorectal cancer patients (11/18, [61%]). The risk of bias and validity of evidence were variable and inconsistent across studies. This review demonstrated that there is tremendous heterogeneity among RCTs that evaluate effectiveness of different postoperative surveillance regimens in cancer patients, rendering the consolidation of data to inform high-quality cancer surveillance guidelines unfeasible. Future RCTs in the field should focus on consistent methodology and primary outcome definition.
Collapse
Affiliation(s)
- Victoria Giglio
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Patricia Schneider
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Kim Madden
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Bill Lin
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | | | - Hassan Baldawi
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Patrick Thornley
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Leen Naji
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
| | - Marc Levin
- Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Peiyao Wang
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Anthony Bozzo
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - David Wilson
- Hamilton Health Sciences, Juravinski Hospital and Cancer Center, Hamilton, ON, Canada
| | - Michelle Ghert
- Hamilton Health Sciences, Juravinski Hospital and Cancer Center, Hamilton, ON, Canada
| |
Collapse
|
17
|
Oitment C, Bozzo A, Martin AR, Rienmuller A, Jentzsch T, Aoude A, Thornley P, Ghert M, Rampersaud R. Primary sarcomas of the spine: population-based demographic and survival data in 107 spinal sarcomas over a 23-year period in Ontario, Canada. Spine J 2021; 21:296-301. [PMID: 32949731 DOI: 10.1016/j.spinee.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/30/2020] [Accepted: 09/06/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND CONTEXT Spinal sarcomas are a rare, heterogeneous group of mesenchymal tumors. Current literature reporting demographic variables and survival information is limited to small case series, and a single registry with variable treatment modalities and time periods. PURPOSE We report on population-level data regarding all spinal sarcomas diagnosed over a 23-year period in Ontario, Canada, for the purposes of calculating incidence and prevalence of these tumors. Secondarily, survival is assessed by tumor type as well as adjuvant therapies during this time period. STUDY DESIGN Retrospective Cohort Study PATIENT SAMPLE: Population-based data from the Institute for Clinical Evaluative Sciences (ICES) between 1993 and 2015. OUTCOME MEASURES Outcome measures include incidence and prevalence of spinal osteosarcoma, Ewing's sarcoma, and chondrosarcoma of the spine, as well as 2-, 5-, 10- and 15-year survival and prevalence of adjuvant therapies. METHODS Utilizing population-based data from the Institute for Clinical Evaluative Sciences (ICES) between 1993 and 2015, ICD codes were searched and available data extracted for the purposes of reporting basic demographic information and calculation of Kaplan Meyer survival curves. Databases include the Ontario Cancer Registry, Discharge Abstract Database, Ontario Health Insurance Plan, National Ambulatory Care Reporting System, Registered Persons DataBase (death) were analyzed. RESULTS One hundred and seven spinal sarcomas were identified, with a mean incidence was 0.38 sarcomas per million population per year, that was stable over time. The mean prevalence was 8.1 sarcomas per million population. The most common diagnosis was Ewing's sarcoma (48 [44.9%] patients), followed by chondrosarcoma (33 [30.8%] patients), and osteosarcoma (26 [24.3%] patients). Chondrosarcoma had the highest survival rates with 77.2% and 64.2% 5- and 10-year survival rates, respectively, followed by Ewing's sarcoma with 48.1% and 44.9% 5 and 10-year survival and osteosarcoma with 36.0% and 30.9% 5- and 10-year survival. CONCLUSIONS Spinal sarcoma is a rare disease with variable survival depending on the histologic diagnosis. This population-level study involves a heterogeneous group of patients with variable stages of disease at presentation and variable treatments. Our data fit with the published literature for survival for those treated conservatively and surgically. Our data show considerable improvement in 5- and 10-year mortality when compared with previous population level studies on earlier patient cohorts, likely reflecting improvements in systemic and surgical treatments.
Collapse
Affiliation(s)
- Colby Oitment
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto Western Hospital, 237 Barton St E, Hamilton, Ontario L8L2X2, Canada; Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
| | - Anthony Bozzo
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Allan R Martin
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto Western Hospital, 237 Barton St E, Hamilton, Ontario L8L2X2, Canada
| | - Anna Rienmuller
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto Western Hospital, 237 Barton St E, Hamilton, Ontario L8L2X2, Canada
| | - Thorsten Jentzsch
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto Western Hospital, 237 Barton St E, Hamilton, Ontario L8L2X2, Canada; Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Ahmed Aoude
- Hamilton Health Sciences, Juravinski Hospital and Cancer Center, Hamilton, Ontario, Canada; Division of Orthopedic Oncology, University of Toronto, Mt. Siani Hospital, Toronto, Ontario, Canada
| | - Patrick Thornley
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michelle Ghert
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Raja Rampersaud
- Division of Orthopedic Surgery, Department of Surgery, University of Toronto, Toronto Western Hospital, 237 Barton St E, Hamilton, Ontario L8L2X2, Canada
| |
Collapse
|
18
|
Missiuna P, Shen J, Nahle I, Shen J, Alanazi M, Rutges J, Rocos B, Miyanji F, Lohkamp L, Grootjen L, Hachem L, Aldebeyan S, Machida M, Padhye K, Rushton P, Jentzsch T, Jentzsch T, Lewis S, Passias P, Pierce K, Lewis S, Passias P, Nielsen C, Glennie A, Crawford E, Schneider N, Ayling O, Christie S, Greene R, Singh S, Beauchamp-Chalifour P, Balasuberamaniam P, Singh S, Mercure-Cyr R, Wilson J, Evaniew N, Martin A, Rienmueller A, Martin A, Karim M, Martin A, Cheung A, Badhiwala J, Diotalevi L, Jaja B, Fallah N, Badhiwala J, Wasim A, Manson N, Lasry O, Crawford E, Brown A, MacLean MA, Khan O, Badhiwala J, Odai KG, Bailly N, Khan O, Evaniew N, Yamamoto S, Singh M, Kashigar A, Persad A, Fernandes RJR, Malakoutian M, Ahuja C, Morris S, Stukas S, Chen T, Babadagli E, Xu M, Nater A, Oitment C, Karim M, Aziz M, Pahuta M, Versteeg A, Sundararajan K, Tanguay R, Stratton A, Cushnie D, Correale M, Sadiq I, Badhiwala J, Passias P, Badhiwala J, McGregor S, Passias P, Badhiwala J, Chen T, Singh S, Ayling O, Bond M, Rienmueller A, Chen T, Lasry O, Lyons F, Ahmed U, Inglis T, Waheed Z, Wilson J, Nater A, Pahuta M, Klein G, McKibben N, Kassam F, Clement A, Kanawati A, Shaikh N, Kanawati A, Alshammari A, Kanawati A, Yamamoto S, Hamilton K, Huschi Z, Peng YN, Huschi Z, Filgueira É, Goulet J, Kashigar A, Chen T, Hadgaonkar S, MacLean M, Chen T, Kerr HL, Meagher J, Wilson J, Stevens M, Rocos B, Pai A, Kingwell S, Thibault J, Touchette C, Moskven E, Greene R, DeVries Z, Sarraj M, Bosakhar B, Thornley P, Donnellan J, Kishta W, Darby P, Nahle I, Alzakri A, Roy-Beaudry M, Joncas J, Turgeon I, Parent S, Shen J, Alzakri A, Roy-Beaudry M, Joncas J, Turgeon I, Parent S, Samson N, Lamontagne-Proulx J, Soulet D, Tremblay Y, Praud JP, Parent S, Parent S, Gross D, Renkens J, Schlösser T, Stadhouder A, Kruyt M, Mostert A, Tee J, de Klerk L, De Kleuver M, Castelein R, Zeller R, Lewis S, Tan T, Lebel D, Rushton P, Petcharaporn M, Samdani A, Newton P, Marks M, Drake J, Dirks P, Rutka J, Kulkarni A, Ibrahim G, Taylor M, Dewan M, Zeller R, Donze S, Damen L, Rutges J, Hokken-Koelega A, Mathieu F, Lamberti-Pasculi M, Hanak B, Zeller R, Kulkarni A, Drake J, Ibrahim G, Rushton P, Ghag R, Miyanji F, Zeller R, Lewis S, Lebel D, Peiro-Garcia A, Benavides B, Parsons D, Ferri-de-Barros F, Aldebeyan S, Ghag R, Miyanji F, Kutschke L, Laux C, Kabelitz M, Schüpbach R, Böni T, Farshad M, Nielsen C, Lewis S, Lenke L, Shaffrey C, Cheung K, Berven S, Qiu Y, Matsuyama Y, Pellisé-Urquiza F, Polly D, Sembrano J, Dahl B, Kelly M, de Kleuver M, Spruit M, Alanay A, Alas H, Kim HJ, Lafage R, Soroceanu A, Hockley A, Ames C, Klineberg E, Burton D, Diebo B, Bess S, Line B, Shaffrey C, Smith J, Schwab F, Lafage V, Passias P, Lafage R, Soroceanu A, Hockley A, Line B, Klineberg E, Bess S, Protopsaltis T, Shaffrey C, Schwab F, Scheer J, Smith J, Lafage V, Ames C, Lenke L, Shaffrey C, Cheung K, Berven S, Qiu Y, Matsuyama Y, Pellisé-Urquiza F, Polly D, Sembrano J, Dahl B, Kelly M, de Kleuver M, Spruit M, Alanay A, Bortz C, Pierce K, Alas H, Brown A, Soroceanu A, Hockley A, Vira S, Ahmad W, Naessig S, Diebo B, Raman T, Protopsaltis T, Buckland A, Gerling M, Lafage R, Lafage V, Lewis S, Lenke L, Shaffrey C, Cheung K, Berven S, Qiu Y, Matsuyama Y, Pellisé-Urquiza F, Polly D, Sembrano J, Dahl B, Kelly M, de Kleuver M, Spruit M, Alanay A, Bailey C, Rampersaud R, Fisher C, Chen T, McIntosh G, Rampersaud R, Karim M, Urquhart J, Fisher C, Street J, Dvorak M, Paquette S, Charest-Morin R, Ailon T, Glennie A, Manson N, Rampersaud R, Thomas K, Rasoulinejad P, Bailey C, Ailon T, Fisher C, Greene R, Glennie A, Duquette D, LeBlanc D, Martell B, Schmidt M, Christie S, Wong DBT, Di Paola C, Ailon T, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Street J, Flexman A, Charest-Morin R, Wasim A, Schwartz C, Stark R, Shrikumar M, Finkelstein J, Gara A, Banaszek D, Wong T, Ailon T, Bryce E, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Persad A, Spiess M, Wu A, Woo A, Hnenny L, Fourney D, Joshi H, Khan O, Badhiwala J, Rampersaud R, Lewis S, Massicotte E, Fehlings M, Cadotte D, Bailey C, Christie S, Dea N, Fisher C, Paquet J, Soroceanu A, Thomas KC, Rampersaud YR, Wilson J, Manson N, Johnson M, Hall H, McIntosh G, Jacobs B, Kalsi-Ryan S, Akbar MA, Badhiwala J, Wilson J, Tetreault L, Nouri A, Rienmuller A, Massicotte E, Fehlings M, Kalsi-Ryan S, Riehm L, Martin A, Badhiwala J, Akbar M, Massicotte E, Fehlings M, Kalsi-Ryan S, Akbar MA, Badhiwala J, Wilson J, Tetreault L, Nouri A, Rienmuller A, Massicotte E, Fehlings M, Jacobs B, Johnson M, Bailey C, Christie S, Paquet J, Nataraj A, Cadotte D, Wilson J, Manson N, Hall H, Thomas K, Rampersaud R, McIntosh G, Fisher C, Dea N, Wilson J, Jentzsch T, Jiang F, Badhiwala J, Moghaddamjou A, Akbar MA, Nater A, Rienmuller A, Ganau M, Massicotte E, Fehlings M, Tu L, Manouchehri N, Kim KT, So K, Webster M, Fisk S, Tigchelaar S, Dalkilic S, Sayre E, Streijger F, Macnab A, Kwon B, Shadgan B, Wilson J, Fehlings M, Bailly N, Wagnac E, Mac-Thiong JM, Goulet J, Petit Y, Badhiwala J, Grossman R, Geisler F, Fehlings M, Wilson J, Rivers C, Kwon B, Waheed Z, Buenaventura J, Humphreys S, Noonan V, Evaniew N, Dvorak M, Wilson J, Fehlings M, Shrikumar M, Balasuberamaniam P, Rapkin B, Schwartz C, Stark R, Finkelstein J, Bigney E, Darling M, Richardson E, El-Mughayyar D, Abraham E, Street J, Radomski L, Rampersaud R, Pierce K, Bortz C, Alas H, Naessig S, Ahmad W, Vira S, Diebo B, Sciubba D, Hassanzadeh H, Hockley A, Soroceanu A, Protopsaltis T, Buckland A, Passias P, Greene R, Christie SD, Badhiwala J, Fehlings M, Witiw C, Wilson J, Fehlings M, Nessek H, Wai E, Phan P, Diotalevi L, Beauséjour MH, Wagnac E, Mac-Thiong JM, Petit Y, Badhiwala J, Fehlings M, Mazlouman S, Belley-Côté E, Jacobs B, Kwon B, Malakoutian M, Theret M, Street J, Brown S, Rossi F, Oxland T, Singh P, Chandra S, Laratta J, Carreon L, Bisson E, Ghogawala Z, Yew A, Mkorombindo T, Mummaneni P, Glassman S, Kindrachuk M, Hnenny L, Wu A, Norton J, Fourney D, Gee A, Kerr HL, Kanawati A, Zdero R, Gurr K, Bailey C, Rasoulinejad P, Yamamoto S, Sadaram S, Speidel J, Liu J, Street J, Brown S, Oxland T, Khazaei M, Walji I, Dadabhoy M, Gulati N, Aiyar N, Ostmeier S, Hasan A, Senthilnathan V, Punjani N, Yao Y, Yue S, Ozdemir G, Lou Z, Luong W, Post A, Tootsi A, Chan P, Fehlings M, Yung A, George S, Prevost V, Bauman A, Kozlowski P, Samadi F, Fournier C, Parker L, Dong K, Streijger F, Moore W, Laule C, Kwon B, Gill J, Cooper J, Dong K, Streijger F, Street J, Paquette S, Ailon T, Charest-Morin R, Fisher C, Dvorak M, Dhall S, Mac-Thiong JM, Parent S, Bailey C, Christie S, Wellington C, Kwon B, Crawford E, Zhang Y, Hardisty M, Finkelstein J, Kureshi N, Julien L, Abidi R, Christie S, Parashin S, Gascoyne T, Goytan M, Chuang J, Liu K, Quraishi N, Pasku D, Wilson J, Fehlings M, Bozzo A, Reinmuller A, Martin A, Hananel SY, Thornley P, Gazendam A, Aoude A, Nielsen C, Rampersaud R, Dea N, Versteeg A, Sahgal A, Verlaan JJ, Morin RC, Rhines L, Sciubba D, Schuster J, Weber M, Lazary A, Fehlings M, Clarke M, Arnold P, Boriani S, Laufer I, Gokaslan Z, Fisher C, Rosenzweig D, Weber M, Fisk F, Versteeg A, Fisher C, Sahgal A, Gokaslan Z, Rhines L, Boriani S, Bettegowda C, Dea N, Gal R, Charest-Morin R, Verlaan JJ, Verkooijen L, Fisher C, Perruccio A, Rampersaud R, Eckenswiller D, Yu A, Klassen K, Lewkonia P, Thomas K, Jacobs B, Miller N, Swamy G, Yang M, Soroceanu A, Phan P, Wai E, Kingwell S, Moravek D, Tierney S, Street J, Sundararajan K, Bosma R, Faclier G, Di Renna T, Rampersaud R, Frederick A, Kassam F, Nicholls F, Swamy G, Lewkonia P, Thomas K, Jacobs B, Miller N, Tanguay R, Soroceanu A, Platt A, Traynelis V, Witiw C, Horn S, Weiser-Horwitz S, Bortz C, Segreto F, Pierce K, Lafage R, Hockley A, Vira S, Lafage V, Witiw C, Wilson J, Nassiri F, da Costa L, Nathens A, Fehlings M, Jacobs B, Alas H, Pierce K, Brown A, Bortz C, Hockley A, Soroceanu A, Vira S, Naessig S, Ahmad W, Lafage R, Lafage V, Witiw C, Wilson J, da Costa L, Nathens A, Fehlings M, Crawford E, McIntosh G, Rampersaud R, Fisher C, Manson N, Thomas K, Hall H, Rampersaud R, Dea N, McIntosh G, Charest-Morin R, Investigators CSORN, Ailon T, Fisher C, Evaniew N, Aldebeyan S, Thomas K, Sundararajan K, Oitment C, Lewis S, Perruccio A, Rampersaud R, Christie S, Yee A, Fisher C, Jarzem P, Roy JF, Bouchard J, Evans D, Kwon B, Splawinski J, Warren D, Street J, Morris S, Costello J, Farrell M, Humphreys S, Kurban D, Rivers C, Jeffrey M, Juutilainen S, Casha S, Christie S, Clarke T, Drew B, Ethans K, Fehlings M, Fox R, Linassi G, Marion T, O’Connell C, Paquet J, Reid J, Scott L, Fourney D, Schouten R, Rivers C, Chen M, Nunnerley J, Croot T, Young L, Patel A, Dvorak M, Kwon B, Rivers C, Buenaventura J, Humphreys S, Noonan V, Fallah N, Evaniew N, Dvorak M, Cronin S, Badhiwala J, Ginsberg H, Fehlings M, Kwon B, Jaglal S, Wilson J, Fehlings M, Fisk F, Versteeg A, Fisher C, Sahgal A, Gokaslan Z, Rhines L, Boriani S, Bettegowda C, Dea N, Martel A, Sahgal A, Finkelstein J, Whyne C, Hardisty M, Baksh N, Nguyen T, Brown S, Jaboin J, Lin C, Yach J, Hardisty M, Whyne C, Fernandez R, Gee A, Urquhart J, Bailey C, Rasoulinejad P, Zhang H, Shewchuk J, Street J, Wilson D, Oxland T, Fernandez R, Gee A, Urquhart J, Bailey C, Rasoulinejad P, Algarni N, Aljarboa N, Jarzem P, Fernandez R, Gee A, Urquhart J, Bailey C, Rasoulinejad P, Whyte T, Van Toen C, Melnyk A, Shewchuk J, Street J, Cripton P, Oxland T, Avila M, Hurlbert RJ, Neuburger L, Ahmed SU, Cheng Y, Fourney D, Hsu HC, Kao CH, Neuburger L, Ahmed SU, Cheng Y, Fourney D, Meves R, de Oliveira AI, da Silva HC, Richard-Denis A, Petit Y, Diotalevi L, Mac-Thiong JM, Laratta J, Bisson E, Carreon L, Yew A, Mkorombindo T, Glassman S, Christie S, Bouchard J, Fisher C, Roy JF, Yee A, Jarzem P, Khurjekar K, Kothari A, Zawar A, Sanchetui P, Shyam A, Touchette C, Han JH, Christie S, Pickett G, Yee A, Bouchard J, Christie S, Fisher C, Jarzem P, Roy JF, Hashem L, Urquhart J, Rasoulinejad P, Gurr K, Siddiqi F, Bailey C, Attabib N, Bigney E, Richardson E, El-Mughayyar D, Darling M, Manson N, Abraham E, Badhiwala J, Jiang F, Wilson J, Fehlings M, Dunning C, Oxner W, Stewart S, Glennie A, Hutchinson J, Oxland T, Zhang H, Shewchuk J, Wilson D, Street J, Wilk S, Wai E, Phan P, Stratton A, Mohammed S, Tsai E, Alkerayf F, Michalowski W, Phan P, Wai E, Hoda M, MacLean M, Brunette-Clément T, Abduljabba F, Weber M, Fourney D, Charest-Morin R, Flexman A, Street J, Frey M, Mackey S, De Carvalho D, Barrowman N, Smit K, Tice A, Mervitz D, Jarvis J, Kingwell S. Canadian Spine SocietyPresentation CPSS1: Spinal insufficiency fracture in the geriatric pediatric spinePresentation CPSS2: The clinical significance of tether breakages in anterior vertebral body growth modulation: a 2-year postoperative analysisPresentation CPSS3: Anterior vertebral body growth modulation for idiopathic scoliosis: early, mid-term and late complicationsPresentation CPSS4: Ovine model of congenital chest wall and spine deformity with alterations of respiratory mechanics: follow-up from birth to 3 monthsPresentation CPSS5: Test–retest reliability and minimum detectable change of the English translation of the Italian Spine Youth Quality of Life questionnaire in adolescents with idiopathic scoliosisPresentation B1. Abstract 31: Incidence of delayed spinal cord injury in pediatric spine deformity surgery seems to be higher than previously assumedPresentation B2. Abstract 155: What is the optimal surgical method for achieving successful symptom relief in pediatric high-grade spondylolisthesis?Presentation B3. Abstract 47: Vertebral body tethering: Truly motion preserving or rather limiting?Presentation B4. Abstract 180: Fusion rates in pediatric patients after posterior cervical spine instrumentationPresentation B5. Abstract 102: Effects of 8 years of growth hormone treatment on the onset and progression of scoliosis in children with Prader–Willi syndromePresentation B6. Abstract 144: Klippel–Feil syndrome: clinical phenotypes associated with surgical treatmentPresentation B7. Abstract 123: Anterior release for idiopathic scoliosis: Is it necessary for curve correction?Presentation B8. Abstract 62: Severe scoliosis: Do we know a better way? A retrospective comparative studyPresentation B9. Abstract 21: Intraoperative skull femoral traction in adolescent idiopathic scoliosis: the correlation of traction with side-bending radiographsPresentation B10. Abstract 147: What is the effect of intraoperative halo-femoral traction on correction of adolescent idiopathic scoliosis?Presentation B11. Abstract 174: Extreme long-term outcome of surgically versus non-surgically treated patients with adolescent idiopathic scoliosisPresentation B12. Abstract 172: The influence of multilevel spinal deformity surgery on the clinical outcome in the elderly: a prospective, observational, multicentre studyPresentation B13. Abstract 49: Demographics of a prospective evaluation of elderly deformity surgery: a prospective international observational multicentre studyPresentation B14. Abstract 119: Timing of conversion to cervical malalignment and proximal junctional kyphosis following surgical correction of adult spinal deformityPresentation B15. Abstract 44: Prioritization of realignment associated with superior clinical outcomes for surgical cervical deformity patientsPresentation B16. Abstract 50: Outcome of multilevel spinal deformity surgery in patients over 60 years of age: a multicentre international prospective studyPresentation B17. Abstract 122: A simpler, modified frailty index weighted by complication occurrence correlates to pain and disability for adult spinal deformity patientsPresentation B18. Abstract 75: Change in Oswestry Disability Index at 24 months following multilevel spinal deformity surgery in patients over 60 years of age: a multicentre international prospective studyPresentation C19. Abstract 19: A prospective cohort study evaluating trends in the surgical treatment of degenerative spondylolisthesis in Canada and the utility of a novel surgical decision aidPresentation C20. Abstract 154: Decompression compared with decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation C21. Abstract ID 77: Lumbar degenerative spondylolisthesis: factors impacting decision to fusePresentation C22. Abstract 27: Patient-reported outcomes following surgery for lumbar disc herniation: comparison of a universal and multitier health care systemPresentation C23. Abstract 151: Do patients with recurrent lumbar disc herniations fair worse with discectomy than primary operations? A retrospective analysis from the Canadian Spine Outcomes and Research NetworkPresentation C24. Abstract 136: A province-wide assessment of the appropriateness of lumbar spine MRIPresentation D25. Abstract 32: Surgical site infection reduction — a 10-year quality improvement journeyPresentation D26. Abstract 34: The impact of frailty on patient-reported outcome measures following elective thoraco-lumbar spine surgeryPresentation D27. Abstract 8: Moving toward better health: exercise practice is associated with improved outcomes after spine surgeryPresentation D28. Abstract 33: Preoperative decolonization does not adversely affect the microbiologic spectrum of spine surgical site infectionPresentation D29. Abstract 61: Feedback: reducing after-hours spine cases using an encrypted messaging systemPresentation D30. Abstract 177: Complex spine surgery is safe and effective in the extremely elderly age group: results from an ambispective study of 722 patients over 75 years old from a single institutionPresentation E31. Abstract 38: Clinical predictors of achieving minimal clinically important difference after surgery for cervical spondylotic myelopathy: an external validation study from the Canadian Spine Outcomes and Research NetworkPresentation E32. Abstract 66: The natural history of degenerative cervical myelopathy: an ambispective longitudinal cohort studyPresentation E33. Abstract 159: Quantitative assessment of gait characteristics in degenerative cervical myelopathy (DCM): a prospective studyPresentation E34. Abstract 130: Prognostic factors in degenerative cervical myelopathy (DCM) for patients managed operatively and nonoperativelyPresentation E35. Abstract 175: Efficacy of surgical decompression in patients with cervical spondylotic myelopathy: results of a Canadian prospective multicentre studyPresentation E36. Abstract 67: Interobserver reliability of the modified Japanese Orthopedic Association (mJOA) score in degenerative cervical myelopathyPresentation F37. Abstract 128: Continuous optical monitoring of spinal cord hemodynamics during the first 7 days after injury in a porcine model of acute spinal cord injuryPresentation F38. Abstract 106: Development of a prediction model for central cord syndrome: an evaluation of motor recovery and the effectiveness of early surgery in a prospective, multicentre cohortPresentation F39. Abstract 135: Spinal cord dynamics under different clinical configurations of thoracolumbar burst fractures through numerical simulationsPresentation F40. Abstract 60: Predicting the heterogeneity of outcome following sensorimotor complete cervical spinal cord injury: trajectory-based analysis of 655 prospectively enrolled patientsPresentation F41. Abstract 167: Mortality in the year following discharge to the community from inpatient care for acute traumatic spinal cord injury: When and why?Presentation F42. Abstract 104: A novel method to classify patients with cervical incomplete spinal cord injury based on potential for recovery: a group-based trajectory analysis using prospective, multicentre data from over 800 patientsPresentation G43. Abstract 7: Responsiveness of standard spine outcome tools: Do they measure up?Presentation G44. Abstract 142: Patient outcomes: important psychological measuresPresentation G45. Abstract 84: Accuracy of surveillance for surgical site infections after spine surgery: a Bayesian latent class analysis using 4 independent data sourcesPresentation G46. Abstract 169: Econometric modelling: development of a surgical cost calculator for degenerative conditions of the lumbar spinePresentation G47. Abstract 124: The economic impact of nonreimbursable events in open, minimally invasive and robot-assisted lumbar fusion surgeryPresentation G48. Abstract 164: Are there sex differences in preoperative health status and health care delivery for patients undergoing scheduled lumbar surgery? An analysis from the Canadian Spine Outcomes and Research NetworkPresentation H49. Abstract 41: Patient phenotypes associated with functional outcomes after spinal cord injury: a principal component analysis in 1119 patientsPresentation H50. Abstract 103: Early versus late surgical decompression for acute traumatic spinal cord injury: a pooled analysis of prospective, multicentre data in 1548 patientsPresentation H51. Abstract 79: Clinical outcome correlation of diffusion tensor imaging and magnetic resonance imaging values: a systematic reviewPresentation H52. Abstract 137: A numerical study on the pathogenesis of central cord syndromePresentation H53. Abstract 42: Feasibility and utility of machine learning in prediction of bladder outcomes after spinal cord injury: analysis of 1250 patients from the European Multicenter Study about Spinal Cord Injury (EMSCI) registryPresentation H54. Abstract 18: Interventions to optimize spinal cord perfusion in patients with acute traumatic spinal cord injuries: a systematic reviewPresentation i55. Abstract 55: The effect of posterior lumbar spinal surgery on passive stiffness of rat paraspinal muscles 13 weeks post-surgeryPresentation i56. Abstract 43: A computed tomographic based morphometric analysis of the axis in adult populationPresentation i57. Abstract 92: Is there value to flexion–extension x-rays for degenerative spondylolisthesis? A multicentre retrospective studyPresentation i58. Abstract 98: The novel “7/20 EMG protocol” in combination with O-arm image-guided navigation for accurate lumbar pedicle placement while minimizing diagnostic radiation exposurePresentation i59. Abstract 148: Comparative biomechanical study of 2 types of transdiscal fixation implants for high-grade L5/S1 spine spondylolisthesis in a porcine modelPresentation i60. Abstract 85: The effects of fibre bundle size and vertebral level on passive stiffness of the lumbar paraspinal muscles in a rat modelPresentation J61. Abstract 157: A self-assembling peptide biomaterial to enhance human neural stem cell-based regeneration of the injured spinal cordPresentation J62. Abstract 162: Measuring demyelination, axonal loss and inflammation after human spinal cord injury with quantitative magnetic resonance imaging and histopathologyPresentation J63. Abstract 179: Characterization of ubiquitin C-terminal hydrolase L1 (UCH-L1) as a fluid biomarker of human traumatic spinal cord injuryPresentation J64. Abstract 13: Utility and role of virtual reality based simulation models in spinal decompression trainingPresentation J65. Abstract 160: Investigating the determinants for predicting surgical patient outcomes through the application of machine learning methodsPresentation J66. Abstract 143: Comparison of screw design and technique on cervical lateral mass screw fixationPresentation K67. Abstract 57: Development of clinical prognostic models for postoperative survival and quality of life in patients with surgically treated metastatic epidural spinal cord compressionPresentation K68. Abstract 170: Sarcomas of the spine: a 20-year survey of disease and treatment strategy in Ontario, CanadaPresentation K69. Abstract 15: Metastatic spine disease: Should patients with short life expectancy be denied surgical care? An international retrospective cohort studyPresentation K70. Abstract 29: Nanoparticle-functionalized polymethyl methacrylate bone cement for sustained chemotherapeutic drug deliveryPresentation K71. Abstract 90: Development of the Spine Oncology Study Group Outcomes Questionnaire – 8 Domain (SOSGOQ-8D)Presentation K72. Abstract 6: Treatment expectations of patients with spinal metastases: What do we tell our patients?Presentation L73. Abstract 48: Factors related to risk of opioid abuse in primary care patients with low back painPresentation L74. Abstract 65: QI/QA of a transitional outpatient pain program for spinePresentation L75. Abstract 168: The effect of preoperative opioid use on hospital length of stay in patients undergoing elective spine surgeryPresentation L76. Abstract 163: Disability or pain: Which best predicts patient satisfaction with surgical outcome? A Canadian Spine Outcomes and Research Network (CSORN) studyPresentation L77. Abstract 58: Rapid access to interventional pain management for lumbar nerve root pain through collaborative interprofessional provider networksPresentation L78. Abstract 63: Chronic preoperative opioid use associated with higher perioperative resource utilization and complications in adult spinal deformity patientsPresentation M79. Abstract 108: Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a longitudinal analysis of reoperationsPresentation M80. Abstract 46: Preliminary results of randomized controlled trial investigating the role of psychological distress on cervical spine surgery outcomes: a baseline analysisPresentation M81. Abstract 110: Operative versus nonoperative treatment of geriatric odontoid fractures: a study of North American trauma centresPresentation M82. Abstract 74: Clinical outcome of posterior cervical foraminotomy versus anterior cervical discectomy and fusionPresentation M83. Abstract 45: “Reverse Roussouly”: ratios of cervical to thoracic shape curvature in an adult cervical deformity populationPresentation M84. Abstract 109: Treatment of acute traumatic central cord syndrome: a study of North American trauma centresPresentation N85. Abstract 118: Comparing minimally invasive versus traditional open lumbar decompression and fusion surgery: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation N86. Abstract 54: Time to return to work after lumbar spine surgeryPresentation N87. Abstract 28: Patient-reported outcomes following surgery for lumbar spinal stenosis: comparison of a universal and multitier health care systemPresentation N88. Abstract 93: Outcomes of surgery in older adults with lumbar spinal stenosisPresentation N89. Abstract 162: Functional objective assessment using the TUG test is a useful tool to evaluate outcome in lumbar spinal stenosisPresentation N90. Abstract 36: A Canadian Spine Outcomes and Research Network (CSORN) matched-cohort study comparing lumbar fusion and disk arthroplastyPresentation o91. Abstract 171: Development of clinical practice guidelines for the management of traumatic spinal column and cord injuries in British Columbia: an approach to standardizing care of spine trauma patientsPresentation o92. Abstract 22: Notes from a small island: stemming the tide of a spinal deluge. The use of encrypted software applications to ensure accountability, quality control and surgical consensus in a national acute adult spinal surgery centrePresentation o93. Abstract 129: Traumatic spinal cord injuries among Aboriginal and non-Aboriginal populations in Canada: an ambispective outcomes studyPresentation o94. Abstract 132: Traumatic spinal cord injury in New Zealand and Canada: a comparative analysisPresentation o95. Abstract 150: Exploring the reasons for readmission following traumatic spinal cord injuryPresentation o96. Abstract 59: Exploring the epidemiology and impact of spinal cord injury in the elderly: a 15-year Canadian population-based cohort studyPresentation P1. Abstract 139: Incidence and management of spinal metastasis in Ontario: a population-based studyPresentation P2. Abstract 91: A general population utility valuation study for the Spine Oncology Study Group Outcomes Questionnaire – 8DPresentation P3. Abstract 158: Metastatic vertebrae segmentation by augmented 3D convolutional neural networkPresentation P4. Abstract 73: Risk factors for failure of radiation therapy for spinal metastasesPresentation P5. Abstract 68: Significance of extracanalicular cement extravasation in thoracolumbar kyphoplastyPresentation P6. Abstract 120: Modelling fracture in osteoblastic vertebraePresentation P7. Abstract 97: The development of novel 2-in-1 patient-specific, 3D-printed laminar osteotomy guides with integrated pedicle screw guidesPresentation P8. Abstract 56: Effect of pelvic retroversion on pelvic geometry and muscle morphometry from upright magnetic resonance imagingPresentation P9. Abstract 161: Anatomic relationship between the accessory process of the lumbar spine and the pedicle screw entry pointPresentation P10. Abstract 20: Novel chair to measure lumbar spine extensors strength in adultsPresentation P11. Abstract 95: Error measurement between human spine, 3D scans, CT-based models, and 3D-printed modelsPresentation P12. Abstract 52: The diagnostic precision of computed tomography for traumatic cervical spine injury: an in vitro investigationPresentation P13. Abstract 94: Epidural abscess causing spinal cord infarctionPresentation P14. Abstract 83: The nerve root sedimentation sign on magnetic resonance imaging is not only correlated with neurogenic claudication: association with all types of leg-dominant mechanical painPresentation P15. Abstract 3: Accuracy of robot-assisted compared with freehand pedicle screw placement in spine surgery: a meta-analysis of randomized controlled trialsPresentation P16. Abstract 82: A positive nerve root sedimentation sign on magnetic resonance imaging is associated with improved surgical outcomes in patients with back dominant painPresentation P17. Abstract 16: Thoracolumbar burst fracture: McCormack load-sharing classification —systematic review and single-arm meta-analysisPresentation P18. Abstract 86: Morphological features of thoracolumbar burst fractures associated with neurologic recovery after thoracolumbar traumatic spinal cord injuryPresentation P19. Abstract 89: Radiographic parameters of listhesis and instability are not associated with health status or clinical outcomes in grade 1 degenerative spondylolisthesisPresentation P20. Abstract 37: Predictive socioeconomic factors following lumbar disk arthroplasty: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation P21. Abstract 25: Effect of in situ fusion in lumbar spondylolisthesis on clinical outcomes and spino-pelvic sagittal balancingPresentation P22. Abstract 10: Sex differences in the surgical management of lumbar degenerative disease: a systematic reviewPresentation P23. Abstract 35: Two-year results of lumbar disk arthroplasty: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation P24. Abstract 78: Does disc morphology affect the success of nonoperative treatment of chronic sciatica from a lumbar disc herniation?Presentation P25. Abstract 141: Opioid prescribing patterns: preliminary investigationPresentation P26. Abstract 133: Frailty is a better predictor of complications than age alone after surgical treatment of degenerative cervical myelopathy: an ambispective study of 5107 elderly patients from the National Surgical Quality Improvement Program databasePresentation P27. Abstract 26: Pathway analysis in spine surgery: a model for evaluating length of stayPresentation P29. Abstract 156: Patients with adolescent idiopathic scoliosis (AIS) have different cervical lordosis than the normal populationPresentation P31. Abstract 64: Investigation of thoracic spinal muscle morphology with upright magnetic resonance imagingPresentation P32. Abstract 80: Postoperative complication prediction between spinal surgeons and a machine learning model: a comparative studyPresentation P33. Abstract 81: Is using a simplified procedural classification as accurate as using current procedural terminology codes to predict future complications in spinal surgery?Presentation P34. Abstract 88: Preoperative patient performance status and frailty phenotype as predictive factors of outcome in surgically treated patients with metastatic spinal disease: a systematic literature reviewPresentation P35. Abstract 101: The measurements of frailty and their application to spine surgeryPresentation P36. Abstract 131: The effect of prolonged sitting on muscle reflexes of the low backPresentation P37. Abstract 87: Implementing a rapid discharge pathway for adolescent idiopathic scoliosis in Canada. Can J Surg 2020. [DOI: 10.1503/cjs.014720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
19
|
Abstract
Three-dimensional printing (3DP) has become more frequently used in surgical specialties in recent years. These uses include pre-operative planning, patient-specific instrumentation (PSI), and patient-specific implant production.The purpose of this review was to understand the current uses of 3DP in orthopaedic surgery, the geographical and temporal trends of its use, and its impact on peri-operative outcomesOne-hundred and eight studies (N = 2328) were included, published between 2012 and 2018, with over half based in China.The most commonly used material was titanium.Three-dimensional printing was most commonly reported in trauma (N = 41) and oncology (N = 22). Pre-operative planning was the most common use of 3DP (N = 63), followed by final implants (N = 32) and PSI (N = 22).Take-home message: Overall, 3DP is becoming more common in orthopaedic surgery, with wide range of uses, particularly in complex cases. 3DP may also confer some important peri-operative benefits. Cite this article: EFORT Open Rev 2020;5:430-441. DOI: 10.1302/2058-5241.5.190024.
Collapse
Affiliation(s)
- Jasmine N. Levesque
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ajay Shah
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Seper Ekhtiari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - James R. Yan
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Thornley
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Dale S. Williams
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
20
|
Kirsch JM, Khan M, Thornley P, Gichuru M, Freehill MT, Neviaser A, Moravek J, Miller BS, Bedi A. Platform shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg 2018; 27:756-763. [PMID: 29046255 DOI: 10.1016/j.jse.2017.08.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Platform shoulder arthroplasty systems may allow conversion to a reverse total shoulder arthroplasty (RTSA) without removing a well-fixed, well-positioned humeral stem. We sought to evaluate the complications associated with humeral stem exchange versus retention in patients undergoing conversion shoulder arthroplasty with a platform shoulder arthroplasty system. METHODS PubMed, MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Embase were searched from database inception through October 9, 2016, for all articles comparing humeral stem retention versus exchange during conversion RTSA or that pertained to conversion RTSA with stem retention alone. All studies were screened in duplicate for eligibility. A methodologic quality assessment was completed for included studies. Pooled outcomes assessing complications, operative time, blood loss, and reoperations were determined. RESULTS We included 7 studies (236 shoulders), including 1 level III and 6 level IV studies. Pooled analysis demonstrated significantly higher overall complications (odds ratio, 6.89; 95% confidence interval [CI], 2.48-19.13; P = .0002), fractures (odds ratio, 4.62; 95% CI, 1.14-18.67; P = .03), operative time (mean difference, 62.09 minutes; 95% CI, 51.17-73.01 minutes; P < .00001), and blood loss (mean difference, 260.06 mL; 95% CI, 165.30-354.83 mL; P < .00001) with humeral stem exchange. Stem exchange was also associated with increased risk of reoperation (P = .0437). CONCLUSION Conversion arthroplasty with retention of the humeral stem is associated with lower overall complications, blood loss, operative time, and reoperations in comparison with stem exchange.
Collapse
Affiliation(s)
- Jacob M Kirsch
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
| | - Moin Khan
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Patrick Thornley
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Mark Gichuru
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Michael T Freehill
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Neviaser
- Department of Orthopaedic Surgery, The Ohio State University, Columbus, OH, USA
| | - James Moravek
- Department of Orthopaedic Surgery, St. Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Bruce S Miller
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Asheesh Bedi
- MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
21
|
Ekhtiari S, Khan M, Kirsch JM, Thornley P, Larson CM, Bedi A. Most elite athletes return to competition following operative management of meniscal tears: a systematic review. J ISAKOS 2018. [DOI: 10.1136/jisakos-2017-000181] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
22
|
Thornley P, Oreskovich S, Provias J, Silva J, Reddy K, Cenic A. Multiple lobar intracerebral hemorrhage and cerebral amyloid angiopathy in the setting of ApoE Є2: a case report of the disease course and call for improved treatment modalities. J Surg Case Rep 2017; 2017:rjx208. [PMID: 29423148 PMCID: PMC5798013 DOI: 10.1093/jscr/rjx208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/17/2017] [Accepted: 10/02/2017] [Indexed: 11/13/2022] Open
Abstract
We describe a case of multiple cerebral amyloid angiopathy-associated intracerebral hemorrhages (ICH) occurring at multi-focal lobar sites of the brain. A review and discussion of the current literature on the importance of Apolipoprotein E (ApoE) genotyping in prediction of ICH outcome and recurrence follows.
Collapse
Affiliation(s)
- Patrick Thornley
- Division of Neurosurgery, Department of Neuropathology and Neurology, McMaster University, Hamilton, Ontario, Canada
| | - Stephan Oreskovich
- Division of Neurosurgery, Department of Neuropathology and Neurology, McMaster University, Hamilton, Ontario, Canada
| | - John Provias
- Division of Neurosurgery, Department of Neuropathology and Neurology, McMaster University, Hamilton, Ontario, Canada
| | - Jamie Silva
- Division of Neurosurgery, Department of Neuropathology and Neurology, McMaster University, Hamilton, Ontario, Canada
| | - Kesava Reddy
- Division of Neurosurgery, Department of Neuropathology and Neurology, McMaster University, Hamilton, Ontario, Canada
| | - Aleksa Cenic
- Division of Neurosurgery, Department of Neuropathology and Neurology, McMaster University, Hamilton, Ontario, Canada
- Correspondence address. 7th Floor, Room 715, McMaster Wing, Hamilton General Hospital 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2, Tel: +905–521-2100 x46781; Fax: +905–577-8008; E-mail:
| |
Collapse
|
23
|
Bozzo A, Oitment C, Thornley P, Yan J, Habib A, Hoppe DJ, Athwal GS, Ayeni OR. Humeral Avulsion of the Glenohumeral Ligament: Indications for Surgical Treatment and Outcomes-A Systematic Review. Orthop J Sports Med 2017; 5:2325967117723329. [PMID: 28840152 PMCID: PMC5560515 DOI: 10.1177/2325967117723329] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background: The inferior glenohumeral ligament, the most important static anterior stabilizer of the shoulder, becomes disrupted in humeral avulsion of the glenohumeral ligament (HAGL) lesions. Unfortunately, HAGL lesions commonly go unrecognized. A missed HAGL during an index operation to treat anterior shoulder instability may lead to persistent instability. Currently, there are no large studies describing the indications for surgical repair or the outcomes of patients with HAGL lesions. Purpose: To search the literature to identify surgical indications for the treatment of HAGL lesions and discuss reported outcomes. Study Design: Systematic review; Level of evidence, 4. Methods: Two reviewers completed a comprehensive literature search of 3 online databases (MEDLINE, EMBASE, and Cochrane Library) from inception until May 25, 2016, using the keywords “humeral avulsion of the glenohumeral ligament” or “HAGL” to generate a broad search. Systematic screening of eligible studies was undertaken in duplicate. Abstracted data were organized in table format, with descriptive statistics presented. Results: After screening, 18 studies comprising 118 patients were found that described surgical intervention and outcomes for HAGL lesions. The mean patient was 22 years (range, 12-50 years), and 82% were male. Sports injuries represented 72% of all HAGL injuries. The main surgical indication was primary anterior instability, followed by pain and failed nonoperative management. Commonly associated injuries in patients with identified HAGL lesions included a Bankart lesion (15%), Hill-Sachs lesions (13%), and glenoid bone loss (7%). Reporting of outcome scores varied among the included studies. Meta-analysis was not possible, but all included studies reported significantly improved postoperative stability and function. There were no demonstrated differences in outcomes for patients treated with open versus arthroscopic surgical techniques. All but 2 patients undergoing operative management for HAGL lesions were able to return to sport at their previous levels; these included Olympians and professional athletes. Conclusion: HAGL lesions typically occur in younger male patients and are often associated with Bankart lesions and bone loss. Open and arthroscopic management techniques are both effective in preventing recurrent instability.
Collapse
Affiliation(s)
- Anthony Bozzo
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Colby Oitment
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Thornley
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - James Yan
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Anthony Habib
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Daniel J Hoppe
- Orthopaedic Sports Medicine Program, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - George S Athwal
- Roth McFarlane Hand and Upper Limb Center, St Joseph's Health Care, University of Western Ontario, London, Ontario, Canada
| | - Olufemi R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
24
|
Affiliation(s)
- Patrick Thornley
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, Hamilton, Ontario, Canada
| | - Anthony Habib
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, Hamilton, Ontario, Canada
| | - Anthony Bozzo
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, Hamilton, Ontario, Canada
| | - Nathan Evaniew
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, Hamilton, Ontario, Canada
| | - Michelle Ghert
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Juravinski Cancer Centre, Hamilton, Ontario, Canada
| |
Collapse
|
25
|
Wood TJ, Thornley P, Petruccelli D, Kabali C, Winemaker M, de Beer J. Preoperative Predictors of Pain Catastrophizing, Anxiety, and Depression in Patients Undergoing Total Joint Arthroplasty. J Arthroplasty 2016; 31:2750-2756. [PMID: 27378638 DOI: 10.1016/j.arth.2016.05.056] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 05/16/2016] [Accepted: 05/25/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The relationship between pain catastrophizing and emotional disorders including anxiety and depression in osteoarthritic patients undergoing total joint arthroplasty (TJA) is an emerging area of study. The purpose of this study was to examine the association of these factors with preoperative patient characteristics. METHODS A prospective cohort study of preoperative TJA patients using the Pain Catastrophizing Scale (PCS) and Hospital Anxiety and Depression Scale (HADS-A/HADS-D) was conducted. Preoperative measures included visual analog pain scale (VAS), Harris Hip and Knee Society scores, Oxford Score, and Kellgren-Lawrence grade. Logistic and quantile regression were used to assess the relationship between preoperative characteristics and PCS or HADS, adjusting for covariate effects. RESULTS We recruited 463 TJA patients. VAS pain (odds ratio [OR] 1.23; 95% confidence interval [CI] 1.04-1.45) and Oxford (OR 1.13; 95% CI 1.07-1.20) were significant predictors for PCS and its subdomains excluding rumination. Oxford was the only significant predictor for abnormal HADS-A (OR 1.10; 95% CI 1.04-1.17). VAS pain (OR 1.27; 95% CI 1.02-1.52) and Oxford (OR 1.09; 95% CI 1.01-1.17) were significant predictors for abnormal HADS-D. The quantile regression showed similar patterns of association, with female gender, younger age, and higher ASA also associated with HADS-A. CONCLUSION The most important predictor of catastrophizing, anxiety and/or depression in TJA patients is preoperative pain and poor subjective function. At-risk patients include those with increased pain and generally good clinical function, as well as younger women with significant comorbidities. Such patients should be identified and targeted psychological therapy implemented preoperatively to optimize coping strategies and adaptive behavior to mitigate potential for inferior TJA outcomes including pain and patient dissatisfaction.
Collapse
Affiliation(s)
- Thomas J Wood
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Hamilton Health Sciences, Juravinski Hospital, Hamilton, Ontario, Canada
| | - Patrick Thornley
- Faculty of Health Sciences, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Danielle Petruccelli
- Hamilton Health Sciences, Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada
| | - Conrad Kabali
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Mitch Winemaker
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Hamilton Health Sciences, Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada
| | - Justin de Beer
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Hamilton Health Sciences, Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada
| |
Collapse
|
26
|
Sabri K, Thornley P, Waltho D, Warren T, Laverty L, Husain S, Farrokhyar F, Higgins D. Assessing accuracy of non-eye care professionals as trainee vision screeners for children. Can J Ophthalmol 2016; 51:25-9. [PMID: 26874155 DOI: 10.1016/j.jcjo.2015.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 10/07/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine the level of agreement between non-eye care trainees and a trainer (ophthalmologist) in a vision screening program. DESIGN Prospective, observational study carried out in 3 phases (Phase I-III). PARTICIPANTS Study population included 1228 children, aged 6-14 years, at 5 elementary schools in the city of Hamilton. METHODS In Phase I, 1228 children were screened by the trainee screeners, of which 273 children failed the vision testing. Of these 273 children, 170 consented to enrolment into Phase II and were examined by an ophthalmologist, who confirmed that 105 of these children were true positives. On retesting (Phase III), the ophthalmologist passed 158 of the 163 randomly selected children who passed in Phase I. RESULTS Overall, trainee screeners had a sample sensitivity of 95.5% and sample specificity of 70.8% in detecting children who should fail vision screening. When we used the positive and negative prediction values obtained, 198 of the 1228 children had vision impairment-providing an estimated prevalence of 16.1%, or 161 children per 1000 population. CONCLUSIONS Non-eye care professionals can be trained to an acceptable degree of accuracy to perform certain vision screening tests on children. Such screening methods may be a useful approach to address existing gaps in provision of eye care for many Canadian children, thereby ensuring that all children receive timely vision screening.
Collapse
Affiliation(s)
- Kourosh Sabri
- Hamilton Health Sciences, Hamilton, Ont; McMaster University, Hamilton, Ont.
| | | | | | | | - Laura Laverty
- Public Health Services for the city of Hamilton, Hamilton, Ont
| | | | | | | |
Collapse
|
27
|
Nuttall J, Evaniew N, Thornley P, Griffin A, Deheshi B, O'Shea T, Wunder J, Ferguson P, Randall RL, Turcotte R, Schneider P, McKay P, Bhandari M, Ghert M. The inter-rater reliability of the diagnosis of surgical site infection in the context of a clinical trial. Bone Joint Res 2016; 5:347-52. [PMID: 27528711 PMCID: PMC5013894 DOI: 10.1302/2046-3758.58.bjr-2016-0036.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 06/07/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The diagnosis of surgical site infection following endoprosthetic reconstruction for bone tumours is frequently a subjective diagnosis. Large clinical trials use blinded Central Adjudication Committees (CACs) to minimise the variability and bias associated with assessing a clinical outcome. The aim of this study was to determine the level of inter-rater and intra-rater agreement in the diagnosis of surgical site infection in the context of a clinical trial. MATERIALS AND METHODS The Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial CAC adjudicated 29 non-PARITY cases of lower extremity endoprosthetic reconstruction. The CAC members classified each case according to the Centers for Disease Control (CDC) criteria for surgical site infection (superficial, deep, or organ space). Combinatorial analysis was used to calculate the smallest CAC panel size required to maximise agreement. A final meeting was held to establish a consensus. RESULTS Full or near consensus was reached in 20 of the 29 cases. The Fleiss kappa value was calculated as 0.44 (95% confidence interval (CI) 0.35 to 0.53), or moderate agreement. The greatest statistical agreement was observed in the outcome of no infection, 0.61 (95% CI 0.49 to 0.72, substantial agreement). Panelists reached a full consensus in 12 of 29 cases and near consensus in five of 29 cases when CDC criteria were used (superficial, deep or organ space). A stable maximum Fleiss kappa of 0.46 (95% CI 0.50 to 0.35) at CAC sizes greater than three members was obtained. CONCLUSIONS There is substantial agreement among the members of the PARITY CAC regarding the presence or absence of surgical site infection. Agreement on the level of infection, however, is more challenging. Additional clinical information routinely collected by the prospective PARITY trial may improve the discriminatory capacity of the CAC in the parent study for the diagnosis of infection.Cite this article: J. Nuttall, N. Evaniew, P. Thornley, A. Griffin, B. Deheshi, T. O'Shea, J. Wunder, P. Ferguson, R. L. Randall, R. Turcotte, P. Schneider, P. McKay, M. Bhandari, M. Ghert. The inter-rater reliability of the diagnosis of surgical site infection in the context of a clinical trial. Bone Joint Res 2016;5:347-352. DOI: 10.1302/2046-3758.58.BJR-2016-0036.R1.
Collapse
Affiliation(s)
- J Nuttall
- Orthopaedic Resident, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - N Evaniew
- Orthopaedic Resident, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - P Thornley
- Orthopaedic Resident, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - A Griffin
- University Musculoskeletal Oncology Unit
- Mount Sinai Hospital, Toronto, Ontario, Canada
| | - B Deheshi
- Department of Surgery, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - T O'Shea
- Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - J Wunder
- University of Toronto, Toronto, Ontario, Canada
| | - P Ferguson
- Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Suite 476(G)
- Toronto, M5G 1X5, Canada
| | - R L Randall
- Department of Orthopaedics, University of Utah, 2000 Circle of Hope, Suite 4260
- Salt Lake City, 84112-5550, USA
| | - R Turcotte
- Division of Orthopaedic Surgery, McGill University, Montreal General Hospital, 1650 Cedar Avenue, Room B5.159.6, Montreal, QC, H3G 1A4, Canada
| | - P Schneider
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - P McKay
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - M Bhandari
- Department of Clinical Epidemiology and Biostatistics and Department of Surgery, McMaster University, 293 Wellington Street North, Suite 110
- Hamilton, ON, L8L 8E7, Canada
| | - M Ghert
- Department of Surgery, McMaster University, 711 Concession Street, Surgical Offices B3 169A, Hamilton, ON, L8V 1C3, Canada
| |
Collapse
|
28
|
Thornley P, de Sa D, Evaniew N, Farrokhyar F, Bhandari M, Ghert M. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016; 5:130-6. [PMID: 27105650 PMCID: PMC4921052 DOI: 10.1302/2046-3758.54.2000578] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 03/09/2016] [Indexed: 11/10/2022] Open
Abstract
Objectives Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. Materials and Methods A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns. Results A total of 353 surgeons completed the survey. Surgeons achieved consensus on the ‘importance’ of three key designs on their practices: randomised controlled trials (94%), meta-analyses (75%) and systematic reviews (66%). The vast majority of respondents support the use of current evidence over historical clinical training; however subjective factors such as journal reputation (72%) and investigator profile (68%) continue to influence clinical decision-making strongly. Conclusion Although intrinsic factors such as study design and sample size have some influence on clinical decision-making, surgeon respondents are equally influenced by extrinsic factors such as investigator reputation and perceived journal quality. Cite this article: Dr M. Ghert. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016;5:130–136. DOI: 10.1302/2046-3758.54.2000578.
Collapse
Affiliation(s)
- P Thornley
- McMaster University, 1280 Main Street West Hamilton, Ontario, L8S 4L8, Canada
| | - D de Sa
- McMaster University, 1280 Main Street West Hamilton, Ontario, L8S 4L8, Canada
| | - N Evaniew
- McMaster University, 1280 Main Street West Hamilton, Ontario, L8S 4L8, Canada
| | - F Farrokhyar
- McMaster University, 39 Charlton Avenue East Hamilton, Ontario, L8N 1Y3, Canada
| | - M Bhandari
- McMaster University, 293 Wellington Street North Hamilton, Ontario, L8L 8E7, Canada
| | - M Ghert
- McMaster University, 711 Concession Street Level B3 Surgical Offices Hamilton, Ontario, L6J 4J9, Canada
| |
Collapse
|
29
|
Thornley P, Al Beshir M, Gregor J, Antoniou A, Khanna N. Efficiency and patient experience with propofol vs conventional sedation: A prospective study. World J Gastrointest Endosc 2016; 8:232-238. [PMID: 26962405 PMCID: PMC4766256 DOI: 10.4253/wjge.v8.i4.232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 12/07/2015] [Accepted: 12/23/2015] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine whether anaesthesiologist-administered sedation with propofol (AAP) or endoscopist-administered conscious sedation (EAC) with fentanyl/midazolam shortens colonoscopy duration/total room time.
METHODS: This is a prospective, non-randomized, comparative study that enrolled patients greater than 18 years of age undergoing colonoscopy in a single Canadian academic outpatient endoscopy unit over a three-month consecutive period. Colonoscopies in this unit are performed both with AAP and EAC. Patient demographics, procedure-related data and adverse events were documented. Additionally, the level of procedure difficulty, and whether a staff endoscopist, trainee with assistance, or independent trainee, performed the procedure were documented. A validated modified 4-question, 5-point Likert scale telephone survey was used to assess patient satisfaction with colonoscopy. The telephone patient satisfaction survey was conducted 24-72 h following the procedure.
RESULTS: Two hundred and thirty patients were enrolled during the study period with 126 patients in the AAP group and 104 patients in the EAC group. Mean procedure time was 18.3 ± 10.1 min in the AAP group and 14.7 ± 7.1 min in the EAC group (P = 0.002). Mean total room time was 36.8 ± 13.7 with AAP and 30.1 ± 11 min with EAC (P < 0.001). Multivariate analysis revealed the use of AAP (P = 0.002), resident participation (P < 0.001), diagnostic interventions (P = 0.033), therapeutic interventions (P < 0.001), lower body mass index (P = 0.008) and American Society of Anaesthesiologist class (P = 0.016), to be predictors of longer total room time. Patient age and gender were not significant predictors. After excluding cases in which trainees were involved, there was no significant difference in procedure time between the two groups (P = 0.941), however total room time was still prolonged in the AAP group (P = 0.019). The amount of pain experienced was lower with AAP (P = 0.02), with a trend toward overall higher patient satisfaction (P = 0.074). There were 2 sedation-related adverse events, both in the AAP group involving a patient with aspiration requiring hospitalization and a patient with hypoxia managed with bronchodilators.
CONCLUSION: EAC results in reduced total room time compared to AAP. Resident participation doubles procedure time regardless of sedation type.
Collapse
|
30
|
de SA D, Thornley P, Niroopan G, Khan M, McCarthy C, Simunovic N, Adamich J, Jamshidi S, Farrokhyar F, Peterson D, Musahl V, Ayeni OR. No difference in outcome between early versus delayed weight-bearing following microfracture surgery of the hip, knee or ankle: a systematic review of outcomes and complications. J ISAKOS 2016. [DOI: 10.1136/jisakos-2015-000028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
31
|
Thornley P, Quinn A, Elley K. A qualitative evaluation of foundation dentists' and training programme directors' perceptions of clinical audit in general dental practice. Br Dent J 2015; 219:177-81. [PMID: 26315182 DOI: 10.1038/sj.bdj.2015.647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2015] [Indexed: 11/09/2022]
Abstract
This study reports on an investigation into clinical audit (CA) educational and service delivery outcomes in a dental foundation training (DFT) programme. The aim was to investigate CA teaching, learning and practice from the perspective of foundation dentists (FDs) and to record suggestions for improvement. A qualitative research methodology was used. Audio recordings of focus group interviews with FDs were triangulated by an interview with a group of training programme directors (TPDs). The interviews were transcribed and thematically analysed using a 'Framework' approach within Nvivo Data Analysis Software. FDs report considerable learning and behaviour change. However, TPDs have doubts about the long-term effects on service delivery. There can be substantial learning in the clinical, managerial, communication and professionalism domains, and in the development of time management, organisational and team-working skills. Information is provided about use of resources and interaction with teachers and colleagues. CA provides learning opportunities not produced by other educational activities including 'awkward conversations' with team-members in the context of change management and providing feedback. This is relevant when applying the recommendations of the Francis report. This paper should be useful to any dentist conducting audit or team training. Suggestions are made for improvements to resources and support including right touch intervention. Trainers should teach in the 'Goldilocks Zone'.
Collapse
Affiliation(s)
| | - A Quinn
- Warwick Medical School, University of Warwick
| | - K Elley
- Health Education West Midlands
| |
Collapse
|
32
|
Thornley P, Evaniew N, Riediger M, Winemaker M, Bhandari M, Ghert M. Postoperative antibiotic prophylaxis in total hip and knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. CMAJ Open 2015; 3:E338-43. [PMID: 26457293 PMCID: PMC4596117 DOI: 10.9778/cmajo.20150012] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Postoperative antibiotic prophylaxis is currently the standard of care for patients undergoing total hip and knee arthroplasty. We evaluated the evidence for this practice in the reduction of surgical-site infections. METHODS We systematically searched MEDLINE, Embase and the Cochrane Library for randomized controlled trials (RCTs) published up to Aug. 15, 2014. We included all RCTs that compared postoperative antibiotic prophylaxis with postoperative placebo or no treatment in patients undergoing primary total hip or knee arthroplasty for osteoarthritis. We combined outcomes for surgical-site infection using a random-effects model and quantified heterogeneity using the χ2 test and the I2 statistic. We assessed the overall quality of the evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS We identified 4 RCTs (n = 4036) that met the inclusion criteria. Surgical-site infections occurred in 3.1% (63/2055) of patients in the prophylaxis group and 2.3% (45/1981) in the control group. Postoperative prophylaxis did not reduce the rate of surgical-site infections compared with placebo (risk difference 0.01, 95% confidence interval 0.00 to 0.02; I2 = 26%). This result was robust to sensitivity testing for losses to follow-up. According to the GRADE approach, the overall quality of evidence was very low. INTERPRETATION The available evidence did not show efficacy of postoperative antibiotic prophylaxis for the prevention of surgical-site infections in patients undergoing total hip or knee arthroplasty. Multicentred RCTs are likely to have an important impact on the confidence in the effect estimate and to change the estimate itself.
Collapse
Affiliation(s)
- Patrick Thornley
- Faculty of Health Sciences (Thornley), Michael G. DeGroote School of Medicine; Division of Orthopaedics (Evanview, Riediger, Winemaker, Bhandari, Ghert), Department of Surgery; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont
| | - Nathan Evaniew
- Faculty of Health Sciences (Thornley), Michael G. DeGroote School of Medicine; Division of Orthopaedics (Evanview, Riediger, Winemaker, Bhandari, Ghert), Department of Surgery; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont
| | - Michael Riediger
- Faculty of Health Sciences (Thornley), Michael G. DeGroote School of Medicine; Division of Orthopaedics (Evanview, Riediger, Winemaker, Bhandari, Ghert), Department of Surgery; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont
| | - Mitchell Winemaker
- Faculty of Health Sciences (Thornley), Michael G. DeGroote School of Medicine; Division of Orthopaedics (Evanview, Riediger, Winemaker, Bhandari, Ghert), Department of Surgery; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont
| | - Mohit Bhandari
- Faculty of Health Sciences (Thornley), Michael G. DeGroote School of Medicine; Division of Orthopaedics (Evanview, Riediger, Winemaker, Bhandari, Ghert), Department of Surgery; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont
| | - Michelle Ghert
- Faculty of Health Sciences (Thornley), Michael G. DeGroote School of Medicine; Division of Orthopaedics (Evanview, Riediger, Winemaker, Bhandari, Ghert), Department of Surgery; Department of Clinical Epidemiology and Biostatistics (Bhandari), McMaster University, Hamilton, Ont
| |
Collapse
|
33
|
|
34
|
de Sa D, Thornley P, Evaniew N, Madden K, Bhandari M, Ghert M. CHAracteristics of research studies that iNfluence practice: a GEneral survey of Canadian orthopaedic Surgeons (CHANGES): a pilot survey. Springerplus 2015; 4:62. [PMID: 25674510 PMCID: PMC4320200 DOI: 10.1186/s40064-015-0855-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/26/2015] [Indexed: 11/10/2022]
Abstract
Background Evidence Based Medicine (EBM) is increasingly being applied to inform clinical decision-making in orthopaedic surgery. Despite the promotion of EBM in Orthopaedic Surgery, the adoption of results from high quality clinical research seems highly unpredictable and does not appear to be driven strictly by randomized trial data. The objective of this study was to pilot a survey to determine if we could identify surgeon opinions on the characteristics of research studies that are perceived as being most likely to influence clinical decision-making among orthopaedic surgeons in Canada. Methods A 28-question electronic survey was distributed to active members of the Canadian Orthopaedic Association (COA) over a period of 11 weeks. The questionnaire sought to analyze the influence of both extrinsic and intrinsic characteristics of research studies and their potential to influence practice patterns. Extrinsic factors included the perceived journal quality and investigator profiles, economic impact, peer/patient/industry influence and individual surgeon residency/fellowship training experiences. Intrinsic factors included study design, sample size, and outcomes reported. Descriptive statistics are provided. Results Of the 109 members of the COA who opened the survey, 95 (87%) completed the survey in its entirety. The overall response rate was 11% (95/841). Surgeons achieved consensus on the influence of three key designs on their practices: 1) randomized controlled trials 94 (99%), 2) meta-analysis 83 (87%), and 3) systematic reviews 81 (85%). Sixty-seven percent of surgeons agreed that studies with sample sizes of 101–500 or more were more likely to influence clinical practice than smaller studies (n = <100). Factors other than design influencing adoption included 1) reputation of the investigators (99%) and 2) perceived quality of the journal (75%). Conclusion Although study design and sample size (i.e. minimum of 100 patients) have some influence on clinical decision making, surgeon respondents are equally influenced by investigator reputation and perceived journal quality. At present, continued emphasis on the generation of large, methodologically sound clinical trials remains paramount to translating research findings to clinical practice changes. Specific to this pilot survey, strategies to solicit more widespread responses will be pursued.
Collapse
Affiliation(s)
- Darren de Sa
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, 237 Barton Street, Hamilton, ON Canada L8L 2X2
| | - Patrick Thornley
- Faculty of Health Sciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON Canada
| | - Nathan Evaniew
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, 237 Barton Street, Hamilton, ON Canada L8L 2X2
| | - Kim Madden
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, 237 Barton Street, Hamilton, ON Canada L8L 2X2.,Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada
| | - Michelle Ghert
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, HHS Hamilton General Hospital, 237 Barton Street, Hamilton, ON Canada L8L 2X2
| |
Collapse
|
35
|
Abstract
BACKGROUND/AIMS Quality of life is an important consideration in the management of patients with Crohn's disease. Previous studies suggest that Crohn's disease patients using opioids may have decreased quality of life and increased risk of mortality. Our aim was to determine the association between health-related quality of life (HRQoL) and opioid use in patients with Crohn's disease while controlling for disease severity. PATIENTS AND METHODS We conducted a cross-sectional study recruiting Crohn's disease patients at our center. Disease activity was measured using the Harvey-Bradshaw Index (HBI), and HRQoL was measured using the Inflammatory Bowel Disease Questionnaire (IBDQ). RESULTS We enrolled 38 Crohn's disease patients using opioids and 62 patients not using opioids. Patients using opioids had an increased duration of disease (median 18.5 vs. 9 years, P = 0.005), increased surgeries related to Crohn's disease (median 3 vs. 0, P < 0.001), and increased prednisone use (29% vs. 11.3%, P = 0.03). Patients using opioids had increased disease activity (median HBI score 9.0 vs. 3.0, P < 0.001). Quality of life was lower in patients using opioids (mean IBDQ score 109.3 vs. 162.9, P < 0.001). This finding was significant when controlling for HBI scores, number of previous surgeries, and prednisone use (P = 0.003). CONCLUSIONS Opioid use in Crohn's disease patients appears to be associated with disease activity and severity. HRQoL is markedly decreased in patients using opioids and this association is significant even when controlling for variables reflecting disease severity. Our findings suggest that Crohn's disease patients using opioids are likely to be significantly impacted by their disease.
Collapse
Affiliation(s)
- David Sanford
- Department of Medicine, Western University, Victoria Hospital, London, ON, Canada,Address for correspondence: Dr. David Sanford, Department of Medicine, Western University, Room E6-208, Victoria Hospital, 800 Commissioners Road East, P. O. Box 5010, London ON, N6A 5W9, Canada. E-mail:
| | - Patrick Thornley
- Faculty of Health Science, McMaster University, W Hamilton, ON, Canada
| | - Anouar Teriaky
- Division of Gastroenterology, Western University, Victoria Hospital, London, ON, Canada
| | - Nilesh Chande
- Division of Gastroenterology, Western University, Victoria Hospital, London, ON, Canada
| | - James Gregor
- Division of Gastroenterology, Western University, Victoria Hospital, London, ON, Canada
| |
Collapse
|
36
|
Stewardson D, Creanor S, Thornley P, Bigg T, Bromage C, Browne A, Cottam D, Dalby D, Gilmour J, Horton J, Roberts E, Westoby L, Burke T. The survival of Class V restorations in general dental practice: part 3, five-year survival. Br Dent J 2012; 212:E14. [DOI: 10.1038/sj.bdj.2012.367] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2012] [Indexed: 01/10/2023]
|
37
|
Abstract
We report a case of laryngeal tuberculosis in a 47-year-old Korean man. Laryngeal tuberculosis is rare and currently accounts for less than 1% of all cases of tuberculosis. Clinical features of laryngeal tuberculosis include hoarseness, odynophagia and dyspnoea. Macroscopically, laryngeal tuberculosis may mimic laryngeal carcinoma, chronic laryngitis or laryngeal candidiasis. The diagnosis is often delayed due to a low index of clinical suspicion and hence may pose a significant public health risk. Laryngeal tuberculosis should be considered in the differential diagnosis of patients who present with any form of laryngeal lesion.
Collapse
Affiliation(s)
- Hk Chen
- Department of Respiratory Medicine, Christchurch Hospital, New Zealand
| | | |
Collapse
|
38
|
Stewardson D, Thornley P, Bigg T, Bromage C, Browne A, Cottam D, Dalby D, Gilmour J, Horton J, Roberts E, Westoby L, Dietrich T, Burke T. The survival of Class V restorations in general dental practice. Part 1, baseline data. Br Dent J 2010; 208:E17; discussion 406-7. [DOI: 10.1038/sj.bdj.2010.445] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2009] [Indexed: 11/09/2022]
|
39
|
|
40
|
|
41
|
Thornley P. Millenium bug. Br Dent J 1999; 186:262-3. [PMID: 10230095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
42
|
Rosenbloom D, Scime J, Elviss OD, Mayhew B, Thompson WJ, Thornley P, Wildeman M. Measurement of insulin wastage in five Ontario hospitals. Can J Hosp Pharm 1994; 47:5-7. [PMID: 10132676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
This study was designed to determine the extent of insulin wastage and the extrapolated cost of wastage for Ontario hospitals. The five hospitals in the study were chosen to include differences in patient mix and drug distribution systems. Beginning and ending inventories of all insulin types were taken spanning a six-week period. The quantity of insulin dispensed and wasted during this time period was recorded. Partial vials were measured using a calibrated scale. Wastage was calculated as insulin discarded divided by the amount of insulin used in the time period. Insulin wastage averaged 34.1%. This was equivalent to up to $8,000 a year for the largest hospital surveyed and translates to an estimated cost of $360,000 a year in all Ontario hospitals. Therefore, hospitals should estimate their insulin wastage and seek ways to reduce it. The pharmaceutical industry should be encouraged to develop cost-effective insulin delivery systems.
Collapse
|
43
|
Hodges ID, Wilkie A, Drennan C, Toop L, Thornley P, O'Hagan J, Town GI. A community wide promotion of asthma self management: process evaluation. N Z Med J 1993; 106:354-7. [PMID: 8255561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
AIMS During the months February through July 1991, a community wide promotion of asthma self-management was undertaken as a pilot study for the national launch of an asthma action plan developed by the Asthma Foundation of New Zealand in conjunction with the Royal New Zealand College of General Practitioners. METHODS A multidisciplinary team of hospital and community-based health workers was established, with the aim of educating and resourcing general practitioners, practice nurses and retail pharmacists to enable them to effectively promote and distribute the asthma action plan. 332 general practitioners and 148 retail pharmacists were surveyed through postal and telephone questionnaires at the completion of the promotion, to assess its impact on health professionals and to obtain feedback for the national promotion of the asthma action plan. RESULTS 108 (73%) of pharmacists who responded and were involved with the promotion found their participation to be worthwhile, although some had difficulty allocating sufficient time to give detailed advice to patients. Of the 240 general practitioners who responded, 77% indicated that they had used the asthma action plan with their patients. They were positive about the use of the workshop format that had provided education and resources for the plan, and of those that had used the plan, 94% indicated that they would continue to promote the plan, or one similar. CONCLUSIONS The promotion of the asthma action plan in Canterbury had a major impact on health professionals. The community-wide promotion might have had a greater impact on people with asthma had television advertising been used. The pilot project provided useful feedback for the Asthma Foundation in their preparation for the national launch.
Collapse
Affiliation(s)
- I D Hodges
- Department of Health, Canterbury Area Health Board, Christchurch
| | | | | | | | | | | | | |
Collapse
|
44
|
Abstract
Nedocromil sodium (4 mg b.d. or q.i.d.) was added to the therapy of 76 chronic asthmatic patients in a four-centre, double-blind cross-over, placebo-controlled trial. Patients had troublesome symptoms uncontrolled by high doses of inhaled corticosteroids (mean 1450 micrograms). In 54 patients who completed the study, nedocromil sodium was significantly more efficacious than placebo (P < 0.01) in relieving morning chest-tightness and cough, in reducing total diary card score and nocturnal bronchodilator usage, and in increasing morning and evening peak flow. Asthma severity at clinic visits decreased significantly (P = 0.001) following treatment with nedocromil sodium, which was globally rated more effective than placebo (P < 0.01). Treatment differences favored q.i.d. over b.d. dosage but without statistical significance. There were no serious adverse effects. Although the pulmonary function changes were small, these findings suggest that the addition of nedocromil sodium may benefit asthmatic patients who are inadequately controlled by high doses of inhaled corticosteroids.
Collapse
Affiliation(s)
- A Wells
- Greenlane Hospital, Auckland, New Zealand
| | | | | | | | | | | |
Collapse
|
45
|
Soutar C, Copland L, Thornley P, Hurley F, Ottery J, Adams W, Bennett B. An epidemiologic study of respiratory disease in workers exposed to polyvinylchloride dust. Chest 1981; 80:60. [PMID: 7249743 DOI: 10.1378/chest.80.1_supplement.60s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
|
46
|
|