Evidence-Based Recommendations for Spine Surgery

Vaccaro, Alexander R.; Fisher, Charles G.; Patel, Alpesh A.; Prasad, Srinivas; Chi, John; Mulpuri, Kishore; Thomas, Kenneth; Whang, Peter G.

doi:10.1097/brs.0000000000002083

Spine

2017

DOI: 10.1097/brs.0000000000002083

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Evidence-Based Recommendations for Spine Surgery

Alexander R. Vaccaro

Charles G. Fisher

Alpesh A. Patel

et al.

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Cited by 2 publications

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“…1 Although these treatment plans demand the most rigorous levels of evidence, the development of these guidelines within spine surgery is challenging. 2 Although spine surgery researchers have had variable success in delivering evidence-based guidelines, some published criteria stand out as more successful. For example, researchers have established well-vetted algorithms for procedures such as decompression and fusion for spondylolisthesis and decompression in the treatment of herniated nucleus pulposus.…”

mentioning

confidence: 99%

Preliminary Evaluation of Standing Full-Length Plain Radiographs Utility in an Adult Degenerative Spine Practice

Parrish

Jenkins

Haws

et al. 2021

J Am Acad Orthop Surg

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Introduction:The role of weight-bearing full-length standing radiographs (FLSRs) of the spine in the preoperative workup of adult degenerative disease of the lumbar spine is a subject of increasing research. This investigation aims to determine whether FLSR influences preoperative planning decisions. Methods: In this prospective study, eight spine surgeons reviewed two 30-patient case series. The first set (set A) contained a patient history, physical examination data, and preoperative images. The second set (set B) contained all information in set A in addition to preoperative FLSR AP and lateral radiographs. Within 2 weeks of evaluating set A, reviewers assessed set B. Case sets were randomized. After reviewing each set, reviewers gave surgical plans and whether they believed an FLSR was important in planning. Decisions were evaluated by subspecialty, years of practice, and postfellowship years. A McNemar test assessed differences between set viewings. A chi-square test assessed differences of preoperative decision changes between different specialties and levels of experience. A Poisson regression assessed characteristics associated with changing preoperative plans. We analyzed patients by the number of unique reviewer procedures, surgical levels, and associated pathology. Results: After viewing an FLSR, 44.7% of reviewers changed procedure. Reviewer opinion of FLSR importance differed between sets (27.1% versus 35.7%, P = 0.047). Among all reviewers, FLSR presentation was associated with aligning the number of proposed procedures in 15 patients. Scoliosis and sacral dysplasia were associated with negative deltas. FLSR viewing reduced the span of operational levels considered. Along the most divided patients, those with a high magnitude ($6 choices) of initial procedures had more negative deltas than did those with a high number ($5 choices) of surgical level choices.

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mentioning

confidence: 99%

Preliminary Evaluation of Standing Full-Length Plain Radiographs Utility in an Adult Degenerative Spine Practice

Parrish

Jenkins

Haws

et al. 2021

J Am Acad Orthop Surg

View full text Add to dashboard Cite

show abstract

Integrating Evidence-Based Medicine into “Value”—It's Time to Change the Paradigm

Fisher

Vaccaro

2020

Spine

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Evidence-Based Recommendations for Spine Surgery

Cited by 2 publications

References 15 publications

Preliminary Evaluation of Standing Full-Length Plain Radiographs Utility in an Adult Degenerative Spine Practice

Preliminary Evaluation of Standing Full-Length Plain Radiographs Utility in an Adult Degenerative Spine Practice

Integrating Evidence-Based Medicine into “Value”—It's Time to Change the Paradigm

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