Thomas Jefferson University Hospital is the flagship hospital of Jefferson Health, a multi-state non-profit health system, based in Philadelphia, United States. The hospital serves as the teaching hospital for Thomas Jefferson University.
Obstructive sleep apnea (OSA) impacts postoperative outcomes in orthopedic procedures. This study compared complications between total shoulder arthroplasty (TSA) patients with and without OSA. We queried the Nationwide Readmission Database (2020–2022) for primary reverse or anatomic TSA patients. Cohorts were identified by OSA diagnosis and propensity score matched for age, BMI, Charlson Comorbidity Index, and sex. Outcomes included 90-day composite complication rates (pulmonary, cardiovascular, surgical), length of stay (LOS), and 30/90-day readmissions. The analysis included 10,290 patients (5,145 OSA, 5,145 non-OSA; mean age 66.5 ± 9.0 years). On multivariate analysis, OSA was associated with increased risk of 90-day composite complications (OR: 1.84; 95
Background: Augmented reality (AR) has rapidly emerged as an important navigational technology in spine surgery, with growing interest in its potential to reduce dependence on fluoroscopy and mitigate radiation exposure for both patients and operating room staff. Methods: This systematic review examined current evidence on radiation-related outcomes of AR-assisted spine procedures. A PRISMA-guided search of PubMed, Embase, and Scopus identified twelve eligible studies, including randomized trials, prospective and retrospective clinical cohorts, and cadaveric or synthetic-model investigations. Results: Across the included studies, AR was consistently associated with reduced fluoroscopy use, with several studies demonstrating statistically significant reductions in exposure time compared with conventional fluoroscopy. Two clinical studies directly measured occupational radiation and reported substantially lower staff doses when AR-based navigation and optimized shielding strategies were employed. Patient radiation exposure was similarly decreased in most studies, particularly when AR was integrated with low-dose cone-beam CT protocols. Operative time findings were mixed, reflecting early learning curves and variability in AR systems, but accuracy remained high across platforms. Conclusion: Current evidence suggests that AR may reduce intraoperative radiation exposure without compromising workflow or surgical precision, available studies are limited by small sample sizes, heterogenous methodologies, and a paucity of direct staff-dosimetry data. Larger, high-quality multicenter studies are needed to clarify the magnitude of AR’s radiation-sparing benefits and to define its role in modern spine surgery.
Identifying predictors of outcomes following mechanical thrombectomy (MT) for stroke is crucial for selecting patients most likely to benefit from the treatment as well as guiding prognostication efforts. When it comes to the role of Body Mass Index (BMI) as a prognostic marker in that context, the evidence is conflicting. A retrospective analysis of a prospectively maintained database including patients undergoing MT between the 2016 and 2024 was performed. The main outcomes were functional recovery (discharge modified Rankin Scale (mRS); < 3 vs. ≥3), discharge National Institute of Health Stroke Scale (NIHSS) score, and in-hospital mortality. Multivariable regression and propensity score matching (PSM) were used. A total of 894 patients were included: 16 (1.8
The purpose of this study was to compare perioperative outcomes between dialysis-dependent and non-dialysis patients undergoing multilevel lumbar fusion. The National Inpatient Sample (2016–2022) was queried for adults undergoing elective multilevel lumbar fusion. Dialysis dependence was identified using ICD-10-CM codes. Demographic, clinical, and hospital characteristics were compared between groups using survey-weighted analyses. Multivariable logistic regression examined the independent association between dialysis status and complications, non-routine discharge, and inpatient mortality. Significance was set at the P < 0.05 level. Among 459,360 weighted admissions, 840 (0.18
To review relevant medial orbital anatomy as well as the most commonly used approaches to this space. The use of the endoscopic endonasal approach for access to the medial orbit, including the intraconal space, has expanded allowing for removal of previously “inoperable” pathology. Each approach has their strength when considering access to the medial orbit, the transcaruncular incision allows for fast access with limited dissection while the transpalebral approach allows for visualization of the medial orbit but also extended access to the superior and lateral orbit. Conversely, the conjunctival approach allows for wider access to the orbital floor and the endonasal approach can be used when the pathology is medial to the optic nerve in the anterior fossa, parasellar region, and orbit.
