In Brief Study Design. Retrospective, observational. Objective. To simulate what episodes of care in spinal surgery might look like a bundled payment system and to evaluate the associated costs characteristics. Summary Background Data. Episode-based bundling has received considerable attention as potential method help curb rise health spending is being investigated new model part Affordable Care Act. Although earlier studies payments number surgical settings, very few focused on spine...

Chronic low blood pressure and orthostatic hypotension remain challenging clinical issues after severe spinal cord injury (SCI), affecting health, rehabilitation, quality of life. We previously reported that targeted lumbosacral epidural stimulation (scES) could promote stand step functions restore voluntary movement in patients with chronic motor complete SCI. This study addresses the effects scES for cardiovascular function (CV-scES) individuals SCI who suffer from hypotension. tested...

The subthalamic nucleus is thought to play a crucial role in controlling impulsive actions. Networked among the basal ganglia and receiving input from several cortical areas, well positioned influence action selection when faced with competing conflicting outcomes. purpose of this study was test dissociable roles dorsal ventral aspects during conflict patients Parkinson's disease undergoing intraoperative neurophysiological recording explore potential mechanism for inhibitory control. We...

Bone morphogenetic protein (BMP) is used in tens of thousands spinal fusions each year. A trial evaluating a high-dose BMP formulation demonstrated that its use may be associated with an increased risk cancer.To evaluate whether BMP, as commonly today, cancer or benign tumors.We performed retrospective study using the Thomson Reuter MarketScan database. We retained all patients who had no previous diagnosis tumor and at least 2 years uninterrupted enrollment database before after their...

In Brief Study Design. A retrospective, cross-sectional study. Objective. To evaluate racial disparities in outcomes of lumbar stenosis surgery. Summary Background Data. Racial inequalities have been described the cardiovascular and orthopedic procedures. There minimal investigation complications costs laminectomies fusions. Methods. We analyzed Medicaid data set Thomson Reuter's MarketScan database. African-American non-Hispanic white patients who underwent laminectomy or fusion for with at...

We evaluated outcome and resource utilization disparities between commercially insured, Medicaid, Medicare patients. further analyzed racial in a subset cohort.We reviewed the MarketScan database (2000-2009) for adult traumatic brain injury (TBI) Analyses were performed to evaluate differences by insurance type race. Outpatient service race also evaluated.Our study included 92,159 TBI patients, 44,108 (47.9%) of whom utilized commercial insurance, 19,743 (21.4%) 28,308 (30.7%) Medicare....

BACKGROUND: Treatment of unruptured intracranial aneurysms (UIAs) involves endovascular coiling or aneurysm clipping. While many studies have compared these treatment modalities with respect to various clinical outcomes, few investigated the economic costs associated each procedure. OBJECTIVE: To determine reoperation rate, postoperative complications, and inpatient outpatient surgical patients UIAs in United States. METHODS: We utilized MarketScan database examine who underwent clipping...

Spinal cord injury (SCI) results in profound neurologic impairment with widespread deficits sensorimotor and autonomic systems. Voluntary control of bladder function is disrupted resulting possible detrusor overactivity, low compliance, uncoordinated external urethral sphincter contractions impairing storage and/or voiding. Conservative treatments managing neurogenic post-injury, such as oral pharmacotherapy catheterization, are important components urological surveillance clinical care....

Abstract In children with spinal cord injury (SCI), scoliosis due to trunk muscle paralysis frequently requires surgical treatment. Transcutaneous stimulation enables stability in adults SCI and may pose a non-invasive preventative therapeutic alternative. This non-randomized, non-blinded pilot clinical trial (NCT03975634) determined the safety efficacy of transcutaneous enable upright sitting posture 8 control impairment acquired using within-subject repeated measures study design. Primary...

Background Middle meningeal artery embolization (MMAE) emerges as an alternative to conventional surgical drainage (CSD) for chronic subdural hematomas (cSDH). Several studies have suggested that MMAE improves the cost efficacy of cSDH treatment. However, further comprehensive analyses outcomes and healthcare costs are necessary. Methods Merative MarketScan Research Database from 2017–2022 was used compare demographics, reoperation rates, complications, utilization, payments patients being...

Background/Objectives: Preliminary observations support the view that spinal cord epidural stimulation (scES) combined with trunk-specific training can improve trunk stability during functional activities in individuals thoracic injury (SCI). We studied acute effects of on sitting postural control. Methods: Twenty-three severe cervical SCI were implanted an stimulator. Postural control was assessed before any activity-based training, without and scES. In particular, participants performed...

Purpose Rocking in a rocking chair may facilitate trunk muscle activation children with spinal cord injury (SCI). To assess this, SCI and typically developing (TD) were evaluated for increases activation, patterns, correlation of control during rocking. Methods Eleven 10 TD aged 1–12 years rocked while surface electromyography activity arm, leg, muscles was captured. Mean at baseline compared each muscle. Temporal patterns groups using cluster analysis. Correlation assessed. Results...

In Brief Study Design. Retrospective analysis of a population-based insurance claims data set. Objective. To evaluate the use spinal cord stimulation (SCS) and lumbar reoperation for treatment failed back surgery syndrome (FBSS), examine their associated complications health care costs. Summary Background Data. FBSS is major source chronic neuropathic pain affects up to 40% patients who undergo lumbosacral spine pain. Thus far, few economic analyses have been performed comparing various...

Surgery remains the mainstay for management of lumbar spondylolisthesis and is considered an effective therapeutic modality following unsuccessful nonoperative treatment. Surgical procedures include decompression, decompression with instrumented arthrodesis, noninstrumented arthrodesis. The purpose this study was to examine complications, reoperation rates, health-care costs associated each these procedures.The MarketScan database utilized identify 16,556 patients a primary diagnosis who...

Retrospective cohort analysis.To examine the complications, reoperation rates, and resource use after each of surgical approaches for treatment spinal stenosis.There are no uniform guidelines which procedure (decompression, decompression with instrumentation, or noninstrumented fusion) to perform stenosis. With clear evidence increased efficacy, rate instrumented fusions is rising.We performed a retrospective analysis patients who underwent stenosis surgery between 2002 2009 in United...

OBJECTIVE Surgery for medically refractory epilepsy (RE) is an underutilized treatment modality, despite its efficacy. Laser interstitial thermal therapy (LITT), which minimally invasive, increasingly being utilized a variety of brain lesions and offers comparable seizure outcomes. The aim this study was to report the national trends open surgical procedures RE with advent LITT. METHODS Data were extracted using ICD-9/10 codes from Nationwide Inpatient Sample (NIS, 2012–2016) in...

Previous studies have shown that epidural stimulation of the lumbosacral spinal cord (scES) can re-enable lower limb volitional motor control in individuals with chronic, clinically complete injury (SCI). This observation entails residual supraspinal connectivity to circuitry still persisted after SCI, although it was non-detectable when scES not provided. In present study, we aimed at exploring further mechanisms underlying scES-promoted recovery by investigating neuroimaging markers lesion...