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- 저자 : F. Haddad (검색결과 4 건)
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Alexander F. Haddad,Justin K. Scheer,Marissa T. Fury,Justin S. Smith,Vedat Deviren,Christopher P. Ames 대한척추신경외과학회 2021 Neurospine Vol.18 No.3
Objective: Extension of the posterior upper-most instrumented vertebra (UIV) into the upper thoracic (UT) spine allows for greater deformity correction and reduced incidence of proximal junction kyphosis (PJK) in adult spinal deformity (ASD) patients. However, it may be associated with chronic postoperative scapular pain (POSP). The goal of this study was to assess the relationship between UT UIV and persistent POSP, describe the pain, and assess its impact on patient disability. Methods: ASD patients who underwent multilevel posterior fusion were retrospectively identified then administered a survey regarding scapular pain and the Oswestry Disability Index (ODI), by telephone. Univariate and multivariate analysis were utilized. Results: A total of 74 ASD patients were included in the study: 37 patients with chronic POSP and 37 without scapular pain. The mean age was 70.5 years, and 63.9% were women. There were no significant differences in clinical characteristics, including mechanical complications (PJK, pseudarthrosis, and rod fracture) or reoperation between groups. Patients with persistent POSP were more likely to have a UT than a lower thoracic UIV (p= 0.018). UT UIV was independently associated with chronic POSP on multivariate analysis (p=0.022). ODI score was significantly higher in patients with scapular pain (p=0.001). Chronic POSP (p=0.001) and prior spine surgery (p=0.037) were independently associated with ODI on multivariate analysis. Conclusion: A UT UIV is independently associated with increased odds of chronic POSP, and this pain is associated with significant increases in patient disability. It is a significant clinical problem despite solid radiographic fusion and the absence of PJK.
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Alexander F. Haddad,John F. Burke,Praveen V. Mummaneni,Andrew K. Chan,Michael M. Safaee,John J. Knightly,Rory R. Mayer,Brenton H. Pennicooke,Anthony M. Digiorgio,Philip R. Weinstein,Aaron J. Clark,Dea 대한척추신경외과학회 2021 Neurospine Vol.18 No.2
Objective: The use of telemedicine has dramatically increased due to the coronavirus disease 2019 pandemic. Many neurosurgeons are now using telemedicine technologies for preoperative evaluations and routine outpatient visits. Our goal was to standardize the telemedicine motor neurologic examination, summarize the evidence surrounding clinical use of telehealth technologies, and discuss financial and legal considerations. Methods: We identified a 12-member panel composed of spine surgeons, fellows, and senior residents at a single institution. We created an initial telehealth strength examination protocol based on published data and developed 10 agree/disagree statements summarizing the protocol. A blinded Delphi method was utilized to build consensus for each statement, defined as >80% agreement and no significant disagreement using a 2-way binomial test (significance threshold of p<0.05). Any statement that did not meet consensus was edited and iteratively resubmitted to the panel until consensus was achieved. In the final round, the panel was unblinded and the protocol was finalized. Results: After the first round, 4/10 statements failed to meet consensus (<80% agreement, and p=0.031, p=0.031, p=0.003, and p=0.031 statistical disagreement, respectively). The disagreement pertained to grading of strength of the upper (3/10 statements) and lower extremities (1/10 statement). The amended statements clarified strength grading, achieved consensus (>80% agreement, p>0.05 disagreement), and were used to create the final telehealth strength examination protocol. Conclusion: The resulting protocol was used in our clinic to standardize the telehealth strength examination. This protocol, as well as our summary of telehealth clinical practice, should aid neurosurgical clinics in integrating telemedicine modalities into their practice.
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Artificial Intelligence for Adult Spinal Deformity
Rushikesh S. Joshi,Alexander F. Haddad,Darryl Lau,Christopher P. Ames 대한척추신경외과학회 2019 Neurospine Vol.16 No.4
Adult spinal deformity (ASD) is a complex disease that significantly affects the lives of many patients. Surgical correction has proven to be effective in achieving improvement of spinopelvic parameters as well as improving quality of life (QoL) for these patients. However, given the relatively high complication risk associated with ASD correction, it is of paramount importance to develop robust prognostic tools for predicting risk profile and outcomes. Historically, statistical models such as linear and logistic regression models were used to identify preoperative factors associated with postoperative outcomes. While these tools were useful for looking at simple associations, they represent generalizations across large populations, with little applicability to individual patients. More recently, predictive analytics utilizing artificial intelligence (AI) through machine learning for comprehensive processing of large amounts of data have become available for surgeons to implement. The use of these computational techniques has given surgeons the ability to leverage far more accurate and individualized predictive tools to better inform individual patients regarding predicted outcomes after ASD correction surgery. Applications range from predicting QoL measures to predicting the risk of major complications, hospital readmission, and reoperation rates. In addition, AI has been used to create a novel classification system for ASD patients, which will help surgeons identify distinct patient subpopulations with unique risk-benefit profiles. Overall, these tools will help surgeons tailor their clinical practice to address patients’ individual needs and create an opportunity for personalized medicine within spine surgery.
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Measurements of Inelastic Neutron Scattering at 96 MeV from Carbon, Iron, Yttriumand Lead
A. Ohrn,C. Gustavsson,M. Blann,V. Blideanu,J. Blomgren,S. Chiba,H. Duarte,F. Haddad,C. Kalbach,J. Klug,A. Koning,C. Le brun,C. Lebrun,F. -R. Lecolley,X. Ledoux,N. Marie-noury,P. Mermod,L. Nilsson,M. O 한국물리학회 2011 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.59 No.23
Inelastic neutron scattering for ^(12)C, ^(56)Fe, ^(89)Y and ^(208)Pb have been measured at 96 MeV at the The Svedberg Laboratory in Uppsala and double-differential cross sections are reported. Data cover an excitation energy range of 0-45 MeV and the angular intervals are 28 - 58˚ for ^(12)C, 26 - 65˚ for ^(56)Fe and 26 - 52˚ for ^(89)Y and ^(208)Pb. In this experiment, neutron detection is based on conversion to protons in an active scintillator converter. An analysis technique in which the neutron spectra have been obtained through a folding procedure using the response of the detector system has been used. The results are compared to and are in reasonable agreement with several model predictions and with inelastic neutron scattering data at 65 MeV from University of California, Davis, USA.
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