Brain & spine最新文献

{"title":"Comparing image normalization techniques in an end-to-end model for automated modic changes classification from MRI images","authors":"Andrea Cina ,&nbsp;Daniel Haschtmann ,&nbsp;Dimitrios Damopoulos ,&nbsp;Nicolas Gerber ,&nbsp;Markus Loibl ,&nbsp;Tamas Fekete ,&nbsp;Frank Kleinstück ,&nbsp;Fabio Galbusera","doi":"10.1016/j.bas.2023.102738","DOIUrl":"https://doi.org/10.1016/j.bas.2023.102738","url":null,"abstract":"<div><h3>Introduction</h3><p>Modic Changes (MCs) are MRI alterations in spine vertebrae's signal intensity. This study introduces an end-to-end model to automatically detect and classify MCs in lumbar MRIs. The model's two-step process involves locating intervertebral regions and then categorizing MC types (MC0, MC1, MC2) using paired T1-and T2-weighted images. This approach offers a promising solution for efficient and standardized MC assessment.</p></div><div><h3>Research question</h3><p>The aim is to investigate how different MRI normalization techniques affect MCs classification and how the model can be used in a clinical setting.</p></div><div><h3>Material and methods</h3><p>A combination of Faster R–CNN and a 3D Convolutional Neural Network (CNN) is employed. The model first identifies intervertebral regions and then classifies MC types (MC0, MC1, MC2) using paired T1-and T2-weighted lumbar MRIs. Two datasets are used for model development and evaluation.</p></div><div><h3>Results</h3><p>The detection model achieves high accuracy in identifying intervertebral areas, with Intersection over Union (IoU) values above 0.7, indicating strong localization alignment. Confidence scores above 0.9 demonstrate the model's accurate levels identification. In the classification task, standardization proves the best performances for MC type assessment, achieving mean sensitivities of 0.83 for MC0, 0.85 for MC1, and 0.78 for MC2, along with balanced accuracy of 0.80 and F1 score of 0.88.</p></div><div><h3>Discussion and conclusion</h3><p>The study's end-to-end model shows promise in automating MC assessment, contributing to standardized diagnostics and treatment planning. Limitations include dataset size, class imbalance, and lack of external validation. Future research should focus on external validation, refining model generalization, and improving clinical applicability.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 102738"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529423010263/pdfft?md5=5c4b4b0fbead3bbed18f403c823c0e95&pid=1-s2.0-S2772529423010263-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature","authors":"Björn Sommer ,&nbsp;Ina Konietzko ,&nbsp;Maximilian Niklas Bonk ,&nbsp;Tina Schaller ,&nbsp;Bruno Märkl ,&nbsp;Klaus Henning Kahl ,&nbsp;Georg Stüben ,&nbsp;Johannes Zenk ,&nbsp;Ehab Shiban","doi":"10.1016/j.bas.2023.102740","DOIUrl":"https://doi.org/10.1016/j.bas.2023.102740","url":null,"abstract":"<div><h3>Introduction</h3><p>The reconstruction of frontobasal defects following oncologic resections of paranasal and anterior skull base (ASB) malignancies remains challenging. Ineffective reconstruction could lead to cerebrospinal fluid leak, meningitis, and tension pneumocephalus.</p></div><div><h3>Research question</h3><p>Aim of this investigation was to analyse postoperative complication rates with or without bone graft for anterior skull base reconstruction.</p></div><div><h3>Material and methods</h3><p>In this retrospective study, we included patients following resection of paranasal and/or anterior skull base malignancies between October 2013 and December 2022. Complications were analysed with regards to the type of skull base reconstruction.</p></div><div><h3>Results</h3><p>Eleven patients were identified (2 female, 9 male, age (median, SD) 64 ± 14.1 years (range 38–81). There were nine cases of paranasal sinus and nasal cavity carcinomas and two cases of olfactory neuroblastomas. Overall survival was 22.5 ± 28 months (range: 5–78), progression free survival was 17.0 ± 20.3 months (range: 11–78). Bone skull base reconstruction using a split graft was performed in three cases. Postoperative complications requiring surgical intervention were seen in 33% (one tension pneumocephalus) of cases in the bone reconstruction group and 50% (three patients with cerebrospinal fluid leak, one infection) in the non-bone reconstruction group.</p></div><div><h3>Discussion and conclusion</h3><p>The structural reinforcement of structural bone chip grafting might provide additional support of the ASB and prevent CSF leakage or encephalocele. Especially in large (&gt;10 cm²) bone defects of advanced sinonasal malignancies extending into the middle cranial fossa, the full armamentarium of reconstruction possibilities should be considered.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 102740"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529423010287/pdfft?md5=1929edb78ddeeb681331d505531debe0&pid=1-s2.0-S2772529423010287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and machine learning for risk prediction and diagnosis of vertebral fractures: A meta-analysis","authors":"S.N. Namireddy ,&nbsp;S.S. Gill ,&nbsp;A. Peerbhai ,&nbsp;A.G. Kamath ,&nbsp;D.S.C. Ramsay ,&nbsp;H.S. Ponniah ,&nbsp;D. Jankovic ,&nbsp;D. Kalasauskas ,&nbsp;J. Neuhoff ,&nbsp;S. Russo ,&nbsp;A. Kramer ,&nbsp;S.G. Thavarajasingam","doi":"10.1016/j.bas.2024.104117","DOIUrl":"10.1016/j.bas.2024.104117","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 104117"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142719902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L5 is a reliable lower instrumented vertebra (LIV) in selected adult spinal deformity (ASD) patients","authors":"S. Núñez-Pereira ,&nbsp;Y.P. Charles ,&nbsp;S. Haddad ,&nbsp;A. Pupak ,&nbsp;J. Pizones ,&nbsp;A. Alanay ,&nbsp;I. Obeid ,&nbsp;F. Kleinstück ,&nbsp;F. Pellisé ,&nbsp;E. European Spine Study Group","doi":"10.1016/j.bas.2024.104114","DOIUrl":"10.1016/j.bas.2024.104114","url":null,"abstract":"","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 104114"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Q-Ball high-resolution fiber tractography: Optimizing corticospinal tract delineation near gliomas and its role in the prediction of postoperative motor deficits– A proof of concept study","authors":"Pavlina Lenga ,&nbsp;Moritz Scherer ,&nbsp;Robin Peretzke ,&nbsp;Peter Neher ,&nbsp;Jessica Jesser ,&nbsp;Andreas W. Unterberg ,&nbsp;Sandro Krieg ,&nbsp;Daniela Becker","doi":"10.1016/j.bas.2024.104139","DOIUrl":"10.1016/j.bas.2024.104139","url":null,"abstract":"<div><h3>Introduction</h3><div>After resection of eloquent gliomas, impacting motor pathways, patients frequently harbour pronounced motor deficits (MD), predominantly attributed to damage to the corticospinal tract (CST).</div></div><div><h3>Research question</h3><div>This study compares the results of conventional DTI-FT and q-ball (QBI)-high resolution FT with patient's postoperative morbidity, relating postoperative MD with the nearest distance from the lesion to the CST (nD-LCST).</div></div><div><h3>Materials and methods</h3><div>In this ongoing prospective trial, we utilized probabilistic High-Resolution Fiber Tracking (HRFT) through q-ball imaging (QBI-FT) and conventional Diffusion Tensor Imaging Fiber Tracking (DTI-FT), based on equal and standard diffusion-weighted MRI. Our analysis focused on the normalized Distance from the lesion to the CST-FT (nD-LCST), compared with MD evaluated via standardized clinical examination.</div></div><div><h3>Results</h3><div>Post-surgery, 4 patients developed new MD or deteriorated respectively. Among these, one patient was diagnosed with glioblastoma, one with diffuse astrocytoma, one with anaplastic astrocytoma, and one with oligodendroglioma. QBI-FT analysis revealed that patients with MD had a significantly lower median nD-LCST (−0.4 IQR = 2.1), in contrast to those without MD (8.4 IQR = 3.9; p = 0.029). Median values of QBI-FT were located within the tumor outlines, when MD deteriorated. Patients with postoperatively impaired MD had larger tumor volumes compared to those without MD.</div></div><div><h3>Discussion and conclusion</h3><div>Our preliminary findings suggest that QBI-FT may offer advantages over DTI-FT in predicting postoperative motor deficits, potentially enhancing neurosurgical planning. However, due to the small sample size of our study, these results are exploratory, and further research with larger patient populations is necessary to confirm the benefits of QBI-FT. QBI-FT shows promise as a complementary tractography technique suitable for clinical purposes alongside standard DTI-FT.</div></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 104139"},"PeriodicalIF":1.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142663184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 3D-navigation and fluoroscopic guidance in percutaneous pedicle screw placement for traumatic fractures of the thoracolumbar junction","authors":"Fenna Brunken ,&nbsp;Eric Mandelka ,&nbsp;Benno Bullert ,&nbsp;Paul Alfred Gruetzner ,&nbsp;Sven Y. Vetter ,&nbsp;Jula Gierse","doi":"10.1016/j.bas.2024.102769","DOIUrl":"10.1016/j.bas.2024.102769","url":null,"abstract":"<div><h3>Introduction</h3><p>Fractures of the thoracolumbar junction are the most common vertebral fractures and can require surgical treatment. Several studies have shown that the accuracy of pedicle screw placement can be improved by the use of 3D-navigation. Still only few studies have focused on the use of navigation in traumatic spine injuries.</p></div><div><h3>Research question</h3><p>The aim of this study was to compare the screw placement accuracy and radiation exposure for 3D-navigated and fluoroscopy-guided percutaneous pedicle screw placement in traumatic fractures of the thoracolumbar junction.</p></div><div><h3>Materials and methods</h3><p>In this single-center study 25 patients undergoing 3D-navigated percutaneous pedicle screw placement for traumatic fractures of the thoracolumbar junction (T12-L2) were compared to a control group of 25 patients using fluoroscopy. Screw accuracy was determined in postoperative CT-scans using the Gertzbein-Robbins classification system. Additionally, duration of surgery, dose area product, fluoroscopy time and intraoperative complications were compared between the groups.</p></div><div><h3>Results</h3><p>The accuracy of 3D-navigated percutaneous pedicle screw placement was 92.66 % while an accuracy of 88.08 % was achieved using standard fluoroscopy (p = 0.19). The fluoroscopy time was significantly less in the navigation group compared to the control group (p = 0.0002). There were no significant differences in radiation exposure, duration of surgery or intraoperative complications between the groups.</p></div><div><h3>Discussion and conclusion</h3><p>The results suggest that 3D-navigation facilitates higher accuracy in percutaneous pedicle screw placement of traumatic fractures of the thoracolumbar junction, although limitations should be considered. In this study 3D-navigation did not increase fluoroscopy time, while radiation exposure and surgery time were comparable.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 102769"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000250/pdfft?md5=9cb50edf7abacbc087614e54433a7e49&pid=1-s2.0-S2772529424000250-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139965851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous reduction of thoracolumbar fractures using monoaxial screws: Comparison of two instruments based on initial reduction and loss of reduction","authors":"Esra Aydin ,&nbsp;Philipp Schenk ,&nbsp;Arija Jacobi ,&nbsp;Thomas Mendel ,&nbsp;Friederike Klauke ,&nbsp;Bernhard Wilhelm Ullrich","doi":"10.1016/j.bas.2024.102778","DOIUrl":"10.1016/j.bas.2024.102778","url":null,"abstract":"<div><h3>Introduction</h3><p>Percutaneous techniques for the surgical treatment of vertebral fractures are constantly progressing. There are different biomechanics involved.</p></div><div><h3>Research question</h3><p>Two percutaneous, monoaxial fixation systems with different reduction tools were analyzed in relation to their reduction capacity. Additionally, the impact of anterior fusion, fracture severity and bone quality on reduction and loss of reduction were examined.</p></div><div><h3>Material and methods</h3><p>117 cases were retrospectively included in the monocentric study. The subsample (N = 53) with complete data at follow-up times was used to analyze the influence of anterior fusion. The dependencies on fracture severity and bone quality were determined using Spearman and Pearson correlation.</p></div><div><h3>Results</h3><p>Both systems achieved equally good reduction (9° mean, 95%-CI: 8°–11°, p &lt; 0.001). Anterior fused patients showed not significant (p = 0.057) less loss of reduction over time. Fracture severity had neither an influence on reduction or loss of reduction. Bone quality was positively correlated with greater amount of reduction and less loss of reduction. Early reduction within two days correlated with a greater amount of reduction (p = 0.006). Screw diameters and the patient's weight had no influence on loss of reduction. Complications occurred only in “V2” group.</p></div><div><h3>Discussion and conclusion</h3><p>Both systems are equivalent in reduction ability. The additional anterior fusion did not result in significantly lower reduction losses. The subsample being small, is a limitation. Good bone quality correlates with better initial reduction and less reduction loss. A preoperative bone density measurement can lead to optimization of surgical techniques.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 102778"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000341/pdfft?md5=4d24c8062211f379691ec64972c6d4ec&pid=1-s2.0-S2772529424000341-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140085262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 72-h sedated porcine model of traumatic spinal cord injury","authors":"Mathias Møller Thygesen ,&nbsp;Seyar Entezari ,&nbsp;Nanna Houlind ,&nbsp;Teresa Haugaard Nielsen ,&nbsp;Nicholas Østergaard Olsen ,&nbsp;Tim Damgaard Nielsen ,&nbsp;Mathias Skov ,&nbsp;Joel Borgstedt-Bendixen ,&nbsp;Alp Tankisi ,&nbsp;Mads Rasmussen ,&nbsp;Halldór Bjarki Einarsson ,&nbsp;Peter Agger ,&nbsp;Dariusz Orlowski ,&nbsp;Stig Eric Dyrskog ,&nbsp;Line Thorup ,&nbsp;Michael Pedersen ,&nbsp;Mikkel Mylius Rasmussen","doi":"10.1016/j.bas.2024.102813","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102813","url":null,"abstract":"<div><h3>Introduction</h3><p>There is an increasing focus on the prevention of secondary injuries following traumatic spinal cord injury (TSCI), especially through improvement of spinal cord perfusion and immunological modulation. Such therapeutic strategies require translational and controlled animal models of disease progression of the acute phases of human TSCI.</p></div><div><h3>Research question</h3><p>Is it possible to establish a 72-h sedated porcine model of incomplete thoracic TSCI, enabling controlled use of continuous, invasive, and non-invasive modalities during the entire sub-acute phase of TSCI?</p></div><div><h3>Material and methods</h3><p>A sham-controlled trial was conducted to establish the model, and 10 animals were assigned to either sham or TSCI. All animals underwent a laminectomy, and animals in the TSCI group were subjected to a weight-drop injury. Animals were then kept sedated for 72 h. The amount of injury was assessed by ex-vivo measures MRI-based fiber tractography, histology and immunohistochemistry.</p></div><div><h3>Results</h3><p>In all animals, we were successful in maintaining sedation for 72 h without comprising vital physiological parameters. The MRI-based fiber tractography showed that all TSCI animals revealed a break in the integrity of spinal neurons, whereas histology demonstrated no transversal sections of the spine with complete injury. Notably, some animals displayed signs of secondary ischemic tissue in the cranial and caudal sections.</p></div><div><h3>Discussion and conclusions</h3><p>This study succeeded in producing a porcine model of incomplete TSCI, which was physiologically stable up to 72 h. We believe that this TSCI model will constitute a potential translational model to study the pathophysiology secondary to TSCI in humans.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 102813"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000699/pdfft?md5=6f9494e86dc7610d716e74bc2620667e&pid=1-s2.0-S2772529424000699-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140618999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The “state of the art” of intraoperative neurophysiological monitoring: An Italian neurosurgical survey","authors":"Riccardo Antonio Ricciuti ,&nbsp;Fabrizio Mancini ,&nbsp;Giusy Guzzi ,&nbsp;Daniele Marruzzo ,&nbsp;Alessandro Dario ,&nbsp;Alessandro della Puppa ,&nbsp;Alessandro Ricci ,&nbsp;Andrea Barbanera ,&nbsp;Andrea Talacchi ,&nbsp;Andreas Schwarz ,&nbsp;Antonino Germanò ,&nbsp;Antonino Raco ,&nbsp;Antonio Colamaria ,&nbsp;Antonio Santoro ,&nbsp;Riccardo Boccaletti ,&nbsp;Carlo Conti ,&nbsp;Carlo Conti ,&nbsp;Nunzia Cenci ,&nbsp;Christian Cossandi ,&nbsp;Claudio Bernucci ,&nbsp;Francesco Sala","doi":"10.1016/j.bas.2024.102796","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102796","url":null,"abstract":"<div><h3>Introduction</h3><p>Intraoperative Neurophysiological Monitoring (IOM) is widely used in neurosurgery but specific guidelines are lacking. Therefore, we can assume differences in IOM application between Neurosurgical centers.</p></div><div><h3>Research question</h3><p>The section of Functional Neurosurgery of the Italian Society of Neurosurgery realized a survey aiming to obtain general data on the current practice of IOM in Italy.</p></div><div><h3>Materials and methods</h3><p>A 22-item questionnaire was designed focusing on: volume procedures, indications, awake surgery, experience, organization and equipe. The questionnaire has been sent to Italian Neurosurgery centers.</p></div><div><h3>Results</h3><p>A total of 54 centers completed the survey. The annual volume of surgeries range from 300 to 2000, and IOM is used in 10–20% of the procedures. In 46% of the cases is a neurologist or a neurophysiologist who performs IOM. For supra-tentorial pathology, almost all perform MEPs (94%) SSEPs (89%), direct cortical stimulation (85%). All centers perform IOM in spinal surgery and 95% in posterior fossa surgery. Among the 50% that perform peripheral nerve surgery, all use IOM. Awake surgery is performed by 70% of centers. The neurosurgeon is the only responsible for IOM in 35% of centers. In 83% of cases IOM implementation is adequate to the request.</p></div><div><h3>Discussion and conclusions</h3><p>The Italian Neurosurgical centers perform IOM with high level of specialization, but differences exist in organization, techniques, and expertise. Our survey provides a snapshot of the state of the art in Italy and it could be a starting point to implement a consensus on the practice of IOM.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 102796"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000523/pdfft?md5=7643f7a796ba3c8299074b18fd106d1e&pid=1-s2.0-S2772529424000523-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140638814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and characteristics of healthcare utilization with different providers among Canadians with chronic back problems: A population-based study","authors":"Jessica J. Wong ,&nbsp;Dan Wang ,&nbsp;Sheilah Hogg-Johnson ,&nbsp;Silvano A. Mior ,&nbsp;Pierre Côté","doi":"10.1016/j.bas.2024.102812","DOIUrl":"https://doi.org/10.1016/j.bas.2024.102812","url":null,"abstract":"<div><h3>Introduction</h3><p>Understanding healthcare utilization by Canadians with back problems informs healthcare planning nationally.</p></div><div><h3>Research question</h3><p>What is the prevalence of utilization of healthcare providers (medical doctors, chiropractors, physiotherapists, nurses), and associated characteristics among Canadians with chronic back problems (2001–2016)?</p></div><div><h3>Material and methods</h3><p>This population-based study used Canadian Community Health Survey data (2001–2016) restricted to respondents with chronic back problems (aged ≥12 years). We used self-reported consultation with healthcare providers (medical doctors, chiropractors, physiotherapists, nurses) from 2001–2010, and self-reported regular healthcare provider from 2015–2016. We calculated the 12-month prevalence of utilization with providers, and used modified Poisson regression to assess sociodemographic, health-related and behavioural factors associated with utilization of different providers.</p></div><div><h3>Results</h3><p>From 2001 to 2010 and 2015/2016, respectively, prevalence of utilization of medical doctors was 87.9% (95% CI 87.6–88.2) and 86.7% (95% CI 85.9–87.5); chiropractors 24.0% (95% CI 23.6–24.4) and 14.5% (95% CI 13.8–15.3); physiotherapists 17.2% (95% CI 16.9–17.6) and 10.7% (95% CI 10.0–11.4); nurses 14.0% (95% CI 13.7–14.2) and 6.6% (95% CI 6.1–7.0). Females were more likely to see any provider than males. Persons of lower socioeconomic status were less likely to consult chiropractors or physiotherapists (2001–2016), or nurses (2001–2010). Immigrants were less likely to consult chiropractors or nurses. Persons aged &gt;65 years were less likely to consult chiropractors or physiotherapists, and those with fair/poor general health were less likely to consult chiropractors, but more likely to consult other providers.</p></div><div><h3>Discussion and conclusion</h3><p>Medical doctors were most commonly consulted by Canadians with back problems, then chiropractors and physiotherapists. Characteristics of healthcare utilization varied by provider. Findings inform the need to strengthen healthcare delivery for Canadians with back problems.</p></div>","PeriodicalId":72443,"journal":{"name":"Brain & spine","volume":"4 ","pages":"Article 102812"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772529424000687/pdfft?md5=cbc79fe3bf5d5f426540f42a2004b8e7&pid=1-s2.0-S2772529424000687-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140643818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}