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Peter D Angevine

Publications and source records attributed to Peter D Angevine.

7 recordsLinked to original sources
PubMed2006

Sagittal imbalance.

Sagittal imbalance may be either segmental (type 1) or global (type 2). Careful preoperative evaluation is essential to determine the presence and extent of any inherent flexibility in the deformity. Flexible deformities may be corrected with careful intraoperative positioning and instrumented fusion. More rigid or fixed sagittal plane deformities may be corrected with one or more osteotomies. Thorough planning and meticulous execution of osteotomies are essential to obtaining optimal surgical results.

Humans↗
PubMed2006

Thoracic and thoracolumbar idiopathic deformity.

Idiopathic scoliosis in adolescents and adults presents many challenges to the spinal surgeon. Preoperative planning, intraoperative technique, and postoperative management all contribute to the ultimate outcome. Avoiding complications in the treatment of idiopathic scoliosis depends on a thorough knowledge of the fundamental principles of spinal deformity evaluation and treatment.

Adolescent↗
PubMed2005

Cost-effectiveness of single-level anterior cervical discectomy and fusion for cervical spondylosis.

STUDY DESIGN: Cost-effectiveness analysis with retrospective cost analysis and literature review. OBJECTIVE: To determine the relative cost-effectiveness of anterior cervical discectomy and fusion (ACDF) with autograft, allograft, and allograft with plating for single-level anterior cervical spondylosis. SUMMARY OF BACKGROUND DATA: There are several accepted methods of surgically treating single-level cervical spondylosis anteriorly. No study has clearly demonstrated the superiority of one method over the alternatives. The techniques may differ in their operative risks and resource use, perioperative complications, short-term outcome, and long-term outcome and complications. Formal cost-effectiveness analysis (CEA) provides a structure for analyzing many variables and comparing different treatment outcomes. Sensitivity analysis is used to test the robustness of the model and to determine variables that have significant effects on the results. Future areas of research and refinements of the CEA model can be developed from these findings. METHODS: A retrospective review of hospital charges was performed for 78 patients who underwent single-level ACDF with allograft alone or ACDF with allograft and plating (ACDFP). The charges were converted to estimated costs for fiscal year 2000 using the ratio of costs to charges method. A CEA model was developed consisting of a decision-analysis model for the first year postsurgery and a Markov model for the next 4 years after surgery. Probabilities and outcome utilities were estimated from the literature. Outcome was measured in quality-adjusted life years (QALYs), and incremental CEA was performed. Several variables were tested in one-way sensitivity analysis. RESULTS: Compared with ACDF with autograft, ACDF with allograft offered an improvement in quality of life at a cost of 496 dollars per QALY. ACDFP provided additional gains in quality of life compared with ACDF with allograft at a cost of 32,560 dollars per QALY in the base case analysis. In sensitivity analysis, these estimates varied between 417 dollars and 741 dollars per QALY and between 19,090 dollars per QALY and domination of ACDFP by ACDF with allograft, respectively. The results were most sensitive to assumptions regarding differences in the length of the postoperative recovery period. CONCLUSIONS: ACDF with allograft offers a benefit relative to ACDF with autograft at a cost of 496 dollars per QALY. ACDFP has a benefit relative to ACDF with allograft at an approximate cost of 32,560 dollars per QALY. CEA provides a method for comparing the benefits and risks of these three procedures. Further research needs to be performed regarding these procedures, particularly examining the postoperative recovery period.

Bone Plates↗
PubMed2003

National and regional rates and variation of cervical discectomy with and without anterior fusion, 1990-1999.

STUDY DESIGN: A national hospitalization database was used to determine rates and trends in the treatment of cervical disc disease. OBJECTIVE: To examine the temporal and geographic variations in hospitalizations and surgical procedures for cervical disc disease. SUMMARY OF BACKGROUND DATA: Studies of spinal surgery during the 1980s showed significant increases in the rates for all procedures, particularly those involving fusion. The management of cervical disc disease continues to be controversial. METHODS: Data from the National Hospital Discharge Survey from 1990 through 1999 were analyzed. Records were selected and categorized according to an algorithm of International Classification of Diseases (ICD-9) procedure and diagnosis codes. RESULTS: During the study period, the rate of hospitalization for surgical and nonsurgical treatment of cervical disc disease did not increase significantly. There was, however, a statistically significant increase in the proportion of hospitalizations for the surgical treatment of cervical disc disease that included a fusion procedure. There also was significant geographic variation in the rate of fusion procedures, with the South having the highest rate. CONCLUSIONS: Although the rate of surgery for cervical disc disease did not increase significantly during the 1990s, the rate of fusion procedures did rise significantly.

Age Distribution↗
PubMed2002

Outcomes research and lumbar discectomy.

Lumbar discectomy is generally performed to reduce pain or disability and thereby improve quality of life. Important surgery-related results, therefore, include the patients' perceptions of the effect of surgery on their health and ability to perform daily tasks. Spine surgeons should have an understanding of basic concepts of outcome measurement and be able to select appropriate questionnaires and incorporate them into their clinical practices and research. A brief review of the fundamental principles of outcome research is presented, and the recent lumbar discectomy literature concerning these ideas is summarized. Properly designed, conducted, and reported outcome studies of lumbar discectomy will assist the spine surgeon in selecting appropriate patients for surgery, educating them regarding expected results, and comparing this procedure with novel treatments for lumbar disc disease.

Diskectomy↗
PubMedDate not supplied

Pseudoaneurysms of the superficial temporal artery secondary to placement of external ventricular drainage catheters.

BACKGROUND: Pseudoaneurysms of the superficial temporal artery have been described following trauma and various surgical procedures. There are no reports in the literature of these lesions following the placement of external ventricular drainage catheters. This article describes two patients and their successful treatment, and reviews diagnostic and treatment strategies. CASE DESCRIPTION: Two patients developed tender, nonpulsatile masses in the scalp along the former subcutaneous tract of an EVD catheter. Both lesions were successfully excised in the operating room and found to be thrombosed pseudoaneurysms of the superficial temporal artery. CONCLUSION: Pseudoaneurysms of the parietal branch of the STA may occur secondary to incision of the skin for twist drill hole placement or the use of a sharp trocar for subcutaneous tunneling of catheters. Use of a blunt-tipped trocar may reduce the risk of developing pseudoaneurysms secondary to EVD placement. Knowledge of the possibility of developing these lesions from catheter placement may aid the neurosurgeon in proper diagnosis and treatment.

Adult↗