Single-level posterior lumbar fusions in patients with Ehlers Danlos Syndrome not found to be associated with increased postoperative adverse events or five-year reoperations

Gouzoulis, Michael J.; Kammien, Alexander J.; Zhu, Justin R; Gillinov, Stephen M.; Moore, Harold E.; Grauer, Jonathan N.

doi:10.1016/j.xnsj.2022.100136

Cited by 13 publications

(13 citation statements)

References 19 publications

(23 reference statements)

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“…This study is also subject to known limitations inherent to retrospective and administrative research, including the potential for selection bias and bias introduced from the misinterpretation of coding and frank errors. [28][29][30][31][32]…”

Section: Discussionmentioning

confidence: 99%

“…The database nature of the study prevents a full understanding of the details of the clinical encounter, including the evaluation of potential options for management between the patient and the surgeon. This study is also subject to known limitations inherent to retrospective and administrative research, including the potential for selection bias and bias introduced from the misinterpretation of coding and frank errors 28–32 …”

Section: Discussionmentioning

confidence: 99%

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Single-level Anterior Cervical discEctomy and Fusion has Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort

Jayaram

Joo

Gouzoulis

et al. 2023

Spine

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Study Design. A retrospective cohort study using the 2010-2020 MSpine PearlDiver administrative data set. Objective. To compare perioperative adverse events and fiveyear revisions for single-level anterior cervical discectomy and fusion (ACDF) versus posterior cervical foraminotomy (PCF). Summary of Background Data. Cervical disk disease can often be treated surgically using single-level ACDF or PCF. Prior studies have suggested that posterior approaches provide similar shortterm outcomes as ACDF; however, posterior procedures may have an increased risk of revision surgery. Materials and Methods. The database was queried for patients undergoing elective single-level ACDF or PCF (excluding cases performed for myelopathy, trauma, neoplasm, and/or infection). Outcomes, including specific complications, readmission, and reoperations, were assessed. Multivariable logistic regression was used to ascertain odds ratios (OR) of 90-day adverse events controlling for age, sex, and comorbidities. Kaplan-Meier survival analysis was performed to determine five-year rates of cervical reoperation in the ACDF and PCF cohorts. Results. A total of 31,953 patients treated by ACDF (29,958, 93.76%) or PCF (1995, 6.24%) were identified. Multivariable analysis, controlling for age, sex, and comorbidities, demonstrated that PCF was associated with significantly greater odds of aggregated serious adverse events (OR 2.17, P < 0.001), wound dehiscence (OR 5.89, P < 0.001), surgical site infection (OR 3.66, P < 0.001), and pulmonary embolism (OR 1.72, P = 0.04).However, PCF was associated with significantly lower odds of readmission (OR 0.32, P < 0.001), dysphagia (OR 0.44, P < 0.001), and pneumonia (OR 0.50, P = 0.004). At five years, PCF cases had a significantly higher cumulative revision rate compared with ACDF cases (19.0% vs. 14.8%, P < 0.001). Conclusions. The current study is the largest to date to compare short-term adverse events and five-year revision rates between single-level ACDF and PCF for nonmyelopathy elective cases. Perioperative adverse events differed by procedure, and it was notable that the incidence of cumulative revisions was higher for PCF. These findings can be used in decision-making when there is clinical equipoise between ACDF and PCF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Single-level Anterior Cervical discEctomy and Fusion has Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort

Jayaram

Joo

Gouzoulis

et al. 2023

Spine

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“…This study used data from the 2015 to 2020 M151 Ortho PearlDiver database, which is well established in the orthopaedic literature. [22][23][24][25][26][27] As the output data are aggregated and deidentified, our Institutional Review Board has determined studies using this database exempt from review.…”

Section: Study Cohortmentioning

confidence: 99%

Trends in and Factors Associated With Surgical Management for Closed Clavicle Fractures

Dhodapkar,

Modrak,

Halperin

et al. 2023

JAAOS Glob Res Rev

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Introduction: Clavicle fractures are common and have historically been managed nonsurgically. Over time, there are increasing surgical considerations for such injuries. Nonetheless, trends over the past decade are not well characterized. Methods: Adult patients presenting for first diagnosis of clavicle fractures were identified from the 2010 to 2020 PearlDiver M151 database. Patients were defined to have undergone surgical management if they received clavicular open reduction and internal fixation within 90 days after fracture diagnosis. Patient age, sex, Elixhauser Comorbidity Index (ECI), geographic region, insurance coverage, fracture anatomic location, and polytraumatic diagnoses were extracted. Factors independently associated with surgical management versus nonsurgical management were assessed with multivariable analysis. Results: Overall, 50,980 patients with clavicle fractures were identified of whom 6,193 (12.1%) were managed surgically. This proportion increased significantly over the study period (7.4% in 2015 to 13.9% in 2020, P < 0.001). Independent predictors of surgical management included fracture diagnosis in 2020 (versus 2015, odds ratio [OR] 2.36), anatomic location (relative to lateral end, shaft OR 1.84 and sternal OR 3.35), and Midwest region of service (OR 1.26, relative to South) (P < 0.001 for all). Discussion: A small but increasing minority of patients with clavicle fractures are managed surgically. Clinical factors and nonclinical factors were associated with surgical management.

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“…The increasing family of collagens and proteins with collagenous domains shows the collagen triple helix to be a basic motif adaptable to a range of proteins and functions [ 3 ]. Abnormal collagen biogenesis leads to dysplasia in bone or skin, such as Schmid metaphyseal chondrodysplasia [ 4 ] and Ehlers–Danlos syndrome [ 5 ]. Even excessive fibrosis associated with wound healing and skin aging is related to the disorder of collagen biogenesis [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Discovery of Natural Small Molecules Promoting Collagen Secretion by High-Throughput Screening in Caenorhabditis elegans

Fang

Meng

et al. 2022

Molecules

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Advancing approaches for drug screening are in great demand to explore natural small molecules that may play important roles in collagen biogenesis, secretion, and assembly, which may find novel lead compounds for treating collagen-related diseases or preventing skin aging. In this study, we generated a single copy insertion transgenic Pcol-19- COL-12::GFP Caenorhabditis elegans (C. elegans) strain to label epidermis collagen XII (COL-12), a cuticle structure component, and established an efficient high-content screening techniques to discover bioactive natural products in this worm strain through quantification of fluorescence imaging. We performed a preliminary screening of 614 compounds from the laboratory’s library of natural small molecule compounds on the COL-12 labeling worm model, which was tested once at a single concentration of 100 µM to screen for compounds that promoted COL-12 protein amount. Besides col-12, the transcriptional levels of worm-associated collagen coding genes col-19 and sqt-3 were also examined, and none of the compounds affected their transcriptional levels. Meanwhile, the protein levels of COL-12 were significantly upregulated after treating with Danshensu, Lawsone, and Sanguinarine. The effects of these drugs on COL-12 overexpressing worms occur mainly after collagen transcription. Through various validation methods, Danshensu, Lawsone, and Sanguinarine were more effective in promoting the synthesis or secretion of COL-12.

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Single-level posterior lumbar fusions in patients with Ehlers Danlos Syndrome not found to be associated with increased postoperative adverse events or five-year reoperations

Cited by 13 publications

References 19 publications

Single-level Anterior Cervical discEctomy and Fusion has Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort

Single-level Anterior Cervical discEctomy and Fusion has Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort

Trends in and Factors Associated With Surgical Management for Closed Clavicle Fractures

Discovery of Natural Small Molecules Promoting Collagen Secretion by High-Throughput Screening in Caenorhabditis elegans

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