Measurements In Spine Care

In the course of evaluating the patient with spinal disease, a myriad of measurements need to be performed before determining the diagnosis and the severity of the disease process. This text explicitly outlines the measurement of the spine from a clinical, laboratory, and radiographic approach. A detailed description of the actual technique of measurement and the clinical implication are presented with accompanying illustrations. This amalgamation of measurement tools for the spine is a beneficial reference for a wide spectrum of healthcare providers: students, nurses, residents, fellows, and established surgeons. In addition to its detailed illustrated presentation, each measurement technique has been graded for scientific and clinical utility with a score that specifically grades: Interobserver reliability Intraobserver reliability Universality Disease specificity Ease of application Simplicity Patient tolerability Expense The detail presented in this text will not only serve as a reference, but will also allow the reader to accurately reproduce measurement techniques, thus enhancing inter-physician communication, research of the spine, and improvement of patient care.

Doody Rating: 3 stars: In a value-based healthcare system, physicians will be required to demonstrate that the procedures they perform and treatment they provide have value. Written by international experts in the field, this book provides the reader with an understanding of value as defined within the context of spine care delivery. There is a specific focus on the outcome and cost measures that comprise the value equation. The concepts and methodology of cost-effectiveness analysis, the Quality Adjusted Life Year (QALY), and comparative effectiveness research are discussed in a clear and comprehensive fashion. After reading this book, the reader will be armed with the tools necessary to measure the value of the care that they provide and to keep pace with the rapid evolution of our value-based health care delivery system. This book is useful for orthopaedic surgeons and spine care specialist.

Quality reporting is a rapidly growing area. Each year, new regulations in the US from the Council of Medicare and Medicaid Services make quality reporting a larger factor in determining reimbursement practices. Quality metrics are common parts of European clinical practice. Value of care is a focus of all payers, with specific interest directed at assessing the quality of care provided by a given healthcare team. While there are many publications in this space, no text has sought to provide an overview of quality in spine care. Quality measurement and quality reporting are ever growing aspects of the healthcare environment. Quality assessment is valuable to all healthcare stakeholders: patients, physicians, facilities, and payers. Patients are drawn to facilities that provide high value care; public reporting systems and grading systems for hospitals offer one opinion with regard to “high quality care.” Most physicians email inboxes are inundated with offers of recognition for being a “Top Doc” for a nominal fee. Some payers offer incentives to patients who chose to be treated at “Centers of Excellence” or similar facilities; the definition of “Excellence” may be unclear. There is little consensus on how to measure quality, how to incorporate patient and procedure factors and achieve accurate risk adjustment, and how to define value of care. Regardless of these challenges, regulatory efforts in the US, as well as numerous international efforts, make quality assessment and quality reporting an important part of physician behaviour. Physician and facility reimbursement for procedures are often tied to quality metrics. Spine procedures are costly, elective, and are a focus of many payer-based programs. Hence, spine care is often a focus of quality reporting efforts. This text summarizes the state of the art with regard to quality measurement, reporting, and value assessment in spine care. We will review quality reporting in the US and internationally. Chapters will outline how quality improvement efforts have achieved success in hospital systems. The reader will be provided with insights in how to achieve success incorporating quality metrics into spine care. Features: 1. Illustrates the state of the art in spine quality reporting: There is no text that thoroughly addresses quality assessment and quality reporting in spine care; there are, however, numerous articles in this space. This book provides a definitive text covering the state of the art for quality reporting in spine care and will be of value to the international orthopedic and neurosurgical spine community. 2. Provides insight on quality reporting in different healthcare systems: The text will allow for comparison of different quality reporting systems from different health care systems. This will provide practitioners with insight into the strengths and weaknesses of different approaches to quality reporting, and may drive improvement in quality assessment and reporting systems. A single text that features review of US, European, and Australia/Asian health care systems’ quality reporting is novel and will be thought provoking for readers. 3. Describes the US and international Healthcare reimbursement systems: Practicing physicians are provided with little information and less insight into the vagaries of the US and other healthcare systems. The text will provide insight into code development, valuation, and how quality reporting affects physician reimbursement 4. Explains risk adjustment: Appropriate risk adjustment and assessing patient and procedure factors that may impact quality reporting are invaluable to accurate quality measurement. The text will review risk adjustment, different approaches to risk assessment/mitigation, and provide physicians with insights into appropriate measures to capture in their clinical practices 5. Provides a foundation for improved quality assessment in spine care: While there are many disparate elements and differing approaches to capturing spine quality metrics, no definitive text has attempted to summarize these efforts in a single volume. By synthesizing these variable approaches, the reader may be provided with insights into superior approaches to quality assessment and a foundation will be provided for improving healthcare systems.

Unique resource from internationally renowned experts details the key role of sagittal spine balance Through evolution, human verticality became associated with a wide range of normal pelvic shapes and associated pelvic incidence angles (PIs). While all types of sagittal alignment generally provide adequate support to young adults, age, stress, and related degeneration can progressively lead to sagittal imbalance and contribute to various spinal pathologies. Sagittal Balance of the Spine by Pierre Roussouly, João Luiz Pinheiro-Franco, Hubert Labelle, Martin Gehrchen, and a cadre of esteemed international contributors focuses on the importance of sagittal alignment and spino-pelvic shape identification in clinical practice. Offering the most comprehensive text on sagittal balance to date, this state-of-the-art, richly illustrated book fills a void in the literature, offering clinical pearls throughout seven sections and 24 chapters. Key Highlights The biomechanics of sagittal balance including spine modeling, primary parameters, spinal curves segmentation, and lumbar lordosis classification The role of sagittal balance in low back pain and degeneration, with discussion of spinal orientation and the contact forces theory, spinal degeneration associated with spinopelvic morphotypes, and compensatory mechanisms Comprehensive analysis of the relationship between sagittal imbalance and isthmic lysis spondylolisthesis, degenerative spondylolisthesis, Scheuermann's kyphosis, adolescent idiopathic scoliosis, and adult scoliosis Posterior and anterior treatment approaches – from spinal fixation and spinal fusion – to spinal osteotomy techniques and management of surgical failure This text is essential reading for every neurosurgical and orthopaedic resident, as well as veteran surgeons who evaluate and treat patients with spine conditions. Clinicians will learn why incorporating sagittal balance evaluations into spinal exams is integral to devising more effective treatment strategies and achieving improved outcomes.

Beginning with a review of current trends in health care delivery leading to more value-based platforms, this unique and up-to-date book then focuses on how modern spine care is being shaped by the aging population, scientific and technological advancements, and the economic impact of various treatment modalities, providing insight into the seminal efforts surrounding sustainable spine care guideline development. The over-utilization of spine fusion surgery and adult spinal deformity are presented as examples that have led to a decline in the value of care delivered, as well as how a multidisciplinary evaluation by the range of clinicians involved in spine surgery can revise recommendations for management. The benefits and risks of LEAN methodology for streamlining and standardizing spine care approaches are discussed, and the specific approach of the Seattle Spine Team is presented as an example of successful system-wide improvement. Similar changes to outcome measurement, specifically for adult spinal deformity, are described. Last, the future of technology in spine care is presented, including robotics, nanotechnology, 3D printing, and the use of biologics and biomaterials. Given the broad scope of topics covered in this book, the intended audience includes not only orthopedic and spinal surgeons, neurosurgeons, physiatrists, and medical students, residents and fellows, but also hospital CEOs, CMOs, administrators, health services researchers, and health care policymakers, consultants and strategists.

This book presents multiple aspects of spine care from the perspective of different disciplines. It's organized by sections focused on non-operative care, spine injections and procedures, perioperative care, operative care, pediatric care, and special topics. Each chapter has been written by a clinician whose active practice involves the topic of their chapter. Practical and clinically relevant, this book educates any practitioner who cares for patients with back and neck pain and other spine conditions about implementing a multidisciplinary team to treat the spine.

The SMART Approach to Spine Clinical Research is a must-have guide for spine care professionals seeking to make a meaningful contribution to the scientific literature and advance their careers by publishing high-quality clinical research. Planning, conducting, and publishing the results of your clinical research can be a long and arduous journey. The SMART Approach to Spine Clinical Research presents and explains the many interrelated components essential to spine clinical research in an easily accessible way, guiding you step-by-step through the principles and methods of planning and evaluating clinical research. With a special focus on bias reduction and spine-related case examples, this SMART approach represents those essential components: - Study question - Searching the literature - Study design - Measurements - Analysis - Resources and funding - Timing Also addressed in the book are special topics such as getting your manuscript published and conducting a meta-analysis. This SMART approach provides a clear and simple road map for the planning, execution, and critical appraisal of clinical research.