Search

Your search keyword '"Geoghegan, Cara E."' showing total 198 results
Start Over Author "Geoghegan, Cara E."
198 results on '"Geoghegan, Cara E."'

11. Impact of Lower Extremity Arthroplasty on Improvement of Quality-of-Life Outcomes Following Lumbar Fusion

Author

Sullivan, T. Barrett, Lynch, Conor P., Cha, Elliot D.K., Geoghegan, Cara E., Jadczak, Caroline N., Mohan, Shruthi, and Singh, Kern

Subjects
Orthopedics and Sports Medicine, Surgery, Lumbar Spine
Abstract

BACKGROUND: Both hip-spine and knee-spine syndromes can significantly impact a patient’s quality of life; however, few studies have investigated their effect on postoperative outcomes following lumbar fusion. OBJECTIVE: Our study aimed to evaluate the impact of a prior lower extremity arthroplasty on the improvement of patient-reported outcome measures (PROMs) following lumbar fusion surgery. METHODS: Patients undergoing primary, single, or multilevel lumbar interbody fusion were retrospectively reviewed. Patients missing preoperative PROMs were excluded. PROMs were collected preoperatively and postoperatively and included the Oswestry Disability Index (ODI), 12-Item Short Form Physical Component Summary, Patient-Reported Outcomes Measurement Information System Physical Function, and visual analog scale (VAS). A minimum clinically important difference (MCID) was calculated. Patients were categorized based on a history of hip/knee arthroplasty and propensity score matched. Intragroup improvement of PROM scores and intergroup differences in mean scores were evaluated using a paired t test and linear regression. MCID achievement differences were evaluated using logistic regression. RESULTS: A total of 335 patients were included, with 25 having a history of hip/knee arthroplasty. Arthroplasty patients were significantly older (P = 0.001) and typically had a higher Charlson Comorbidity Index (P ≤ 0.003, both). Patients differed in spinal pathology of degenerative spondylolisthesis (P = 0.049). Nonarthroplasty patients demonstrated significant improvements in all PROMs by 2 years (P < 0.001, all). The arthroplasty group demonstrated significant improvements in all PROMs by 1 year (P < 0.031, all). Preoperative VAS back was significantly worse for nonarthroplasty patients (P = 0.035). MCID achievement did not significantly differ between groups except at 6 months for ODI (P = 0.035). CONCLUSION: Following lumbar fusion, patients with a past surgical history did not demonstrate differences in outcome measures or MCID from those without. These results suggest that comorbid orthopedic conditions requiring surgery do not negatively impact the ability of patients to improve following lumbar fusion. CLINICAL RELEVANCE: Prior surgical history of lower extremity arthroplasty should not discourage the use of lumbar fusion when properly indicated, as patients reported clinical improvement regardless of history of hip or knee arthroplasty. LEVEL OF EVIDENCE: 3.

Published
2022

13. Risk Factors for Failing to Reach a Minimal Clinically Important Difference Following Minimally Invasive Lumbar Decompression

Author

Cha, Elliot D.K., Lynch, Conor P., Geoghegan, Cara E., Jadczak, Caroline N., Mohan, Shruthi, and Singh, Kern

Subjects
Orthopedics and Sports Medicine, Surgery, Lumbar Spine
Abstract

BACKGROUND: Clinically important postoperative changes can be best evaluated through the minimal clinically important difference (MCID). Our study aims to evaluate risk factors associated with failure to achieve MCID following lumbar decompression (LD). METHODS: Demographics, perioperative characteristics, and patient-reported outcome measures (PROM) for pain, disability, and physical function were retrospectively reviewed and collected for patients undergoing LD. MCID achievement was calculated using established values. Relative risk of demographic and perioperative characteristics with failure to meet MCID for all PROMs was calculated. Least absolute shrinkage and selection operator (LASSO) was used to estimate individual risk factors, and postestimation logistic regression was performed. RESULTS: The study cohort included 811 patients. Comorbidity burden was associated with failed MCID for visual analog scale (VAS) back and leg pain and Oswestry Disability Index (ODI). Operative levels or duration was associated with failed MCID for VAS leg pain, 12-item short form physical component summary (SF-12 PCS), and the patient-reported outcomes measurement information system physical function (PROMIS PF). Preoperative spinal pathology was associated with failed MCID for VAS leg pain, ODI, SF-12 PCS, and PROMIS PF. Additional risk factors included the type of operation, insurance, age, and body mass index. LASSO selected insurance, age, comorbidity burden, blood loss, operative duration, and type of spinal pathology as significant risk factors for failure to reach MCID. CONCLUSION: Failure to reach MCID was greatest for VAS back. Age, comorbidity burden, and prolonged procedures were significantly associated with risk for failure to reach MCID for a majority of PROMs. Comorbidity burden combined with operative outcomes may place patients at increased risk for failure to reach MCID for pain, disability, and physical function following LD. LEVEL OF EVIDENCE: 4. CLINICAL RELEVANCE: Establishes risk factors for failing to reach the threshold of meaningful difference in symptoms after LD surgery.

Published
2022

14. Outcomes of Transforaminal Lumbar Interbody Fusion Using Unilateral Versus Bilateral Interbody Cages

Author

Lynch, Conor P., Cha, Elliot D.K., Rush III, Augustus J., Jadczak, Caroline N., Mohan, Shruthi, Geoghegan, Cara E., and Singh, Kern

Subjects
instrumentation, interbody cage, patient-reported outcomes, transforaminal lumbar interbody fusion, Original Article, Surgery, Neurology (clinical), Neurology. Diseases of the nervous system, RC346-429, humanities, lumbar fusion
Abstract

Objective: To assess the impact of bilateral versus unilateral interbody cages on outcomes for minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) procedures.Methods: A retrospective review for primary, elective, single-level MIS TLIF procedures with bilateral posterior instrumentation from 2008–2020 was performed. Patients were grouped according to unilateral or bilateral interbody cage use. Procedures performed without static interbody cages or indicated for trauma, infection, malignancy were excluded. Patient-reported outcomes (PROs) included visual analogue scale (VAS), Oswestry Disability Index, 12-item Short Form health survey physical composite score (SF-12 PCS), PatientReported Outcome Measurement Information System physical function (PROMIS-PF). PROs were collected preoperatively and postoperatively. Change in PROs (Δ) was calculated and compared between groups. Achievement of minimum clinically important difference (MCID) was calculated using established values from the literature. Achievement rates were compared between groups using logistic regression.Results: The study included 151 patients, with 111 unilateral and 40 bilateral cage placements. Charlson Comorbidity Index, diabetes, and insurance status differed between groups (p < 0.050). Prevalence of degenerative and isthmic spondylolisthesis (both p ≤ 0.002), operative level (p = 0.003), and postoperative length of stay (p = 0.022) significantly differed between groups. The unilateral group had lower 1-year arthrodesis rates (p = 0.035). Preoperative VAS leg (p = 0.017) and SF-12 PCS (p = 0.045) were worse for the unilateral group. ΔPROMIS-PF was greater for the bilateral group at 2 years (p = 0.001). Majority of patients achieved an overall MCID for all PROs, except VAS leg (bilateral group).Conclusion: While preoperative status and postoperative arthrodesis rates differed, patients achieved an MCID at similar rates regardless of use of unilateral or bilateral cages.

Published
2021

26. The Worldwide Influence of Social Media on Cervical Spine Literature

Author

Lynch, Conor P., primary, Cha, Elliot D.K, additional, Jacob, Kevin C., additional, Patel, Madhav R., additional, Jenkins, Nathaniel W., additional, Parrish, James M., additional, Jadczak, Caroline N., additional, Mohan, Shruthi, additional, Geoghegan, Cara E., additional, and Singh, Kern, additional

Published
2022
Full Text
View/download PDF

32. Preliminary Evaluation of Standing Full-Length Plain Radiographs Utility in an Adult Degenerative Spine Practice

Author

Parrish, James M., primary, Jenkins, Nathaniel W., additional, Haws, Brittany E., additional, Cha, Elliot D. K., additional, Lynch, Conor P., additional, Patel, Madhav R., additional, Jacob, Kevin C., additional, Jadczak, Caroline N., additional, Mohan, Shruthi, additional, Geoghegan, Cara E., additional, Louie, Philip K., additional, Hirsch, Brandon P., additional, Colman, Matthew W., additional, and Singh, Kern, additional

Published
2021
Full Text
View/download PDF

40. Multimodal Analgesic Management for Lumbar Decompression Surgery in the Ambulatory Setting: Clinical Case Series and Review of the Literature

Author

Nolte, Michael T., primary, Parrish, James M., additional, Jenkins, Nathaniel W., additional, Cha, Elliot D.K., additional, Lynch, Conor P., additional, Jacob, Kevin C., additional, Patel, Madhav R., additional, Jadczak, Caroline N., additional, Geoghegan, Cara E., additional, Mohan, Shruthi, additional, Podnar, Jeffrey, additional, Buvanendran, Asokumar, additional, and Singh, Kern, additional

Published
2021
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results