Medical Specialties Commons^™

Comparative Efficacy, Quality Of Life, Safety, And Tolerability Of Atogepant And Rimegepant In Migraine Prevention: A Matching-Adjusted Indirect Comparison Analysis, Cristina Tassorelli, Kateryna Onishchenko, Rashmi B. Halker Singh, Molly Duan, Laure Dupont-Benjamin, Matthew Hemstock, Corey Voller, Peter Mcallister, Stephanie J. Nahas, Pranav Gandhi, Jessica Ailani

Department of Neurology Faculty Papers

BACKGROUND: Comparative evaluations of preventive migraine treatments can help inform clinical decision making for managing migraine in clinical practice.

METHODS: An anchored matching-adjusted indirect comparison analysis was conducted using pooled participant-level data from two phase 3 atogepant trials (ADVANCE and PROGRESS) and one phase 2/3 rimegepant trial (BHV3000-305) to evaluate the relative efficacy and safety/tolerability of atogepant and rimegepant as preventive migraine treatments. Participants receiving atogepant 60 mg once daily, rimegepant orally disintegrating tablet 75 mg once every other day, and placebo were included. Only participants meeting the BHV3000-305 inclusion/exclusion criteria were analyzed: ≥6 monthly migraine days and ≤18 monthly …

Medication Utilization For Patients With Chronic Rhinosinusitis With Nasal Polyposis (Crswnp) And Asthma In 12 Months Pre- And Post-Dupilumab Initiation, Emily Garvey, Bita Naimi, Alexander Duffy, Chase Kahn, Douglas Farquhar, Marc Rosen, Mindy Rabinowitz, Damaris Pena Evertz, Jessica Most, Elina Toskala, Gurston G. Nyquist

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Key Points:

• This study examines the impact of dupilumab on medication use for chronic rhinosinusitis with nasal polyposis (CRSwNP) and asthma patients.
• Patients on dupilumab had a reduction in oral/inhaled/topical steroids, antibiotics, and leukotriene receptor antagonists (LTRAs).
• The reduction in medication use had no impact on total polyp or SNOT-22 scores.

Cervical Cancer Screening Barriers And Facilitators From The Perspectives Of Women With A History Of Criminal-Legal System Involvement And Substance Use, Amanda Emerson, Marissa Dogan, Elizabeth Hawes, Kiana Wilson, Sofía Mildrum Chana, Patricia J. Kelly, Megan Comfort, Megha Ramaswamy

College of Nursing Faculty Papers & Presentations

BACKGROUND: The wide availability of routine screening with Papanicolaou (Pap) tests and vaccinations against human papillomavirus has resulted in a decline in rates of cervical cancer. As with other diseases, however, disparities in incidence and mortality persist. Cervical cancer, is found more often, at later stages, and has worse outcomes in people who live in rural areas, identify as Black or Hispanic, and in people who are incarcerated. Studies report 4-5 times higher rates of cervical cancer incidence in people detained in jails and prisons than in community-based samples. Studies to explain cervical cancer differences have been inconclusive, though there …

Stereotactic Electroencephalogram Recordings In Temporal Lobectomy Patients Demonstrates The Predictive Value Of Interictal Cross-Frequency Correlations: A Retrospective Study, Anish Sathe, Mahdi Alizadeh, Emily Johannan, Christian Raimondo, Michael R Sperling, Ashwini Sharan, Michael Kogan

Department of Neurosurgery Faculty Papers

BACKGROUND: Positive correlations between low- and high-frequency spectra from stereotactic electroencephalogram (SEEG) recordings have been implicated in pathological brain activity interictally and have been used for ictal detection in both focal and network models.

OBJECTIVE: We evaluated SEEG signals in patients who ultimately underwent temporal lobectomy to evaluate their utility in seizure localization and prediction of seizure freedom post-resection.

METHODS: We retrospectively analyzed cross-frequency correlations between beta and high gamma (HG) interictal SEEG signals from 22 patients. We compared signals based on temporal versus extra-temporal locations, seizure-free (SF) versus non-seizure-free (NSF) outcomes, and mesial (M) versus mesial temporal-plus (M+) onset. …

Racial Discrimination, Knowledge, And Health Outcomes: The Mediating Role Of Hepatitis B-Related Stigma Among Patients With Chronic Hepatitis B, Julia G. Katcher, Ann C. Klassen, Hie-Won Hann, Mimi Chang, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty-five CHB patients were recruited and …

Exploring The Mechanical Strength, Antimicrobial Performance, And Bioactivity Of 3d-Printed Silicon Nitride-Peek Composites In Cervical Spinal Cages, Cemile Basgul, Paul Desantis, Tabitha Derr, Noreen J. Hickok, Ryan M. Bock, Steven M. Kurtz

Department of Orthopaedic Surgery Faculty Papers

In this study, our goal was to assess the suitability of a polyether-ether-ketone (PEEK) and silicon nitride (Si3N4) polymer composite for antimicrobial three-dimensional (3D)-printed cervical cages. Generic cage designs (PEEK and 15 vol.% Si3N4-PEEK) were 3D-printed, including solid and porous cage designs. Cages were tested in static compression, compression shear, and torsion per ASTM F2077. For antibacterial testing, virgin and composite filament samples were inoculated with Staphylococcus epidermidis and Escherichia coli. In vitro cell testing was conducted using MC3T3-E1 mouse preosteoblasts, where cell proliferation, cumulative mineralization, and osteogenic activity were measured. The 3D-printed PEEK and Si3N4-PEEK cages exhibited adequate mechanical …

Diagnostic And Therapeutic Challenge: A Case Of Right Ventricular Thrombus, Angad Bedi, Muhammad Sabri, Prerana Sevella, Hussam Al Hennawi, Gregory Pirolli

Abington Jefferson Health Papers

Right ventricular thrombus is a rare finding found in 4% of people diagnosed with pulmonary embolism. Although right ventricular thrombi are usually associated with atrial fibrillation, deep venous vein thrombi, or intracardiac procedures, isolated right ventricular thrombi are rare. Right ventricular thrombus has also been reported in patients with right ventricular infarction, as hypokinesis of the right ventricle causes blood stasis and promotes thrombosis as per Virchow’s triad. However, we present a case of isolated RV thrombus in a patient without evidence of deep vein thrombosis or right ventricular hypokinesis who presented with dyspnea on exertion.

The Curious Case Of Kounis Syndrome: Exploring Clinical Manifestations And Management In The Presence Of Nonobstructive Coronary Arteries, Darren Drittel, Dylan Deyar, Eric Boxer, Hussam Al Hennawi, Margaret Mack

Abington Jefferson Health Papers

Kounis syndrome, an allergic hypersensitivity coronary disorder, is a rare but potentially life-threatening condition triggered by various allergens, including medications. We present the case of a 41-year-old male with no prior cardiac history, who developed Kounis syndrome following vancomycin administration for suspected cellulitis. The patient initially presented with rash, fever, and malaise, which progressed to chest discomfort associated with diaphoresis and elevated troponin levels. Diagnostic evaluations, including electrocardiographic changes and coronary angiography, confirmed a diagnosis of type I Kounis syndrome. This case adds to the limited literature on vancomycin-induced Kounis syndrome, and underscores the importance of considering this diagnosis in …

Current Concepts In The Evaluation, Management, And Prevention Of Common Foot And Ankle Injuries In The Runner, Alexis S. Tingan, Aisha Bowen, Chelsea Salas-Tam, Matthew Roland, Apurva Srivastav

Department of Exercise Science Faculty Papers

Purpose of Review Running-related injuries (RRIs) are a common cause of dysfunction among runners. Foot and ankle injuries are among the most common RRIs. The purpose of this review is to detail current concepts in the pathophysiology, evaluation, management, and prevention of foot and ankle RRIs.

Recent Findings Running gait analyses are helpful in identifying biomechanical and kinematic abnormalities that can be targeted in rehabilitation. Musculoskeletal ultrasonography is now being used to both qualitatively and quantitatively assess tissue integrity to guide diagnosis, prognosis, and return to run decision-making. Recent treatment analyses have demonstrated that rehabilitation exercises are vital for restoring …

Social Needs Risk And Patient Outcomes With Supportive Oncology Care, Rebecca Cammy, Lcsw, Joshua Banks, Ma

Department of Medical Oncology Posters

Objective

This study utilized social risk data in the electronic heath record collected in routine clinical practice and examined relationships with supportive oncology care contacts and patient outcomes.

Combination Radiofrequency Ablation And Vertebral Cement Augmentation For Spinal Metastatic Tumors: A Systematic Review And Meta-Analysis Of Safety And Treatment Outcomes, Andrew Chen, Navraj Sagoo, Christopher Vannabouathong, Yashas Reddy, Sathvik Deme, Sahiti Patibandla, Peter Passias, Shaleen Vira

SKMC Student Presentations and Publications

BACKGROUND: The treatment of spine metastases continues to pose a significant clinical challenge, requiring the integration of multiple therapeutic modalities to address the multifactorial aspects of this disease process. Radiofrequency ablation (RFA) and vertebral cement augmentation (VCA) are 2 less invasive modalities compared to open surgery that have emerged as promising strategies, offering the potential for both pain relief and preservation of vertebral stability. The utility of these approaches, however, remains uncertain and subject to ongoing investigation.This systematic review and meta-analysis evaluates the available evidence and synthesize the results of studies that have investigated the combination of RFA and VCA …

The Hip Spine Relationship—What We Know And What We Don’T: A Narrative Review, Michael Mccurdy, Yunsoo Lee, Gino Dinicola, Albert Ku, Alex R. Vaccaro, Alan S. Hilibrand, Gregory D. Schroeder, Christopher K. Kepler, Mark J. Lambrechts

Rothman Institute Papers

Background and Objective: The hip-spine syndrome was first described in 1983. The premise of the report was that the hip and spine are closely related and patients can easily have overlapping conditions and misdiagnoses. Since that time, there has been considerable advancement in our understanding of spinopelvic parameters and how degenerative disc disease can affect the pelvis and subsequently the acetabulum. Our objective is to provide an updated review on the relationship between hip and spine degeneration, how we define the relationship, and what steps should be taken when planning surgical intervention for these patients.

Methods: A literature review was …

Cros Or Hearing Aid? Selecting The Ideal Solution For Unilateral Ci Patients With Limited Aidable Hearing In The Contralateral Ear, Sarah Lively, Smita Agrawal, Matthew Stewart, Robert Dwyer, Laura Strobel, Paula Marcinkevich, Chris Hetlinger, Julia Croce

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

A hearing aid or a contralateral routing of signal device are options for unilateral cochlear implant listeners with limited hearing in the unimplanted ear; however, it is uncertain which device provides greater benefit beyond unilateral listening alone. Eighteen unilateral cochlear implant listeners participated in this prospective, within-participants, repeated measures study. Participants were tested with the cochlear implant alone, cochlear implant + hearing aid, and cochlear implant + contralateral routing of signal device configurations with a one-month take-home period between each in-person visit. Audiograms, speech perception in noise, and lateralization were evaluated. Subjective feedback was obtained via questionnaires. Marked improvement in …

Real-World Effectiveness Of Add-Onfremanezumab In Patients Receiving Onabotulinumtoxina For The Prevention Of Chronic Migraine In A Us Tertiary Headache Center: A Retrospective Chart Review Study, Hsiangkuo Yuan, Fred Cohen, Maurice T. Driessen, Lynda J. Krasenbaum, Mario Ortega, Mary Hopkins, Michael J. Marmura

Department of Jefferson Headache Center Papers and Presentations

Background: Concomitant fremanezumab, a calcitonin gene-related peptide (CGRP) pathway monoclonal antibody (mAb), and onabotulinumtoxinA (onabotA) improve treatment response compared with onabotA alone in patients with chronic migraine (CM). Methods: This was a single-center, retrospective, observational study that assessed treatment response (change over time in monthly headache days [MHD] and pain intensity [PI]) in adult patients with CM receiving fremanezumab as add-on therapy to onabotA for CM prevention. Results: In the study population (N = 116, age 50.0 ± 13.1, female 85.3%, pre-index onabotA use 46.5 ± 34.2 months) receiving concurrent onabotA and fremanezumab for 17.5 ± 11.6 months, MHD decreased …

In-Hospital Mortality Trends After Surgery For Traumatic Thoracolumbar Injury: A National Inpatient Sample Database Study, Michael Mccurdy, Rajkishen Narayanan, Omar Tarawneh, Yunsoo Lee, Matthew Sherman, Teeto Ezeonu, Michael Carter, Jose A. Canseco, Alan S. Hilibrand, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Department of Orthopaedic Surgery Faculty Papers

INTRODUCTION: Given the increasing incidence of traumatic thoracolumbar injuries in recent years, studies have sought to investigate potential risk factors for outcomes in these patients.

RESEARCH QUESTION: The aim of this study was to investigate trends and risk factors for in-hospital mortality after fusion for traumatic thoracolumbar injury.

MATERIALS AND METHODS: Patients undergoing thoracolumbar fusion after traumatic injury were queried from the National Inpatient Sample (NIS) from 2012 to 2017. Analysis was performed to identify risk factors for inpatient mortality after surgery.

RESULTS: Patients in 2017 were on average older (51.0 vs. 48.5, P = 0.004), had more admitting diagnoses …

Current Strategies For Increasing Knock-In Efficiency In Crispr/Cas9-Based Approaches, Andrés Felipe Leal, Angelica María Herreno-Pachón, Eliana Benincore-Flórez, Amali Karunathilaka, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Since its discovery in 2012, the clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated protein 9 (Cas9) system has supposed a promising panorama for developing novel and highly precise genome editing-based gene therapy (GT) alternatives, leading to overcoming the challenges associated with classical GT. Classical GT aims to deliver transgenes to the cells via their random integration in the genome or episomal persistence into the nucleus through lentivirus (LV) or adeno-associated virus (AAV), respectively. Although high transgene expression efficiency is achieved by using either LV or AAV, their nature can result in severe side effects in humans. For instance, …

Risk Factors Associated With Poor Outcomes After Quadriceps Tendon Repair, Carlo Coadonato, Neel K. Patel, John Hayden Sonnier, Gregory Connors, Matthew Sabitsky, Emma Johnson, Donald W. Mazur, Shyam Brahmabhatt, Kevin Freedman

Rothman Institute Papers

Background:

Ruptures of the quadriceps tendon present most frequently in older adults and individuals with underlying medical conditions.

Purpose:

To examine the relationship between patient-specific factors and tear characteristics with outcomes after quadriceps tendon repair.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A retrospective review was conducted on all patients who underwent quadriceps tendon repair between January 1, 2016, and January 1, 2021, at a single institution. Patients <18 years and those with chronic quadriceps tendon tears (>6 weeks to surgery) were excluded. Information was collected regarding patient characteristics, presenting symptoms, tear characteristics, physical examination findings, and postoperative outcomes. Poor outcome was defined as a need for …

Differences In Spine Growth Potential For Sanders Maturation Stages 7a And 7b Have Implications For Treatment Of Idiopathic Scoliosis, Yusuke Hori, Burak Kaymaz, Luiz Carlos Almeida Da Silva, Kenneth J. Rogers, Petya K. Yorgova, Peter G. Gabos, Suken Shah, Md

Department of Orthopaedic Surgery Faculty Papers

Purpose
This study aimed to clarify the differences in spine and total body height growth and curve progression between Sanders maturation stage (SMS) 7A and 7B in patients with adolescent idiopathic scoliosis (AIS).

Methods
This retrospective case–control study involving patients with AIS at SMS 7 evaluated the differential gains in the spine (T1-S1) and total body height and curve progression between SMS 7A and 7B. A validated formula was used to calculate the corrected height, accounting for height loss due to scoliosis. A multivariable non-linear and logistic regression model was applied to assess the distinct growth and curve progression patterns …

The Effect Of Sirolimus Immunosuppression On Cardiovascular Outcomes In Liver Transplantation, Jason Ho, Zach Breslin, Lauren Lally, Dina Halegoua-De Marzio, Danielle M. Tholey

Division of Gastroenterology and Hepatology Faculty Papers

Introduction: Non-alcoholic steatohepatitis (NASH) is a rising cause of liver transplantation and is linked to higher rates of cardiovascular complications. The aim of this study was to evaluate the risk of post-transplant cardiac events in patients with NASH that were exposed to sirolimus (SRL) vs. calcineurin-inhibitor (CNI) immunosuppression. Methods: We retrospectively reviewed all adult liver transplant recipients at our institution between 2002 and 2020. Subjects were grouped based on immunosuppressive regimen. We also analyzed the subgroup of patients with NASH as the primary indication for transplant, as well as a non-NASH subpopulation. The primary outcome measure was risk of major …

Abstinence Scoring Algorithms For Treatment Of Neonatal Opioid Withdrawal Syndrome (Nows), Brenton A. Maisel, Susan C. Adeniyi-Jones, Eric Selvage, Samuel Ng, Walter K. Kraft, Inna Chervoneva

Department of Pharmacology and Experimental Therapeutics Faculty Papers

OBJECTIVE: Chervoneva et al. (2020) developed an abbreviated score (sMNAS-9) derived from full modified Finnegan MOTHER NAS scale (MNAS) for evaluating severity of NOWS. We sought to develop NOWS treatment algorithms for clinical decision rules based on scores utilizing the shorter sMNAS.

STUDY DESIGN: This was a retrospective study of 373 infants with NOWS scored with MNAS and treated with morphine between 2007 and 2016. The infants were randomly split into training/test sets. The training set was used to derive optimized cutoff values for sMNAS-9 scores. The independent set evaluated the sMNAS-9 clinical decision rules based on full MNAS in …

Virtual Facilitation Best Practices And Research Priorities: A Scoping Review, Asya Agulnik, Derrecka Boykin, Denalee M O'Malley, Julia Price, Mia Yang, Mark Mckone, Geoffrey Curran, Mona J Ritchie

Department of Pediatrics Faculty Papers

BACKGROUND: Facilitation is an implementation strategy that supports the uptake of evidence-based practices. Recently, use of virtual facilitation (VF), or the application of facilitation using primarily video-based conferencing technologies, has become more common, especially since the COVID-19 pandemic. Thorough assessment of the literature on VF, however, is lacking. This scoping review aimed to identify and describe conceptual definitions of VF, evaluate the consistency of terminology, and recommend "best" practices for its use as an implementation strategy.

METHODS: We conducted a scoping review to identify literature on VF following the PRISMA-ScR guidance. A search of PubMed, Embase, Web of Science, and …

Chatgpt Can Offer Satisfactory Responses To Common Patient Questions Regarding Elbow Ulnar Collateral Ligament Reconstruction, William Johns, Alec Kellish, Dominic Farronato, Michael G. Ciccotti, Sommer Hammoud

Rothman Institute Papers

PURPOSE: To determine whether ChatGPT effectively responds to 10 commonly asked questions concerning ulnar collateral ligament (UCL) reconstruction.

METHODS: A comprehensive list of 90 UCL reconstruction questions was initially created, with a final set of 10 "most commonly asked" questions ultimately selected. Questions were presented to ChatGPT and its response was documented. Responses were evaluated independently by 3 authors using an evidence-based methodology, resulting in a grading system categorized as follows: (1) excellent response not requiring clarification; (2) satisfactory requiring minimal clarification; (3) satisfactory requiring moderate clarification; and (4) unsatisfactory requiring substantial clarification.

RESULTS: Six of 10 ten responses were …

Understanding The Role Of Palliative Care Within Routine Care Of Advanced Liver Disease, Simone A. Jarrett, Edward Bley, Richard S. Kalman

Einstein Health Papers

Purpose of Review

This paper aims to investigate the crucial role of palliative care in the management of chronic liver disease (CLD) and cirrhosis. Faced with a global surge in liver-related morbidity and mortality, our goal is to understand the impact of early engagement with palliative care specialists on symptom management, quality of life, and the overall trajectory of advanced liver disease.

Recent Findings

While strides have been made in preventing and treating specific etiologies of CLD, such as viral infections, the escalating rates of alcohol use and obesity present new challenges for physicians. Despite advancements, liver transplantation unfortunately remains …

Correction To: Should We Use Rifampicin In Periprosthetic Joint Infections Caused By Staphylococci When The Implant Has Been Exchanged? A Multicenter Observational Cohort Study, Tobias Siegfried Kramer, Alex Soriano, Sarah Tedeschi, Antonia Chen, Pierre Tattevin, Eric Senneville, Joan Gomez-Junyent, Victoria Birlutiu, Sabine Petersdorf, Vicens Diaz De Brito, Ignacio Sancho Gonzalez, Katherine Belden, Marjan Wouthuyzen-Bakker

Division of Infectious Diseases and Environmental Medicine Faculty Papers

No abstract provided.

Efficacy And Safety Of Artificial Tears Containing Lipidure And Hypromellose For The Treatment Of Moderate Dry Eye Disease In Contact Lens Wearers, Caterina Gagliano, Marco Zeppieri, Antonio Longo, Giovanni Rubegni, Roberta Amato, Roberta Foti, Francesco Cappellani, Massimiliano Cocuzza, Federico Visalli, Ludovica Cannizzaro, Alessandro Avitabile, Giuseppe Gagliano, Lucia Lapenna, Fabiana D'Esposito

Wills Eye Hospital Papers

Background and Objectives: Dry eye disease (DED) affects 5–50% of the global population and deeply influences everyday life activities. This study compared the efficacy, tolerability, and safety of novel Respilac artificial tears containing lipidure and hypromellose (HPMC) with the widely used Nextal artificial tears, which are also HPMC-based, for the treatment of moderate DED in contact lenses (CL) wearers.

Materials and Methods: In a prospective, single-center, randomized investigation, 30 patients aged ≥18 years, diagnosed with moderate DED, and wearing CL were randomly assigned to the Respilac (n = 15) or Nextal group (n = 15). Patients self-administrated one drop of …

Hepatitis C Virus Detection And Management After Implementation Of Universal Screening In Pregnancy, Sarah Boudova, Danielle Tholey, Elizabeth Ferries-Rowe

Division of Gastroenterology and Hepatology Faculty Papers

BACKGROUND: Accurately identifying cases of hepatitis C virus has important medical and public health consequences. In the setting of rising hepatitis C virus prevalence and highly effective treatment with direct-acting antivirals, the Society for Maternal-Fetal Medicine guidelines recently changed to recommend universal screening for hepatitis C virus during pregnancy. However, there is little data on the influence of this policy change on case identification and management. OBJECTIVE: We aimed to examine the influence of universal hepatitis C virus screening on our patient population. Our primary objective was to determine if there was a difference in the detected hepatitis C virus …

Toward Reducing Racialized Pain Care Disparities: Approaching Cannabis Research And Access Through The Lens Of Equity And Inclusion, Brooke Worster, Salimah H. Meghani, Amy E. Leader, Shannon M. Nugent, Katie Fitzgerald Jones, Katherine A. Yeager, Kevin Liou, Rebecca L. Ashare

Department of Medical Oncology Faculty Papers

There is growing interest in cannabis use for cancer pain. This commentary aims to discuss the evidence surrounding cannabis use for cancer pain in the context of the long-racialized landscape of cannabis policies and the disparity in pain control among cancer patients holding minoritized racial identities. Much evidence surrounding both the benefits and harms of cannabis use in cancer patients, and all patients in general, is lacking. Although drawing on the research in cancer that is available, it is also important to illustrate the broader context about how cannabis' deep roots in medical, political, and social history impact patient use …

Interobserver Reliability In The Classification Of Thoracolumbar Fractures Using The Ao Spine Tl Injury Classification System Among 22 Clinical Experts In Spine Trauma Care, Jose A. Canseco, Taylor Paziuk, Gregory D. Schroeder, Marcel F. Dvorak, Cumhur F. Öner, Lorin M. Benneker, Emiliano Vialle, Shanmuganathan Rajasekaran, Mohammad El-Sharkawi, Richard J. Bransford, Rishi M. Kanna, Martin Holas, Sander Muijs, Eugen Cezar Popescu, Charlotte Dandurand, Jin W. Tee, Gaston Camino-Willhuber, Mohamed M. Aly, Andrei Fernandes Joaquim, Ory Keynan, Harvinder Singh Chhabra, Sebastian Bigdon, Ulrich J. Spiegl, Klaus Schnake, Alexander R. Vaccaro

Rothman Institute Papers

STUDY DESIGN: Reliability study utilizing 183 injury CT scans by 22 spine trauma experts with assessment of radiographic features, classification of injuries and treatment recommendations.

OBJECTIVES: To assess the reliability of the AOSpine TL Injury Classification System (TLICS) including the categories within the classification and the M1 modifier.

METHODS: Kappa and Intraclass correlation coefficients were produced. Associations of various imaging characteristics (comminution, PLC status) and treatment recommendations were analyzed through regression analysis. Multivariable logistic regression modeling was used for making predictive algorithms.

RESULTS: Reliability of the AO Spine TLICS at differentiating A3 and A4 injuries (N = 71) (K = …

The Ao Spine Thoracolumbar Injury Classification System And Treatment Algorithm In Decision Making For Thoracolumbar Burst Fractures Without Neurologic Deficit, Barry T.S. Kweh, Jin Wee Tee, Charlotte Dandurand, Alexander R. Vaccaro, Benneker M. Lorin, Klaus Schnake, Emiliano Vialle, Shanmuganathan Rajasekaran, Mohammad El-Skarkawi, Richard J. Bransford, Rishi M. Kanna, Mohamed M. Aly, Martin Holas, Jose A. Canseco, Sander Muijs, Eugen C. Popescu, Gaston Camino-Willhuber, Andrei F. Joaquim, Harvinder S. Chhabra, Sebastian Frederick Bigdon, Ulrich Spiegel, Marcel Dvorak, Cumhur F. Öner, Gregory Schroeder

Rothman Institute Papers

STUDY DESIGN: Prospective Observational Study.

OBJECTIVE: To determine the alignment of the AO Spine Thoracolumbar Injury Classification system and treatment algorithm with contemporary surgical decision making.

METHODS: 183 cases of thoracolumbar burst fractures were reviewed by 22 AO Spine Knowledge Forum Trauma experts. These experienced clinicians classified the fracture morphology, integrity of the posterior ligamentous complex and degree of comminution. Management recommendations were collected.

RESULTS: There was a statistically significant stepwise increase in rates of operative management with escalating category of injury (P < .001). An excellent correlation existed between recommended expert management and the actual treatment of each injury category: A0/A1/A2 (OR 1.09, 95% CI 0.70-1.69, P = .71), A3/4 (OR 1.62, 95% CI 0.98-2.66, P = .58) and B1/B2/C (1.00, 95% …

Expert Opinion, Real-World Classification, And Decision-Making In Thoracolumbar Burst Fractures Without Neurologic Deficits?, Gaston Camino-Willhuber, Sebastian Bigdon, Charlotte Dandurand, Marcel F. Dvorak, Cumhur F. Öner, Klaus Schnake, Sander Muijs, Lorin M. Benneker, Emiliano Vialle, Jin W. Tee, Ory Keynan, Harvinder S. Chhabra, Andrei F. Joaquim, Eugen C. Popescu, Jose A Canseco, Martin Holas, Rishi M. Kanna, Mohamed M. Aly, Nader Fallah, Gregory D. Schroeder, Ulrich Spiegl, Mohammad El-Skarkawi, Richard J. Bransford, Shanmuganathan Rajasekaran, Alexander R. Vaccaro

Rothman Institute Papers

STUDY DESIGN: Retrospective analysis of prospectively collected data.

OBJECTIVES: To compare decision-making between an expert panel and real-world spine surgeons in thoracolumbar burst fractures (TLBFs) without neurological deficits and analyze which factors influence surgical decision-making.

METHODS: This study is a sub-analysis of a prospective observational study in TL fractures. Twenty two experts were asked to review 183 CT scans and recommend treatment for each fracture. The expert recommendation was based on radiographic review.

RESULTS: Overall agreement between the expert panel and real-world surgeons regarding surgery was 63.2%. In 36.8% of cases, the expert panel recommended surgery that was not performed …