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Background: To analyze gender differences regarding the recovery experience (pain, function, complications) after spinal arthrodesis surgery. Methods: Pre-operative and post-operative gender-based differences in patient-reported outcomes for open posterior spinal arthrodesis at 6 weeks, 3 months, 6 months, and 1 year were studied, including age, comorbidities, body mass index (BMI), diagnosis, number of vertebrae fused, type of surgery, primary vs. revision surgery, and complications. Statistical analysis included the use of Student’s t-test, Chi square, linear regression, Mann–Whitney U test, and Spearman’s rho. Results: Primary or revision posterior arthrodesis was performed on 1931 consecutive adults (1219 females, 712 males) for deformity and degenerative pathologies. At surgery, females were older than males (61.7 years vs. 59.7 years, p &lt, 0.01), had slightly more comorbidities (1.75 vs. 1.5, p &lt, 0.01), and were more likely to undergo deformity correction (38% vs. 22%, p &lt, 0.01). Females described more pre-op pain (female VAS = 6.54 vs. male VAS = 6.41, p &lt, 0.01) and lower pre-op function (female ODI = 49.73 vs. male ODI = 46.52, p &lt, 0.01). By 3 months post-op, there was no significant gender difference in VAS or ODI scores. Similar pain and function scores between males and females continued through 6 months and 12 months. Conclusion: Although females have more pain and dysfunction before undergoing spinal surgery, the differences in these values do not reach the Minimum Clinically Important Difference (MCID). Post-operatively, there is no difference in pain and function scores among males and females at 3, 6, and 12 months.

This research monograph consists of 17 papers under the framework of contemporary economic and business issues which we can structure into several main research fields. These fields relate to the regulation of economic and business activities, especially in the context of digitalization processes, fiscal and monetary issues, dealing with the impact of digitalization and COVID19 pandemics on traditional academic and business debates, as well as on innovation processes in both government and the corporate sector. We can borrow the phrase from one of our papers and confirm that the papers presented show that the innovative market and digital society, as the new global development and technology paradigm of the modern world, together with its capabilities and standards, has changed the character of entrepreneurship and the state/government in terms of their new interactions. Thus, the contributions from the research monograph are made more urgent by the main objective of introspection of the traditional economic and business sectors and activities under the prism of digital transformation. The researchers were particularly interested in the impact of the COVID19 pandemic on the economic and business sectors. Although the conference was held in the midst of the pandemics, researchers were able to present valuable studies showing the extent of the threat posed by COVID 19 to the public health and economic outcomes of EU citizens. Significant pressure was placed on member state spending, particularly in countries with lower fiscal capacity, resulting in a severe temporary deterioration in the fiscal deficit and public debt. It is also noted that the crisis COVID -19 will have an uneven impact on member states and could deepen their divergence. Therefore, new and creative fiscal policies to support investment in digital transformation, green transition and innovation are of utmost importance. This monograph provides some guidance.

Study Design: Retrospective review. Objectives: (1) Identify the 90-day rate of readmission following revision lumbar fusion, (2) identify independent risk factors associated with increased rates of readmission within 90 days, (3) and identify the hospital costs associated with revision lumbar fusion and subsequent readmission within 90 days. Methods: Utilizing 2014 data from the Nationwide Readmissions Database, patients undergoing elective revision lumbar fusion were identified. With this sample, multivariate logistic regression was utilized to identify independent predictors of readmission within 90 days. An analysis of total hospital costs was also conducted. Results: In 2014, an estimated 14 378 patients underwent elective revision lumbar fusion. The readmission rate at 90 days was 3.1% (n = 446). Diabetes with chronic complications was the only comorbidity found to carry significantly increased odds of readmission. Surgical complications such as deep venous thrombosis, surgical wound disruption, hematoma, and pneumonia (experienced during the index admission) were also independent predictors of readmission. Anterior approaches were associated with increased odds of readmission. The most common related diagnoses on readmission were hardware issues, postoperative infection, and disc herniation. Readmissions were associated with an average of $96 152 in increased hospital costs per patient compared with those not readmitted. Conclusion: Relevant patient comorbidities and surgical complications were associated with increased readmission within 90 days. Readmission within 90 days was associated with significant increases in hospital costs.

Study Design: Retrospective comparative analysis of prospective cohort. Objective: To determine whether sacroiliac (SI) screw fixation ipsilateral to hand dominance compared to bilateral fixation impacts personal hygiene (wiping) after toileting. Methods: Inclusion criteria were adult spinal deformity (ASD) patients with long arthrodesis (≥T12-pelvis) who had undergone primary unilateral or bilateral SI fixation with a minimum of 2-years-follow-up. Results: 117 consecutive patients were included and separated into 2 groups: bilateral SI fixation (BL, n = 61) and unilateral SI fixation (UNI, n = 56), with no difference in age. Of UNI patients, 10.7% (6) performed personal hygiene with a different hand after surgery, compared to 6.6% (4) of patients who received BL fixation ( P = 0.422). All UNI patients who switched hands were right-hand dominant, and 5/6 received right-sided fixation. There was no statistical difference found between number of levels fused (11 levels) and changes in personal hygiene habits. Over a third of patients from both groups had difficulty performing personal hygiene after fusion (UNI = 39.3% BL = 36.1%, P = 0.719). Conclusion: SI screws increase the difficulty of performing personal hygiene; yet, the side of unilateral screws does not significantly change personal hygiene habits when compared to bilateral screw placement. Moreover, the length of the construct does not have a significant impact on ability to perform personal hygiene, cause changes in habits, or require the assistance of another individual. However, among our sample of individuals, bilateral fixation did result in a higher rate of revision instrumentation.

Background. Teratomas in the pediatric population are most commonly found in the sacrococcygeal region. Pediatric intraspinal teratomas, however, are an exceedingly rare central nervous system (CNS) neoplasm. The clinical presentation of these intraspinal neoplasms can vary significantly and thus can be difficult to identify in infants less than one year of age where verbal expression and motor development are still lacking. Case Description. A 7-month-old, previously healthy male presented with a thoracic scoliosis and an asymptomatic right midupper thoracic spinal prominence present since birth. MRI revealed an extensive heterogenous mass in the right epidural space from T5-T6 and the right paravertebral space, resulting in severe spinal stenosis. Outcome. Complete resection of the tumor, including a three-level neurotomy, was achieved by posterior decompression/laminectomy. The final tumor was consistent with a mature teratoma. The surgical resection was performed without any immediate complications. Conclusions. Extramedullary epidural teratomas are exceptionally rare tumors in the pediatric population. Clinical presentation can be ambiguous, particularly in an infant. MRI was useful in suggesting a teratoma as a potential diagnosis and for postoperative surveillance for recurrence. However, histopathological analysis remains the gold standard for definitive diagnosis. Surgical resection is the mainstay of treatment, especially in the setting of cord compression and progressive loss of motor function. Close follow-up is crucial to monitor for progressive spinal deformity or recurrence.

Introduction State legalization and widespread marketing efforts have increased the accessibility and consumption of off-label, non-FDA-approved, cannabinoid (CBD) products. Although clinical evidence is largely absent for the treatment of musculoskeletal pain, patients are experimenting with these products in efforts to relieve joint pain. Assessment of the prevalence, perceived efficacy compared with other nonsurgical modalities, and usage patterns is warranted. The purpose of this study was to report the prevalence and perceived self-efficacy of CBD products in patients with symptomatic hip and/or knee osteoarthritis (OA). Methods Two-hundred consecutive patients presenting with painful hip or knee OA were surveyed at their initial evaluation at a large academic center. Using Single Assessment Numeric Evaluation (SANE) scores, survey questions assessed perceived pain and effectiveness of CBD products, in addition to other nonsurgical treatment modalities. Chart review provided demographic factors. Descriptive statistics were used to characterize the data. Results Of the 200 patients (80 hip OA, 108 knee OA, and 12 both), 66% were female, and average age was 67 years (range 36 to 89 years). Twenty-four percent (48/200) of patients endorsed use of CBD products before their presentation. The average presenting SANE score (range 0 to 100) for non-CBD users was 50.8 compared with 41.3 among CBD users (P = 0.012). Sixty percent of patients learned about CBD through friends, and 67% purchased CBD directly from a dispensary. Oral tinctures (43%) and topical applications (36%) were the most commonly used forms. In addition, 8% of participants in this study had tried marijuana for their pain. Conclusion A 24% incidence of CBD usage was found among patients presenting with hip or knee OA. No significant perceived benefit of CBD use seems to exist compared with its nonuse, as patients who used CBD reported significantly worse SANE and visual analogue scale scores than nonusers at baseline. Follow-up studies are warranted to assess these findings.

There is no question that the mechanical reproducibility of film technologythe photographic basis of the medium, the regularized actions of gears and shutters, as well as the repeatability of effects-had secured cinema's status by the 1920s as the visual medium of the industrial era par excellence. Photogenie, that elusive concept at the heart of early French film theory (generally considered to be the very first theory of the film as medium) was, in an important sense, an attempt to define the nature of a cinematic art around the formal and perceptual properties of a new type of mechanical reproduction-a process that produced no concrete objects or images but rather the traces of a movement that occurred between photographic frames (or afterimages, to cite one of the English definitions of the term "photogene").1 Still, lest we forget that mechanical reproduction is only one of the ways in which the cinema can be defined, consider the following incidentwhich, as far as I can tell, is not cited in any accounts of cinema and modernity. In the years immediately following World War I, French film industry journals reported regularly on a dispute that arose between the union of moviehouse owners and operators, the Syndicat des Directeurs de Cinemas, and Compagnie Parisienne de Distribution d'Electricite over the rate at which the electricity used to light the lamp in the cinematograph should be tariffed.2 At the heart of the dispute lay a distinction, which had been written into the French laws of energy distribution in the late nineteenth century, between the energy used to drive