Patient satisfaction scores are increasing in importance. Although the influence of selected pati... more Patient satisfaction scores are increasing in importance. Although the influence of selected patient and physician characteristics on satisfaction scores has been identified, the impact of different pediatric diagnoses is unknown. The purpose of this study was to compare patient satisfaction scores in visits for mechanical back pain with visits for clubfoot or scoliosis. A retrospective analysis of patient satisfaction scores from pediatric visits for back pain, clubfoot, and scoliosis at three tertiary centers was performed. Satisfaction data were obtained from survey questions that used a 5-point scale ranging from very poor (1) to very good (5). Statistical analysis was performed using χ(2) and Fisher exact tests. Data from 565 visits for scoliosis, 81 for clubfoot, and 57 for mechanical back pain were used. The mean scores in back pain visits for the likelihood of recommending the care provider, confidence in the care provider, and explanation by the care provider were 4.87, 4.7...
The authors evaluated the efficacy of posterior instrumentation for the management of spontaneous... more The authors evaluated the efficacy of posterior instrumentation for the management of spontaneous spinal infections. Standard surgical management of spontaneous spinal infection is based on debridement of the infected tissue. However, this can be very challenging as most of these patients are medically debilitated and the surgical debridement requires a more aggressive approach to the spine either anteriorly or via an expanded posterior approach. The authors present their results using an alternative treatment method of posterior-only neuro-decompression and stabilization without formal debridement of anterior tissue for treating spontaneous spinal infection. Fifteen consecutive patients were treated surgically by 2 of the authors. All patients had osteomyelitis and discitis and were treated postoperatively with intravenous antibiotics for at least 6 weeks. The indications for surgery were failed medical management, progressive deformity with ongoing persistent spinal infection, or ...
Descriptive, retrospective cohort analysis. To evaluate the presentation, etiology, and treatment... more Descriptive, retrospective cohort analysis. To evaluate the presentation, etiology, and treatment of surgical site infections (SSI) after spinal surgery. SSI after spine surgery is frequently seen. Small case control studies have been published reporting the results of treatment options of SSI. We performed this study to identify the most common clinical and laboratory presentation of a SSI, the most frequently seen infective organism, and evaluate the effectiveness of current treatment. All patients who underwent spinal surgery at our institution for diagnosis other than infection between June 1996 and December 2005 (N=3174) were reviewed. All cases of SSI were identified. Patient and operative characteristics were reviewed. Infection type (deep or superficial), treatment course, laboratory and culture results were abstracted. A total of 132 cases of SSI (84 deep and 48 superficial) were identified. About 72.7% of the SSI were detected as outpatients an average 28.7 days (deep, 29.9; superficial, 25.2) after the index procedure. Wound drainage was the most common complaint (68.2%). C-reactive protein level was elevated in 98.0%, erythrocyte sedimentation rate was elevated in 94.4%, but only 48.6% had elevated white blood cell count. Staphylococcus aureus was isolated in 72.6% of deep and 85.7% of superficial positive cultures. Seventy-six percent of deep SSI could be treated with a single debridement to clear the SSI. Instrumentation was retained or primarily exchanged if loose in all cases. Around 72.9% of superficial SSI were treated without formal debridement in the operating room. Antibiotic treatment was longer in deep SSI (40.8 vs. 19.6 days). Deep SSI following spinal surgery was effectively treated with single stage debridement and intravenous antibiotics. Superficial SSI could be treated effectively with local wound care and oral antibiotic therapy.
Patient satisfaction scores are increasing in importance. Although the influence of selected pati... more Patient satisfaction scores are increasing in importance. Although the influence of selected patient and physician characteristics on satisfaction scores has been identified, the impact of different pediatric diagnoses is unknown. The purpose of this study was to compare patient satisfaction scores in visits for mechanical back pain with visits for clubfoot or scoliosis. A retrospective analysis of patient satisfaction scores from pediatric visits for back pain, clubfoot, and scoliosis at three tertiary centers was performed. Satisfaction data were obtained from survey questions that used a 5-point scale ranging from very poor (1) to very good (5). Statistical analysis was performed using χ(2) and Fisher exact tests. Data from 565 visits for scoliosis, 81 for clubfoot, and 57 for mechanical back pain were used. The mean scores in back pain visits for the likelihood of recommending the care provider, confidence in the care provider, and explanation by the care provider were 4.87, 4.7...
The authors evaluated the efficacy of posterior instrumentation for the management of spontaneous... more The authors evaluated the efficacy of posterior instrumentation for the management of spontaneous spinal infections. Standard surgical management of spontaneous spinal infection is based on debridement of the infected tissue. However, this can be very challenging as most of these patients are medically debilitated and the surgical debridement requires a more aggressive approach to the spine either anteriorly or via an expanded posterior approach. The authors present their results using an alternative treatment method of posterior-only neuro-decompression and stabilization without formal debridement of anterior tissue for treating spontaneous spinal infection. Fifteen consecutive patients were treated surgically by 2 of the authors. All patients had osteomyelitis and discitis and were treated postoperatively with intravenous antibiotics for at least 6 weeks. The indications for surgery were failed medical management, progressive deformity with ongoing persistent spinal infection, or ...
Descriptive, retrospective cohort analysis. To evaluate the presentation, etiology, and treatment... more Descriptive, retrospective cohort analysis. To evaluate the presentation, etiology, and treatment of surgical site infections (SSI) after spinal surgery. SSI after spine surgery is frequently seen. Small case control studies have been published reporting the results of treatment options of SSI. We performed this study to identify the most common clinical and laboratory presentation of a SSI, the most frequently seen infective organism, and evaluate the effectiveness of current treatment. All patients who underwent spinal surgery at our institution for diagnosis other than infection between June 1996 and December 2005 (N=3174) were reviewed. All cases of SSI were identified. Patient and operative characteristics were reviewed. Infection type (deep or superficial), treatment course, laboratory and culture results were abstracted. A total of 132 cases of SSI (84 deep and 48 superficial) were identified. About 72.7% of the SSI were detected as outpatients an average 28.7 days (deep, 29.9; superficial, 25.2) after the index procedure. Wound drainage was the most common complaint (68.2%). C-reactive protein level was elevated in 98.0%, erythrocyte sedimentation rate was elevated in 94.4%, but only 48.6% had elevated white blood cell count. Staphylococcus aureus was isolated in 72.6% of deep and 85.7% of superficial positive cultures. Seventy-six percent of deep SSI could be treated with a single debridement to clear the SSI. Instrumentation was retained or primarily exchanged if loose in all cases. Around 72.9% of superficial SSI were treated without formal debridement in the operating room. Antibiotic treatment was longer in deep SSI (40.8 vs. 19.6 days). Deep SSI following spinal surgery was effectively treated with single stage debridement and intravenous antibiotics. Superficial SSI could be treated effectively with local wound care and oral antibiotic therapy.
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