Decreasing Trend in Medicare Physician Reimbursements for Flap and Microvascular Surgery Procedures From 2002 to 2023.

Purpose: This study aimed to evaluate how major US health care policy changes have influenced long-term Medicare reimbursement trends for upper-extremity flap and microvascular procedures from 2002 to 2023.

Methods: Reimbursement data for 28 common flap and microvascular procedures were extracted from the Medicare Physician Fee Schedule database using Current Procedural Terminology codes. Adjustments for inflation were made using the Consumer Price Index.

Patient Demographics and Risk Factors for Surgical Site Infections After Open Reduction and Internal Fixation for Bimalleolar Ankle Fractures.

Background: The purpose of this study was to identify the incidence and risk factors associated with surgical site infection (SSI) after open reduction and internal fixation of bimalleolar ankle fractures. Bimalleolar ankle fractures are one of the most common subtypes of ankle fractures, accounting for 15% to 20% of all ankle fractures. Recent studies have shown that 4.

Age-based prediction of non-routine discharge after anterior cervical discectomy and fusion using machine learning.

Purpose: To examine factors influencing non-routine discharge in ACDF patients stratified by age utilizing machine learning.

Methods: A cohort of 219,380 weighted ACDF cases from the National Inpatient Sample (NIS) database spanning 2016-2020 was divided into three age groups: 50-64, 65-79, and 80 + years. Eight supervised machine learning models predicted non-routine discharge based on patient characteristics, including age, length of stay (LOS), and comorbidities.

Postoperative complications, length of stay, and discharge disposition following single-level anterior lumbar interbody fusion in elderly and octogenarian patients.

Background: Anterior lumbar interbody fusion (ALIF) has become a widely accepted treatment for degenerative lumbar spine pathologies, with increasing prevalence due to its effectiveness in restoring lumbar lordosis and improving spinal balance. This study aims to evaluate postoperative complications, length of stay (LOS), and discharge disposition following ALIF across different age groups.

Methods: A total of 92,800 weighted cases of patients aged 50 and older underwent single-level ALIF in the National Inpatient Sample (NIS) from 2016 to 2020.

Prediction of non-routine discharge following single-level cervical disc arthroplasty using machine learning.

Background: Non-routine discharge following single-level cervical disc arthroplasty (CDA) is associated with increased morbidity and healthcare burden. Identifying key predictors can improve perioperative planning and patient outcomes. The aim of this study is to predict non-routine discharge following single-level CDA and identify key discharge predictors.

Increasing public interest in lumbar decompression and fusion surgery in the United States: higher search volumes in the Northeast region from 2015 to 2024.

Study Design: A cross-sectional study.

Purpose: This study aimed to investigate temporal patterns, seasonal variations, and geographic differences in the US public interest in lumbar decompression and fusion surgery.

Overview Of Literature: The number of lumbar decompression and fusion surgery procedures for various surgical indications has significantly increased in the United States over the past few decades.

Single-level anterior cervical discectomy and fusion is associated with higher nonroutine discharge rates compared to cervical disc arthroplasty in obese patients.

Context: Obesity is a recognized risk factor for adverse outcomes in cervical spine surgery. While cervical disc arthroplasty (CDA) has emerged as an alternative to anterior cervical discectomy and fusion (ACDF), comparative outcomes among obese patients remain underexplored.

Aims: The aim of this study is to compare nonroutine discharge rates and other postoperative outcomes between obese patients undergoing single-level ACDF and CDA.

Teriparatide use is associated with increased odds of 2-year implant failure and revision in osteopenic patients undergoing cervical fusion.

Context: Cervical fusion outcomes are influenced by bone quality, with osteopenia increasing the risk of implant failure and revision surgery. The impact of teriparatide in this population remains unclear.

Aims: The aim of this study was to investigate the association between teriparatide use and 90-day medical complications, 2-year surgical complications, and hospital readmissions in this population.

Procedural, Reimbursement, and Geographic Trends in Adult Spinal Deformity Correction Surgery: A Medicare Analysis.

Purpose: This study aims to evaluate national trends in procedural volume, Medicare reimbursement rates, and geographic distribution of adult spinal deformity (ASD) correction surgeries among spine surgeons in the United States from 2013 to 2021.

Methods: Data was obtained from the Medicare Physician & Other Practitioners dataset, using Current Procedural Terminology (CPT) codes relevant to ASD surgeries. Median reimbursement rates were inflation-adjusted to 2021 dollars, with procedural volume and reimbursement trends assessed via univariate regression.

Comparison of Industry and National Institutes of Health Funding for Orthopedic Surgery Research.

Background: The aims of this study were to analyze trends in National Institutes of Health (NIH) funding for musculoskeletal (MSK) research from 2012 to 2021, compare private industry funding to NIH funding, determine the proportion of total MSK research funding from public versus private sources, and examine how private industry research and development (R&D) spending has evolved in relation to net sales.

Materials And Methods: Public research funding from 2012 to 2021 was aggregated using NIH data for MSK conditions with >$10M in funding. Private R&D funding was obtained from the top five orthopedic companies by revenue and compared to net sales to calculate R&D as a percentage of total sales.

Geographic and Socioeconomic Disparities in Robotic Spine Surgery Access in the Continental United States: A Cross-Sectional Ecological Analysis.

Study DesignCross-sectional ecological analysis.ObjectivesThis study aims to assess the availability of robotic spine surgery across the United States and identify disparities in access.MethodsWe utilized provider-finding functions from major medical equipment manufacturers to identify robotic spine surgeons and categorized affiliated hospitals.

Influence of hospital size on postoperative outcomes, length of stay, and costs following single-level cervical disc arthroplasty.

Background: Hospital size has been shown to influence resource availability, staffing, and patient care quality. This study aims to evaluate the impact of hospital size on postoperative outcomes such as length of stay (LOS), total costs, complications, and non-routine discharge rates in patients undergoing single-level CDA.

Methods: The National Inpatient Sample (NIS) was queried to identify 14,315 weighted cases of patients who underwent single-level CDA between 2016 and 2020.

Impact of Postoperative Dysphagia on Health Care Resource Utilization Following Single-Level Cervical Disc Arthroplasty.

Study DesignRetrospective cohort study.ObjectivesThis study seeks to highlight differences in 1) postoperative complications, 2) recovery course, and 3) associated costs between patients with and without postoperative dysphagia who underwent single-level CDA.MethodsThe National Inpatient Sample (NIS) was queried to identify patients who underwent single-level CDA between 2016 and 2020.

High Volume Hospitals are Associated With Decreased Rates of Non-Routine Discharge Following Single-Level Cervical Disc Arthroplasty.

Study DesignRetrospective cohort study.ObjectivesThis study aims to evaluate the impact of hospital volume on postoperative outcomes following single-level cervical disc arthroplasty (CDA), focusing on non-routine discharge rates, length of stay (LOS), and hospital costs.MethodsAfter applying the appropriate exclusion criteria, the National Inpatient Sample (NIS) was queried to identify 14,315 weighted cases of patients undergoing single-level CDA between 2016 and 2020.

Increased rates of dysphagia, longer length of stay, nonroutine discharge, and higher hospital costs in patients over 65 undergoing single-level cervical disc arthroplasty: A propensity score-matched analysis.

Context: Cervical disc arthroplasty (CDA) is a safe and effective treatment for cervical spine conditions, with increasing utilization. As the population over 65 grows, understanding the suitability of CDA in older patients is critical.

Aims: This study evaluates differences in postoperative complications, hospital course, and costs between patients aged 18 and 65 and those over 65 undergoing CDA.

Prediction of Primary Admission Total Charges Following Single-Level Lumbar Arthrodesis Utilizing Machine Learning.

Study DesignRetrospective analysis utilizing machine learning.ObjectivesThis study aims to identify the key factors influencing total charges during the primary admission period following single-level lumbar arthrodesis, using machine learning models to enhance predictive accuracy.MethodsData were extracted from the National Inpatient Sample (NIS) database and analyzed using various machine learning models, including random forest, gradient boosting trees, and logistic regression.

Semaglutide use is associated with higher rates of pseudarthrosis and dysphagia in patients undergoing posterior cervical fusion.

Background Context: Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has shown efficacy in managing glycemic control and obesity but its effects on surgical outcomes, particularly in posterior cervical fusion (PCF), are underexplored.

Purpose: To evaluate the association between semaglutide use and postoperative complications, costs, and readmissions in patients undergoing PCF.

Design: Retrospective cohort study.

Obstructive Sleep Apnea is Associated With Increased Rates of Acute Respiratory Failure, Length of Stay, and Hospital Costs in Patients Undergoing Elective Single-Level Anterior Cervical Discectomy and Fusion.

Study designRetrospective cohort study.ObjectivesTo examine differences in postoperative complications, recovery course, and costs between patients with and without obstructive sleep apnea (OSA) undergoing single-level anterior cervical discectomy and fusion (ACDF).MethodsThe National Inpatient Sample (NIS) database was queried to identify patients undergoing single-level ACDF between 2016 and 2022.

Outcomes of ambulatory versus outpatient hospital-based surgical center shoulder arthroplasty: complications, readmissions, and charges.

Purpose: The rising demand for primary total shoulder arthroplasty (TSA) has spurred interest in comparing the safety and cost-effectiveness of outpatient TSA in ambulatory surgical centers (ASCs) versus hospital-based centers (HSCs). This study evaluates ASCs and HSCs for medical complications, readmission rates, implant complications, and costs.

Methods: This retrospective cohort study used the PearlDiver Mariner Database to identify patients undergoing primary TSA in ASCs or HSCs, assessing medical complications, readmissions, implant issues, and costs.

GPT-4 as a Source of Patient Information for Carpal Tunnel Surgery: A Comparative Analysis Against Google Web Search.

Introduction: Carpal tunnel surgery (CTS) accounts for approximately 577,000 surgeries in the United States annually. This high frequency raises concerns over the dissemination of medical information through artificial intelligence chatbots, Google, and healthcare professionals. The objectives of this study are to determine whether GPT-4 and Google differ in (1) the type of questions asked, (2) the readability of responses, and (3) the accuracy of numerical responses for the top 10 most frequently asked questions (FAQs) about CTS.

Orthopaedic fracture site and wound healing risk among end-stage renal disease patients undergoing open reduction internal fixation: A database analysis.

Introduction: The aims of this study are to 1) identify incidence rate of fracture occurrence among end-stage renal disease (ESRD) patients requiring open reduction internal fixation (ORIF) stratified by anatomic site and 2) assess the risk of perioperative wound complications among ESRD fracture patients requiring ORIF compared to non-ESRD patients.

Materials And Methods: This retrospective cohort study utilized the Nationwide Inpatient Sample database, covering the period from January 2002 to December 2014, to examine patients over 18 years of age who underwent ORIF for extremity fractures in the United States. Two-sample Z-tests were employed to assess differences in patient demographics, comorbidities, and anatomical fracture sites between ESRD and non-ESRD cohorts.

Surgical Trends in Use of Lumbar Disk Arthroplasty Versus Lumbar Fusion From 2010 to 2021.

Introduction: Lumbar disk arthroplasty (LDA) is a relatively novel procedure with limited indications and use in the United States, especially relative to lumbar fusion (LF). This study aimed to determine surgical trends between LDA versus LF over the past 10 years to quantify absolute/relative surgical volume over time and compare baseline patient demographics, readmission, 2-year revision rates, and costs-of-care.

Methods: A total of 714,268 patients were identified from a nationwide database who underwent LF (n = 710,527) or LDA (n = 3,741) from 2010 to 2021.

Management of Pathologic Hip Fracture Secondary to Musculoskeletal Echinococcosis: A Case Report.

A 50-year-old female from Uzbekistan presented to our emergency department with severe right hip pain and loss of ambulation. Her history included multiple hepatic echinococcal cyst resections. After a fall, she underwent a proximal femur open reduction and internal fixation (ORIF) and revision in Uzbekistan, which revealed broken screws and cystic lesions.

Reevaluating Informed Consent: Integrating Shared Decision-Making into Spinal Surgery for Better Patient Outcomes.

Study DesignNarrative review.ObjectivesThe objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?MethodsN/A.ResultsSDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, alternatives, and postoperative expectations.

Prediction of primary admission total charges following cervical disc arthroplasty utilizing machine learning.

Background Context: Cervical disc arthroplasty (CDA) has become an increasingly popular alternative to anterior cervical discectomy and fusion, offering benefits such as motion preservation and reduced risk of adjacent segment disease. Despite its advantages, understanding the economic implications associated with varying patient and hospital factors remains critical.

Purpose: To evaluate how hospital size, geographic region, and patient-specific variables influence charges associated with the primary admission period following CDA.