Editor's Note Use of the Perioperative Surgical Home (PSH) model in patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion improved surgical outcomes, this study finds. A multidisciplinary group created evidence-based protocols for preoperative, postoperative, and postdischarge patient care. Anesthesiologist comanagement of patients also allowed a new pathway for patients…

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Editor's Note Postoperative ischemic optic neuropathy (ION) in spinal fusion patients significantly decreased from 1998 to 2012 by almost 3-fold, this study finds. Age over 50, male gender, blood transfusion during procedure, and obesity significantly increased the risk of ION. The authors attribute the decline in risk to the increasing…

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Editor's Note A new model consisting of four risk factors can help surgeons predict the risk of complications after surgery for cervical spondylotic myelopathy (CSM), this multi-center study finds. Surgical CSM patients have a higher risk of perioperative complications if they have a greater number of comorbidities, coexisting diabetes mellitus,…

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Editor's Note Psychological disorders, such as depression and anxiety, were independently associated with higher all cause 30-day readmissions after elective spine surgery in this study. Of 400 patients involved in the study, outcomes data was available for 107. Results showed the rate of readmission was three-fold greater for patients with…

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A new tool that assesses postoperative surgical site infection (SSI) risk in spine patients shows promise for improved patient care. Research on the tool, developed by a nurse, is still ongoing, but early results suggest the tool could help clinicians develop strategies to prevent many SSIs. Postoperative SSI rates for…

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Editor's Note A report by Q2 Metrics predicts the US market for spinal implants will reach $6.4 billion by 2024, up from $5 billion this year. The largest product segments include posterior thoracolumbar pedicle screw fixation and traditional anterior cervical plating. There is also strong momentum in hospital and physician…

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Patients come first. That is the brief, yet insightful, first principle for the ambulatory surgery industry: Give patients a safe, cost-effective, convenient, and attractive place to have their elective surgery, and profits and career satisfaction will follow. Well, perhaps, but it is all too easy to become involved in regulations,…

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When Kimberley Murray, MS, RN, CNOR, administrator for the orthopedic and spine service line at St Joseph’s Hospital (SJH) in Syracuse, New York, set up a successful system for negotiating with orthopedic vendors on total hip and knee replacement surgery, she knew that spine implants would be the next mountain…

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During spinal surgery, it is sometimes necessary to implant and then remove, or explant, instrumentation in the same procedure. Explantation occurs when an implanted plate or spacer does not fit, or implanted screws are too loose or too short. Explanted instrumentation cannot be reused and must be discarded, adding to…

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Use of bone morphogenic protein (BMP) has risen sharply in the past decade, adding costs without evidence of better outcomes, according to a study in the February 2012 issue of Spine. BMP use rose rapidly, from 5.5% of lumbar fusions in 2003 to nearly a third (28.1%) of procedures in…

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