ORCID Profile
0000-0002-8518-8780
Current Organisations
The University of Auckland
,
Waikato Hospital
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2019
DOI: 10.1097/BPO.0000000000000990
Abstract: Congenital scoliosis (CS) is associated with more rigid, complex deformities relative to adolescent idiopathic scoliosis (AIS) which theoretically increases surgical complications. Despite extensive literature studying AIS patients, few studies have been performed on CS patients. The purpose of this study was to evaluate complications associated with spinal fusions for CS and AIS. A retrospective review of the Kid’s Inpatient Database (KID) years 2000 to 2009 was performed. Inclusion: patients under 20 years with ICD-9 diagnosis codes for idiopathic scoliosis (IS—without concomitant congenital anomalies) and CS, undergoing spinal fusion from the KID years 2000 to 2009. Two analyses were performed according to age below 10 years and 10 years and above. Univariate analysis described differences in demographics, comorbidities, intraoperative complications, and clinical values between groups. Binary logistic regression controlling for age, sex, race, and invasiveness predicted complications risk in CS (odds ratios 95% confidence interval). In total, 25,131 patients included (IS, n=22443 CS, n=2688). For patients under age 10, CS patients underwent 1 level shorter fusions ( P .001), had fewer comorbidities ( P .001), and sustained similar complication incidence. In the 10 and over age analysis, CS patients similarly had shorter fusions, but greater comorbidities, and significantly more complications (odds ratio, 1.6 confidence interval, 1.4-1.8). CS patients have higher in-hospital complication rates. With more comorbidities, these patients have increased risk of sustaining procedure-related complications such as shock, infection, and Adult Respiratory Distress Syndrome. These data help to counsel patients and their families before spinal fusion. Level III—retrospective review of a prospectively collected database.
Publisher: International Journal of Spine Surgery
Date: 04-2019
DOI: 10.14444/6028
Publisher: Springer Science and Business Media LLC
Date: 03-2019
DOI: 10.1016/J.JSPD.2018.07.007
Abstract: Retrospective review from a single institution. To evaluate intraoperative T1-pelvic angle (TPA), T4PA, and T9PA as predictors of postoperative global alignment after adult spinal deformity (ASD) surgery. Malalignment following adult spinal surgery is associated with disability and correlates with health-related quality of life. Preoperative planning and intraoperative verification are crucial for optimal postoperative outcomes. Currently, only pelvic incidence minus lumbar lordosis (PI-LL) mismatch has been used to assess intraoperative correction. Patients undergoing ≥4-level spinal fusion with full-length pre-, intra-, and first postoperative calibrated radiographs were included from a single institution. Alignment measurements were obtained for sagittal vertical axis (SVA), PI-LL, TPA, T4PA, and T9PA. The whole cohort was ided into upper thoracic (UT: UIV > T7) and lower thoracic fusions (LT: UIV .09). For LT (n = 31), intraoperative and postoperative T9PA and LL were similar (p > .10) but TPA and T4PA differed (p < .02). For UT, all intraoperative and postoperative spinopelvic angles strongly correlated (r = 0.8-0.9). For LT, intraoperative to postoperative T9PA strongly correlated (r = 0.83) and TPA, T4PA, and LL correlated moderately (r = 0.65-0.70). LT trended toward more reciprocal kyphosis postoperatively (8.1° vs. 2.6° p = .059). Intraoperative measurements of TPA, T4PA, and T9PA correlated better with postoperative global alignment than PI-LL, demonstrating their utility in confirming alignment goals. When comparing intraoperative to postoperative films, only T9PA was similar in LT whereas all spinopelvic angles were similar in UT. Reciprocal kyphosis in unfused segments of LT fusions may account for difference in TPA and T4PA from intraoperative to postoperative films. Level III.
Publisher: Elsevier BV
Date: 10-2016
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2012
Publisher: Springer Science and Business Media LLC
Date: 08-04-2016
DOI: 10.1007/S00264-016-3181-8
Abstract: Cervical disc replacement has become an acceptable alternative to anterior cervical fusion for the surgical treatment of cervical spine spondylosis resulting in radiculopathy or myelopathy following anterior discectomy and decompression. This concise overview considers the current state of knowledge regarding the continued debate of the role of cervical disc replacement with an update in light of the latest clinical trial results. A literature review was performed identifying clinical trials pertaining to the use of cervical disc replacement compared to cervical discectomy and fusion. Single level disease and two level disease were considered. Outcome data from the major clinical trials was reviewed and salient points identified. With lengthier follow-up data becoming available, the equivalence of CDR in appropriately selected cases is becoming clear. This is chiefly manifested by reduced re-operation rates and reduced incidence of adjacent level disease in those treated with arthroplasty. Cervical disc replacement shows emerging equivalence in outcomes compared to the gold standard anterior cervical discectomy and fusion. Further longer term results are anticipated to confirm this trend.
Location: United States of America
No related grants have been discovered for Joseph Baker.