Economic impact of improving outcomes of lumbar discectomy

Sherman, John E.; Cauthen, Joseph C.; Schoenberg, Doug; Burns, Matthew F.; Reaven, Nancy L.; Griffith, Steven L.

doi:10.1016/j.spinee.2009.08.453

Cited by 87 publications

(58 citation statements)

References 43 publications

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“…This metric does not take into account the multitude of other direct costs associated with surgery for spondylosis, such as radiology, preoperative evaluation, and medications administered postoperatively, nor does it consider indirect costs, such as productivity losses and gains associated with the disease and its treatment [17]. Furthermore, given the regional differences in cost and practice patterns associated with the treatment of lumbar spondylosis, our findings may have limited generalizability to other institutions [18,19].…”

Section: Limitationsmentioning

confidence: 99%

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis

Walcott

Khanna

Yanamadala

et al. 2015

Journal of Clinical Neuroscience

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Section: Limitationsmentioning

confidence: 99%

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis

Walcott

Khanna

Yanamadala

et al. 2015

Journal of Clinical Neuroscience

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“…Degenerative disk disease continues to be a prevalent health and socioeconomic problem [1,2]. Current surgical treatments that involve the use of implants predominantly seek to arrest the degeneration cascade and do not attempt to repair tissue damage.…”

Section: Introductionmentioning

confidence: 99%

A Computational Model to Describe the Regional Interlamellar Shear of the Annulus Fibrosus

Labus

Han

Hsieh

et al. 2014

Journal of Biomechanical Engineering

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A Computational Model to Describe the Regional Interlamellar Shear of the Annulus FibrosusInterlamellar shear may play an important role in the homeostasis and degeneration of the intervertebral disk. Accurately modeling the shear behavior of the interlamellar compartment would enhance the study of its mechanobiology. In this study, physical experiments were utilized to describe interlamellar shear and define a constitutive model, which was implemented into a finite element analysis. Ovine annulus fibrosus (AF) specimens from three locations within the intervertebral disk (lateral, outer anterior, and inner anterior) were subjected to in vitro mechanical shear testing. The local shear stress-stretch relationship was described for the lamellae and across the interlamellar layer of the AF. A hyperelastic constitutive model was defined for interlamellar and lamellar materials at each location tested. The constitutive models were incorporated into a finite element model of a block of AF, which modeled the interlamellar and lamellar layers using a continuum description. The global shear behavior of the AF was compared between the finite element model and physical experiments. The shear moduli at the initial and final regions of the stress-strain curve were greater within the lamellae than across the interlamellar layer. The difference between interlamellar and lamellar shear was greater at the outer anterior AF than at the inner anterior region. The finite element model was shown to accurately predict the global shear behavior or the AF. Future studies incorporating finite element analysis of the interlamellar compartment may be useful for predicting its physiological mechanical behavior to inform the study of its mechanobiology.

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“…The clinical necessity of investigating fibrocartilage is highlighted by the large numbers of individuals affected by degeneration of these joints. It is estimated that 10 million Americans are affected by temporomandibular joint disorders, as many as 5 million people are affected by lower back pain attributed to IVD degeneration (Sherman et al, 2010), and 600,000 knee surgeries are performed per year in the United States (Sweigart & Athanasiou, 2001). …”

Section: Introductionmentioning

confidence: 99%

A review of in-vitro fibrocartilage tissue engineered therapies with a focus on the temporomandibular joint

Lowe

Almarza

2017

Archives of Oral Biology

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The inability of fibrocartilage, specifically the temporomandibular joint (TMJ) disc, to regenerate and remodel following injury presents a unique problem for clinicians. Tissue engineering then offers a potential regenerative therapy. In vitro testing provides a valuable screening tool for potential tissue engineered solutions. The conclusions drawn for TMJ in vitro research were compared against state of the art fibrocartilage studies in the knee meniscus, and annulus fibrosus of the intervertebral disc (IVD). For TMJ disc regeneration, in vitro tissue engineered approaches, focused on cellular therapies with fibrochondrocytes, have displayed an inability to produce enough collagen, as well as an inability to recapitulate native mechanical properties. Biomaterial approaches have recapitulated the native properties of the TMJ disc, but their in vivo efficacy has yet to be determined. By comparison, the knee meniscus field is the most progressive in the use of stem cells as a cell source. The knee meniscus field has moved away from measuring mechanical properties, and are instead more focused on biochemistry and gene expression. IVD studies mainly use electrospun scaffolds, and have produced the best success in mechanical properties. The TMJ field, in comparison to knee meniscus and IVD, needs to employ stem cell therapies, new biomaterials and manufacturing techniques, and cutting edge molecular assays, in future in vitro approaches to screen for viable technologies to move to in vivo studies.

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Economic impact of improving outcomes of lumbar discectomy

Cited by 87 publications

References 43 publications

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis

Cost analysis of spinal and general anesthesia for the surgical treatment of lumbar spondylosis

A Computational Model to Describe the Regional Interlamellar Shear of the Annulus Fibrosus

A review of in-vitro fibrocartilage tissue engineered therapies with a focus on the temporomandibular joint

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