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Ajoku U, Johnson MG, McIntosh G, Thomas K, Bailey CS, Hall H, Fisher CG, Manson N, Rampersaud YR, Dea N, Christie S, Abraham E, Weber MH, Charest-Morin R, Attabib N, le Roux A, Phan P, Paquet J, Lewkonia P, Goytan M. Temporal analysis of complication rates of cervical spine surgery for degenerative spine disease between younger and older cohorts using the CSORN registry: Is age just a number? Eur Spine J 2023; 32:3583-3590. [PMID: 37596474 DOI: 10.1007/s00586-023-07882-3] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/14/2023] [Accepted: 07/31/2023] [Indexed: 08/20/2023]
Abstract
STUDY DESIGN An ambispective review of consecutive cervical spine surgery patients enrolled in the Canadian Spine Outcomes and Research Network (CSORN) between January 2015 and September 2019. PURPOSE To compare complication rates of degenerative cervical spine surgery over time between older (> 65) and younger age groups (< 65). More elderly people are having spinal surgery. Few studies have examined the temporal nature of complications of cervical spine surgery by patient age groups. METHODS Adverse events were collected prospectively using adverse event forms. Binary logistic regression analysis was utilized to assess associations between risk modifiers and adverse events at the intra-, peri-operative and 3 months post-surgery. RESULTS Of the 761 patients studied (age < 65, n = 581 (76.3%) and 65 + n = 180 (23.7%), the intra-op adverse events were not significantly different; < 65 = 19 (3.3%) vs 65 + = 11 (6.1%), p < 0.087. Peri-operatively, the < 65 group had significantly lower percentage of adverse events (65yrs (11.2%) vs. 65 + = (26.1%), p < 0.001). There were no differences in rates of adverse events at 3 months post-surgery (< 65 = 39 (6.7%) vs. 65 + = 12 (6.7%), p < 0.983). Less blood loss (OR = 0.99, p < 0.010) and shorter length of hospital stay (OR = 0.97, p < 0.025) were associated with not having intra-op adverse events. Peri-operatively, > 1 operated level (OR = 1.77, p < 0.041), shorter length of hospital stay (OR = 0.86, p < 0.001) and being younger than 65 years (OR = 2.11, p < 0.006) were associated with not having adverse events. CONCLUSION Following degenerative cervical spine surgery, the older and younger age groups had significantly different complication rates at peri-operative time points, and the intra-operative and 3-month post-operative complication rates were similar in the groups.
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Affiliation(s)
- Uchenna Ajoku
- Winnipeg Spine Program, Health Sciences Centre, University of Manitoba, Winnipeg, MB, Canada
| | - Michael G Johnson
- Winnipeg Spine Program, Health Sciences Centre, University of Manitoba, Winnipeg, MB, Canada
| | - Greg McIntosh
- Canadian Spine Outcome Research Network, 10 Armstrong Crescent, PO Box 1053, Markdale, ON, N0C 1H0, Canada.
| | - Ken Thomas
- University of Calgary, Calgary, AB, Canada
| | - Christopher S Bailey
- London Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, ON, Canada
| | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Charles G Fisher
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Neil Manson
- Canada East Spine Centre, Saint John Orthopedics, Dalhousie Medicine New Brunswick, Saint John Campus, Saint John, NB, Canada
| | - Y Raja Rampersaud
- Divisions of Orthopaedic and Neurosurgery, University of Toronto, Toronto, ON, Canada
| | - Nicolas Dea
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Sean Christie
- Department of Surgery, Dalhousie University, Halifax, NS, Canada
| | - Edward Abraham
- Canada East Spine Centre, Saint John Orthopedics, Dalhousie Medicine New Brunswick, Saint John Campus, Saint John, NB, Canada
| | | | - Raphaele Charest-Morin
- Combined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Najmedden Attabib
- Canada East Spine Centre, Division of Neurosurgery, Zone 2, Horizon Health Network, Saint John, NB, Canada
| | - André le Roux
- Canada East Spine Centre, Division of Neurosurgery, Zone 2, Horizon Health Network, Saint John, NB, Canada
| | | | - Jerome Paquet
- Centre de Recherche CHU de Quebec, CHU de Quebec-Universite Laval, Quebec City, QC, Canada
| | | | - Michael Goytan
- Winnipeg Spine Program, Health Sciences Centre, University of Manitoba, Winnipeg, MB, Canada
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2
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Kameda-Smith MM, Ragulojan M, Hart S, Duda TR, MacLean MA, Chainey J, Aminnejad M, Rizzuto M, Bergeron D, Eagles M, Chalil A, Langlois AM, Gariepy C, Persad A, Hasen M, Wang A, Elkaim L, Christie S, Farrokhyar F, Reddy K. A Canadian National Survey of the Neurosurgical Management of Intracranial Abscesses. Can J Neurol Sci 2023; 50:679-686. [PMID: 36184886 DOI: 10.1017/cjn.2022.299] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Intracerebral abscess is a life-threatening condition for which there are no current, widely accepted neurosurgical management guidelines. The purpose of this study was to investigate Canadian practice patterns for the medical and surgical management of primary, recurrent, and multiple intracerebral abscesses. METHODS A self-administered, cross-sectional, electronic survey was distributed to active staff and resident members of the Canadian Neurosurgical Society and Canadian Neurosurgery Research Collaborative. Responses between subgroups were analyzed using the Chi-square test. RESULTS In total, 101 respondents (57.7%) completed the survey. The majority (60.0%) were staff neurosurgeons working in an academic, adult care setting (80%). We identified a consensus that abscesses >2.5 cm in diameter should be considered for surgical intervention. The majority of respondents were in favor of excising an intracerebral abscess over performing aspiration if located superficially in non-eloquent cortex (60.4%), located in the posterior fossa (65.4%), or causing mass effect leading to herniation (75.3%). The majority of respondents were in favor of reoperation for recurrent abscesses if measuring greater than 2.5 cm, associated with progressive neurological deterioration, the index operation was an aspiration and did not include resection of the abscess capsule, and if the recurrence occurred despite prior surgery combined with maximal antibiotic therapy. There was no consensus on the use of topical intraoperative antibiotics. CONCLUSION This survey demonstrated heterogeneity in the medical and surgical management of primary, recurrent, and multiple brain abscesses among Canadian neurosurgery attending staff and residents.
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Affiliation(s)
- Michelle M Kameda-Smith
- McMaster University, Hamilton, Ontario, Canada
- Department of Surgery, Neurosurgery, London, UK
| | | | - Shannon Hart
- McMaster University, Hamilton, Ontario, Canada
- Department of Surgery, Neurosurgery, London, UK
| | - Taylor R Duda
- McMaster University, Hamilton, Ontario, Canada
- Department of Surgery, Neurosurgery, London, UK
| | - Mark A MacLean
- Dalhousie University, Department of Surgery, Neurosurgery, QEII Health Sciences Center, Halifax Infirmary, Halifax, Nova Scotia, Canada
| | - Jonathan Chainey
- University of Alberta, Department of Surgery, Neurosurgery, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Minoo Aminnejad
- McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton General Hospital, Hamilton, Ontario, Canada
| | - Michael Rizzuto
- University of British Columbia, Department of Surgery, Neurosurgery, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - David Bergeron
- Université de Montreal, Department of Surgery, Neurosurgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Mathew Eagles
- University of Calgary, Department of Surgery, Neurosurgery, Foothills Medical Center, Calgary, Alberta, Canada
| | - Alan Chalil
- University of Western Ontario, Department of Surgery, Neurosurgery, University Hospital, London, Ontario, Canada
| | - Anne-Mare Langlois
- Université de Sherbrooke, Department of Surgery, Neurosurgery, Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Charles Gariepy
- Université de Laval, Department of Surgery, Neurosurgery, Hôpital de l'Enfant-Jésus Quebec City, Québec, Canada
| | - Amit Persad
- University of Saskatchewan, Department of Surgery, Neurosurgery, Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Mohammed Hasen
- University of Manitoba, Department of Surgery, Neurosurgery, Health Science Center (HSC), Winnipeg, Manitoba, Canada
| | - Alick Wang
- University of Ottawa, Department of Surgery, Neurosurgery, Ottawa Hospital, Ottawa, Ontario, Canada
| | - Lior Elkaim
- University of McGill, Department of Surgery, Neurosurgery, Montreal Neurological Institute (MNI) Hospital, Montreal, Quebec, Canada
| | - Sean Christie
- Dalhousie University, Department of Surgery, Neurosurgery, QEII Health Sciences Center, Halifax Infirmary, Halifax, Nova Scotia, Canada
| | - Forough Farrokhyar
- McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton General Hospital, Hamilton, Ontario, Canada
| | - Kesava Reddy
- McMaster University, Hamilton, Ontario, Canada
- Department of Surgery, Neurosurgery, London, UK
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3
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Whelan A, McVeigh S, Barker P, Glennie A, Wang D, Chen M, Cheng CL, Humphreys S, O'Connell C, Attabib N, Engelbrecht A, Christie S. The effect of rurality and distance from care on health outcomes, environmental barriers, and healthcare utilization patterns in persons with traumatic spinal cord injury. Spinal Cord 2023; 61:399-408. [PMID: 37169867 PMCID: PMC10173934 DOI: 10.1038/s41393-023-00898-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/21/2023] [Accepted: 04/03/2023] [Indexed: 05/13/2023]
Abstract
STUDY DESIGN Cohort study. OBJECTIVES To evaluate the association between residential living location and health outcomes, environmental barriers, quality of life, and healthcare utilization patterns after traumatic spinal cord injury (tSCI). SETTING Community setting, Atlantic Canada. METHODS An ambispective study of data collected on a subset of individuals enrolled in the Rick Hansen Spinal Cord Injury Registry (RHSCIR) from 2012 to 2018. Outcomes were analyzed using two measures of rurality: postal codes at community follow-up (rural versus urban) and residential travel distance to the nearest RHSCIR facility (>100 km versus ≤100 km). Outcomes studied included the Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Short Form-36 Version 2 (SF36v2), Life Satisfaction Questionnaire (LISAT-11), Spinal Cord Independence Measure (SCIM), secondary health complications and healthcare utilization patterns. Outcomes were assessed 9 to 24 months post-discharge from initial hospitalization. RESULTS 104 participants were studied, 21 rural and 83 urban based on postal codes at community follow-up. 59 participants lived more than 100 km away from the nearest RHSCIR facility, while 45 participants lived within 100 km. Individuals from urban area codes reported a greater magnitude of perceived barriers on the policies and work/school subscales of the CHIEF-SF. No differences in function, quality of life, and healthcare utilization patterns according to the measures of rurality were observed. Individuals living >100 km from the nearest RHSCIR facility reported greater rates of sexual dysfunction. CONCLUSIONS Despite differences in environmental barriers, individuals from urban and rural locations in Eastern Canada reported similar health outcomes and quality of life after tSCI.
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Affiliation(s)
- Alexander Whelan
- Department of Medicine (Physical Medicine and Rehabilitation), Dalhousie University, Halifax, NS, Canada
| | - Sonja McVeigh
- Department of Medicine (Physical Medicine and Rehabilitation), Dalhousie University, Halifax, NS, Canada
| | - Paula Barker
- Faculty of Medicine, Memorial University of Newfoundland, Corner Brook, NF, Canada
| | - Andrew Glennie
- Department of Surgery (Orthopaedics), Dalhousie University, Halifax, NS, Canada
| | - Di Wang
- Praxis Spinal Cord Institute, Vancouver, BC, Canada
| | - Melody Chen
- Praxis Spinal Cord Institute, Vancouver, BC, Canada
| | | | | | - Colleen O'Connell
- Division of Physical Medicine and Rehabilitation, Dalhousie Medicine New Brunswick, Fredericton, NB, Canada
| | - Najmedden Attabib
- Division of Neurosurgery, Dalhousie University, Saint John, NB, Canada
| | - Andre Engelbrecht
- Division of Neurosurgery, Memorial University of Newfoundland, St. John's, NF, Canada
| | - Sean Christie
- Department of Surgery (Neurosurgery), Dalhousie University, Halifax, NS, Canada.
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4
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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
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McIntosh MK, Christie S. Opportunities and challenges for robotic-assisted spine surgery: feasible indications for the MAZOR™ X Stealth Edition. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38082935 DOI: 10.1109/embc40787.2023.10340228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The clinical use of new technologies has several potential benefits including improved accuracy, precision and efficiency. Robotic assistance during surgery is one such technology and it is making its way into neurosurgical operating rooms with increasing frequency. The Mazor X™ Stealth robot was first used in Canada for spine surgery during July 2022 and since then multiple indications for its use have been identified and evaluated.The outcomes of robot-assisted spine surgery have been promising but there is a lack of supportive studies which would serve to refine indications, establish protocols and disseminate practical information. To begin filling this gap we gathered a list of use-cases for which this new technology was successfully employed. In combination with cases that took place in our Centre, we reviewed the existing reported uses of the Mazor X™ Stealth for spine surgery and recorded their respective procedures and outcomes for patients and surgeons.Through this review we identified common uses of the Mazor X™ Stealth for spine surgery. Usage of robotic-assisted technology had a net positive impact on outcomes for patients as well as surgeons (e.g., improved accuracy of pedicle screw placement and reduced radiation burden). This curation remains a dynamic list, and we foresee the addition of more indications in the future.Clinical Relevance- Enabling the use of technology including robotic systems has the potential to attract clinical research expertise, reduce resource usage and to improve surgical outcomes.
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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, Bailey CS, Dhall S, Mac-Thiong JM, Wilson JR, Christie S, Dvorak MF, Wellington CL, Kwon BK. Association of CSF and Serum Neurofilament Light and Glial Fibrillary Acidic Protein, Injury Severity, and Outcome in Spinal Cord Injury. Neurology 2023; 100:e1221-e1233. [PMID: 36599698 PMCID: PMC10033160 DOI: 10.1212/wnl.0000000000206744] [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] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 11/15/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Traumatic spinal cord injury (SCI) is highly heterogeneous, and tools to better delineate pathophysiology and recovery are needed. Our objective was to profile the response of 2 biomarkers, neurofilament light (NF-L) and glial fibrillary acidic protein (GFAP), in the serum and CSF of patients with acute SCI to evaluate their ability to objectively characterize injury severity and predict neurologic recovery. METHODS Blood and CSF samples were obtained from prospectively enrolled patients with acute SCI through days 1-4 postinjury, and the concentration of NF-L and GFAP was quantified using Simoa technology. Neurologic assessments defined the ASIA Impairment Scale (AIS) grade and motor score (MS) at presentation and 6 months postinjury. RESULTS One hundred eighteen patients with acute SCI (78 AIS A, 20 AIS B, and 20 AIS C) were enrolled, with 113 (96%) completing 6-month follow-up. NF-L and GFAP levels were strongly associated between paired serum and CSF specimens, were both increased with injury severity, and distinguished among baseline AIS grades. Serum NF-L and GFAP were significantly (p = 0.02 to <0.0001) higher in AIS A patients who did not improve at 6 months, predicting AIS grade conversion with a sensitivity and specificity (95% CI) of 76% (61, 87) and 77% (55, 92) using NF-L and 72% (57, 84) and 77% (55, 92) using GFAP at 72 hours, respectively. Independent of clinical baseline assessment, a serum NF-L threshold of 170 pg/mL at 72 hours predicted those patients who would be classified as motor complete (AIS A/B) compared with motor incomplete (AIS C/D) at 6 months with a sensitivity of 87% (76, 94) and specificity of 84% (69, 94); a serum GFAP threshold of 13,180 pg/mL at 72 hours yielded a sensitivity of 90% (80, 96) and specificity of 84% (69, 94). DISCUSSION The potential for NF-L and GFAP to classify injury severity and predict outcome after acute SCI will be useful for patient stratification and prognostication in clinical trials and inform communication of prognosis. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that higher serum NF-L and GFAP are associated with worse neurological outcome after acute SCI. TRIAL REGISTRATION INFORMATION Registered on ClinicalTrials.gov: NCT00135278 (March 2006) and NCT01279811 (January 2012).
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Affiliation(s)
- Sophie Stukas
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jennifer Cooper
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jasmine Gill
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Nader Fallah
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Michael A Skinnider
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Lise Belanger
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Leanna Ritchie
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Angela Tsang
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Kevin Dong
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Femke Streijger
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - John Street
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Scott Paquette
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Tamir Ailon
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Nicolas Dea
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Raphaele Charest-Morin
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Charles G Fisher
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Christopher S Bailey
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Sanjay Dhall
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jean-Marc Mac-Thiong
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Jefferson R Wilson
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Sean Christie
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Marcel F Dvorak
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Cheryl L Wellington
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada
| | - Brian K Kwon
- From the Djavad Mowafaghian Centre for Brain Health (S.S., J.C., J.G., C.L.W.), Department of Pathology and Laboratory Medicine (S.S, J,C, J.G.,C.L.W.) Division of Neurology, Department of Medicine (N.F.), Division of Neurosurgery (S.P., T.A., N.D.), Michael Smith Laboratories (M.A.S.), and School of Biomedical Engineering (C.L.W.), University of British Columbia, Vancouver, British Columbia; Praxis Spinal Cord Institute (N.F.), and Vancouver Spine Research Program (L.B., L.R., A.T.), Vancouver General Hospital, Blusson Spinal Cord Center, Vancouver, British Columbia; International Collaboration on Repair Discoveries (ICORD) (K.D., F.S., J.S., M.F.D., C.L.W., B.K.K.) and Vancouver Spine Surgery Institute, Department of Orthopaedics (J.S., R.C.-M., C.G.F., M.F.D., B.K.K.), University of British Columbia, Blusson Spinal Cord Center, Vancouver, British Columbia; Division of Orthopaedics (C.S.B.), Schulich School of Medicine, University of Western Ontario, London, Canada; Department of Neurosurgery (S.D.), University of California San Francisco; Department of Surgery (J-M., M-T.), Hôpital du Sacré-Coeur de Montréal, Quebec; Department of Surgery (J.-M., M.-T.), Chu Sainte-Justine, University of Montreal, Quebec; Division of Neurosurgery (J.R.W.), University of Toronto, St. Michael's Hospital, Ontario; and Division of Neurosurgery (S.C.), Halifax Infirmary, Dalhousie University, Nova Scotia, Canada.
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7
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Lawrence DC, Montazeripouragha A, Wai EK, Roffey DM, Phan KM, Phan P, Stratton A, Kingwell S, McIntosh G, Soroceanu A, Abraham E, Bailey CS, Christie S, Paquet J, Glennie A, Nataraj A, Hall H, Fisher C, Rampersaud YR, Thomas K, Manson N, Johnson M, Zarrabian M. Beneficial Effects of Preoperative Exercise on the Outcomes of Lumbar Fusion Spinal Surgery. Physiother Can 2023; 75:22-28. [PMID: 37250725 PMCID: PMC10211389 DOI: 10.3138/ptc-2021-0030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/03/2021] [Accepted: 08/18/2021] [Indexed: 02/11/2024]
Abstract
Purpose: To determine whether there was an association between self-reported preoperative exercise and postoperative outcomes after lumbar fusion spinal surgery. Method: We performed a retrospective multivariable analysis of the prospective Canadian Spine Outcomes and Research Network (CSORN) database of 2,203 patients who had elective single-level lumbar fusion spinal surgeries. We compared adverse events and hospital length of stay between patients who reported regular exercise (twice or more per week) prior to surgery ("Regular Exercise") to those exercising infrequently (once or less per week) ("Infrequent Exercise") or those who did no exercise ("No Exercise"). For all final analyses, we compared the Regular Exercise group to the combined Infrequent Exercise or No Exercise group. Results: After making adjustments for known confounding factors, we demonstrated that patients in the Regular Exercise group had fewer adverse events (adjusted odds ratio 0.72; 95% CI: 0.57, 0.91; p = 0.006) and significantly shorter lengths of stay (adjusted mean 2.2 vs. 2.5 d, p = 0.029) than the combined Infrequent Exercise or No Exercise group. Conclusions: Patients who exercised regularly twice or more per week prior to surgery had fewer postoperative adverse events and significantly shorter hospital lengths of stay compared to patients that exercised infrequently or did no exercise. Further study is required to determine effectiveness of a targeted prehabilitation programme.
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Affiliation(s)
| | | | - Eugene K. Wai
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Darren M. Roffey
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Health Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Kim M. Phan
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Philippe Phan
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Alexandra Stratton
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Stephen Kingwell
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Division of Orthopaedic Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Greg McIntosh
- Research Operations, Canadian Spine Outcomes Research Network, Markdale, Ontario, Canada
| | - Alex Soroceanu
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Edward Abraham
- Canada East Spine Center and Horizon Health Network, Dalhousie University, Saint John, New Brunswick, Canada
| | - Christopher S. Bailey
- Lawson Health Research Institute/London Health Sciences Centre, Division of Orthopaedics, Department of Surgery, Western University, London, Ontario, Canada
| | - Sean Christie
- Department of Surgery, Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jerome Paquet
- Hôpital de l’Enfant-Jésus, Laval University, Quebec City, Quebec, Canada
| | - Andrew Glennie
- Department of Surgery, Division of Orthopedics, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Charles Fisher
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Y. Raja Rampersaud
- Arthritis Program, Krembil Research Institute, University Health Network, Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Kenneth Thomas
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Neil Manson
- Canada East Spine Center and Horizon Health Network, Dalhousie University, Saint John, New Brunswick, Canada
| | - Michael Johnson
- Winnipeg Spine Program Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mohammad Zarrabian
- Winnipeg Spine Program Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba, Canada
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8
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Senthinathan A, Cronin SM, Ho C, New PW, Guilcher SJ, Noonan VK, Craven BC, Christie S, Wai EK, Tsai EC, Sreenivasan V, Wilson J, Fehlings MG, Welk B, Jaglal SB. Using Clinical Vignettes and a Modified Expert Delphi Panel to Determine Parameters for Identifying Non-Traumatic Spinal Cord Injury in Health Administrative and Electronic Medical Record Databases. Arch Phys Med Rehabil 2023; 104:63-73. [PMID: 36002056 DOI: 10.1016/j.apmr.2022.08.002] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To obtain expert consensus on the parameters and etiologic conditions required to retrospectively identify cases of non-traumatic spinal cord injury (NTSCI) in health administrative and electronic medical record (EMR) databases based on the rating of clinical vignettes. DESIGN A modified Delphi process included 2 survey rounds and 1 remote consensus panel. The surveys required the rating of clinical vignettes, developed after chart reviews and expert consultation. Experts who participated in survey rounds were invited to participate in the Delphi Consensus Panel. SETTING An international collaboration using an online meeting platform. PARTICIPANTS Thirty-one expert physicians and/or clinical researchers in the field of spinal cord injury (SCI). MAIN OUTCOME MEASURE(S) Agreement on clinical vignettes as NTSCI. Parameters to classify cases of NTSCI in health administrative and EMR databases. RESULTS In health administrative and EMR databases, cauda equina syndromes should be considered SCI and classified as a NTSCI or TSCI based on the mechanism of injury. A traumatic event needs to be listed for injury to be considered TSCI. To be classified as NTSCI, neurologic sufficient impairments (motor, sensory, bowel, and bladder) are required, in addition to an etiology. It is possible to have both a NTSCI and a TSCI, as well as a recovered NTSCI. If information is unavailable or missing in health administrative and EMR databases, the case may be listed as "unclassifiable" depending on the purpose of the research study. CONCLUSION The Delphi panel provided guidelines to appropriately classify cases of NTSCI in health administrative and EMR databases.
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Affiliation(s)
- Arrani Senthinathan
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.
| | - Shawna M Cronin
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Chester Ho
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Peter W New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Caulfield, Australia; Department of Medicine & Rehabilitation and Aged Services Program, Kingston Centre, Monash Health, Cheltenham, Australia; Epworth-Monash Rehabilitation Medicine Unit, Monash University, Richmond, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Prahran, Australia
| | - Sara Jt Guilcher
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada; Rehabilitation Science Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, Canada; International Collaboration on Repair Discoveries, Vancouver, Canada
| | - B Catherine Craven
- KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, Canada
| | - Eugene K Wai
- Division of Orthopaedic Surgery and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Eve C Tsai
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Division of Neurosurgery, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Vidya Sreenivasan
- Physical Medicine and Rehabilitation, The Ottawa Hospital, Ottawa, Canada
| | - Jefferson Wilson
- Division of Neurosurgery, University of Toronto, Toronto, Canada; St. Michael's Hospital, Toronto, Canada
| | - Michael G Fehlings
- Division of Neurosurgery, University of Toronto, Toronto, Canada; Department of Surgery and Epidemiology & Biostatistics, Western University, London, Canada
| | - Blayne Welk
- Division of Neurosurgery and Division of Genetics and Development, Krembil Neuroscience Centre, University Health Network, Toronto, Canada
| | - Susan B Jaglal
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada; Rehabilitation Science Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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9
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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
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Cushnie D, Soroceanu A, Stratton A, Dea N, Finkelstein J, Bailey CS, Weber MH, Paquet J, Glennie A, Hall H, Rampersaud R, Ahn H, Kelly A, Christie S, Nataraj A, Johnson M, Abraham E, Attabib N, Fisher C, Manson N, Thomas K. Outcome of spine surgery in patients with depressed mental states: a Canadian spine outcome research network study. Spine J 2022; 22:1700-1707. [PMID: 35671946 DOI: 10.1016/j.spinee.2022.05.012] [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: 03/17/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Depression is higher among spine patients than among the general population. Some small studies, but not others, have suggested that depression may be a predictor of worse outcome after surgery. PURPOSE Determination whether there is an association between depression and worse response to surgery among spine patients. STUDY DESIGN/SETTING The national, prospective, Canadian Spine Outcome Research Network (CSORN) surgical outcome registry. PATIENT SAMPLE All patients in the CSORN registry who received surgery for thoracic or lumbar degenerative deformity, stenosis, spondylolisthesis, disc disease, or disc herniation with a minimum of 12 months follow-up postoperation (n = 2310). OUTCOME MEASURES Oswestry Disability Index (ODI), SF12 Physical Component Score (PCS), European Quality of Life (EuroQoL), and pain scales. METHODS Change in preoperative to 12-month postoperative ODI, and secondary measures, were compared to assess if there was an association between preoperative depression, as measured by PHQ9, and smaller response to surgery. Multivariate regression analysis was used to search for preoperative factors which might interact with PHQ9 to predict ODI outcome. RESULTS Patients with PHQ9<5, associated with minimal to no depression, had the smallest ODI improvement (-16.8 [95%CI -18.1 to -15.3]) and patients with severe preoperative depression (PHQ9 ≥ 10) had the largest ODI improvement (-22.8 [95%CI -24.1 to -21.5]; p<.00001). Similar findings were found in the EQ5D and PCS. Pain improvement was not different between depression levels. Multivariate modeling found worse baseline PHQ9 and ODI, greater age, nicotine use, more operative levels, and worse American Society of Anesthesiology score was predictive of worse ODI outcomes. CONCLUSIONS Depressed patients have similar or better relative improvements in disability, quality of life, and pain, when compared to nondepressed patients, although their preoperative and postoperative levels of disability are higher. Surgeons should not be concerned that depression will reduce the patient-reported beneficial response to surgical intervention.
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Affiliation(s)
| | | | | | - Nicolas Dea
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | - Henry Ahn
- University of Toronto, Toronto, Ontario, Canada
| | - Adrienne Kelly
- Northern Ontario School of Medicine, Sault Ste. Marie, Ontario, Canada
| | | | | | | | - Ed Abraham
- Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Charles Fisher
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Neil Manson
- Dalhousie University, Halifax, Nova Scotia, Canada
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Williams C, French D, Christie S, Castonguay M, Wallace A. Pleural solitary fibrous tumour with brain metastasis: an aggressive tumour and pathologic conundrum. J Surg Case Rep 2022; 2022:rjac344. [PMID: 35935465 PMCID: PMC9352268 DOI: 10.1093/jscr/rjac344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/30/2022] [Accepted: 07/10/2022] [Indexed: 12/27/2022] Open
Abstract
Abstract
Solitary fibrous tumours of the pleura are a rare finding; those with brain metastases are rarer still. Here, we present the evolution of a pleural solitary fibrous tumour in a 70-year-old male treated surgically, and subsequent brain metastasis requiring emergent craniotomy and excision. The patient received adjuvant radiotherapy to the brain and had no recurrence of brain metastases; however, 1 year surveillance imaging demonstrated metastases to the lungs, liver and spleen for which he received chemotherapy but eventually succumbed to the disease process. Solitary fibrous tumours are most often slow-growing, relatively benign neoplasms. However, up to 10% are malignant. This case highlights the importance of surgical resection of these benign tumours with malignant potential.
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Affiliation(s)
- Catherine Williams
- Department of Surgery , Division of Thoracic Surgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
- Dalhousie University , Division of Thoracic Surgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
| | - Daniel French
- Department of Surgery , Division of Thoracic Surgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
- Dalhousie University , Division of Thoracic Surgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
| | - Sean Christie
- Department of Surgery , Division of Neurosurgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
- Dalhousie University , Division of Neurosurgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
| | - Mathieu Castonguay
- Department of Pathology , Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
- Dalhousie University , Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
| | - Alison Wallace
- Department of Surgery , Division of Thoracic Surgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
- Dalhousie University , Division of Thoracic Surgery, Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
- Department of Pathology , Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
- Dalhousie University , Queen Elizabeth II Health Sciences Centre, , Halifax, Nova Scotia, Canada
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12
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Romagna A, Wilson JR, Jacobs WB, Johnson MG, Bailey CS, Christie S, Paquet J, Nataraj A, Cadotte DW, Manson N, Hall H, Thomas KC, Schwartz C, Rampersaud YR, McIntosh G, Fisher CG, Dea N. Factors Associated With Return to Work After Surgery for Degenerative Cervical Spondylotic Myelopathy: Cohort Analysis From the Canadian Spine Outcomes and Research Network. Global Spine J 2022; 12:573-578. [PMID: 33063549 PMCID: PMC9109566 DOI: 10.1177/2192568220958669] [Citation(s) in RCA: 1] [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] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Retrosepctive analysis of prospectively collected data from the multicentre Canadian Surgical Spine Registry (CSORN). OBJECTIVE Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in North America. Few studies have evaluated return to work (RTW) rates after DCM surgery. Our goals were to determine rates and factors associated with postoperative RTW in surgically managed patients with DCM. METHODS Data was derived from the prospective, multicenter Canadian Spine Outcomes and Research Network (CSORN). From this cohort, we included all nonretired patients with at least 1-year follow-up. The RTW rate was defined as the proportion of patients with active employment at 1 year from the time of surgery. Unadjusted and adjusted analyses were used to identify patient characteristics, disease, and treatment variables associated with RTW. RESULTS Of 213 surgically treated DCM patients, 126 met eligibility, with 49% working and 51% not working in the immediate period before surgery; 102 had 12-month follow-up data. In both the unadjusted and the adjusted analyses working preoperatively and an anterior approach were associated with a higher postoperative RTW (P < .05), there were no significant differences between the postoperative employment groups with respect to age, gender, preoperative mJOA (modified Japanese Orthopaedic Association) score, and duration of symptoms (P > .05). Active preoperative employment (odds ratio = 15.4, 95% confidence interval = 4.5, 52.4) and anterior surgical procedures (odds ratio = 4.7, 95% confidence interval = 1.2, 19.6) were associated with greater odds of RTW at 1 year. CONCLUSIONS The majority of nonretired patients undergoing surgery for DCM had returned to work 12 months after surgery; active preoperative employment and anterior surgical approach were associated with RTW in this analysis.
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Affiliation(s)
- Alexander Romagna
- University of Toronto, Toronto,
Ontario, Canada,Paracelsus Private Medical
University, Salzburg, Austria
| | | | | | | | | | | | - Jerome Paquet
- CHU de Quebec-Universite Laval,
Quebec City, Quebec, Canada
| | - Andrew Nataraj
- University of Alberta Hospital,
Edmonton, Alberta, Canada
| | | | - Neil Manson
- Dalhousie University, Saint John,
New Brunswick, Canada
| | | | | | | | | | - Greg McIntosh
- Canadian Spine Outcomes and
Research Network, Markdale, Ontario, Canada,Greg McIntosh, Canadian Spine Outcomes and
Research Network, 10 Armstrong Cres, PO Box 1053, Markdale, Ontario, Canada N0C
1H0.
| | - Charles G. Fisher
- Vancouver General Hospital,
Vancouver, British Columbia, Canada,University of British Columbia,
Vancouver, British Columbia, Canada
| | - Nicolas Dea
- Vancouver General Hospital,
Vancouver, British Columbia, Canada,University of British Columbia,
Vancouver, British Columbia, Canada
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13
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Evaniew N, Charest-Morin R, Jacobs WB, Johnson M, Bailey CS, Christie S, Paquet J, Nataraj A, Cadotte DW, Wilson JR, Craig M, Xu M, Manson N, Hall H, Thomas KC, Rampersaud YR, McIntosh G, Fisher CG, Dea N. Cervical Sagittal Alignment in Patients with Cervical Spondylotic Myelopathy: An Observational Study From the Canadian Spine Outcomes and Research Network. Spine (Phila Pa 1976) 2022; 47:E177-E186. [PMID: 34845179 DOI: 10.1097/brs.0000000000004296] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 02/01/2023]
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVE Among patients with CSM, we aimed to evaluate the extent to which: (1) Preoperative cervical sagittal alignment is associated with health-related quality of life, function, and symptoms; (2) Surgery leads to changes in cervical sagittal alignment; and (3) Postoperative cervical sagittal alignment is associated with health-related quality of life, function, and symptoms at 12 months of follow-up. SUMMARY OF BACKGROUND DATA The importance of maintaining or improving cervical sagittal alignment in the surgical management of patients with CSM has not been established. METHODS We measured C2-C7 Cobb angle, T1 slope, and C2-C7 cervical sagittal vertical axis (cSVA). We tested for associations with Neck Disability Index, Pain Scales for neck and arm pain, EuroQol 5D, Short Form 12 Physical and Mental Component Summaries, and modified Japanese Orthopaedic Association scores. We adjusted for potential confounders using multiple linear regression, and we performed various prespecified subgroup (cSVA > 40 mm, surgical approach) and sensitivity analyses. RESULTS Among 250 patients, adjusted analyses yielded significant inverse associations prior to surgery between each of cSVA and T1 slope with SF12 Physical Component Summaries (T1 slope: -0.14, 95% CI -0.26 to -0.01, P = 0.03; C2-C7 cSVA: -0.13, 95% CI --0.21 to -0.05 P < 0.01). Surgery was associated with a small but statistically significant increase in cSVA across the cohort (+5.8 mm [SD 11.7], P < 0.01) but no change in Cobb angle or T1 slope. At 12-months after surgery, there were no significant associations between alignment parameters or change in alignment and any measures of health-related quality of life, function, or symptoms. Results were consistent across subgroup and sensitivity analyses. CONCLUSION Increased cSVA and T1 slope were associated with inferior health-related quality of life at presentation among patients with CSM, but no significant associations were observed following surgical treatment.Level of Evidence: 3.
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Affiliation(s)
- Nathan Evaniew
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Raphaële Charest-Morin
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Bradley Jacobs
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
| | - Michael Johnson
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jérôme Paquet
- Department of Orthopaedics, Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
| | - Andrew Nataraj
- Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada
| | - David W Cadotte
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute and Departments of Clinical Neurosciences and Radiology, Division of Neurosurgery, Cumming School of Medicine, University of Calgary
| | | | - Michael Craig
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mark Xu
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Neil Manson
- Canada East Spine Centre, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ken C Thomas
- University of Calgary Spine Program, University of Calgary, Calgary, Alberta, Canada
| | - Y Raja Rampersaud
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Charles G Fisher
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicolas Dea
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
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14
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Ayling OGS, Ailon T, Street JT, Dea N, McIntosh G, Abraham E, Jacobs WB, Soroceanu A, Johnson MG, Paquet J, Rasoulinejad P, Phan P, Yee A, Christie S, Nataraj A, Glennie RA, Hall H, Manson N, Rampersaud YR, Thomas K, Fisher CG. The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes After Lumbar Spine Surgery. Neurosurgery 2021. [DOI: 10.1093/neuros/nyaa427_s095] [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: 11/13/2022] Open
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15
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Cushnie D, Fisher C, Hall H, Johnson M, Christie S, Bailey C, Phan P, Abraham E, Glennie A, Jacobs B, Paquet J, Thomas K. Mental health improvements after elective spine surgery: a Canadian Spine Outcome Research Network (CSORN) study. Spine J 2021; 21:1332-1339. [PMID: 33831545 DOI: 10.1016/j.spinee.2021.03.032] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 02/19/2021] [Accepted: 03/29/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Spine patients have a higher rate of depression then the general population which may be caused in part by levels of pain and disability from their spinal disease. PURPOSE Determination whether improvements in health-related quality of life (HRQOL) resulting from successful spine surgery leads to improvements in mental health. STUDY DESIGN/SETTING The Canadian Spine Outcome Research Network prospective surgical outcome registry. OUTCOME MEASURES Change between preoperative and postoperative SF12 Mental Component Score (MCS). Secondary outcomes include European Quality of Life (EuroQoL) Healthstate, SF-12 Physical Component Score (PCS), Oswestry Disability Index (ODI), Patient Health Questionaire-9 (PHQ9), and pain scales. METHODS The Canadian Spine Outcome Research Network registry was queried for all patients receiving surgery for degenerative thoracolumbar spine disease. Exclusion criteria were trauma, tumor, infection, and previous spine surgery. SF12 Mental Component Scores (MCS) were compared between those with and without significant improvement in postoperative disability (ODI) and secondary measures. Multivariate analysis examined factors predictive of MCS improvement. RESULTS Eighteen hospitals contributed 3222 eligible patients. Worse ODI, EuroQoL, PCS, back pain and leg pain correlated with worse MCS at all time points. Overall, patients had an improvement in MCS that occurred within 3 months of surgery and was still present 24 months after surgery. Patients exceeding Minimally Clinically Important Differences in ODI had the greatest improvements in MCS. Major depression prevalence decreased up to 48% following surgery, depending on spine diagnosis. CONCLUSIONS Large scale, real world, registry data suggests that successful surgery for degenerative lumbar disease is associated with reduction in the prevalence of major depression regardless of the specific underlaying diagnosis. Worse baseline MCS was associated with worse baseline HRQOL and improved postoperatively with coincident improvement in disability, emphasizing that mental wellness is not a static state but may improve with well-planned spine surgery.
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Affiliation(s)
- D Cushnie
- McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada, L8S 4L8.
| | - C Fisher
- University of British Columbia, 6th floor, 818 West 10th Avenue, Vancouver, British Columbia, Canada, V5Z 1M9
| | - H Hall
- University of Toronto, 494851 Traverston Road, Markdale, Ontario, Canada, N0C 1H0
| | - M Johnson
- University of Manitoba, AD401 - 820 Sherbrook Street, Winnipeg, Manitoba, Canada, R3A 1R9
| | - S Christie
- Dalhousie University, Department of Surgery (Neurosurgery), Halifax, Nova Scotia, Canada, B3H 4R2
| | - C Bailey
- Western University, 800 Commissioners Rd. E., E1-317London, Ontario, Canada, N6A 5W9
| | - P Phan
- University of Ottawa, 1053 Carling Ave, Ottawa, Ontario, Canada, K1Y 4E9
| | - E Abraham
- Dalhousie University, 555 Somerset St, Suite 200, Saint John, New Brunswick, Canada, E2K 4X2
| | - A Glennie
- Dalhousie University, Department of Surgery (Neurosurgery), Halifax, Nova Scotia, Canada, B3H 4R2
| | - B Jacobs
- University of Calgary, Foothills Medical Centre, 1403 - 29th Street NW Calgary, AB, Canada T2N 2T9
| | - J Paquet
- CHU de Québec-Université Laval, 1401 18e rue, Québec City, Quebec, Canada, G1J 1Z4
| | - K Thomas
- University of Calgary, Foothills Medical Centre, 1403 - 29th Street NW Calgary, AB, Canada T2N 2T9
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16
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Stukas S, Gill J, Cooper J, Belanger L, Ritchie L, Tsang A, Dong K, Streijger F, Street J, Paquette S, Ailon T, Dea N, Charest-Morin R, Fisher CG, Dhall S, Mac-Thiong JM, Wilson JR, Bailey C, Christie S, Dvorak MF, Wellington C, Kwon BK. Characterization of Cerebrospinal Fluid Ubiquitin C-Terminal Hydrolase L1 as a Biomarker of Human Acute Traumatic Spinal Cord Injury. J Neurotrauma 2021; 38:2055-2064. [PMID: 33504255 DOI: 10.1089/neu.2020.7352] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
A major obstacle for translational research in acute spinal cord injury (SCI) is the lack of biomarkers that can objectively stratify injury severity and predict outcome. Ubiquitin C-terminal hydrolase L1 (UCH-L1) is a neuron-specific enzyme that shows promise as a diagnostic biomarker in traumatic brain injury (TBI), but has not been studied in SCI. In this study, cerebrospinal fluid (CSF) and serum samples were collected over the first 72-96 h post-injury from 32 acute SCI patients who were followed prospectively to determine neurological outcomes at 6 months post-injury. UCH-L1 concentration was measured using the Quanterix Simoa platform (Quanterix, Billerica, MA) and correlated to injury severity, time, and neurological recovery. We found that CSF UCH-L1 was significantly elevated by 10- to 100-fold over laminectomy controls in an injury severity- and time-dependent manner. Twenty-four-hour post-injury CSF UCH-L1 concentrations distinguished between American Spinal Injury Association Impairment Scale (AIS) A and AIS B, and AIS A and AIS C patients in the acute setting, and predicted who would remain "motor complete" (AIS A/B) at 6 months with a sensitivity of 100% and a specificity of 86%. AIS A patients who did not improve their AIS grade at 6 months post-injury were characterized by sustained elevations in CSF UCH-L1 up to 96 h. Similarly, the failure to gain >8 points on the total motor score at 6 months post-injury was associated with higher 24-h CSF UCH-L1. Unfortunately, serum UCH-L1 levels were not informative about injury severity or outcome. In conclusion, CSF UCH-L1 in acute SCI shows promise as a biomarker to reflect injury severity and predict outcome.
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Affiliation(s)
- Sophie Stukas
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jasmine Gill
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Cooper
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lise Belanger
- Vancouver Spine Research Program, Vancouver General Hospital, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leanna Ritchie
- Vancouver Spine Research Program, Vancouver General Hospital, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Angela Tsang
- Vancouver Spine Research Program, Vancouver General Hospital, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kevin Dong
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Femke Streijger
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - John Street
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Spine Surgery Institute, Department of Orthopaedics, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Paquette
- Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tamir Ailon
- Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicolas Dea
- Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raphaële Charest-Morin
- Vancouver Spine Surgery Institute, Department of Orthopaedics, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles G Fisher
- Vancouver Spine Surgery Institute, Department of Orthopaedics, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sanjay Dhall
- Department of Neurosurgery, University of California San Francisco, San Francisco, California, USA
| | - Jean-Marc Mac-Thiong
- Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
- Department of Surgery, Chu Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Jefferson R Wilson
- Division of Neurosurgery, University of Toronto, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Christopher Bailey
- Division of Orthopaedic Surgery, Schulich Medicine & Dentistry, Victoria Hospital, London, Ontario, Canada
| | - Sean Christie
- Division of Neurosurgery, Halifax Infirmary, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marcel F Dvorak
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Spine Surgery Institute, Department of Orthopaedics, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cheryl Wellington
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian K Kwon
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Spine Surgery Institute, Department of Orthopaedics, Blusson Spinal Cord Center, University of British Columbia, Vancouver, British Columbia, Canada
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Power JD, Glennie A, Rogers S, Aziz M, Singh S, Dandurand C, Tauh S, Richard-Denis A, Morris S, Richard-Denis A, Lim V, Mputu PM, Soroceanu A, Sadiq I, Daly C, Dandurand C, Larouche J, Correale M, Sharma A, Charest-Morin R, Lee J, Ajoku U, Moskven E, Asif H, Al-attar ENM, Mishreky A, Rocos B, Rocos B, Rocos B, Srivastava SK, Patgaonkar P, Cummins D, Bednar D, Chan V, Bowker R, Evaniew N, Hathi K, Hall H, Ludwig T, Ludwig T, Truong VT, Passalent L, Wang S, Shaikh N, Pelletier-Roy R, Shen J, Wang Z, Singh S, Machida M, Machida M, Fernandes R, Fernandes R, Marathe N, Kerr J, Magnan MC, Visva S, Jarvis J, Jarvis J, Jentzsch T, Cherry A, Cherry A, Cherry A, Dandurand C, Rampersaud R, Sundararajan K, Levasseur A, Fernandes R, Fernandes R, Fullerton K, Malone H, Daly C, Peloza J, Peloza J, Walden K, Elsemin O, MacLean MA, Rose J, Oppermann M, Ferguson D, Hindi M, Dermott JA, DeVries Z, Lebel D, Ayling O, Singh V, Craig M, Lasswell T, Perruccio AV, Canizares M, McIntosh G, Rampersaud YR, Urquhart J, Koto P, Rasoulinejad P, Sequeira K, Miller T, Watson J, Rosedale R, Gurr K, Siddiqi F, Bailey C, Manson N, Bigney E, Vandewint A, Richardson E, El-Mughayyar D, McPhee R, Abraham E, Weber M, McIntosh G, Kelly A, Santaguida C, Ouellet J, Reindl R, Jarzem P, Lasry O, Dea N, Fisher C, Street J, Boyd M, Charest-Morin R, Rhines L, Boriani S, Charest-Morin R, Gokaslan Z, Gasbarrini A, Saghal A, Laufer II, Lazary A, Bettegowda C, Kawahara N, Clarke M, Rampersaud YR, Reynolds J, Disch A, Chou D, Shin JH, Wei F, Hornicek FJ, Barzilai O, Fisher C, Dea N, Nickel D, Thorpe L, Brown J, Weiler R, Linassi G, Fourney D, Dionne A, Bégin J, Mac-Thiong JM, Yung A, George S, Prevost V, Bauman A, Kozlowski P, Samadi F, Fournier C, Parker L, Dong K, Streijger F, Moore GW, Laule C, Kwon B, Gravel LF, Dionne A, Bourassa-Moreau E, Maurais G, Khoueir P, Mac-Thiong JM, Richard-Denis A, Dionne A, Bourassa-Moreau É, Bégin J, Mac-Thiong JM, Beausejour M, Richard-Denis A, Begin J, Dionne A, Mac-Thiong JM, Scheer J, Protopsaltis T, Gupta M, Passias P, Gum J, Smith J, Bess S, Lafage V, Ames C, Klineberg E, Frederick A, Nicholls F, Lewkonia P, Thomas K, Jacobs B, Swamy G, Miller N, Tanguay R, Soroceanu A, Nevin J, Bourassa-Moreau E, Dvorak M, Fisher C, Paquette S, Kwon B, Dea N, Ailon T, Charest-Morin R, Street J, Hindi M, Kwon B, Dvorak M, Ailon T, Paquette S, Fisher C, Charest-Morin R, Dea N, Street J, Finkelstein J, Bowes J, Ford M, Yee A, Soever L, Rachevitz M, Bigness A, Robertson S, Wilson R, Wong W, Nugent J, Frantzeskos S, Duffy M, Rampersaud R, Marathe N, Agarwal R, Bailey CS, Paquet J, Dea N, Goytan M, McIntosh G, Street J, Fisher C, Jacobs B, Johnson M, Paquet J, Hall H, Bailey C, Christie S, Nataraj A, Manson N, Phan P, Rampersaud R, Thomas K, McIntosh G, Abraham E, Glennie A, Jarzem P, Ahn H, Blanchard J, Hogan G, Kelly A, Charest-Morin R, Tohidi M, Hopman W, Yen D, Parent S, Miyanji F, Murphy J, El-Hawary R, Lebel D, Zeller R, Reda L, Dodds M, Lebel D, Zeller R, Zeller R, Marathe N, Bhosale S, Raj A, Marathe N, Goyal V, Theologis A, Witiw C, Fehlings M, Morash K, Yaszay B, Andras L, Sturm P, Sponseller P, El-Hawary R, Swamy G, Jacobs WB, Bouchard J, Cho R, Manson NA, Rampersaud YR, Paquet J, Bailey CS, Johnson M, Attabib N, Fisher CG, McIntosh G, Thomas KC, Bigney E, Richardson E, Alugo T, El-Mughayyar D, Vandewint A, Manson N, Abraham E, Attabib N, Prostko R, Cheng B, Haring K, Fischer M, Bourget-Murray J, Sridharan S, Frederick A, Johnston K, Edwards B, Nicholls F, Soroceanu A, Bouchard J, Shedid D, Al-Shakfa F, Shen J, Boubez G, Yuh SJ, Wang Z, Sundararajan K, Perruccio A, Coyte P, Bombardier C, Bloom J, Hawke C, Haroon N, Inman R, Rampersaud YR, Hebert J, Abraham E, Vandewint A, Bigney E, Richardson E, El-Mughayyar D, Attabib N, Small C, Manson N, Zhang H, Beresford-Cleary N, Street J, Wilson D, Oxland T, Richard-Denis A, Jean S, Bourassa-Moreau É, Fleury J, Beauchamp-Vien G, Bégin J, Mac-Thiong JM, Boudier-Revéret M, Majdalani C, Truong VT, Wang Z, Shedid D, Najjar A, Yuh SJ, Boubez G, Sebaaly A, McIntosh G, Ailon T, Dea N, Fisher C, Charest-Morin R, Lebel D, Rocos B, Zabjek K, Zeller R, Zabjek K, Rocos B, Lebel D, Zeller R, Gee A, Schneider N, Kanawati A, Schemitsch E, Bailey C, Rasoulinejad P, Zdero R, Schneider N, Gee A, Kanawati A, Zdero R, Bailey C, Rasoulinejad P, Lohkamp LN, Fehlings M, Abraham E, Vandewint A, Bigney E, Hebert J, Richardson E, El-Mughayyar D, Chorney J, El-Hawary R, Manson N, Wai E, Phan P, Kingwell S, Tierney S, Stratton A, AlDuwaisan A, Moravek D, Wai E, Kingwell S, Stratton A, Phan P, Devries Z, Barrowman N, Smit K, Tice A, Devries Z, Barrowman N, Smit K, Tice A, Sundararajan K, Rampersaud YR, Oitment C, Wunder J, Ferguson P, Rampersaud R, Rampersaud R, Rampersaud R, Ailon T, Dvorak M, Kwon B, Paquette S, Charest-Morin R, Dea N, Fisher C, Street J, Bailey C, Casha S, Glennie A, Fox R, McIntosh G, Yee A, Fisher C, Perruccio A, Perruccio A, Rampersaud YR, Mac-Thiong JM, Richard-Denis A, Gee A, Kanawati A, Rasoulinejad P, Zdero R, Bailey C, Gee A, Kanawati A, Rasoulinejad P, Zdero R, Bailey C, Klein G, Emmenegger U, Finkelstein J, Lyons F, Whyne C, Hardisty M, Millgram M, Guyer R, Harel R, Ashkenazi E, Dvorak M, Fisher C, Paquette S, Street J, Dea N, Ailon T, Charest-Morin R, Kwon B, Millgram M, Guyer R, Le Huec JC, Ashkenazi E, Millgram M, Guyer R, Harel R, Kutz S, Ashkenazi E, Parsons J, Bailey CS, Dhaliwal P, Fourney DR, Noonan V, Mac-Thiong JM, Beausejour M, Sassine S, Joncas J, Barchi S, Le May S, Cobetto N, Fortin C, Carl-Éric A, Parent S, Labelle H, Bailey C, Fisher C, Rampersaud R, Glennie A, Manson N, Bigney E, Vandewint A, Hebert J, El-Mughayyar D, Richardson E, Ghallab N, Flood M, Attabib N, Abraham E, Swamy G, Nicholls F, Thomas K, Jacobs WB, Soroceanu A, Evaniew N, Stevens M, Dunning C, Oxner W, Glennie A, Dandurand C, Paquette S, Kwon B, Ailon T, Dvorak M, Dea N, Charest-Morin R, Fisher C, Street J, Kim D, Lebel DE, Jarvis J, Tice A, Smit K, Campbell F, Mashida M, Isaac L, Bath N, Stocki D, Levin D, Koyle M, Ruskin D, Stinson J, Ailon T, Dea N, Fisher C, Evaniew N, Soroceanu A, Nicholls F, Jacobs WB, Thomas K, Cho R, Lewkonia P, Swamy G, Lasry O, Ailon T, Zamani N, Rampersaud R, Rasoulinejad P. 2021 Canadian Spine Society Abstracts. Can J Surg 2021; 64:S1-S36. [PMID: 34296831 PMCID: PMC8410468 DOI: 10.1503/cjs.012621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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18
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Rosner J, Negraeff M, Bélanger LM, Tsang A, Ritchie L, Mac-Thiong JM, Christie S, Wilson JR, Dhall S, Charest-Morin R, Street J, Ailon T, Paquette S, Dea N, Fisher CG, Dvorak MF, Finnerup NB, Kwon BK, Kramer JLK. Characterization of Hyperacute Neuropathic Pain after Spinal Cord Injury: A Prospective Study. J Pain 2021; 23:89-97. [PMID: 34302956 DOI: 10.1016/j.jpain.2021.06.013] [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] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 06/19/2021] [Accepted: 06/25/2021] [Indexed: 10/20/2022]
Abstract
There is currently a lack of information regarding neuropathic pain in the very early stages of spinal cord injury (SCI). In the present study, neuropathic pain was assessed using the Douleur Neuropathique 4 Questions (DN4) for the patient's worst pain within the first 5 days of injury (i.e., hyperacute) and on follow-up at 3, 6, and 12 months. Within the hyperacute time frame (i.e., 5 days), at- and below-level neuropathic pain were reported as the worst pain in 23% (n = 18) and 5% (n = 4) of individuals with SCI, respectively. Compared to the neuropathic pain observed in this hyperacute setting, late presenting neuropathic pain was characterized by more intense painful electrical and cold sensations, but less itching sensations. Phenotypic differences between acute and late neuropathic pain support the incorporation of timing into a mechanism-based classification of neuropathic pain after SCI. The diagnosis of acute neuropathic pain after SCI is challenged by the presence of nociceptive and neuropathic pains, with the former potentially masking the latter. This may lead to an underestimation of the incidence of neuropathic pain during the very early, hyperacute time points post-injury. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT01279811) PERSPECTIVE: This article presents distinct pain phenotypes of hyperacute and late presenting neuropathic pain after spinal cord injury and highlights the challenges of pain assessments in the acute phase after injury. This information may be relevant to clinical trial design and broaden our understanding of neuropathic pain mechanisms after spinal cord injury.
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Affiliation(s)
- Jan Rosner
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Department of Neurology, University Hospital Bern, Inselspital, University of Bern, Bern, Switzerland
| | - Michael Negraeff
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Lise M Bélanger
- Vancouver Spine Program, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Angela Tsang
- Vancouver Spine Program, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Leanna Ritchie
- Vancouver Spine Program, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Jean-Marc Mac-Thiong
- Hôpital du Sacré-Coeur de Montréal, Montréal, Quebec, Canada; Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Sean Christie
- Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jefferson R Wilson
- Division of Neurosurgery, Department of Surgery, University of Toronto, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sanjay Dhall
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California
| | - Raphaële Charest-Morin
- Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - John Street
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tamir Ailon
- Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Paquette
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicolas Dea
- Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles G Fisher
- Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marcel F Dvorak
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nanna B Finnerup
- Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Brian K Kwon
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - John L K Kramer
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada; Department of Anesthesiology, Pharmacology, and Therapeutics, Faculty of Medicine, University of British Columbia, British Columbia, Canada.
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Ayling OGS, Ailon T, Street JT, Dea N, McIntosh G, Abraham E, Jacobs WB, Soroceanu A, Johnson MG, Paquet J, Rasoulinejad P, Phan P, Yee A, Christie S, Nataraj A, Glennie RA, Hall H, Manson N, Rampersaud YR, Thomas K, Fisher CG. The Effect of Perioperative Adverse Events on Long-Term Patient-Reported Outcomes After Lumbar Spine Surgery. Neurosurgery 2021; 88:420-427. [PMID: 33009559 DOI: 10.1093/neuros/nyaa427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 06/28/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Perioperative adverse events (AEs) lead to patient disappointment and greater costs. There is a paucity of data on how AEs affect long-term outcomes. OBJECTIVE To examine perioperative AEs and their impact on outcome after lumbar spine surgery. METHODS A total of 3556 consecutive patients undergoing surgery for lumbar degenerative disorders enrolled in the Canadian Spine Outcomes and Research Network were analyzed. AEs were defined using the validated Spine AdVerse Events Severity system. Outcomes at 3, 12, and 24 mo postoperatively included the Owestry Disability Index (ODI), 12-Item Short-Form Health Survey (SF-12) Physical (PCS) and Mental (MCS) Component Summary scales, visual analog scale (VAS) leg and back, EuroQol-5D (EQ5D), and satisfaction. RESULTS AEs occurred in 767 (21.6%) patients, and 85 (2.4%) patients suffered major AEs. Patients with major AEs had worse ODI scores and did not reach minimum clinically important differences at 2 yr (no AE: 25.7 ± 19.2, major: 36.4 ± 19.1, P < .001). Major AEs were associated with worse ODI scores on multivariable linear regression (P = .011). PCS scores were lower after major AEs (43.8 ± 9.5, vs 37.7 ± 20.3, P = .002). On VAS leg and back and EQ5D, the 2-yr outcomes were significantly different between the major and no AE groups (<0.01), but these differences were small (VAS leg: 3.4 ± 3.0 vs 4.0 ± 3.3; VAS back: 3.5 ± 2.7 vs 4.5 ± 2.6; EQ5D: 0.75 ± 0.2 vs 0.64 ± 0.2). SF12 MCS scores were not different. Rates of satisfaction were lower after major AEs (no AE: 84.6%, major: 72.3%, P < .05). CONCLUSION Major AEs after lumbar spine surgery lead to worse functional outcomes and lower satisfaction. This highlights the need to implement strategies aimed at reducing AEs.
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Affiliation(s)
- Oliver G S Ayling
- Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, Canada
| | - Tamir Ailon
- Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, Canada
| | - John T Street
- Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, Canada
| | - Nicolas Dea
- Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, Canada
| | | | - Edward Abraham
- Department of Surgery, Canada East Spine Centre, Saint John, Canada
| | - W Bradly Jacobs
- Department of Surgery, University of Calgary, Calgary, Canada
| | - Alex Soroceanu
- Department of Surgery, University of Calgary, Calgary, Canada
| | - Michael G Johnson
- Departments of Orthopedics and Neurosurgery, University of Manitoba, Winnipeg, Canada
| | - Jerome Paquet
- Department of Surgery, Laval University, Quebec City, Canada
| | | | - Phillipe Phan
- Department of Surgery, University of Ottawa, Ottawa, Canada
| | - Albert Yee
- Department of Surgery, University of Toronto, Toronto, Canada
| | - Sean Christie
- Department of Surgery, Dalhousie University, Halifax, Canada
| | - Andrew Nataraj
- Department of Surgery, University of Alberta, Edmonton, Canada
| | | | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Canada
| | - Neil Manson
- Department of Surgery, Canada East Spine Centre, Saint John, Canada
| | | | - Kenneth Thomas
- Department of Surgery, University of Calgary, Calgary, Canada
| | - Charles G Fisher
- Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, Canada
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Aoude A, Litowski M, Aldebeyan S, Fisher C, Hall H, Manson N, Bailey CS, Ahn H, Abraham E, Nataraj A, Paquet J, Stratton A, Christie S, Cadotte D, Nicholls F, Soroceanu A, Rampersaud YR, Thomas KC. A Comparison of Patient and Surgeon Expectations of Spine Surgical Outcomes. Global Spine J 2021; 11:331-337. [PMID: 32875885 PMCID: PMC8013940 DOI: 10.1177/2192568220907603] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
STUDY DESIGN Ambispective cohort study. OBJECTIVE Limited data exists comparing surgeon and patient expectations of outcome following spine surgery. The objective of this study was to elicit whether any differences exist between patient and surgeon expectations for common spine surgeries. METHODS Ten common age-appropriate clinical scenarios were generated and sent to Canadian spine surgeons to determine surgeon expectations for standard spine surgeries. Patients in the Canadian Spine Outcomes and Research Network (CSORN) registry matching the clinical scenarios were identified. Aggregated patient expectations were compared with surgeon responses for each scenario. A χ2 analysis was then completed to determine discrepancies between surgeon and patient expectations for each scenario. RESULTS A total of 51 Canadian spine surgeons completed the survey on surgical expectations. A total of 919 patients from multiple centers were identified within the CSORN database that matched the clinical scenarios. Our results demonstrated that patients tend to be more optimistic about the expected outcomes of surgery compared with the treating surgeon. The majority of patients in all clinical scenarios anticipated improvement in back or neck pain after surgery, which differed from surgeon expectations. Results also highlighted the effect of patient age on both patient and surgeon expectations. Discrepancies between patient and surgeon expectations were higher for older patients. CONCLUSION We present data on patient and surgeon expectations for spine surgeries and show that differences exist particularly concerning the improvement of neck or back pain. Patient age plays a role in the agreement between the treating physicians and patients in regard to surgical expectations. The reasons for the discrepancies remain unclear.
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Affiliation(s)
- Ahmed Aoude
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Madison Litowski
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Sultan Aldebeyan
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada,National Neuroscience Institute, Riyadh, Saudi Arabia
| | - Charles Fisher
- University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | | | - Neil Manson
- Dalhousie University, Halifax, Nova Scotia, Canada,Canada East Spine Centre, Saint John, New Brunswick, Canada
| | | | - Henry Ahn
- University of Toronto, Toronto, Ontario, Canada,St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Edward Abraham
- Dalhousie University, Halifax, Nova Scotia, Canada,Canada East Spine Centre, Saint John, New Brunswick, Canada
| | | | - Jerome Paquet
- CHU de Québec-Université Laval, Laval, Quebec, Canada
| | | | | | - David Cadotte
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Fred Nicholls
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Alex Soroceanu
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Y. Raja Rampersaud
- University of Toronto, Toronto, Ontario, Canada,University Health Network, Krembil Research Institute, Toronto, Ontario, Canada
| | - Kenneth C. Thomas
- University of Calgary, Foothills Medical Centre, Calgary, Alberta, Canada,Kenneth C. Thomas, Foothills Medical Centre, 1403 29th St NW, Calgary, Alberta, Canada T2N 2T9.
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Leck E, Christie S, Barry T, Barry S. The preliminary opinion of Canadian spine surgeons on Medical Assistance in Dying (MAID); a cross-sectional survey of Canadian Spine Society (CSS) members. North American Spine Society Journal (NASSJ) 2020; 4:100037. [PMID: 35141605 PMCID: PMC8820034 DOI: 10.1016/j.xnsj.2020.100037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/20/2020] [Accepted: 11/16/2020] [Indexed: 11/10/2022]
Abstract
Background On June 17, 2016, providing medical assistance in dying became legal in Canada. This controversial change has had reverberating implications for the entire medical community. This is especially true for physicians that regularly deal with end-of-life decisions, among them neurosurgical and orthopedic spine surgeons, whose patients suffer from a variety of debilitating conditions. With this study we sought to document the opinions of Canadian spine surgeons in hopes of better understanding the sentiment within the speciality towards this change and assess how it evolves over time. Methods A cross-sectional survey was sent out to members of the Canadian Spine Society (CSS). The survey encompassed 21 questions pertaining to opinions and attitudes regarding MAID and different facets of the legislation. Results A total of 51 surgeons responded to the survey, comprised of a mix of orthopedic surgeons (68.6%), pediatric orthopedic surgeons (5.9%), and neurosurgeons (21.6%), practicing all across Canada. The majority support the patients’ right to obtain MAID (62.8%) and the right of physicians to participate (82.4%). Most also support the right to conscientious objection (90.1%). The results were split on duty to refer patients for MAID (49.0%). Respondents were also divided on whether they could foresee themselves referring to a MAID service, with 37.2% responding yes. A small minority of respondents (3.9%) felt they could see themselves actively involved in MAID. Conclusions At the advent of legal MAID, the majority of members of the CSS supported both the right of patients to participate in MAID and the right of physicians to provide this service if they so choose, while still respecting the principle of conscientious objection. Of note, only a small minority were willing to be actively involved. This survey provides a useful baseline of opinions in this practice area and will be used to analyze changes over the next 10 years.
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Bond M, Evaniew N, Bailey CS, Glennie RA, Paquet J, Dea N, Hall H, Manson N, Thomas K, McIntosh G, Soroceanu A, Abraham E, Johnson M, Kingwell S, Charest-Morin R, Christie S, Rampersaud YR, Fisher CG. Back pain in surgically treated degenerative lumbar spondylolisthesis: what can we tell our patients? Spine J 2020; 20:1940-1947. [PMID: 32827708 DOI: 10.1016/j.spinee.2020.08.009] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 02/03/2023]
Abstract
OF BACKGROUND DATA Surgery for degenerative lumbar spondylolisthesis (DLS) has traditionally been indicated for patients with neurogenic claudication. Surgery improves patients' disability and lower extremity symptoms, but less is known about the impact on back pain. OBJECTIVE To evaluate changes in back pain after surgery and identify factors associated with these changes in surgically-treated DLS. STUDY DESIGN Retrospective review of prospectively collected data. METHODS There were 486 consecutive patients with surgically-treated DLS who were enrolled in the Canadian Spine Outcomes Research Network prospective registry and identified for this study. Patients had demographic data, clinical information, disability (Oswestry Disability Index), and back pain rating scores collected prospectively at baseline, and 12 months follow-up RESULTS: Of the 486 DLS patients, 376 (77.3%) were successfully followed at 12 months. Mean age at baseline was 66.7 (standard deviation [SD] 9.2) years old, and 63% were female. Back pain improved significantly at 12 months, compared with baseline (p<.001). Improvement in Numeric Rating Scale (NRS)-back pain ratings was on average 2.97 (SD 2.5) points at one year and clinically significant improvement in back pain was observed in 75% of patients (minimal clinically important difference (MCID) NRS-Pain 1.2 points). Multivariable logistic regression revealed five factors associated with meeting MCID NRS-back pain at 12 month follow up: higher baseline back pain, better baseline physical function (higher SF-12 Physical Component Score), symptoms duration less than 1 to 2 years, and having no intraoperative adverse events. CONCLUSIONS Back pain improved significantly for patients treated surgically for DLS at 1-year follow-up.
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Affiliation(s)
- Michael Bond
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan Evaniew
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada; Departments of Surgery and Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Christopher S Bailey
- Division of Orthopaedics, Department of Surgery, Orthopaedic Spine Program, London Health Science Centre, University of Western Ontario, London, Ontario, Canada
| | | | - Jerome Paquet
- Hôpital de L'Enfant-Jésus, Laval University, Quebec City, Quebec, Canada
| | - Nicolas Dea
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hamilton Hall
- Departments of Surgery and Orthopedics, University of Toronto, Toronto, Ontario, Canada
| | - Neil Manson
- Canada East Spine Center and Dalhousie University, Saint John, New Brunswick, Canada; Department of Orthopaedic Surgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Ken Thomas
- Departments of Surgery and Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Greg McIntosh
- Research Operations, Canadian Spine Society, 10 Armstrong Crescent, Markdale, Ontario, Canada.
| | - Alex Soroceanu
- Departments of Surgery and Clinical Neurosciences, University of Calgary, Alberta, Canada
| | - Edward Abraham
- Canada East Spine Center and Dalhousie University, Saint John, New Brunswick, Canada; Department of Orthopaedic Surgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Michael Johnson
- Orthopedics and Neurosurgery, Winnipeg Spine Program, University of Manitoba, Winning, Manitoba, Canada
| | - Stephen Kingwell
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Raphaele Charest-Morin
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Y Raja Rampersaud
- Departments of Surgery and Orthopedics, University of Toronto, Toronto, Ontario, Canada
| | - Charles G Fisher
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia, Canada
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Glennie RA, Oxner WM, Alant J, Barry SP, Christie S. Case costing in spine surgery: Can surgeons assist with accurate capture of operating room costs? Healthc Manage Forum 2020; 34:158-162. [PMID: 33148024 DOI: 10.1177/0840470420969915] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Surgical case costing is critical for health leaders to make decisions about resource utilization. Synoptic reporting offers the potential for surgeons to capture these costs and work with other leaders to make evidence-based decisions. The purpose of this study was to determine whether surgeons documented intra-operative cost drivers as part of their operative report. This article outlines a synoptic reporting system at a quaternary spine care centre. Data were captured from 2015 to 2020. Surgeon rates of documentation for specific devices, bone graft, and surgical adjuncts were evaluated. It is hoped that the results of this survey will help to guide programs to capture costs in other settings.
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Affiliation(s)
- R Andrew Glennie
- Department of Surgery, 12361Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - William M Oxner
- Department of Surgery, 12361Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Jacob Alant
- Department of Surgery, 12361Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Sean P Barry
- Department of Surgery, 12361Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Sean Christie
- Department of Surgery, 12361Dalhousie University, Halifax, Nova Scotia, Canada.,Nova Scotia Health, Halifax, Nova Scotia, Canada
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Attabib N, Kurban D, Cheng CL, Rivers CS, Bailey CS, Christie S, Ethans K, Flett H, Furlan JC, Tsai EC, O'Connell C. Factors Associated with Recovery in Motor Strength, Walking Ability, and Bowel and Bladder Function after Traumatic Cauda Equina Injury. J Neurotrauma 2020; 38:322-329. [PMID: 32907483 PMCID: PMC7826419 DOI: 10.1089/neu.2020.7303] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Traumatic cauda equina injury (TCEI) is usually caused by spine injury at or below L1 and can result in motor and/or sensory impairments and/or neurogenic bowel and bladder. We examined factors associated with recovery in motor strength, walking ability, and bowel and bladder function to aid in prognosis and establishing rehabilitation goals. The analysis cohort was comprised of persons with acute TCEI enrolled in the Rick Hansen Spinal Cord Injury Registry. Multi-variable regression analysis was used to determine predictors for lower-extremity motor score (LEMS) at discharge, walking ability at discharge as assessed by the walking subscores of either the Functional Independence Measure (FIM) or Spinal Cord Independence Measure (SCIM), and improvement in bowel and bladder function as assessed by FIM-relevant subscores. Age, sex, neurological level and severity of injury, time from injury to surgery, rehabilitation onset, and length of stay were examined as potential confounders. The cohort included 214 participants. Median improvement in LEMS was 4 points. Fifty-two percent of participants were able to walk, and >20% recovered bowel and bladder function by rehabilitation discharge. Multi-variable analyses revealed that shorter time from injury to rehabilitation admission (onset) was a significant predictor for both improvement in walking ability and bowel function. Longer rehabilitation stay and being an older female were associated with improved bladder function. Our results suggest that persons with TCEI have a reasonable chance of recovery in walking ability and bowel and bladder function. This study provides important information for rehabilitation goals setting and communication with patients and their families regarding prognosis.
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Affiliation(s)
- Najmedden Attabib
- Dalhousie University, Horizon Health Network, Division of Neurosurgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Dilnur Kurban
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | | | - Carly S Rivers
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Christopher S Bailey
- Division of Orthopaedics, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Sean Christie
- Research Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karen Ethans
- Department of Medicine, Section of Physical Medicine and Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Heather Flett
- Brain and Spinal Cord Injury Rehab Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Julio C Furlan
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada.,Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Eve C Tsai
- Department of Surgery, Division of Neurosurgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Colleen O'Connell
- Physical Medicine and Rehabilitation, Dalhousie University Faculty of Medicine, Stan Cassidy Centre for Rehabilitation, Fredericton, New Brunswick, Canada
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Abstract
Summary The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact on health care delivery and has resulted in a backlog of patients needing surgery. There is a lack of experience and guidance in dealing with this increased demand on an already overburdened health care system. We created an online tool (www.covidbacklog.com) that helps surgeons explore how resource allocation within their group will affect wait times for patients. After inputting a handful of readily available variables, the computer program generates a forecast of how long it will take to see the backlog of patients. This information could be used to allow surgical groups to run simulations to explore different resource allocation strategies in order to help prevent downstream consequences of delayed patient care.
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Affiliation(s)
- David M Brandman
- From the Division of Neurosurgery (Department of Surgery), Dalhousie University, Halifax, NS
| | - Erika Leck
- From the Division of Neurosurgery (Department of Surgery), Dalhousie University, Halifax, NS
| | - Sean Christie
- From the Division of Neurosurgery (Department of Surgery), Dalhousie University, Halifax, NS
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Inglis T, Banaszek D, Rivers CS, Kurban D, Evaniew N, Fallah N, Waheed Z, Christie S, Fox R, Thiong JMM, Ethans K, Ho C, Linassi AG, Ahn H, Attabib N, Bailey CS, Fehlings MG, Fourney DR, Paquet J, Townson A, Tsai E, Cheng CL, Noonan VK, Dvorak MF, Kwon BK. In-Hospital Mortality for the Elderly with Acute Traumatic Spinal Cord Injury. J Neurotrauma 2020; 37:2332-2342. [PMID: 32635809 PMCID: PMC7585611 DOI: 10.1089/neu.2019.6912] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
As the incidence of traumatic spinal cord injury (tSCI) in the elderly rises, clinicians are increasingly faced with difficult discussions regarding aggressiveness of management, likelihood of recovery, and survival. Our objective was to outline risk factors associated with in-hospital mortality in elderly surgical and non-surgical patients following tSCI and to determine those unlikely to have a favorable outcome. Data from elderly patients (≥ 65 years of age) in the Canadian Rick Hansen SCI Registry from 2004 to 2017 were analyzed using descriptive analysis. Survival and mortality groups in each of the surgical and non-surgical group were compared to explore factors associated with in-hospital mortality and their impact, using logistical regression. Of 1340 elderly patients, 1018 had surgical data with 826 having had surgery. In the surgical group, the median time to death post-injury was 30 days with 75% dying within 50 days compared with 7 days and 20 days, respectively, in the non-surgical group. Significant predictors for in-hospital mortality following surgery are age, comorbidities, neurological injury severity (American Spinal Injury Association [ASIA] Impairment Scale [AIS]), and ventilation status. The odds of dying 50 days post-surgery are six times higher for patients ≥77 years of age versus those 65–76 years of age, five times higher for those with AIS A versus those with AIS B/C/D, and seven times higher for those who are ventilator dependent. An expected probability of dying within 50 days post-surgery was determined using these results. In-hospital mortality in the elderly after tSCI is high. The trend with age and time to death and the significant predictors of mortality identified in this study can be used to inform clinical decision making and discussions with patients and their families.
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Affiliation(s)
- Tom Inglis
- Department of Orthopaedics, Vancouver Spine Surgery Institute, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dan Banaszek
- Department of Orthopaedics, Vancouver Spine Surgery Institute, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Carly S Rivers
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Dilnur Kurban
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Nathan Evaniew
- Department of Orthopaedics, Vancouver Spine Surgery Institute, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nader Fallah
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Zeina Waheed
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Sean Christie
- Research Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Richard Fox
- Faculty of Medicine and Dentistry, Division of Neurosurgery, University of Alberta, Edmonton, Alberta, Canada
| | - Jean-Marc Mac Thiong
- Department of Surgery, Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
| | - Karen Ethans
- Section of Physical Medicine and Rehabilitation, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Chester Ho
- Department of Clinical Neurosciences, Division of Physical Medicine & Rehabilitation, University of Calgary, Foothills Hospital, Calgary, Alberta, Canada
| | - Angelo Gary Linassi
- Physical Medicine and Rehabilitation, and University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Henry Ahn
- Spine Program, University of Toronto, Toronto, Ontario, Canada
| | - Najmedden Attabib
- Horizon Health Network, Division of Neurosurgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Christopher S Bailey
- Department of Surgery, Division of Orthopaedics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | | | - Daryl R Fourney
- Division of Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jérôme Paquet
- Sciences Neurologiques, Laval University, Québec, Québec, Canada
| | - Andrea Townson
- Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eve Tsai
- Department of Surgery, Division of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Marcel F Dvorak
- Department of Orthopaedics, Vancouver Spine Surgery Institute, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian K Kwon
- Department of Orthopaedics, Vancouver Spine Surgery Institute, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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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
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McLean KA, Ahmed WUR, Akhbari M, Claireaux HA, English C, Frost J, Henshall DE, Khan M, Kwek I, Nicola M, Rehman S, Varghese S, Drake TM, Bell S, Nepogodiev D, McLean KA, Drake TM, Glasbey JC, Borakati A, Drake TM, Kamarajah S, McLean KA, Bath MF, Claireaux HA, Gundogan B, Mohan M, Deekonda P, Kong C, Joyce H, Mcnamee L, Woin E, Burke J, Khatri C, Fitzgerald JE, Harrison EM, Bhangu A, Nepogodiev D, Arulkumaran N, Bell S, Duthie F, Hughes J, Pinkney TD, Prowle J, Richards T, Thomas M, Dynes K, Patel M, Patel P, Wigley C, Suresh R, Shaw A, Klimach S, Jull P, Evans D, Preece R, Ibrahim I, Manikavasagar V, Smith R, Brown FS, Deekonda P, Teo R, Sim DPY, Borakati A, Logan AE, Barai I, Amin H, Suresh S, Sethi R, Bolton W, Corbridge O, Horne L, Attalla M, Morley R, Robinson C, Hoskins T, McAllister R, Lee S, Dennis Y, Nixon G, Heywood E, Wilson H, Ng L, Samaraweera S, Mills A, Doherty C, Woin E, Belchos J, Phan V, Chouari T, Gardner T, Goergen N, Hayes JDB, MacLeod CS, McCormack R, McKinley A, McKinstry S, Milligan W, Ooi L, Rafiq NM, Sammut T, Sinclair E, Smith M, Baker C, Boulton APR, Collins J, Copley HC, Fearnhead N, Fox H, Mah T, McKenna J, Naruka V, Nigam N, Nourallah B, Perera S, Qureshi A, Saggar S, Sun L, Wang X, Yang DD, Caroll P, Doyle C, Elangovan S, Falamarzi A, Perai KG, Greenan E, Jain D, Lang-Orsini M, Lim S, O'Byrne L, Ridgway P, Van der Laan S, Wong J, Arthur J, Barclay J, Bradley P, Edwin C, Finch E, Hayashi E, Hopkins M, Kelly D, Kelly M, McCartan N, Ormrod A, Pakenham A, Hayward J, Hitchen C, Kishore A, Martins T, Philomen J, Rao R, Rickards C, Burns N, Copeland M, Durand C, Dyal A, Ghaffar A, Gidwani A, Grant M, Gribbon C, Gruhn A, Leer M, Ahmad K, Beattie G, Beatty M, Campbell G, Donaldson G, Graham S, Holmes D, Kanabar S, Liu H, McCann C, Stewart R, Vara S, Ajibola-Taylor O, Andah EJE, Ani C, Cabdi NMO, Ito G, Jones M, Komoriyama A, Patel P, Titu L, Basra M, Gallogly P, Harinath G, Leong SH, Pradhan A, Siddiqui I, Zaat S, Ali A, Galea M, Looi WL, Ng JCK, Atkin G, Azizi A, Cargill Z, China Z, Elliot J, Jebakumar R, Lam J, Mudalige G, Onyerindu C, Renju M, Babu VS, Hussain M, Joji N, Lovett B, Mownah H, Ali B, Cresswell B, Dhillon AK, Dupaguntla YS, Hungwe C, Lowe-Zinola JD, Tsang JCH, Bevan K, Cardus C, Duggal A, Hossain S, McHugh M, Scott M, Chan F, Evans R, Gurung E, Haughey B, Jacob-Ramsdale B, Kerr M, Lee J, McCann E, O'Boyle K, Reid N, Hayat F, Hodgson S, Johnston R, Jones W, Khan M, Linn T, Long S, Seetharam P, Shaman S, Smart B, Anilkumar A, Davies J, Griffith J, Hughes B, Islam Y, Kidanu D, Mushaini N, Qamar I, Robinson H, Schramm M, Tan CY, Apperley H, Billyard C, Blazeby JM, Cannon SP, Carse S, Göpfert A, Loizidou A, Parkin J, Sanders E, Sharma S, Slade G, Telfer R, Huppatz IW, Worley E, Chandramoorthy L, Friend C, Harris L, Jain P, Karim MJ, Killington K, McGillicuddy J, Rafferty C, Rahunathan N, Rayne T, Varathan Y, Verma N, Zanichelli D, Arneill M, Brown F, Campbell B, Crozier L, Henry J, McCusker C, Prabakaran P, Wilson R, Asif U, Connor M, Dindyal S, Math N, Pagarkar A, Saleem H, Seth I, Sharma S, Standfield N, Swartbol T, Adamson R, Choi JE, El Tokhy O, Ho W, Javaid NR, Kelly M, Mehdi AS, Menon D, Plumptre I, Sturrock S, Turner J, Warren O, Crane E, Ferris B, Gadsby C, Smallwood J, Vipond M, Wilson V, Amarnath T, Doshi A, Gregory C, Kandiah K, Powell B, Spoor H, Toh C, Vizor R, Common M, Dunleavy K, Harris S, Luo C, Mesbah Z, Kumar AP, Redmond A, Skulsky S, Walsh T, Daly D, Deery L, Epanomeritakis E, Harty M, Kane D, Khan K, Mackey R, McConville J, McGinnity K, Nixon G, Ang A, Kee JY, Leung E, Norman S, Palaniappan SV, Sarathy PP, Yeoh T, Frost J, Hazeldine P, Jones L, Karbowiak M, Macdonald C, Mutarambirwa A, Omotade A, Runkel M, Ryan G, Sawers N, Searle C, Suresh S, Vig S, Ahmad A, McGartland R, Sim R, Song A, Wayman J, Brown R, Chang LH, Concannon K, Crilly C, Arnold TJ, Burgin A, Cadden F, Choy CH, Coleman M, Lim D, Luk J, Mahankali-Rao P, Prudence-Taylor AJ, Ramakrishnan D, Russell J, Fawole A, Gohil J, Green B, Hussain A, McMenamin L, McMenamin L, Tang M, Azmi F, Benchetrit S, Cope T, Haque A, Harlinska A, Holdsworth R, Ivo T, Martin J, Nisar T, Patel A, Sasapu K, Trevett J, Vernet G, Aamir A, Bird C, Durham-Hall A, Gibson W, Hartley J, May N, Maynard V, Johnson S, Wood CM, O'Brien M, Orbell J, Stringfellow TD, Tenters F, Tresidder S, Cheung W, Grant A, Tod N, Bews-Hair M, Lim ZH, Lim SW, Vella-Baldacchino M, Auckburally S, Chopada A, Easdon S, Goodson R, McCurdie F, Narouz M, Radford A, Rea E, Taylor O, Yu T, Alfa-Wali M, Amani L, Auluck I, Bruce P, Emberton J, Kumar R, Lagzouli N, Mehta A, Murtaza A, Raja M, Dennahy IS, Frew K, Given A, He YY, Karim MA, MacDonald E, McDonald E, McVinnie D, Ng SK, Pettit A, Sim DPY, Berthaume-Hawkins SD, Charnley R, Fenton K, Jones D, Murphy C, Ng JQ, Reehal R, Robinson H, Seraj SS, Shang E, Tonks A, White P, Yeo A, Chong P, Gabriel R, Patel N, Richardson E, Symons L, Aubrey-Jones D, Dawood S, Dobrzynska M, Faulkner S, Griffiths H, Mahmood F, Patel P, Perry M, Power A, Simpson R, Ali A, Brobbey P, Burrows A, Elder P, Ganyani R, Horseman C, Hurst P, Mann H, Marimuthu K, McBride S, Pilsworth E, Powers N, Stanier P, Innes R, Kersey T, Kopczynska M, Langasco N, Patel N, Rajagopal R, Atkins B, Beasley W, Lim ZC, Gill A, Ang HL, Williams H, Yogeswara T, Carter R, Fam M, Fong J, Latter J, Long M, Mackinnon S, McKenzie C, Osmanska J, Raghuvir V, Shafi A, Tsang K, Walker L, Bountra K, Coldicutt O, Fletcher D, Hudson S, Iqbal S, Bernal TL, Martin JWB, Moss-Lawton F, Smallwood J, Vipond M, Cardwell A, Edgerton K, Laws J, Rai A, Robinson K, Waite K, Ward J, Youssef H, Knight C, Koo PY, Lazarou A, Stanger S, Thorn C, Triniman MC, Botha A, Boyles L, Cumming S, Deepak S, Ezzat A, Fowler AJ, Gwozdz AM, Hussain SF, Khan S, Li H, Morrell BL, Neville J, Nitiahpapand R, Pickering O, Sagoo H, Sharma E, Welsh K, Denley S, Khan S, Agarwal M, Al-Saadi N, Bhambra R, Gupta A, Jawad ZAR, Jiao LR, Khan K, Mahir G, Singagireson S, Thoms BL, Tseu B, Wei R, Yang N, Britton N, Leinhardt D, Mahfooz M, Palkhi A, Price M, Sheikh S, Barker M, Bowley D, Cant M, Datta U, Farooqi M, Lee A, Morley G, Amin MN, Parry A, Patel S, Strang S, Yoganayagam N, Adlan A, Chandramoorthy S, Choudhary Y, Das K, Feldman M, France B, Grace R, Puddy H, Soor P, Ali M, Dhillon P, Faraj A, Gerard L, Glover M, Imran H, Kim S, Patrick Y, Peto J, Prabhudesai A, Smith R, Tang A, Vadgama N, Dhaliwal R, Ecclestone T, Harris A, Ong D, Patel D, Philp C, Stewart E, Wang L, Wong E, Xu Y, Ashaye T, Fozard T, Galloway F, Kaptanis S, Mistry P, Nguyen T, Olagbaiye F, Osman M, Philip Z, Rembacken R, Tayeh S, Theodoropoulou K, Herman A, Lau J, Saha A, Trotter M, Adeleye O, Cave D, Gunwa T, Magalhães J, Makwana S, Mason R, Parish M, Regan H, Renwick P, Roberts G, Salekin D, Sivakumar C, Tariq A, Liew I, McDade A, Stewart D, Hague M, Hudson-Peacock N, Jackson CES, James F, Pitt J, Walker EY, Aftab R, Ang JJ, Anwar S, Battle J, Budd E, Chui J, Crook H, Davies P, Easby S, Hackney E, Ho B, Imam SZ, Rammell J, Andrews H, Perry C, Schinle P, Ahmed P, Aquilina T, Balai E, Church M, Cumber E, Curtis A, Davies G, Dennis Y, Dumann E, Greenhalgh S, Kim P, King S, Metcalfe KHM, Passby L, Redgrave N, Soonawalla Z, Waters S, Zornoza A, Gulzar I, Hole J, Hull K, Ishaq H, Karaj J, Kelkar A, Love E, Patel S, Thakrar D, Vine M, Waterman A, Dib NP, Francis N, Hanson M, Ingleton R, Sadanand KS, Sukirthan N, Arnell S, Ball M, Bassam N, Beghal G, Chang A, Dawe V, George A, Huq T, Hussain A, Ikram B, Kanapeckaite L, Khan M, Ramjas D, Rushd A, Sait S, Serry M, Yardimci E, Capella S, Chenciner L, Episkopos C, Karam E, McCarthy C, Moore-Kelly W, Watson N, Ahluwalia V, Barnfield J, Ben-Gal O, Bloom I, Gharatya A, Khodatars K, Merchant N, Moonan A, Moore M, Patel K, Spiers H, Sundaram K, Turner J, Bath MF, Black J, Chadwick H, Huisman L, Ingram H, Khan S, Martin L, Metcalfe M, Sangal P, Seehra J, Thatcher A, Venturini S, Whitcroft I, Afzal Z, Brown S, Gani A, Gomaa A, Hussein N, Oh SY, Pazhaniappan N, Sharkey E, Sivagnanasithiyar T, Williams C, Yeung J, Cruddas L, Gurjar S, Pau A, Prakash R, Randhawa R, Chen L, Eiben I, Naylor M, Osei-Bordom D, Trenear R, Bannard-Smith J, Griffiths N, Patel BY, Saeed F, Abdikadir H, Bennett M, Church R, Clements SE, Court J, Delvi A, Hubert J, Macdonald B, Mansour F, Patel RR, Perris R, Small S, Betts A, Brown N, Chong A, Croitoru C, Grey A, Hickland P, Ho C, Hollington D, McKie L, Nelson AR, Stewart H, Eiben P, Nedham M, Ali I, Brown T, Cumming S, Hunt C, Joyner C, McAlinden C, Roberts J, Rogers D, Thachettu A, Tyson N, Vaughan R, Verma N, Yasin T, Andrew K, Bhamra N, Leong S, Mistry R, Noble H, Rashed F, Walker NR, Watson L, Worsfold M, Yarham E, Abdikadir H, Arshad A, Barmayehvar B, Cato L, Chan-lam N, Do V, Leong A, Sheikh Z, Zheleniakova T, Coppel J, Hussain ST, Mahmood R, Nourzaie R, Prowle J, Sheik-Ali S, Thomas A, Alagappan A, Ashour R, Bains H, Diamond J, Gordon J, Ibrahim B, Khalil M, Mittapalli D, Neo YN, Patil P, Peck FS, Reza N, Swan I, Whyte M, Chaudhry S, Hernon J, Khawar H, O'Brien J, Pullinger M, Rothnie K, Ujjal S, Bhatte S, Curtis J, Green S, Mayer A, Watkinson G, Chapple K, Hawthorne T, Khaliq M, Majkowski L, Malik TAM, Mclauchlan K, En BNW, Parton S, Robinson SD, Saat MI, Shurovi BN, Varatharasasingam K, Ward AE, Behranwala K, Bertelli M, Cohen J, Duff F, Fafemi O, Gupta R, Manimaran M, Mayhew J, Peprah D, Wong MHY, Farmer N, Houghton C, Kandhari N, Khan K, Ladha D, Mayes J, McLennan F, Panahi P, Seehra H, Agrawal R, Ahmed I, Ali S, Birkinshaw F, Choudhry M, Gokani S, Harrogate S, Jamal S, Nawrozzadeh F, Swaray A, Szczap A, Warusavitarne J, Abdalla M, Asemota N, Cullum R, Hartley M, Maxwell-Armstrong C, Mulvenna C, Phillips J, Yule A, Ahmed L, Clement KD, Craig N, Elseedawy E, Gorman D, Kane L, Livie J, Livie V, Moss E, Naasan A, Ravi F, Shields P, Zhu Y, Archer M, Cobley H, Dennis R, Downes C, Guevel B, Lamptey E, Murray H, Radhakrishnan A, Saravanabavan S, Sardar M, Shaw C, Tilliridou V, Wright R, Ye W, Alturki N, Helliwell R, Jones E, Kelly D, Lambotharan S, Scott K, Sivakumar R, Victor L, Boraluwe-Rallage H, Froggatt P, Haynes S, Hung YMA, Keyte A, Matthews L, Evans E, Haray P, John I, Mathivanan A, Morgan L, Oji O, Okorocha C, Rutherford A, Spiers H, Stageman N, Tsui A, Whitham R, Amoah-Arko A, Cecil E, Dietrich A, Fitzpatrick H, Guy C, Hair J, Hilton J, Jawad L, McAleer E, Taylor Z, Yap J, Akhbari M, Debnath D, Dhir T, Elbuzidi M, Elsaddig M, Glace S, Khawaja H, Koshy R, Lal K, Lobo L, McDermott A, Meredith J, Qamar MA, Vaidya A, Acquaah F, Barfi L, Carter N, Gnanappiragasam D, Ji C, Kaminski F, Lawday S, Mackay K, Sulaiman SK, Webb R, Ananthavarathan P, Dalal F, Farrar E, Hashemi R, Hossain M, Jiang J, Kiandee M, Lex J, Mason L, Matthews JH, McGeorge E, Modhwadia S, Pinkney T, Radotra A, Rickard L, Rodman L, Sales A, Tan KL, Bachi A, Bajwa DS, Battle J, Brown LR, Butler A, Calciu A, Davies E, Gardner I, Girdlestone T, Ikogho O, Keelan G, O'Loughlin P, Tam J, Elias J, Ngaage M, Thompson J, Bristow S, Brock E, Davis H, Pantelidou M, Sathiyakeerthy A, Singh K, Chaudhry A, Dickson G, Glen P, Gregoriou K, Hamid H, Mclean A, Mehtaji P, Neophytou G, Potts S, Belgaid DR, Burke J, Durno J, Ghailan N, Hanson M, Henshaw V, Nazir UR, Omar I, Riley BJ, Roberts J, Smart G, Van Winsen K, Bhatti A, Chan M, D'Auria M, Green S, Keshvala C, Li H, Maxwell-Armstrong C, Michaelidou M, Simmonds L, Smith C, Wimalathasan A, Abbas J, Cairns C, Chin YR, Connelly A, Moug S, Nair A, Svolkinas D, Coe P, Subar D, Wang H, Zaver V, Brayley J, Cookson P, Cunningham L, Gaukroger A, Ho M, Hough A, King J, O'Hagan D, Widdison A, Brown R, Brown B, Chavan A, Francis S, Hare L, Lund J, Malone N, Mavi B, McIlwaine A, Rangarajan S, Abuhussein N, Campbell HS, Daniels J, Fitzgerald I, Mansfield S, Pendrill A, Robertson D, Smart YW, Teng T, Yates J, Belgaumkar A, Katira A, Kossoff J, Kukran S, Laing C, Mathew B, Mohamed T, Myers S, Novell R, Phillips BL, Thomas M, Turlejski T, Turner S, Varcada M, Warren L, Wynell-Mayow W, Church R, Linley-Adams L, Osborn G, Saunders M, Spencer R, Srikanthan M, Tailor S, Tullett A, Ali M, Al-Masri S, Carr G, Ebhogiaye O, Heng S, Manivannan S, Manley J, McMillan LE, Peat C, Phillips B, Thomas S, Whewell H, Williams G, Bienias A, Cope EA, Courquin GR, Day L, Garner C, Gimson A, Harris C, Markham K, Moore T, Nadin T, Phillips C, Subratty SM, Brown K, Dada J, Durbacz M, Filipescu T, Harrison E, Kennedy ED, Khoo E, Kremel D, Lyell I, Pronin S, Tummon R, Ventre C, Walls L, Wootton E, Akhtar A, Davies E, El-Sawy D, Farooq M, Gaddah M, Griffiths H, Katsaiti I, Khadem N, Leong K, Williams I, Chean CS, Chudek D, Desai H, Ellerby N, Hammad A, Malla S, Murphy B, Oshin O, Popova P, Rana S, Ward T, Abbott TEF, Akpenyi O, Edozie F, El Matary R, English W, Jeyabaladevan S, Morgan C, Naidu V, Nicholls K, Peroos S, Prowle J, Sansome S, Torrance HD, Townsend D, Brecher J, Fung H, Kazmi Z, Outlaw P, Pursnani K, Ramanujam N, Razaq A, Sattar M, Sukumar S, Tan TSE, Chohan K, Dhuna S, Haq T, Kirby S, Lacy-Colson J, Logan P, Malik Q, McCann J, Mughal Z, Sadiq S, Sharif I, Shingles C, Simon A, Burnage S, Chan SSN, Craig ARJ, Duffield J, Dutta A, Eastwood M, Iqbal F, Mahmood F, Mahmood W, Patel C, Qadeer A, Robinson A, Rotundo A, Schade A, Slade RD, De Freitas M, Kinnersley H, McDowell E, Moens-Lecumberri S, Ramsden J, Rockall T, Wiffen L, Wright S, Bruce C, Francois V, Hamdan K, Limb C, Lunt AJ, Manley L, Marks M, Phillips CFE, Agnew CJF, Barr CJ, Benons N, Hart SJ, Kandage D, Krysztopik R, Mahalingam P, Mock J, Rajendran S, Stoddart MT, Clements B, Gillespie H, Lee S, McDougall R, Murray C, O'Loane R, Periketi S, Tan S, Amoah R, Bhudia R, Dudley B, Gilbert A, Griffiths B, Khan H, McKigney N, Roberts B, Samuel R, Seelarbokus A, Stubbing-Moore A, Thompson G, Williams P, Ahmed N, Akhtar R, Chandler E, Chappelow I, Gil H, Gower T, Kale A, Lingam G, Rutler L, Sellahewa C, Sheikh A, Stringer H, Taylor R, Aglan H, Ashraf MR, Choo S, Das E, Epstein J, Gentry R, Mills D, Poolovadoo Y, Ward N, Bull K, Cole A, Hack J, Khawari S, Lake C, Mandishona T, Perry R, Sleight S, Sultan S, Thornton T, Williams S, Arif T, Castle A, Chauhan P, Chesner R, Eilon T, Kamarajah S, Kambasha C, Lock L, Loka T, Mohammad F, Motahariasl S, Roper L, Sadhra SS, Sheikh A, Toma T, Wadood Q, Yip J, Ainger E, Busti S, Cunliffe L, Flamini T, Gaffing S, Moorcroft C, Peter M, Simpson L, Stokes E, Stott G, Wilson J, York J, Yousaf A, Borakati A, Brown M, Goaman A, Hodgson B, Ijeomah A, Iroegbu U, Kaur G, Lowe C, Mahmood S, Sattar Z, Sen P, Szuman A, Abbas N, Al-Ausi M, Anto N, Bhome R, Eccles L, Elliott J, Hughes EJ, Jones A, Karunatilleke AS, Knight JS, Manson CCF, Mekhail I, Michaels L, Noton TM, Okenyi E, Reeves T, Yasin IH, Banfield DA, Harris R, Lim D, Mason-Apps C, Roe T, Sandhu J, Shafiq N, Stickler E, Tam JP, Williams LM, Ainsworth P, Boualbanat Y, Doull C, Egan E, Evans L, Hassanin K, Ninkovic-Hall G, Odunlami W, Shergill M, Traish M, Cummings D, Kershaw S, Ong J, Reid F, Toellner H, Alwandi A, Amer M, George D, Haynes K, Hughes K, Peakall L, Premakumar Y, Punjabi N, Ramwell A, Sawkins H, Ashwood J, Baker A, Baron C, Bhide I, Blake E, De Cates C, Esmail R, Hosamuddin H, Kapp J, Nguru N, Raja M, Thomson F, Ahmed H, Aishwarya G, Al-Huneidi R, Ali S, Aziz R, Burke D, Clarke B, Kausar A, Maskill D, Mecia L, Myers L, Smith ACD, Walker G, Wroe N, Donohoe C, Gibbons D, Jordan P, Keogh C, Kiely A, Lalor P, McCrohan M, Powell C, Foley MP, Reynolds J, Silke E, Thorpe O, Kong JTH, White C, Ali Q, Dalrymple J, Ge Y, Khan H, Luo RS, Paine H, Paraskeva B, Parker L, Pillai K, Salciccioli J, Selvadurai S, Sonagara V, Springford LR, Tan L, Appleton S, Leadholm N, Zhang Y, Ahern D, Cotter M, Cremen S, Durrigan T, Flack V, Hrvacic N, Jones H, Jong B, Keane K, O'Connell PR, O'sullivan J, Pek G, Shirazi S, Barker C, Brown A, Carr W, Chen Y, Guillotte C, Harte J, Kokayi A, Lau K, McFarlane S, Morrison S, Broad J, Kenefick N, Makanji D, Printz V, Saito R, Thomas O, Breen H, Kirk S, Kong CH, O'Kane A, Eddama M, Engledow A, Freeman SK, Frost A, Goh C, Lee G, Poonawala R, Suri A, Taribagil P, Brown H, Christie S, Dean S, Gravell R, Haywood E, Holt F, Pilsworth E, Rabiu R, Roscoe HW, Shergill S, Sriram A, Sureshkumar A, Tan LC, Tanna A, Vakharia A, Bhullar S, Brannick S, Dunne E, Frere M, Kerin M, Kumar KM, Pratumsuwan T, Quek R, Salman M, Van Den Berg N, Wong C, Ahluwalia J, Bagga R, Borg CM, Calabria C, Draper A, Farwana M, Joyce H, Khan A, Mazza M, Pankin G, Sait MS, Sandhu N, Virani N, Wong J, Woodhams K, Croghan N, Ghag S, Hogg G, Ismail O, John N, Nadeem K, Naqi M, Noe SM, Sharma A, Tan S, Begum F, Best R, Collishaw A, Glasbey J, Golding D, Gwilym B, Harrison P, Jackman T, Lewis N, Luk YL, Porter T, Potluri S, Stechman M, Tate S, Thomas D, Walford B, Auld F, Bleakley A, Johnston S, Jones C, Khaw J, Milne S, O'Neill S, Singh KKR, Smith R, Swan A, Thorley N, Yalamarthi S, Yin ZD, Ali A, Balian V, Bana R, Clark K, Livesey C, McLachlan G, Mohammad M, Pranesh N, Richards C, Ross F, Sajid M, Brooke M, Francombe J, Gresly J, Hutchinson S, Kerrigan K, Matthews E, Nur S, Parsons L, Sandhu A, Vyas M, White F, Zulkifli A, Zuzarte L, Al-Mousawi A, Arya J, Azam S, Yahaya AA, Gill K, Hallan R, Hathaway C, Leptidis I, McDonagh L, Mitrasinovic S, Mushtaq N, Pang N, Peiris GB, Rinkoff S, Chan L, Christopher E, Farhan-Alanie MMH, Gonzalez-Ciscar A, Graham CJ, Lim H, McLean KA, Paterson HM, Rogers A, Roy C, Rutherford D, Smith F, Zubikarai G, Al-Khudairi R, Bamford M, Chang M, Cheng J, Hedley C, Joseph R, Mitchell B, Perera S, Rothwell L, Siddiqui A, Smith J, Taylor K, Wright OW, Baryan HK, Boyd G, Conchie H, Cox L, Davies J, Gardner S, Hill N, Krishna K, Lakin F, Scotcher S, Alberts J, Asad M, Barraclough J, Campbell A, Marshall D, Wakeford W, Cronbach P, D'Souza F, Gammeri E, Houlton J, Hall M, Kethees A, Patel R, Perera M, Prowle J, Shaid M, Webb E, Beattie S, Chadwick M, El-Taji O, Haddad S, Mann M, Patel M, Popat K, Rimmer L, Riyat H, Smith H, Anandarajah C, Cipparrone M, Desai K, Gao C, Goh ET, Howlader M, Jeffreys N, Karmarkar A, Mathew G, Mukhtar H, Ozcan E, Renukanthan A, Sarens N, Sinha C, Woolley A, Bogle R, Komolafe O, Loo F, Waugh D, Zeng R, Crewe A, Mathias J, Mills A, Owen A, Prior A, Saunders I, Baker A, Crilly L, McKeon J, Ubhi HK, Adeogun A, Carr R, Davison C, Devalia S, Hayat A, Karsan RB, Osborne C, Scott K, Weegenaar C, Wijeyaratne M, Babatunde F, Barnor-Ahiaku E, Beattie G, Chitsabesan P, Dixon O, Hall N, Ilenkovan N, Mackrell T, Nithianandasivam N, Orr J, Palazzo F, Saad M, Sandland-Taylor L, Sherlock J, Ashdown T, Chandler S, Garsaa T, Lloyd J, Loh SY, Ng S, Perkins C, Powell-Chandler A, Smith F, Underhill R. Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Stratton A, Wai E, Kingwell S, Phan P, Roffey D, El Koussy M, Christie S, Jarzem P, Rasoulinejad P, Casha S, Paquet J, Johnson M, Abraham E, Hall H, McIntosh G, Thomas K, Rampersaud R, Manson N, Fisher C. Opioid use trends in patients undergoing elective thoracic and lumbar spine surgery. Can J Surg 2020; 63:E306-E312. [PMID: 32463627 DOI: 10.1503/cjs.018218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Opioid use in North America has increased rapidly in recent years. Preoperative opioid use is associated with several negative outcomes. Our objectives were to assess patterns of opioid use over time in Canadian patients who undergo spine surgery and to determine the effect of spine surgery on 1-year postoperative opioid use. Methods A retrospective analysis was performed on prospectively collected data from the Canadian Spine Outcomes and Research Network for patients undergoing elective thoracic and lumbar surgery. Self-reported opioid use at baseline, before surgery and at 1 year after surgery was compared. Baseline opioid use was compared by age, sex, radiologic diagnosis and presenting complaint. All patients meeting eligibility criteria from 2008 to 2017 were included. Results A total of 3134 patients provided baseline opioid use data. No significant change in the proportion of patients taking daily (range 32.3%-38.2%) or intermittent (range 13.7%-22.5%) opioids was found from pre-2014 to 2017. Among patients who waited more than 6 weeks for surgery, the frequency of opioid use did not differ significantly between the baseline and preoperative time points. Significantly more patients using opioids had a chief complaint of back pain or radiculopathy than neurogenic claudication (p < 0.001), and significantly more were under 65 years of age than aged 65 years or older (p < 0.001). Approximately 41% of patients on daily opioids at baseline remained so at 1 year after surgery. Conclusion These data suggest that additional opioid reduction strategies are needed in the population of patients undergoing elective thoracic and lumbar spine surgery. Spine surgeons can be involved in identifying patients taking opioids preoperatively, emphasizing the risks of continued opioid use and referring patients to appropriate evidence-based treatment programs.
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Affiliation(s)
- Alexandra Stratton
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Eugene Wai
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Stephen Kingwell
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Philippe Phan
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Darren Roffey
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Mohamed El Koussy
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Sean Christie
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Peter Jarzem
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Parham Rasoulinejad
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Steve Casha
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Jerome Paquet
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Michael Johnson
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Edward Abraham
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Hamilton Hall
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Greg McIntosh
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Kenneth Thomas
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Raja Rampersaud
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Neil Manson
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
| | - Charles Fisher
- From the Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ont. (Stratton, Wai, Kingwell, Phan); The Ottawa Hospital Research Institute, Ottawa, Ont. (Roffey, El Koussy); the Division of Neurosurgery, Dalhousie University, Halifax, N.S. (Christie); the Department of Surgery, McGill Scoliosis & Spine Group, McGill University, Montreal, Que. (Jarzem); Victoria Hospital, London Health Sciences Centre, London, Ont. (Rasoulinejad); the Foothills Medical Centre, University of Calgary, Calgary, Alta. (Casha, Thomas); Université Laval, Québec, Que. (Paquet); the Winnipeg Spine Program, Health Sciences Centre, Winnipeg, Man. (Johnson); the Canada East Spine Centre, Saint John Regional Hospital, Saint John, N.B. (Abraham, Manson); the Department of Surgery, University of Toronto, Toronto, Ont. (Hall); Canadian Spine Outcomes and Research Network, Toronto, Ont.(McIntosh); Division of Orthopaedic Surgery, University of Toronto, Toronto, Ont. (Rampersaud); and the Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, B.C. (Fisher)
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Canizares M, Glennie RA, Perruccio AV, Abraham E, Ahn H, Attabib N, Christie S, Johnson MG, Nataraj A, Nicholls F, Paquet J, Phan P, Rasoulinejad P, Manson N, Hall H, Thomas K, Fisher CG, Rampersaud YR. Erratum to 'Patients' expectations of spine surgery for degenerative conditions: results from the Canadian Spine Outcomes and Research Network (CSORN)'. [Spine J. 2020;20(3):399-408]. Spine J 2020; 20:674. [PMID: 32081566 DOI: 10.1016/j.spinee.2020.02.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- M Canizares
- The Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.
| | - R A Glennie
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Halifax, Nova Scotia, Canada
| | - A V Perruccio
- The Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - E Abraham
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Saint John, New Brunswick, Canada
| | - H Ahn
- Canadian Spine Outcomes and Research Network, Canada; University of Toronto, Toronto, Ontario, Canada
| | - N Attabib
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Saint John, New Brunswick, Canada
| | - S Christie
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Halifax, Nova Scotia, Canada
| | - M G Johnson
- Canadian Spine Outcomes and Research Network, Canada; University of Manitoba, Winnipeg, Manitoba, Canada
| | - A Nataraj
- Canadian Spine Outcomes and Research Network, Canada; University of Alberta, Edmonton, Alberta, Canada
| | - F Nicholls
- Canadian Spine Outcomes and Research Network, Canada; University of Calgary, Calgary, Alberta, Canada
| | - J Paquet
- Canadian Spine Outcomes and Research Network, Canada; Universite Laval, Quebec City, Quebec, Canada
| | - P Phan
- Canadian Spine Outcomes and Research Network, Canada; The Ottawa Hospital - Civic Campus, Ottawa, Ontario, Canada
| | - P Rasoulinejad
- Canadian Spine Outcomes and Research Network, Canada; Western University, London Health Sciences, London, Ontario, Canada
| | - N Manson
- Canadian Spine Outcomes and Research Network, Canada; Dalhousie University, Saint John, New Brunswick, Canada
| | - H Hall
- Canadian Spine Outcomes and Research Network, Canada; University of Toronto, Toronto, Ontario, Canada
| | - K Thomas
- Canadian Spine Outcomes and Research Network, Canada; University of Calgary, Calgary, Alberta, Canada
| | - C G Fisher
- Canadian Spine Outcomes and Research Network, Canada; University of British Columbia, Vancouver, British Columbia, Canada
| | - Y R Rampersaud
- The Arthritis Program, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Canadian Spine Outcomes and Research Network, Canada; University of Toronto, Toronto, Ontario, Canada
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Bond M, McIntosh G, Fisher C, Jacobs B, Johnson M, Bailey CS, Christie S, Charest-Morin R, Paquet J, Nataraj A, Cadotte D, Wilson J, Manson N, Hall H, Thomas K, Rampersaud YR, Dea N. Treatment of Mild Cervical Myelopathy: Factors Associated With Decision for Surgical Intervention. Spine (Phila Pa 1976) 2019; 44:1606-1612. [PMID: 31205181 DOI: 10.1097/brs.0000000000003124] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 02/01/2023]
Abstract
STUDY DESIGN Prospective Cohort OBJECTIVE.: The aim of this study was to evaluate which demographic, clinical, or radiographic factors are associated with selection for surgical intervention in patients with mild cervical spondylotic myelopathy (CSM). SUMMARY OF BACKGROUND DATA Surgery has not been shown superior to best conservative management in mild CSM comparative studies; trials of conservative management represent an acceptable alternative to surgical decompression. It is unknown what patients benefit from surgery. METHODS This is a prospective study of patients with mild CSM, defined as modified Japanese Orthopaedic Association Score (mJOA) ≥15. Patients were recruited from seven sites contributing to the Canadian Spine Outcomes Research Network. Demographic, clinical, radiographic and health related quality of life data were collected on all patients at baseline. Multivariate logistic regression modeling was used to identify factors associated with surgical intervention. RESULTS There were 122 patients enrolled, 105 (86.0%) were treated surgically, and 17 (14.0%) were treated nonoperatively. Overall mean age was 54.8 years (SD 12.6) with 80 (65.5%) males. Bivariate analysis revealed no statistically significant differences between surgical and nonoperative groups with respect to age, sex, BMI, smoking status, number of comorbidities and duration of symptoms; mJOA scores were significantly higher in the nonoperative group (16.8 [SD 0.99] vs. 15.9 [SD 0.89], P < 0.001). There was a statistically significant difference in Neck Disability Index, SF12 Physical Component, SF12 Mental Component Score, EQ5D, and PHQ-9 scores between groups; those treated surgically had worse baseline questionnaire scores (P < 0.05). There was no difference in radiographic parameters between groups. Multivariable analysis revealed that lower quality of life scores on EQ5D were associated with selection for surgical management (P < 0.018). CONCLUSION Patients treated surgically for mild cervical myelopathy did not differ from those treated nonoperatively with respect to baseline demographic or radiographic parameters. Patients with worse EQ5D scores had higher odds of surgical intervention. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Michael Bond
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia
| | | | - Charles Fisher
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia
| | - Bradley Jacobs
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
| | - Michael Johnson
- Department of Surgery, Section of Orthopaedics and Neurosurgery, University of Manitoba, Winnipeg, Manitoba
| | | | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia
| | - Raphaele Charest-Morin
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia
| | - Jérome Paquet
- Department of Orthopaedics, Centre Hospitalier Universitaire de Quebec, Quebec, Quebec
| | - Andrew Nataraj
- Division of Neurosurgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta
| | - David Cadotte
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
| | - Jeff Wilson
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario
| | - Neil Manson
- Canada East Spine Centre, Saint John Regional Hospital, Saint John, New Brunswick
| | - Hamilton Hall
- Department of Surgery, University of Toronto, Toronto, Ontario
| | - Kenneth Thomas
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta
| | - Yoga Raja Rampersaud
- Division of Orthopaedic Surgery and Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Nicolas Dea
- Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, British Columbia
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Christie S, Styn G, Ford G, Terryberry K. Proximal Plantar Intrinsic Tendinopathy: Anatomical and Biomechanical Considerations in Plantar Heel Pain. J Am Podiatr Med Assoc 2019; 109:412-415. [PMID: 31599667 DOI: 10.7547/17-198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/03/2023]
Abstract
Plantar heel pain is often managed through podiatric and physical therapy interventions. Numerous differential diagnoses may be implicated in patients presenting with plantar heel pain; however, symptoms are often attributed to plantar fasciitis. Abductor hallucis, flexor digitorum brevis, and quadratus plantae share proximal anatomic attachment sites and mechanical function with the plantar fascia. Although these plantar intrinsic muscles each perform isolated digital actions based on fiber orientation and attachment sites, they function collectively to resist depression of the lateral and medial longitudinal arches of the foot. Overuse injury is the primary contributing factor in tendinopathy. The close anatomic proximity and mechanical function of these muscles relative to the plantar fascia suggests potential for proximal plantar intrinsic tendinopathy as a result of repetitive loading during gait and other weightbearing activities. To date, this diagnosis has not been proposed in the scientific literature. Future studies should seek to confirm or refute the existence of proximal plantar intrinsic tendinopathic changes in patients with acute and chronic plantar heel pain through diagnostic imaging studies, analysis of lactate concentration in pathologic versus nonpathologic tendons, and response to specific podiatric and physical therapy interventions germane to tendinopathy of these muscles.
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Affiliation(s)
- Sean Christie
- Department of Physical Therapy, Daemen College, Buffalo, NY
- North Hills Orthopedic and Sports Physical Therapy, Pittsburgh, PA
| | - Gary Styn
- Department of Physical Therapy, Daemen College, Buffalo, NY
| | - Gregory Ford
- Department of Physical Therapy, Daemen College, Buffalo, NY
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33
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Squair JW, Bélanger LM, Tsang A, Ritchie L, Mac-Thiong JM, Parent S, Christie S, Bailey C, Dhall S, Charest-Morin R, Street J, Ailon T, Paquette S, Dea N, Fisher CG, Dvorak MF, West CR, Kwon BK. Empirical targets for acute hemodynamic management of individuals with spinal cord injury. Neurology 2019; 93:e1205-e1211. [PMID: 31409736 DOI: 10.1212/wnl.0000000000008125] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/25/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine the hemodynamic conditions associated with optimal neurologic improvement in individuals with acute traumatic spinal cord injury (SCI) who had lumbar intrathecal catheters placed to measure CSF pressure (CSFP). METHODS Ninety-two individuals with acute SCI were enrolled in this multicenter prospective observational clinical trial. We monitored mean arterial pressure (MAP) and CSFP during the first week after injury and assessed neurologic function at baseline and 6 months after injury. We used relative risk iterations to determine transition points at which the likelihood of either improving neurologically or remaining unchanged neurologically was equivalent. These transition points guided our analyses in which we examined the linear relationships between time spent within target hemodynamic ranges (i.e., clinical adherence) and neurologic recovery. RESULTS Relative risk transition points for CSFP, MAP, and spinal cord perfusion pressure (SCPP) were linearly associated with neurologic improvement and directed the identification of key hemodynamic target ranges. Clinical adherence to the target ranges was positively and linearly related to improved neurologic outcomes. Adherence to SCPP targets, not MAP targets, was the best indicator of improved neurologic recovery, which occurred with SCPP targets of 60 to 65 mm Hg. Failing to maintain the SCPP within the target ranges was an important detrimental factor in neurologic recovery, particularly if the target range is set lower. CONCLUSION We provide an empirical, data-driven approach to aid institutions in setting hemodynamic management targets that accept the real-life challenges of adherence to specific targets. Our results provide a framework to guide the development of widespread institutional management guidelines for acute traumatic SCI.
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Affiliation(s)
- Jordan W Squair
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Lise M Bélanger
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Angela Tsang
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Leanna Ritchie
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Jean-Marc Mac-Thiong
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Stefan Parent
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Sean Christie
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Christopher Bailey
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Sanjay Dhall
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Raphaele Charest-Morin
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - John Street
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Tamir Ailon
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Scott Paquette
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Nicolas Dea
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Charles G Fisher
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Marcel F Dvorak
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Christopher R West
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada
| | - Brian K Kwon
- From the International Collaboration on Repair Discoveries (J.W.S., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), School of Kinesiology (C.R.W.), and Department of Orthopaedics (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital, British Columbia; Department of Surgery (J.-M.M.-T., S. Parent), Hôpital du Sacré-Coeur de Montréal, and Chu Sainte-Justine (S.C.), Department of Surgery, Université de Montréal, Quebec; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; Department of Neurological Surgery (S.D.), University of California, San Francisco; Vancouver Spine Surgery Institute (R.C.-M., J.S., T.A., S. Paquette, N.D., C.G.F., M.F.D., B.K.K.); and Division of Neurosurgery (B.K.K.), University of British Columbia, Blusson Spinal Cord Centre, Vancouver, Canada.
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Christie S, Ng CKC, Sá Dos Reis C. Australasian radiographers' choices of immobilisation strategies for paediatric radiological examinations. Radiography (Lond) 2019; 26:27-34. [PMID: 31902451 DOI: 10.1016/j.radi.2019.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/07/2019] [Accepted: 06/09/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Immobilisation may be necessary to ensure patient safety and examination success in paediatric medical imaging. Little guidance exists regarding the selection of different immobilisation methods. The purpose of this study was to explore radiographers' selection of immobilisation methods in paediatric medical imaging and the influences on their choices. METHODS Ethical approval was obtained. A mixed methods approach consisting of online questionnaire distribution followed by individual interviews was used to explore Australasian radiographers' self-reported patterns of immobilisation use and the underlying reasons and beliefs. Quantitative data were described using frequency data, with a Fisher's Exact test used to determine any association between demographic variables and immobilisation methods. Qualitative data were evaluated using content analysis. RESULTS Sixty-five radiographers returned completed questionnaires, with seven participating in interviews. Psychological immobilisation methods were preferred to minimise patient pain and distress, but physical methods were considered more effective, with parental holding the most likely method to be used (63/65, 96.9%). Participants assumed certain methods to be more appropriate based on patient age and examination type, but adapted their choices based on many other factors, seeking to provide personalised care. Further training was strongly desired (48/64, 75.0%). Participants disagreed on whether introducing written guidance would be beneficial (33/62, 53.2%). CONCLUSION Choosing an immobilisation method appears to be a case-by-case activity requiring critical assessment of multiple factors in order to balance patient care with examination success. IMPLICATIONS FOR PRACTICE Improvements in quality and quantity of education are recommended to enhance radiographers' ability to make choices based on all relevant factors.
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Affiliation(s)
- S Christie
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - C K C Ng
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - C Sá Dos Reis
- Discipline of Medical Radiation Sciences, School of Molecular and Life Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Av. de Beaumont 21, 1011, Lausanne, Switzerland; CISP - Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Portugal.
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Tigchelaar S, Gupta R, Shannon CP, Streijger F, Sinha S, Flibotte S, Rizzuto MA, Street J, Paquette S, Ailon T, Charest-Morin R, Dea N, Fisher C, Dvorak MF, Dhall S, Mac-Thiong JM, Parent S, Bailey C, Christie S, Van Keuren-Jensen K, Nislow C, Kwon BK. MicroRNA Biomarkers in Cerebrospinal Fluid and Serum Reflect Injury Severity in Human Acute Traumatic Spinal Cord Injury. J Neurotrauma 2019; 36:2358-2371. [PMID: 30827169 DOI: 10.1089/neu.2018.6256] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Spinal cord injury (SCI) is a devastating condition with variability in injury mechanisms and neurologic recovery. Spinal cord impairment after SCI is measured and classified by a widely accepted standard neurological examination. In the very acute stages post-injury, however, this examination is extremely challenging (and often impossible) to conduct and has modest prognostic value in terms of neurological recovery. The lack of objective tools to classify injury severity and predict outcome is a barrier for clinical trials and thwarts development of therapies for those with SCI. Biological markers (biomarkers) represent a promising, complementary approach to these challenges because they represent an unbiased approach to classify injury severity and predict neurological outcome. Identification of a suitable panel of molecular biomarkers would comprise a fundamental shift in how patients with acute SCI are evaluated, stratified, and treated in clinical trials. MicroRNA are attractive biomarker candidates in neurological disorders for several reasons, including their stability in biological fluids, their conservation between humans and model mammals, and their tissue specificity. In this study, we used next-generation sequencing to identify microRNA associated with injury severity within the cerebrospinal fluid (CSF) and serum of human patients with acute SCI. The CSF and serum samples were obtained 1-5 days post-injury from 39 patients with acute SCI (24 American Spinal Injury Association Impairment Scale [AIS] A, 8 AIS B, 7 AIS C) and from five non-SCI controls. We identified a severity-dependent pattern of change in microRNA expression in CSF and identified a set of microRNA that are diagnostic of baseline AIS classification and prognostic of neurological outcome six months post-injury. The data presented here provide a comprehensive description of the CSF and serum microRNA expression changes that occur after acute human SCI. This data set reveals microRNA candidates that warrant further evaluation as biomarkers of injury severity after SCI and as key regulators in other neurological disorders.
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Affiliation(s)
- Seth Tigchelaar
- 1International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Rishab Gupta
- 1International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Casey P Shannon
- 2Prevention of Organ Failure (PROOF) Centre of Excellence, Vancouver, British Columbia, Canada
| | - Femke Streijger
- 1International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Sunita Sinha
- 3Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephane Flibotte
- 3Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael A Rizzuto
- 1International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - John Street
- 4Department of Orthopedics, Division of Spine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Paquette
- 5Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tamir Ailon
- 5Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raphaele Charest-Morin
- 4Department of Orthopedics, Division of Spine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicolas Dea
- 5Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles Fisher
- 4Department of Orthopedics, Division of Spine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marcel F Dvorak
- 1International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada.,4Department of Orthopedics, Division of Spine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sanjay Dhall
- 6Department of Neurosurgery, University of California San Francisco, San Francisco, California
| | | | - Stefan Parent
- 8Department of Surgery, Chu Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Christopher Bailey
- 9Division of Orthopaedic Surgery, Schulich Medicine & Dentistry, Victoria Hospital, London, Ontario, Canada
| | - Sean Christie
- 10Division of Neurosurgery, Halifax Infirmary, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Corey Nislow
- 3Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian K Kwon
- 1International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada.,4Department of Orthopedics, Division of Spine, University of British Columbia, Vancouver, British Columbia, Canada
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Althagafi A, Ekong C, Wheelock BW, Moulton R, Gorman P, Reddy K, Christie S, Fleetwood I, Barry S. Canadian neurosurgeons' views on medical assistance in dying (MAID): a cross-sectional survey of Canadian Neurosurgical Society (CNSS) members. J Med Ethics 2019; 45:309-313. [PMID: 30862709 DOI: 10.1136/medethics-2018-105160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 10/21/2018] [Revised: 02/06/2019] [Accepted: 02/13/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The Supreme Court of Canada removed the prohibition on physicians assisting in patients dying on 6 February 2015. Bill C-14, legalising medical assistance in dying (MAID) in Canada, was subsequently passed by the House of Commons and the Senate on 17 June 2016. As this remains a divisive issue for physicians, the Canadian Neurosurgical Society (CNSS) has recently published a position statement on MAID. METHODS We conducted a cross-sectional survey to understand the views and perceptions among CNSS members regarding MAID to inform its position statement on the issue. Data was collected from May to June 2016. RESULTS Of the 300 active membes of the CNSS who recevied the survey, 89 respondents completed the survey, 71% of whom were attending neurosurgeons and 29% were neurosurgery residents. Most respondents,74.2%, supported the right of physicians to participate in MAID with 7.8% opposing. 37% had current patients in their practice fitting the criteria for MAID. 23.6% had been asked by patients to assist with MAID, but only 11% would consider personally providing it. 84% of neurosurgeons surveyed supported the physicians' right to conscientious objection to MAID while 21% thought attending surgeons should be removed from the inquiry and decision-making process. 43.8% agreed that the requirment to refer a patient to a MAID service should be mandatory. Glioblastoma multiforme (65%), quadriplegia/quadriparesis secondary to spinal tumour/trauma (54%) and Parkinson's disease (24%) were the most common suggested potential indications for MAID among the neurosurgical population. CONCLUSIONS Our results demonstrate that most neurosurgeons in Canada are generally supportive of MAID in select patients. However, they also strongly support the physicians' right to conscientious objection.
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Affiliation(s)
- Alwalaa Althagafi
- Division of Neurosurgery, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
| | - Chris Ekong
- Division of Neurosurgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Brian W Wheelock
- Department of Neurosurgery, Saint John Regional Hospital, Saint John, New Brunswick, Canada
| | - Richard Moulton
- Division of Neurosurgery, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Peter Gorman
- Department of Neurosurgery, The Moncton Hospital, Moncton, New Brunswick, Canada
| | - Kesh Reddy
- Department of Surgery, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
| | - Ian Fleetwood
- Department of Neurosurgery, University of British Columbia Faculty of Medicine - Vancouver Island Health, Victoria, B.C., Canada
| | - Sean Barry
- Division of Neurosurgery, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
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Ayling OGS, Ailon T, McIntosh G, Soroceanu A, Hall H, Nataraj A, Bailey CS, Christie S, Stratton A, Ahn H, Johnson M, Paquet J, Thomas K, Manson N, Rampersaud YR, Fisher CG. Clinical outcomes research in spine surgery: what are appropriate follow-up times? J Neurosurg Spine 2019; 30:397-404. [DOI: 10.3171/2018.8.spine18715] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/24/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVEThere has been a generic dictum in spine and musculoskeletal clinical research that a minimum 2-year follow-up is necessary for patient-reported outcomes (PROs) to adequately assess the therapeutic effect of surgery; however, the rationale for this duration is not evidence based. The purpose of this study was to determine the follow-up time necessary to ensure that the effectiveness of a lumbar surgical intervention is adequately captured for three lumbar pathologies and three common PROs.METHODSUsing the different PROs of pain, physical function, and mental quality of life from the Canadian Spine Outcomes and Research Network (CSORN) prospective database, the authors assessed the time course to the recovery plateau following lumbar spine surgery for lumbar disc herniation, degenerative spondylolisthesis, and spinal stenosis. One-way ANOVA with post hoc testing was used to compare scores on the following standardized PRO measures at baseline and 3, 12, and 24 months postoperatively: Disability Scale (DS), visual analog scale (VAS) for leg and back pain, and SF-12 Mental Component Summary (MCS) and Physical Component Summary (PCS).RESULTSSignificant differences for all spine pathologies and specific PROs were found with one-way ANOVA (p < 0.0001). The time to plateaued recovery after surgery for lumbar disc herniation (661 patients), lumbar stenosis (913 patients), and lumbar spondylolisthesis (563 patients) followed the same course for the following PRO measures: VAS for back and leg pain, 3 months; DS, 12 months; PCS, 12 months; and MCS, 3 months. Beyond these time points, no further significant improvements in PROs were seen. Patients with degenerative spondylolisthesis or spinal stenosis who had undergone fusion surgery plateaued at 12 months on the DS and PCS, compared to 3 months in those who had not undergone fusion.CONCLUSIONSSpecific health dimensions follow distinctly different recovery plateaus, indicating that a 2-year postoperative follow-up is not required for all PROs to accurately assess the treatment effect of lumbar spinal surgery. Ultimately, the clinical research question should dictate the follow-up time and the outcome measure utilized; however, there is now evidence to guide the specific duration of follow-up for pain, physical function, and mental quality of life dimensions.
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Affiliation(s)
- Oliver G. S. Ayling
- 1Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, British Columbia
| | - Tamir Ailon
- 1Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, British Columbia
| | | | | | - Hamilton Hall
- 4Department of Surgery, University of Toronto, Ontario
| | - Andrew Nataraj
- 5Department of Surgery, University of Alberta, Edmonton, Alberta
| | | | - Sean Christie
- 7Department of Surgery, Dalhousie University, Halifax, Nova Scotia
| | | | - Henry Ahn
- 4Department of Surgery, University of Toronto, Ontario
| | - Michael Johnson
- 9Departments of Orthopedics and Neurosurgery, University of Manitoba, Winnipeg, Manitoba
| | - Jerome Paquet
- 10Department of Surgery, Laval University, Quebec City, Quebec; and
| | | | - Neil Manson
- 11Department of Surgery, Canada East Spine Centre, Saint John, New Brunswick, Canada
| | | | - Charles G. Fisher
- 1Department of Surgery, Vancouver General Hospital/University of British Columbia, Vancouver, British Columbia
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Glennie RA, Barry SP, Alant J, Christie S, Oxner WM. Will cost transparency in the operating theatre cause surgeons to change their practice? J Clin Neurosci 2019; 60:1-6. [DOI: 10.1016/j.jocn.2018.09.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 09/26/2018] [Indexed: 01/07/2023]
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Ailon T, Tee J, Manson N, Hall H, Thomas K, Rampersaud YR, Yee A, Dea N, Glennie A, Bailey C, Christie S, Weber MH, Nataraj A, Paquet J, Johnson M, Norton J, Ahn H, McIntosh G, Fisher CG. Patient-reported outcomes following surgery for degenerative spondylolitshtesis: comparison of a universal and multitier health care system. Spine J 2019; 19:24-33. [PMID: 30312774 DOI: 10.1016/j.spinee.2018.10.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 12/18/2017] [Revised: 10/03/2018] [Accepted: 10/03/2018] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Retrospective review of results from a prospectively collected Canadian cohort in comparison to published literature. OBJECTIVES (1) To investigate whether patients in a universal health care system have different outcomes than those in a multitier health care system in surgical management of degenerative spondylolisthesis (DS). (2) To identify independent factors predictive of outcome in surgical DS patients. SUMMARY OF BACKGROUND DATA Canada has a national health insurance program with unique properties. It is a single-payer system, coverage is universal, and access to specialist care requires referral by the primary care physician. The United States on the other hand is a multitier public/private payer system with more rapid access for insured patients to specialist care. METHODS Surgical DS patients treated between 2013 and 2016 in Canada were identified through the Canadian Spine Outcome Research Network (CSORN) database, a national registry that prospectively enrolls consecutive patients with spinal pathology from 16 tertiary care academic hospitals. This population was compared with the surgical DS arm of patients treated in the Spine Patients Outcome Research Trial (SPORT) study. We compared baseline demographics, spine-related, and health-related quality of life (HRQOL) outcomes at 3 months and 1 year. Multivariate analysis was used to identify factors predictive of outcome in surgical DS patients. RESULTS The CSORN cohort of 213 patients was compared with the SPORT cohort of 248 patients. Patients in the CSORN cohort were younger (mean age 60.1 vs. 65.2; p<.001), comprised fewer females (60.1% vs. 67.7%; p=.09), and had a higher proportion of smokers (23.3% vs. 8.9%; p<.001). The SPORT cohort had more patients receiving compensation (14.6% vs. 7.7%; p<.001). The CSORN cohort consisted of patients with slightly greater baseline disability (Oswestry disability index scores: 47.7 vs. 44.0; p=.008) and had more patients with symptom duration of greater than 6 months (93.7% vs. 62.1%; p<.001). The CSORN cohort showed greater satisfaction with surgical results at 3 months (91.1% vs. 66.1% somewhat or very satisfied; p<.01) and 1 year (88.2% vs. 71.0%, p<.01). Improvements in back and leg pain were similar comparing the two cohorts. On multivariate analysis, duration of symptoms, treatment group (CSORN vs. SPORT) or insurance type (public/Medicare/Medicaid vs. Private/Employer) predicted higher level of postoperative satisfaction. Baseline depression was also associated with worse Oswestry disability index at 1-year postoperative follow-up in both cohorts. CONCLUSIONS Surgical DS patients treated in Canada (CSORN cohort) reported higher levels of satisfaction than those treated in the United States (SPORT cohort) despite similar to slightly worse baseline HRQOL measures. Symptom duration and insurance type appeared to impact satisfaction levels. Improvements in other patient-reported health-related quality of life measures were similar between the cohorts.
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Affiliation(s)
- Tamir Ailon
- University of British Columbia, Vancouver, British Columbia, Canada.
| | - Jin Tee
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Neil Manson
- Dalhousie University, Saint John, New Brunswick, Canada; Canadian Spine Outcomes and Research Network, Canada
| | - Hamilton Hall
- University of Toronto, Toronto, Ontario, Canada; Canadian Spine Outcomes and Research Network, Canada
| | - Ken Thomas
- University of Calgary, Calgary, Alberta, Canada; Canadian Spine Outcomes and Research Network, Canada
| | - Y Raja Rampersaud
- University of Toronto, Toronto, Ontario, Canada; Canadian Spine Outcomes and Research Network, Canada
| | - Albert Yee
- University of Toronto, Toronto, Ontario, Canada
| | - Nicolas Dea
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Chris Bailey
- University of Western Ontario, London, Ontario, Canada
| | - Sean Christie
- Dalhousie University, Saint John, New Brunswick, Canada
| | | | | | | | - Mike Johnson
- University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Henry Ahn
- University of Toronto, Toronto, Ontario, Canada
| | - Greg McIntosh
- Canadian Spine Outcomes and Research Network, Canada
| | - Charles G Fisher
- University of British Columbia, Vancouver, British Columbia, Canada; Canadian Spine Outcomes and Research Network, Canada
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Hayhoe R, Christie S, Rechel B, Smith L, Welch A. Integrating public health messages and fire safety checks: a pilot scheme in Norfolk, United Kingdom. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky218.004] [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: 11/12/2022] Open
Affiliation(s)
- R Hayhoe
- University of East Anglia, Norwich, UK
| | - S Christie
- Public Health, Norfolk County Council, Norwich, UK
| | - B Rechel
- Public Health, Norfolk County Council, Norwich, UK
| | - L Smith
- Public Health, Norfolk County Council, Norwich, UK
| | - A Welch
- University of East Anglia, Norwich, UK
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Christie S, Hiebert B, Seifer C, Khoo C. COMPARING CLINICAL OUTCOMES OF CRT-P VS CRT-D IN ELDERLY PATIENTS WITH HEART FAILURE. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.118] [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: 10/28/2022] Open
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Paquet J, Rivers CS, Kurban D, Finkelstein J, Tee JW, Noonan VK, Kwon BK, Hurlbert RJ, Christie S, Tsai EC, Ahn H, Drew B, Bailey CS, Fourney DR, Attabib N, Johnson MG, Fehlings MG, Parent S, Dvorak MF. The impact of spine stability on cervical spinal cord injury with respect to demographics, management, and outcome: a prospective cohort from a national spinal cord injury registry. Spine J 2018; 18:88-98. [PMID: 28673827 DOI: 10.1016/j.spinee.2017.06.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 04/04/2017] [Revised: 06/13/2017] [Accepted: 06/26/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Emergent surgery for patients with a traumatic spinal cord injury (SCI) is seen as the gold standard in acute management. However, optimal treatment for those with the clinical diagnosis of central cord syndrome (CCS) is less clear, and classic definitions of CCS do not identify a unique population of patients. PURPOSE The study aimed to test the authors' hypothesis that spine stability can identify a unique group of patients with regard to demographics, management, and outcomes, which classic CCS definitions do not. STUDY DESIGN/SETTING This is a prospective observational study. PATIENT SAMPLE The sample included participants with cervical SCI included in a prospective Canadian registry. OUTCOME MEASURES The outcome measures were initial hospitalization length of stay, change in total motor score from admission to discharge, and in-hospital mortality. METHODS Patients with cervical SCI from a prospective Canadian SCI registry were grouped into stable and unstable spine cohorts. Bivariate analyses were used to identify differences in demographic, injury, management, and outcomes. Multivariate analysis was used to better understand the impact of spine stability on motor score improvement. No conflicts of interest were identified. RESULTS Compared with those with an unstable spine, patients with cervical SCI and a stable spine were older (58.8 vs. 44.1 years, p<.0001), more likely male (86.4% vs. 76.1%, p=.0059), and have more medical comorbidities. Patients with stable spine cervical SCI were more likely to have sustained their injury by a fall (67.4% vs. 34.9%, p<.0001), and have high cervical (C1-C4; 58.5% vs. 43.3%, p=.0009) and less severe neurologic injuries (ASIA Impairment Scale C or D; 81.3% vs. 47.5%, p<.0001). Those with stable spine injuries were less likely to have surgery (67.6% vs. 92.6%, p<.0001), had shorter in-hospital lengths of stay (median 84.0 vs. 100.5 days, p=.0062), and higher total motor score change (20.7 vs. 19.4 points, p=.0014). Multivariate modeling revealed that neurologic severity of injury and spine stability were significantly related to motor score improvement; patients with stable spine injuries had more motor score improvement. CONCLUSIONS We propose that classification of stable cervical SCI is more clinically relevant than classic CCS classification as this group was found to be unique with regard to demographics, neurologic injury, management, and outcome, whereas classic CCS classifications do not . This classification can be used to assess optimal management in patients where it is less clear if and when surgery should be performed.
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Affiliation(s)
- Jérôme Paquet
- Laval University, 1401, 18e Rue, Sciences Neurologiques, Québec, QC G1J 1Z4, Canada.
| | - Carly S Rivers
- Rick Hansen Institute, 6400-818 West 10th Ave, Vancouver, BC V5Z 1M9, Canada
| | - Dilnur Kurban
- Rick Hansen Institute, 6400-818 West 10th Ave, Vancouver, BC V5Z 1M9, Canada
| | - Joel Finkelstein
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Room MG 361, Toronto, ON M4N 3M5, Canada
| | - Jin W Tee
- Department of Neurosurgery, National Trauma Research Institute (NTRI), The Alfred Hospital, 55 Commercial Rd, Melbourne, VIC 3004, Australia
| | - Vanessa K Noonan
- Rick Hansen Institute, 6400-818 West 10th Ave, Vancouver, BC V5Z 1M9, Canada
| | - Brian K Kwon
- Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, International Collaboration on Repair Discoveries (ICORD), UBC, 818 West 10th Ave, Vancouver, BC V5Z 1M9, Canada
| | - R John Hurlbert
- Department of Clinical Neurosciences, University of Calgary, 12th Floor Foothills Hospital, 1403 29 St NW, Calgary, AB T2N 2T9, Canada
| | - Sean Christie
- Research Division of Neurosurgery, Dalhousie University, 1796 Summer St, Rm 3814, Halifax, NS B3H 3A7, Canada
| | - Eve C Tsai
- Department of Surgery, Division of Surgery, University of Ottawa, C2-1053 Carling Ave, Ottawa, ON K1Y 4E9, Canada
| | - Henry Ahn
- University of Toronto Spine Program, 55 Queen St East, Suite 1008, Toronto, ON M5C1R6 Canada
| | - Brian Drew
- Department of Orthopaedic Surgery, McMaster University, 237 Barton St West, Hamilton, ON L8L 2X2, Canada
| | - Christopher S Bailey
- Division of Orthopaedics, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, Room E4, 800 Commissioners Rd East, London, ON N6A 5W9, Canada
| | - Daryl R Fourney
- Division of Neurosurgery, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada
| | - Najmedden Attabib
- Dalhousie University, Horizon Health Network, Division of Neurosurgery Saint John Regional Hospital, P.O. Box 2100, Saint John, NB E2L4L2, Canada
| | - Michael G Johnson
- University of Manitoba, Department of Surgery, Orthopaedics and Neurosurgery, AD4-820 Sherbrook St, Winnipeg, MB, R3A 1R9, Canada
| | - Michael G Fehlings
- Department of Surgery, University of Toronto, 399 Bathurst St, Suite 4ww-449, Toronto, ON M5T 2S8, Canada
| | - Stefan Parent
- Professeur-Agrégé Département de Chirurgie Chaire Académique sur les Déformations de la Colonne, 5400 boul. Western Gouin, Montréal, QC H4L 1C5, Canada
| | - Marcel F Dvorak
- Vancouver Spine Surgery Institute, Department of Orthopaedics, University of British Columbia, 818 West 10th Ave, Vancouver, BC V5Z 1M9, Canada
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Noonan VK, Chan E, Santos A, Soril L, Lewis R, Singh A, Cheng CL, O'Connell C, Truchon C, Paquet J, Christie S, Ethans K, Tsai E, Ford MH, Drew B, Linassi AG, Bailey CS, Fehlings MG. Traumatic Spinal Cord Injury Care in Canada: A Survey of Canadian Centers. J Neurotrauma 2017; 34:2848-2855. [PMID: 28367684 PMCID: PMC5653141 DOI: 10.1089/neu.2016.4928] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Specialized centers of care for persons sustaining a traumatic spinal cord injury (tSCI) have been established in many countries, but the ideal system of care has not been defined. The objective of this study was to describe care delivery, with a focus on structures and services, for persons with tSCI in Canada. A survey was sent to 26 facilities (12 acute, 11 rehabilitation, and three integrated) from eight provinces participating in the Access to Care and Timing project. The survey included questions about: 1) care provision; 2) structural attributes and; 3) service availability. Survey completion rate was 100%. Data sources used to complete the survey were the Rick Hansen Spinal Cord Injury Registry, other hospital databases, clinical protocols, and subject matter experts. Acute and rehabilitation care provided by integrated facilities were described separately, resulting in data from 15 acute and 14 rehabilitation facilities. The number of admissions for tSCI over a 12-month period between 2009-2011 ranged from 17 to 104 (median 39), and 11 to 96 (median 32), for acute and rehabilitation facilities, respectively. Grouping of patients was reported by 8/15 acute and 10/14 rehabilitation facilities. Criteria for admission to the inpatient rehabilitation facilities varied among facilities (25 different criteria reported). Results from the survey revealed similarities in the basic structure and the provision of general services, but also some differences in the degree of specialization of care for persons with tSCI. Continued work on the impact of specialized care for both the patient and healthcare system is needed.
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Affiliation(s)
| | - Elaine Chan
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Argelio Santos
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Lesley Soril
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Rachel Lewis
- Centre for Operations Excellence, Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anoushka Singh
- Spinal Cord Injury Clinical Research Unit, Toronto Western Hospital, Toronto, Ontario, Canada
| | | | - Colleen O'Connell
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Catherine Truchon
- Trauma and Critical Care Evaluation Unit, Institut national d'excellence en santé et en services sociaux, Québec City, Québec, Canada
| | - Jérôme Paquet
- Department of Surgery, Université Laval, Québec City, Québec, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karen Ethans
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Eve Tsai
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael H. Ford
- Orthopedic Spine and Trauma, Integrated Spine Unit, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
| | - Brian Drew
- Department of Orthopedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - A. Gary Linassi
- Department of Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Elbatarny M, Mazine A, Rocha R, Fan C, Christie S, Rao V, Ouzounian M. LONG-TERM OUTCOMES OF CONSERVATIVE VS NON-CONSERVATIVE ROOT MANAGEMENT IN ACUTE TYPE A DISSECTIONS: A PROPENSITY MATCHED STUDY. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.174] [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: 11/24/2022] Open
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Hui S, Fan C, Christie S, Feindel C, David T, Ouzounian M. THE AORTIC ROOT DOES NOT DILATE OVER TIME AFTER AORTIC VALVE AND ASCENDING AORTA REPLACEMENT IN PATIENTS WITH BICUSPID OR TRICUSPID AORTIC VALVES. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.210] [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: 11/24/2022] Open
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Squair JW, Bélanger LM, Tsang A, Ritchie L, Mac-Thiong JM, Parent S, Christie S, Bailey C, Dhall S, Street J, Ailon T, Paquette S, Dea N, Fisher CG, Dvorak MF, West CR, Kwon BK. Spinal cord perfusion pressure predicts neurologic recovery in acute spinal cord injury. Neurology 2017; 89:1660-1667. [PMID: 28916535 DOI: 10.1212/wnl.0000000000004519] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 07/10/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether spinal cord perfusion pressure (SCPP) as measured with a lumbar intrathecal catheter is a more predictive measure of neurologic outcome than the conventionally measured mean arterial pressure (MAP). METHODS A total of 92 individuals with acute spinal cord injury were enrolled in this multicenter prospective observational clinical trial. MAP and CSF pressure (CSFP) were monitored during the first week postinjury. Neurologic impairment was assessed at baseline and at 6 months postinjury. We used logistic regression, systematic iterations of relative risk, and Cox proportional hazard models to examine hemodynamic patterns commensurate with neurologic outcome. RESULTS We found that SCPP (odds ratio 1.039, p = 0.002) is independently associated with positive neurologic recovery. The relative risk for not recovering neurologic function continually increased as individuals were exposed to SCPP below 50 mm Hg. Individuals who improved in neurologic grade dropped below SCPP of 50 mm Hg fewer times than those who did not improve (p = 0.012). This effect was not observed for MAP or CSFP. Those who were exposed to SCPP below 50 mm Hg were less likely to improve from their baseline neurologic impairment grade (p = 0.0056). CONCLUSIONS We demonstrate that maintaining SCPP above 50 mm Hg is a strong predictor of improved neurologic recovery following spinal cord injury. This suggests that SCPP (the difference between MAP and CSFP) can provide useful information to guide the hemodynamic management of patients with acute spinal cord injury.
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Affiliation(s)
- Jordan W Squair
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Lise M Bélanger
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Angela Tsang
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Leanna Ritchie
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Jean-Marc Mac-Thiong
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Stefan Parent
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Sean Christie
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Christopher Bailey
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Sanjay Dhall
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - John Street
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Tamir Ailon
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Scott Paquette
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Nicolas Dea
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Charles G Fisher
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Marcel F Dvorak
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Christopher R West
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco
| | - Brian K Kwon
- From the International Collaboration on Repair Discoveries (ICORD) (J.W.S., M.F.D., C.R.W., B.K.K.); MD/PhD Training Program (J.W.S.), Department of Orthopaedics (J.S., C.G.F., M.F.D, B.K.K) and Division of Neurosurgery (T.A., S. Paquette, N.D.), Vancouver Spine Surgery Institute, Blusson Spinal Cord Centre, and School of Kinesiology (C.R.W.), University of British Columbia; Vancouver Spine Program (L.M.B., A.T., L.R.), Vancouver General Hospital; Department of Surgery, Hôpital du Sacré-Coeur de Montréal (J.-M.M.-T., S. Parent), and Chu Sainte-Justine, Department of Surgery (S.C.), Université de Montréal; Division of Orthopaedic Surgery (C.B.), London Health Sciences Centre, University of Western Ontario, Canada; and Department of Neurological Surgery (S.D.), University of California, San Francisco.
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47
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Ahn H, Lewis R, Santos A, Cheng CL, Noonan VK, Dvorak MF, Singh A, Linassi AG, Christie S, Goytan M, Atkins D. Forecasting Financial Resources for Future Traumatic Spinal Cord Injury Care Using Simulation Modeling. J Neurotrauma 2017; 34:2917-2923. [PMID: 28594315 PMCID: PMC5653147 DOI: 10.1089/neu.2016.4936] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Survivors of traumatic spinal cord injury (tSCI) have intense healthcare needs during acute and rehabilitation care and often through the rest of life. To prepare for a growing and aging population, simulation modeling was used to forecast the change in healthcare financial resources and long-term patient outcomes between 2012 and 2032. The model was developed with data from acute and rehabilitation care facilities across Canada participating in the Access to Care and Timing project. Future population and tSCI incidence for 2012 and 2032 were predicted with data from Statistics Canada and the Canadian Institute for Health Information. The projected tSCI incidence for 2012 was validated with actual data from the Rick Hansen SCI Registry of the participating facilities. Using a medium growth scenario, in 2032, the projected median age of persons with tSCI is 57 and persons 61 and older will account for 46% of injuries. Admissions to acute and rehabilitation facilities in 2032 were projected to increase by 31% and 25%, respectively. Because of the demographic shift to an older population, an increase in total population life expectancy with tSCI of 13% was observed despite a 22% increase in total life years lost to tSCI between 2012 and 2032. Care cost increased 54%, and rest of life cost increased 37% in 2032, translating to an additional CAD $16.4 million. With the demographics and management of tSCI changing with an aging population, accurate projections for the increased demand on resources will be critical for decision makers when planning the delivery of healthcare after tSCI.
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Affiliation(s)
- Henry Ahn
- 1 University of Toronto Spine Program , Toronto, Ontario, Canada
| | - Rachel Lewis
- 2 Centre for Operations Excellence, Sauder School of Business, University of British Columbia , Vancouver, British Columbia, Canada
| | - Argelio Santos
- 3 Rick Hansen Institute , Vancouver, British Columbia, Canada
| | | | | | - Marcel F Dvorak
- 4 Department of Orthopaedics, University of British Columbia , Vancouver, British Columbia, Canada
| | - Anoushka Singh
- 5 SCI Clinical Research Unit, Toronto Western Hospital , Toronto, Ontario, Canada
| | - A Gary Linassi
- 6 Department of Physical Medicine and Rehabilitation, University of Saskatchewan , Saskatoon, Saskatchewan, Canada
| | - Sean Christie
- 7 Research Division of Neurosurgery, Dalhousie University , Halifax, Nova Scotia, Canada
| | - Michael Goytan
- 8 Sections of Orthopedics and Neurosurgery, University of Manitoba , Winnipeg, Manitoba, Canada
| | - Derek Atkins
- 9 Operations and Logistics Division, Sauder School of Business, University of British Columbia , Vancouver, British Columbia, Canada
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48
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Maghsoud-Lou E, Christie S, Abidi SR, Abidi SSR. Protocol-Driven Decision Support within e-Referral Systems to Streamline Patient Consultation, Triaging and Referrals from Primary Care to Specialist Clinics. J Med Syst 2017; 41:139. [PMID: 28766103 DOI: 10.1007/s10916-017-0791-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/26/2017] [Indexed: 11/25/2022]
Abstract
Patient referral is a protocol where the referring primary care physician refers the patient to a specialist for further treatment. The paper-based current referral process at times lead to communication and operational issues, resulting in either an unfulfilled referral request or an unnecessary referral request. Despite the availability of standardized referral protocols they are not readily applied because they are tedious and time-consuming, thus resulting in suboptimal referral requests. We present a semantic-web based Referral Knowledge Modeling and Execution Framework to computerize referral protocols, clinical guidelines and assessment tools in order to develop a computerized e-Referral system that offers protocol-based decision support to streamline and standardize the referral process. We have developed a Spinal Problem E-Referral (SPER) system that computerizes the Spinal Condition Consultation Protocol (SCCP) mandated by the Halifax Infirmary Division of Neurosurgery (Halifax, Canada) for referrals for spine related conditions (such as back pain). The SPER system executes the ontologically modeled SCCP to determine (i) patient's triaging option as per severity assessments stipulated by SCCP; and (b) clinical recommendations as per the clinical guidelines incorporated within SCCP. In operation, the SPER system identifies the critical cases and triages them for specialist referral, whereas for non-critical cases SPER system provides clinical guideline based recommendations to help the primary care physician effectively manage the patient. The SPER system has undergone a pilot usability study and was deemed to be easy to use by physicians with potential to improve the referral process within the Division of Neurosurgery at QEII Health Science Center, Halifax, Canada.
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Affiliation(s)
- Ehsan Maghsoud-Lou
- NICHE Research Group, Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, NS, Canada
| | - Samina Raza Abidi
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Syed Sibte Raza Abidi
- NICHE Research Group, Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada.
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49
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Dvorak MF, Cheng CL, Fallah N, Santos A, Atkins D, Humphreys S, Rivers CS, White BA, Ho C, Ahn H, Kwon BK, Christie S, Noonan VK. Spinal Cord Injury Clinical Registries: Improving Care across the SCI Care Continuum by Identifying Knowledge Gaps. J Neurotrauma 2017; 34:2924-2933. [PMID: 28745934 PMCID: PMC5653140 DOI: 10.1089/neu.2016.4937] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Timely access and ongoing delivery of care and therapeutic interventions is needed to maximize recovery and function after traumatic spinal cord injury (tSCI). To ensure these decisions are evidence-based, access to consistent, reliable, and valid sources of clinical data is required. The Access to Care and Timing Model used data from the Rick Hansen SCI Registry (RHSCIR) to generate a simulation of healthcare delivery for persons after tSCI and to test scenarios aimed at improving outcomes and reducing the economic burden of SCI. Through model development, we identified knowledge gaps and challenges in the literature and current health outcomes data collection throughout the continuum of SCI care. The objectives of this article were to describe these gaps and to provide recommendations for bridging them. Accurate information on injury severity after tSCI was hindered by difficulties in conducting neurological assessments and classifications of SCI (e.g., timing), variations in reporting, and the lack of a validated SCI-specific measure of associated injuries. There was also limited availability of reliable data on patient factors such as multi-morbidity and patient-reported measures. Knowledge gaps related to structures (e.g., protocols) and processes (e.g., costs) at each phase of care have prevented comprehensive evaluation of system performance. Addressing these knowledge gaps will enhance comparative and cost-effectiveness evaluations to inform decision-making and standards of care. Recommendations to do so were: standardize data element collection and facilitate database linkages, validate and adopt more outcome measures for SCI, and increase opportunities for collaborations with stakeholders from diverse backgrounds.
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Affiliation(s)
- Marcel F. Dvorak
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Nader Fallah
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Argelio Santos
- Rick Hansen Institute, Vancouver, British Columbia, Canada
| | - Derek Atkins
- Operations and Logistics Division, Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | - Chester Ho
- Division of Physical Medicine and Rehabilitation, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Henry Ahn
- University of Toronto Spine Program, Toronto, Ontario, Canada
| | - Brian K. Kwon
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sean Christie
- Research Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
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50
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Streijger F, Skinnider MA, Rogalski JC, Balshaw R, Shannon CP, Prudova A, Belanger L, Ritchie L, Tsang A, Christie S, Parent S, Mac-Thiong JM, Bailey C, Urquhart J, Ailon T, Paquette S, Boyd M, Street J, Fisher CG, Dvorak MF, Borchers CH, Foster LJ, Kwon BK. A Targeted Proteomics Analysis of Cerebrospinal Fluid after Acute Human Spinal Cord Injury. J Neurotrauma 2017; 34:2054-2068. [DOI: 10.1089/neu.2016.4879] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Femke Streijger
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael A. Skinnider
- Department of Biochemistry & Molecular Biology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
- Genome Sciences & Technologies Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jason C. Rogalski
- Department of Biochemistry & Molecular Biology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert Balshaw
- BC Center for Disease Control, Vancouver, British Columbia, Canada
- PROOF Centre of Excellence, Vancouver, British Columbia, Canada
| | | | - Anna Prudova
- Department of Biochemistry & Molecular Biology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lise Belanger
- Vancouver Spine Program, Vancouver, British Columbia, Canada
| | - Leanna Ritchie
- Vancouver Spine Program, Vancouver, British Columbia, Canada
| | - Angela Tsang
- Vancouver Spine Program, Vancouver, British Columbia, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax Infirmary Halifax, Halifax, Nova Scotia, Canada
| | - Stefan Parent
- Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Quebec, Canada
- Chu Sainte-Justine, Department of Surgery, Université de Montréal, Montréal, Quebec, Canada
| | - Jean-Marc Mac-Thiong
- Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Quebec, Canada
- Chu Sainte-Justine, Department of Surgery, Université de Montréal, Montréal, Quebec, Canada
| | - Christopher Bailey
- Division of Orthopaedic Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
| | - Jennifer Urquhart
- Division of Orthopaedic Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
| | - Tamir Ailon
- Vancouver Spine Surgery Institute, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Paquette
- Vancouver Spine Surgery Institute, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Boyd
- Vancouver Spine Surgery Institute, Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - John Street
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Charles G. Fisher
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marcel F. Dvorak
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Leonard J. Foster
- Department of Biochemistry & Molecular Biology and Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Brian K. Kwon
- International Collaboration on Repair Discoveries (ICORD), Blusson Spinal Cord Centre, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
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