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BACKGROUND CONTEXT Lumbar spinal stenosis is now the most common and fastest growing reason for spinal surgery in adults older than 65 years. There are not yet clearly identified preoperative predictive factors for postoperative clinical outcome. We have previously reported on the clinical outcome of patients treated operatively and nonoperatively. (More)
For patients with clinical and radiographic lumbar spinal stenosis, is surgery or continued nonsurgical treatment a better option for improvements in baseline disability scores; and what proportion of patients treated surgically and nonsurgically get better, worse, or remain the same with time? We prospectively evaluated 125 consecutive patients for this(More)
BACKGROUND Several studies addressing intrathecal morphine (ITM) use following spine surgery have been published either involving the pediatric population, using mid- to high-dose ITM, or not in conjunction with morphine patient-controlled analgesia (PCA). OBJECTIVES To determine whether low-dose ITM is a useful adjunct to PCA for postoperative pain(More)
OBJECT The authors assessed the long-term results of anterior decompressive and vertebral body reconstructive surgery in which the Wellesley Wedge was applied in patients with metastatic spinal lesions over the life span of these individuals. METHODS The authors performed a retrospective review of the outcome of 27 consecutively treated patients who(More)
OBJECTIVE To determine ways to improve the delivery of service in a surgical clinic, based on the outcome of surgical consultations for back pain. DESIGN A prospective outcome study. SETTING A university teaching hospital providing secondary and tertiary care. PATIENTS One hundred and forty-two consecutive patients who presented to surgical clinics(More)
OBJECTIVE To determine the efficiency of a program designed to maintain prophylactic oral anticoagulation within a target range for 6 weeks after hip and knee arthroplasty. DESIGN A prospective continuous quality improvement indicator. SETTING A tertiary care university hospital. PATIENTS Patients who underwent hip and knee arthroplasty and had no(More)
BACKGROUND A large number of patients presenting for total hip and knee arthroplasty report an allergy to penicillin. the reported incidence of cross reactions with cephalosporins in patients with penicillin allergy ranges from 3% to 18%. Perioperative antibiotic prophylaxis practices range from using cephalosporins to substituting clindamycin or(More)
BACKGROUND We sought to determine the association between radiologic and clinical diagnoses and to measure the impact of more magnetic resonance imaging (MRI) and computed tomography (CT) scans on clinical decision-making in patients referred to a surgical clinic for back pain. METHODS We conducted a 7-week prospective study of patients referred for back(More)
BACKGROUND Surgical training places unique stresses on residents that can lead to decreased levels of presenteeism. We hypothesized that presenteeism levels could be positively influenced by improving workplace hygiene. METHODS a cohort of surgical residents was asked to complete the Stanford Presenteeism Scale: Health Status and Employee Productivity(More)