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5. Canadian Spine Society: 24th Annual Scientific Conference, Wednesday, February 28 - Saturday, March 2, Fairmont Chateau Whistler, Whistler, B.C., Canada.

Author

Dionne A, Al-Zakri M, Labelle H, Joncas J, Parent S, Mac-Thiong JM, Miyanji F, Lonner B, Eren A, Cahill P, Parent S, Newton P, Dermott JA, Jaakkimainen L, To T, Bouchard M, Howard A, Lebel DE, Hardy S, Malhotra AK, Dermott J, Thevarajah D, Mathias KDA, Yoon S, Sakhrekar R, Lebel DE, Kim DJ, Hadi A, Doria A, Mitani A, Dermott J, Howard A, Lebel D, Yoon S, Mathias K, Dermott J, Lebel D, Miyanji F, Newton P, Lonner B, Bastrom T, Samdani A, Roy-Beaudry M, Beauséjour M, Imbeault R, Dufresne J, Parent S, Romeo J, Livock H, Smit K, Jarvis J, Tice A, Chan VK, Cho R, Poon S, Skaggs DL, Shumilak GK, Rocos B, Sardi JP, Charalampidis A, Gum J, Lewis SJ, Tretiakov PS, Onafowokan O, Mir J, Das A, Williamson T, Dave P, Imbo B, Lebovic J, Jankowski P, Passias PG, Lewis S, Aljamaan Y, Lenke LG, Smith J, Varshney VP, Sahjpaul R, Paquette S, Osborn J, Pelletier-Roy R, Asmussen M, Birk M, Ludwig T, Nicholls F, Zohar A, Loomans J, Pellise F, Smith JS, Kato S, Sardar Z, Lenke L, Lewis SJ, Abbas A, Toor J, Sahi G, Kovacevic D, Lex J, Miyanji F, Rampersaud R, Perruccio AV, Mahomed N, Canizares M, Rizkallah M, Lebreton MA, Boubez G, Shen J, AlShakfa F, Kamel Y, Osman G, Wang Z, Koegl N, Herrington B, Fernandes RR, Urquhart JC, Rampersaud YR, Bailey CS, Hakimjavadi R, Zhang T, DeVries Z, Wai EK, Kingwell SP, Stratton A, Tsai E, Wang Z, Phan P, Rampersaud R, Fine N, Stone L, Kapoor M, Chênevert A, Bédard S, McIntosh G, Goulet J, Couture J, Investigators C, LaRue B, Rosenstein B, Rye M, Roussac A, Naghdi N, Macedo LG, Elliott J, DeMont R, Weber MH, Pepin V, Dover G, Fortin M, Wang Z, Rizkallah M, Shen J, Lebreton MA, Florial E, AlShakfa F, Boubez G, Raj A, Amin P, McIntosh G, Rampersaud YR, AlDuwaisan AASM, Hakimjavadi R, Zhang T, Phan K, Stratton A, Tsai E, Kingwell S, Wai E, Phan P, Hebert J, Nowell S, Wedderkopp N, Vandewint A, Manson N, Abraham E, Small C, Attabib N, Bigney E, Koegl N, Craig M, Al-Shawwa A, Ost K, Tripathy S, Evaniew N, Jacobs B, Cadotte D, Malhotra AK, Evaniew N, Dea N, Investigators C, McIntosh G, Wilson JR, Evaniew N, Bailey CS, Rampersaud YR, Jacobs WB, Phan PP, Nataraj A, Cadotte DW, Weber MH, Thomas KC, Manson N, Attabib N, Paquet J, Christie SD, Wilson JR, Hall H, Fisher CG, McIntosh G, Dea N, Liu EY, Persad ARL, Baron N, Fourney D, Shakil H, Investigators C, Evaniew N, Wilson JR, Dea N, Phan P, Huang J, Fallah N, Dandurand C, Alfawaz T, Zhang T, Stratton A, Tsai E, Wai E, Kingwell S, Wang Z, Phan P, Investigators C, Zaldivar-Jolissaint JF, Charest-Morin R, McIntosh G, Fehlings MG, Pedro KM, Alvi MA, Wang JCW, Charest-Morin R, Dea N, Fisher C, Dvorak M, Kwon B, Ailon T, Paquette S, Street J, Dandurand C, Mumtaz R, Skaik K, Wai EK, Kingwell S, Stratton A, Tsai E, Phan PTN, Wang Z, Investigators C, Manoharan R, McIntosh G, Rampersaud YR, Smith-Forrester J, Douglas JE, Nemeth E, Alant J, Barry S, Glennie A, Oxner W, Weise L, Christie S, Liu EY, Persad ARL, Saeed S, Toyota P, Su J, Newton B, Coote N, Fourney D, Rachevits MS, Razmjou H, Robarts S, Yee A, Finkelstein J, Almojuela A, Zeiler F, Logsetty S, Dhaliwal P, Abdelnour M, Zhang Y, Wai E, Kingwell SP, Stratton A, Tsai E, Phan PT, Investigators C, Smith TA, Small C, Bigney E, Richardson E, Kearney J, Manson N, Abraham E, Attabib N, Bond M, Dombrowski S, Price G, García-Moreno JM, Hebert J, Qiu S, Surendran V, Cheung VSE, Ngana S, Qureshi MA, Sharma SV, Pahuta M, Guha D, Essa A, Shakil H, Malhotra A, Byrne J, Badhiwala J, Yuan E, He Y, Jack A, Mathieu F, Wilson JR, Witiw CD, Shakil H, Malhotra AK, Yuan E, Smith CW, Harrington EM, Jaffe RH, Wang AP, Ladha K, Nathens AB, Wilson JR, Witiw CD, Sandarage RV, Galuta A, Tsai EC, Rotem-Kohavi N, Dvorak MF, Xu J, Fallah N, Waheed Z, Chen M, Dea N, Evaniew N, Noonan V, Kwon B, Kwon BK, Malomo T, Charest-Morin R, Paquette S, Ailon T, Dandurand C, Street J, Fisher CG, Dea N, Heran M, Dvorak M, Jaffe R, Coyte P, Chan B, Malhotra A, Hancock-Howard R, Wilson J, Witiw C, Cho N, Squair J, Aureli V, James N, Bole-Feysot L, Dewany I, Hankov N, Baud L, Leonhartsberger A, Sveistyte K, Skinnider M, Gautier M, Galan K, Goubran M, Ravier J, Merlos F, Batti L, Pagès S, Bérard N, Intering N, Varescon C, Carda S, Bartholdi K, Hutson T, Kathe C, Hodara M, Anderson M, Draganski B, Demesmaeker R, Asboth L, Barraud Q, Bloch J, Courtine G, Christie SD, Greene R, Nadi M, Alant J, Barry S, Glennie A, Oxner B, Weise L, Julien L, Lownie C, Dvorak MF, Öner CFC, Dandurand C, Joeris A, Schnake K, Phillips M, Vaccaro AR, Bransford R, Popescu EC, El-Sharkawi M, Rajasekaran S, Benneker LM, Schroeder GD, Tee JW, France J, Paquet J, Allen R, Lavelle WF, Vialle E, Dea N, Dionne A, Magnuson D, Richard-Denis A, Petit Y, Bernard F, Barthélémy D, Mac-Thiong JM, Grassner L, Garcia-Ovejero D, Beyerer E, Mach O, Leister I, Maier D, Aigner L, Arevalo-Martin A, MacLean MA, Charles A, Georgiopoulos M, Charest-Morin R, Goodwin R, Weber M, Brouillard E, Richard-Denis A, Dionne A, Laassassy I, Khoueir P, Bourassa-Moreau É, Maurais G, Mac-Thiong JM, Zaldivar-Jolissaint JF, Dea N, Brown AA, So K, Manouchehri N, Webster M, Ethridge J, Warner A, Billingsley A, Newsome R, Bale K, Yung A, Seneviratne M, Cheng J, Wang J, Basnayake S, Streijger F, Heran M, Kozlowski P, Kwon BK, Golan JD, Elkaim LM, Alrashidi Q, Georgiopoulos M, Lasry OJ, Bednar DA, Love A, Nedaie S, Gandhi P, Amin PC, Raj A, McIntosh G, Neilsen CJ, Swamy G, Rampersaud R (On behalf of CSORN investigators), Vandewint A, Rampersaud YR, Hebert J, Bigney E, Manson N, Attabib N, Small C, Richardson E, Kearney J, Abraham E, Rampersaud R, Raj A, Marathe N, McIntosh G, Dhiman M, Bader TJ, Hart D, Swamy G, Duncan N, Dhiman M, Bader TJ, Ponjevic D, Matyas JR, Hart D, Swamy G, Duncan N, O'Brien CP, Hebert J, Bigney E, Kearney J, Richardson E, Abraham E, Manson N, Attabib N, Small C, LaRochelle L, Rivas G, Lawrence J, Ravinsky R, Kim D, Dermott J, Mitani A, Doria A, Howard A, Lebel D, Dermott JA, Switzer LS, Kim DJ, Lebel DE, Montpetit C, Vaillancourt N, Rosenstein B, Fortin M, Nadler E, Dermott J, Kim D, Lebel DE, Wolfe D, Rosenstein B, Fortin M, Wolfe D, Dover G, Boily M, Fortin M, Shakil H, Malhotra AK, Badhiwala JH, Karthikeyan V, He Y, Fehlings MG, Sahgal A, Dea N, Kiss A, Witiw CD, Redelmeier DR, Wilson JR, Caceres MP, Freire V, Shen J, Al-Shakfa F, Ahmed O, Wang Z, Kwan WC, Zuckerman SL, Fisher CG, Laufer I, Chou D, O'Toole JE, Schultheiss M, Weber MH, Sciubba DM, Pahuta M, Shin JH, Fehlings MG, Versteeg A, Goodwin ML, Boriani S, Bettegowda C, Lazary A, Gasbarrini A, Reynolds JJ, Verlaan JJ, Sahgal A, Gokaslan ZL, Rhines LD, Dea N, Truong VT, Dang TK, Osman G, Al-Shakfa F, Boule D, Shen J, Wang Z, Rizkallah M, Boubez G, Shen J, Phan P, Alshakfa F, Boule D, Belguendouz C, Kafi R, Yuh SJ, Shedid D, Wang Z, Wang Z, Shen J, Boubez G, Alshakfa F, Boulé D, Belguendouz C, Kafi R, Phan P, Shedid D, Yuh SJ, Rizkallah M, Silva YGMD, Weber L, Leão F, Essa A, Malhotra AK, Shakil H, Byrne J, Badhiwala J, Nathens AB, Azad TD, Yuan E, He Y, Jack AS, Mathieu F, Wilson JR, Witiw CD, Craig M, Guenther N, Valosek J, Bouthillier M, Enamundram NK, Rotem-Kohavi N, Humphreys S, Christie S, Fehlings M, Kwon B, Mac-Thiong JM, Phan P, Paquet J, Guay-Paquet M, Cohen-Adad J, Cadotte D, Dionne A, Mac-Thiong JM, Hong H, Kurban D, Xu J, Barthélémy D, Christie S, Fourney D, Linassi G, Sanchez AL, Paquet J, Sreenivasan V, Townson A, Tsai EC, Richard-Denis A, Kwan WC, Laghaei P, Kahlon H, Ailon T, Charest-Morin R, Dandurand C, Paquette S, Dea N, Street J, Fisher CG, Dvorak MF, Kwon BK, Thibault J, Dionne A, Al-Sofyani M, Pelletier-Roy R, Richard-Denis A, Bourassa-Moreau É, Mac-Thiong JM, Bouthillier M, Valošek J, Enamundram NK, Guay-Paquet M, Guenther N, Rotem-Kohavi N, Humphreys S, Christie S, Fehlings M, Kwon BK, Mac-Thiong JM, Phan P, Cadotte D, Cohen-Adad J, Reda L, Kennedy C, Stefaniuk S, Eftekhar P, Robinson L, Craven C, Dengler J, Kennedy C, Reda L, Stefaniuk S, Eftekhar P, Robinson L, Craven C, Dengler J, Roukerd MR, Patel M, Tsai E, Galuta A, Jagadeesan S, Sandarage RV, Phan P, Michalowski W, Van Woensel W, Vig K, Kazley J, Arain A, Rivas G, Ravinsky R, Lawrence J, Gupta S, Patel J, Turkstra I, Pustovetov K, Yang V, Jacobs WB, Mariscal G, Witiw CD, Harrop JS, Essa A, Witiw CD, Mariscal G, Jacobs WB, Harrop JS, Essa A, Du JT, Cherry A, Kumar R, Jaber N, Fehlings M, Yee A, Dukkipati ST, Driscoll M, Byers E, Brown JL, Gallagher M, Sugar J, Rockall S, Hektner J, Donia S, Chernesky J, Noonan VK, Varga AA, Slomp F, Thiessen E, Lastivnyak N, Maclean LS, Ritchie V, Hockley A, Weise LM, Potvin C, Flynn P, Christie S, Turkstra I, Oppermann B, Oppermann M, Gupta S, Patel J, Pustovetov K, Lee K, Chen C, Rastgarjazi M, Yang V, Hardy S, Strantzas S, Anthony A, Dermott J, Vandenberk M, Hassan S, Lebel D, Silva YGMD, LaRue B, Couture J, Pimenta N, Blanchard J, Chenevert A, Goulet J, Greene R, Christie SD, Hall A, Etchegary H, Althagafi A, Han J, Greene R, Christie S, Pickett G, Witiw C, Harrop J, Jacobs WB, Mariscal G, Essa A, Jacobs WB, Mariscal G, Witiw C, Harrop JS, Essa A, Lasswell T, Rasoulinejad P, Hu R, Bailey C, Siddiqi F, Hamdoon A, Soliman MA, Maraj J, Jhawar D, Jhawar B, Schuler KA, Orosz LD, Yamout T, Allen BJ, Lerebo WT, Roy RT, Schuler TC, Good CR, Haines CM, Jazini E, Ost KJ, Al-Shawwa A, Anderson D, Evaniew N, Jacobs BW, Lewkonia P, Nicholls F, Salo PT, Thomas KC, Yang M, Cadotte D, Sarraj M, Rajapaksege N, Dea N, Evaniew N, McIntosh G, Pahuta M, Alharbi HN, Skaik K, Wai EK, Kingwell S, Stratton A, Tsai E, Phan PTN, Wang Z, Investigators C, Zaldivar-Jolissaint JF, Gustafson S, Polyzois I, Gascoyne T, Goytan M, Bednar DA, Sarra M, Rocos B, Sardi JP, Charalampidis A, Gum J, Lewis SJ, Ghag R, Kirk S, Shirley O, Bone J, Morrison A, Miyanji F, Parekh A, Sanders E, Birk M, Nicholls F, Smit K, Livock H, Romeo J, Jarvis J, Tice A, Frank S, Labelle H, Parent S, Barchi S, Joncas J, Mac-Thiong JM, Thibault J, Joncas J, Barchi S, Parent S, Beausejour M, Mac-Thiong JM, Dionne A, Mac-Thiong JM, Parent S, Shen J, Joncas J, Barchi S, Labelle H, Birk MS, Nicholls F, Pelletier-Roy R, Sanders E, Lewis S, Aljamaan Y, Lenke LG, Smith J, Sardar Z, Mullaj E, Lebel D, Dermott J, Bath N, Mathias K, Kattail D, Zohar A, Loomans J, Pellise F, Smith JS, Kato S, Sardar Z, Lenke L, Lewis SJ, Bader TJ, Dhiman M, Hart D, Duncan N, Salo P, Swamy G, Lewis SJ, Lawrence PL, Smith J, Pellise F, Sardar Z, Lawrence PL, Lewis SJ, Smith J, Pellise F, Sardar Z, Levett JJ, Alnasser A, Barak U, Elkaim LM, Hoang TS, Alotaibi NM, Guha D, Moss IL, Weil AG, Weber MH, de Muelenaere P, Parvez K, Sun J, Iorio OC, Rosenstein B, Naghdi N, Fortin M, Manocchio F, Ankory R, Stallwood L, Ahn H, Mahdi H, Naeem A, Jhawar D, Moradi M, Jhawar B, Qiu S, Surendran V, Shi V, Cheung E, Ngana S, Qureshi MA, Sharma SV, Pahuta M, and Guha D

Published
2024
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6. Earlier Initiation of Postoperative Physical Therapy Decreases Opioid Use after Total Knee Arthroplasty.

Author

Frenkel Rutenberg T, Izchak H, Rosenthal Y, Barak U, Shemesh S, and Heller S

Subjects
Analgesics, Opioid therapeutic use, Humans, Knee Joint surgery, Pain, Postoperative drug therapy, Pain, Postoperative etiology, Pain, Postoperative prevention & control, Physical Therapy Modalities, Range of Motion, Articular, Treatment Outcome, Arthroplasty, Replacement, Knee methods
Abstract

For patients with advanced osteoarthritis of the knee, total knee arthroplasty (TKA) has been shown to provide significant pain relief and improved function with consistent, reproducible results. Post-operative physical therapy (PT) plays an important role is restoring muscle strength and range of motion (ROM). Yet, the impact of earlier physical therapy initiation after TKA has not been well defined. We assessed 205 patients that underwent primary TKA including 136 patients who started PT on the first post-operative day (POD1) and a second group that started PT 3 days after surgery (POD3), or later. Length of hospital stay (LOS), opioid use during hospital stay, complications, re-admissions, knee ROM and the need for subsequent hospitalized rehabilitation were recorded. LOS was not significantly shorter in the early PT group, compared with the delayed PT group (6.4 ± 2.2 days vs. 6.8 ± 2 days, respectively, P  = .217). Patients in the delayed PT group consumed more opioids during their inpatient stay compared with the early PT group on both POD 3 (89% vs 82%, p  = 0.013) and POD 4 (81% vs 66%, p  = 0.005). There was no significant difference in the incidence of Immediate post-operative complications or final knee ROM between the two groups. While early postoperative PT did not impact hospital LOS or final knee ROM, it was associated with an earlier reduction in postoperative opioid consumption after primary TKA., Competing Interests: None declared., (Thieme. All rights reserved.)

Published
2022
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7. C5 Palsy Following Cervical Spine Decompression.

Author

Barak U, Sheinis D, Sidon E, Shemesh S, Amitai A, and Ohana N

Subjects
Cervical Vertebrae surgery, Female, Humans, Israel epidemiology, Male, Middle Aged, Muscle Weakness diagnosis, Muscle Weakness etiology, Outcome and Process Assessment, Health Care, Retrospective Studies, Risk Assessment, Spinal Cord Ischemia etiology, Spinal Cord Ischemia physiopathology, Cervical Plexus injuries, Decompression, Surgical adverse effects, Decompression, Surgical methods, Deltoid Muscle innervation, Deltoid Muscle physiopathology, Intraoperative Complications diagnosis, Intraoperative Complications physiopathology, Paresis diagnosis, Paresis etiology, Postoperative Complications diagnosis, Postoperative Complications etiology, Postoperative Complications physiopathology
Abstract

Background: Cervical spinal surgery is considered safe and effective. One of the few specific complications of this procedure is C5 nerve root palsy. Expressed primarily by deltoid muscle and biceps brachii weakness, it is rare and has been related to nerve root traction or to ischemic spinal cord damage., Objectives: To determine the clinical and epidemiological traits of C5 palsy. To determine whether C5 palsy occurs predominantly in one specific surgical approach compared to others., Methods: A retrospective study of patients who underwent cervical spine surgery at our medical center during a consecutive 8-year period was conducted. The patient data were analyzed for demographics, diagnosis, and surgery type and approach, as well as for complications, with emphasis on the C5 nerve root palsy., Results: The study group was comprised of 124 patients. Seven (5.6%) developed a C5 palsy following surgery. Interventions were either by anterior, by posterior or by a combined approach. Seven patients developed this complication. All of whom had myelopathy and were older males. A combined anteroposterior (5 patients) and posterior access (2 patients) were the only approaches that were associated with the C5 palsy. None of the patients who were operated via an anterior approach did develop this sequel., Conclusions: The incidence of the C5 root palsy in our cohort reached 5.6%. Interventions performed through a combined anterior-posterior access in older myelopathic males, may carry the highest risk for this complication.

Published
2021

8. Minute-to-minute urine flow rate variability: a retrospective survey of its ability to provide early warning of acute hypotension in critically ill multiple trauma patients.

Author

Brotfain E, Klein Y, Toledano R, Shamir MY, Koyfman L, Barak U, Guttmann T, Zlotnik A, and Klein M

Subjects
APACHE, Adult, Female, Humans, Injury Severity Score, Israel, Male, Retrospective Studies, Vital Signs, Critical Illness, Hypotension urine, Multiple Trauma urine, Urination
Abstract

Purpose: Dynamic changes in urine output and neurological status are the recognized clinical signs of hemodynamically significant hemorrhage. In the present study, we analyzed the dynamic minute-to-minute changes in the UFR and also the changes in its minute-to-minute variability in a group of critically ill multiple trauma patients whose blood pressures were normal on admission to the ICU but who subsequently developed hypotension within the first few hours of their ICU admission., Patients and Methods: The study was retrospective and observational. Demographic and clinical data were extracted from the computerized register information systems initially; the clinical and laboratory data of 100 critically ill patients with multiple trauma who were admitted to the ICU during the study period were analyzed. Of this group, ten patients were eventually included in the study on the basis of the inclusion criteria., Results: The minute-to-minute urine flow rate (UFR) and urine flow rate variability (UFRV) both decreased significantly during the periods of hypotension (p values 0.001 and 0.006, respectively). Notably, the decrease in UFRV preceded by at least 30 min a corresponding decline in the systolic and mean arterial blood pressures, which manifested as a flattening of UFRV amplitude which was observed prior to the occurrence of the lowest recorded systolic and mean arterial blood pressures. Statistical analysis by the Pearson method demonstrated a strong direct correlation between the decrease in UFRV and the decrease in the MAP (R = 0.9, p = 0.001), and SBP (R = 0.86, p = 0.001) and the decreasing urine output per hour (R = 0.88, p < 0.001)., Conclusion: We found that changes in UFRV correlate strongly with systolic and mean arterial blood pressures. We feel that this parameter could potentially serve as an early signal of hemodynamic deterioration due to occult bleeding in critically ill trauma patients, and might also be able to identify the optimal end-point of hemodynamic resuscitative measures in these patients.

Published
2020
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9. Perianal abscess in infants: Amenable to conservative treatment in selected cases.

Author

Samuk I, Avinadav E, Barak U, Seguier E, Steiner Z, and Freud E

Subjects
Abscess diagnosis, Anus Diseases diagnosis, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Male, Retrospective Studies, Treatment Outcome, Abscess therapy, Anti-Bacterial Agents therapeutic use, Anus Diseases therapy, Conservative Treatment methods, Drainage methods
Abstract

Background: Perianal abscess is a common surgical condition in daily pediatric practice. Management is a subject of controversy and a variety of approaches are practiced. While the most frequent approach is drainage with/without fistulotomy, the superiority of this approach and the place of conservative approach has not been established. The aim of this study was to evaluate the outcomes of conservative approach in selected cases of perianal abscesses in infants., Methods: Data of 19 patients aged <24 months treated conservatively for perianal abscess at a tertiary hospital in 2014-2018 were retrospectively reviewed., Results: Criteria for a conservative approach were: spontaneous drainage into the anal canal (n = 8) or perianal skin (n = 4), and phlegmonous infiltrate with fluid collection detected on ultrasound (n = 7). Mean age at symptom onset was 8.4 months. Twelve patients were managed for the first time. Previous care in seven patients included 1-4 drainage procedures (n = 4), spontaneous drainage (n = 1) and antibiotics (n = 2). Five patients were on oral antibiotics at presentation. After diagnosis, 18 patients received i.v. antibiotics and one, oral antibiotics. Three patients (15.7%) ultimately required surgical drainage; two were lost to follow up. During follow up (mean, 22.4 months) four patients (28.5%) had a single recurrent episode; abscess in three (managed conservatively in two and surgically in one) and fistula-in-ano in one patient that healed spontaneously. Thus, surgical intervention was prevented in 13/17 patients (76.4%) available for follow up., Conclusions: Perianal abscess in infants is amenable to conservative management in selected cases. Avoiding surgical intervention is advantageous, especially given the high recurrence rate., (© 2019 Japan Pediatric Society.)

Published
2019
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