Degenerative changes of the lumbar motion segment often lead to stenosis of the spinal canal or neuroforamen. Axial lumbar interbody fusion (AxiaLIF) is intended to indirectly increase and stabilize foraminal dimensions by restoring disc height in patients with degenerative disc disease, thereby relieving axial and radicular pain. Therefore, this study investigated the effects of AxiaLIF on anterior disc height, posterior disc height, foraminal height and foraminal width as well as to determine the effectiveness of this minimally-invasive technique for indirect decompression and restoration of disc height. Eighty-one patients who underwent a 360 degree lumbar interbody fusion at L4-S1 and L5-S1 with AxiaLIF between November 2008 and May 2010 and satisfied all inclusion criteria were included. The preoperative and three-month postoperative digital radiographs were reviewed and analyzed. Disc heights were measured in the planes of the anterior and posterior surfaces of the adjacent vertebral bodies. Foraminal height was measured as the maximum distance between the inferior margin of the pedicle of the superior vertebra and the superior margin of the pedicle of the inferior vertebra. Foraminal width was measured as the shortest distance between the edge of the superior facet of the caudal vertebra and the posterior edge of inferior endplate of the cranial vertebra. Potential magnification error between pre- and post-operative radiographs was corrected using the anterior vertebral height of L5 vertebra.Purpose
Method
A change in lumbar lordosis can affect the outcome following lumbar fusion, and intraoperative positioning is a prime determinant of the postoperative lordosis. The purpose of this study is to determine the change in lordosis and sacral slope (SS) following axial lumbar interbody fusion (AxiaLIF). We retrospectively reviewed 81 patients who underwent a 360 lumbar interbody fusion at L4-5/L5-S1 (two-level procedure) or solely at L5-S1 (one-level) for degenerative disc disease and spondylolithesis utilizing the AxiaLIF with posterior segmental instrumentation. For the two-level procedures, 25 patients had the AxiaLIF placed first and 27 had pedicle screws placed first. For the one-level procedures, 11 patients had the AxiaLIF placed first and 18 had pedicle screws placed first. Standing lateral preoperative radiographs were compared to standing lateral postoperative films. Lumbar Cobb angles were measured at L1-S1, L4-S1 and individual lumbar levels. SS was measured for sacral version.Purpose
Method
The patient-physician relationship is a complex interaction and the importance of effective communication is well documented. The importance and implications of effective physician-patient communication is highlighted by the implementation of Communication Skills as a core competency by ACGME. The purpose of this study was to evaluate anonymous surveys completed by orthopaedic clinic patients to assess their visit experiences and whether they would recommend their physician to a friend or family member. Data were collected from patients exiting SIUs Division of Orthopaedic Surgery outpatient clinics through the completion of an anonymous survey. The survey was distributed on a sample of days between 2002 and 2004 and again in 2009. Responders were asked to complete the survey and return it prior to leaving the office. Participating surgeons were aware of the project occurring but did not know the dates on which surveys would be collected from their clinic patients. All surveys were scanned for data entry and if there was any difficulty with the scanning process then the data was entered manually.Purpose
Method
Residency programs are continually attempting to predict the performance of both current and potential residents. Previous studies have supported the use of USMLE Step 1 and 2 as predictors of Orthopaedic In-Training Examination and eventual American Board of Orthopaedic Surgery board success, while others show no significant correlation. A strong performance on OITE exams does correlate with strong residency performance, and some believe OITE scores are good predictors of future written board success. The current study was designed to examine potential differences in resident assessment measures and their predictive value for written boards. A retrospective review of resident performance data was performed for the past 10 years. Personalized information was removed by the residency coordinator. USMLE Step 1, USMLE Step 2, in-training exams (from first to fifth years of training), and written orthopaedic specialty board scores were collected. Subsequently, the residents were separated into two groups, those scoring above the 35th percentile on in-training examinations and those scoring below. Data were analyzed using correlation and regression analyses to compare and contrast the scores across all tests.Purpose
Method
