Biomedical subjects

David L Greene

Publications and source records attributed to David L Greene.

3 recordsLinked to original sources

PubMed2005

Lumbar disc herniation: evaluation of information on the internet.

STUDY DESIGN: An original study was performed evaluating the information presented on existing web sites for the topic of lumbar disc herniation. OBJECTIVES: The purpose of this study was to evaluate the type and quality of internet information available to patients on the topic of lumbar disc herniation. Our secondary objectives were to rank the identified World Wide Web sites with respect to the caliber of relevant information and to determine the propensity for secondary commercial gain by the web site sponsors. SUMMARY OF BACKGROUND DATA: Two-thirds of the United States population "surfs" the internet. A substantial percentage of internet users search for medical information on the World Wide Web. Because no standards exist regarding the publication of medical literature on the internet, the relevant web sites vary dramatically in terms of content and quality. Misleading or inaccurate information poses a theoretical risk to patients seeking treatment for medical conditions. METHODS.: Five search terms (lumbar disc herniation, herniated nucleus pulposus, herniated disc, slipped disc, and sciatica) were entered into 5 commonly used search engines. The first 25 links displayed by each engine were evaluated for a theoretical total of 625 web sites. Each site was evaluated in terms of content, authorship, and secondary commercial gain. An information quality score of 0 to 25 points was generated for each site; a score of 20 or greater was indicative of "high-quality" content. RESULTS: Our search identified 169 unique web sites of which only 16 (9.5%) scored >or=20 on the information quality score; 103 (60.9%) scored <or=10. The overall mean information quality score was 9. Highest mean scores were noted for commercial corporate (13.1) and hospital-based sites (11.2). Overall, 34.3% of sites sought secondary commercial gain. Higher scoring sites were more likely to appear within the first 10 links identified by each search engine. CONCLUSIONS: The quality of internet information on lumbar disc herniation is variable. Less than 10% of relevant web sites were determined to be of high-quality. The vast majority of sites were of poor informational value and more than one-third sought secondary commercialgain. The rank list of high quality sites generated from ourinformational quality score should prove useful to patients seeking information on the internet pertaining to lumbar disc herniation.

Humans↗

PubMed2004

A technique for reducing splash exposure during pulsatile lavage.

Pulsatile lavage is a frequently used method among orthopaedic traumatologists at our institution in the management of open fractures and contaminated wounds. Due to the pressure generated by the pulsatile lavage systems, splash exposure in the operating room environment becomes an unavoidable occurrence. The potential exists for a mucocutaneous exposure for either the surgeon or the operating room personnel. We have devised a method of decreasing the exposure risk to surgeons and operating room personnel during the pulsatile lavage irrigation portion of the procedure. An x-ray cassette drape is placed over the affected limb with enough clamps to create a closed system. Then small holes are created for the pulsatile lavage and the suction tubing, and the irrigation procedure is begun. This inexpensive cassette cover has proved to be a substantial advantage in our institution for decreasing mucocutaneous exposure.

Adult↗

PubMedDate not supplied

Biomechanical comparison of cervical interbody cage versus structural bone graft.

BACKGROUND CONTEXT: Clinically, cervical interbody cages provide fusion rates equivalent to structural bone grafting. No published studies have biomechanically compared cages with grafts. PURPOSE: We sought to compare the stability offered by threaded interbody cages versus structural bone graft and to evaluate the additional stability provided by adding a one- or two-level anterior plate to both interbody techniques. STUDY DESIGN/SETTING: Nondestructive nonconstraining repeated-measures in vitro flexibility tests were performed on surgically instrumented specimens. SUBJECT SAMPLE: Sixteen human cadaveric specimens were separated into two groups (specimens receiving graft and specimens receiving cage) with matched bone mineral density. OUTCOME MEASURES: Angular range of motion (ROM), neutral zone (NZ) and elastic zone (EZ) were quantified to assess stability. Student's t tests compared outcomes between and within groups. METHODS: Quasistatic nonconstraining torques (maximum 1.5 Nm) induced flexion, extension, lateral bending and axial rotation while angular motion was recorded stereophotogrammetrically. Specimens were tested normal, after discectomy, with graft or cage, with two-level plate and with one-level plate. RESULTS: Graft alone and cage alone reduced ROM and EZ but not NZ to within normal. In both groups, adding a one- or two-level plate significantly reduced motion in all modes of loading. There were no significant differences in motion parameters between groups whether plated or unplated. A two-level plate provided significantly better stability than a one-level plate. CONCLUSIONS: The interbody cage performed equivalently to the structural graft. Substantial increases in stability can be gained for either interbody technique by adding an anterior plate.

Adult↗