Weekend Admission Increases Risk of Readmissions Following Elective Thoracolumbar Spinal Fusion.

STUDY DESIGN: Retrospective database study. OBJECTIVES: The goal of this study was to assess the influence of weekend admission on patients undergoing elective thoracolumbar spinal fusion by investigating hospital readmission outcomes and analyzing differences in demographics, comorbidities, and postoperative factors. METHODS: The 2016-2018 Nationwide Readmission Database was used to identify adult patients who underwent elective thoracolumbar spinal fusion. The sample was divided into weekday and weekend admission patients. Demographics, comorbidities, complications, and discharge status data were compiled. The primary outcomes were 30-day and 90-day readmission. Univariate logistic regression analyzed the relationship between weekday or weekend admission and 30- or 90-day readmission, and multivariate regression determined the impact of covariates. RESULTS: 177,847 patients were identified in total, with 176,842 in the weekday cohort and 1005 in the weekend cohort. Multivariate regression analysis found that 30-day readmissions were significantly greater for the weekend cohort after adjusting for sex, age, Medicare or Medicaid status, and comorbidity status (OR 2.00, 95% CI: 1.60-2.48; P < .001), and 90-day readmissions were also greater for the weekend cohort after adjustment (OR 2.01, 95% CI: 1.68-2.40, P < .001). CONCLUSIONS: Patients undergoing elective thoracolumbar spinal fusion surgery who are initially admitted on weekends are more likely to experience hospital readmission. These patients have increased incidence of deep vein thrombosis, postoperative infection, and non-routine discharge status. These factors are potential areas of focus for reducing the impact of the "weekend effect" and improving outcomes for elective thoracolumbar spinal fusion.

Successful Non-operative Management of Metacarpophalangeal Collateral Ligament and Sagittal Band Rupture of the Long Finger: A Case Report.

The metacarpophalangeal (MCP) joint is surrounded by various structures critical to its stability and function. Though the ligamentous injury to the digits is common, rupture of the metacarpophalangeal collateral ligament and a sagittal band of the same finger is not well represented in the literature. We report a chronic case of a concurrent metacarpophalangeal collateral ligament and sagittal band injury. Though surgery would have been the most appropriate treatment soon after the injury, restrictions on elective procedures due to the COVID-19 pandemic precluded surgical treatment. The patient was alternatively treated with buddy tape, and a close follow-up was done. This is the first reported case of a concurrent metacarpophalangeal collateral ligament, and sagittal band injury successfully treated using nonoperative management.

Hypersensitivity Reaction to Carbon Fiber-Polyetheretherketone Composite Spinal Implant: A Case Report.

CASE: A 52-year-old woman presented with localized hypersensitivity symptoms immediately after insertion of a carbon fiber-polyetheretherketone (CF-PEEK) vertebral fusion device. After a modified cutaneous patch test confirmed an allergic reaction to the implant, the device was surgically removed. The patient's symptoms were largely resolved 1 month after the removal of the device. CONCLUSION: CF-PEEK is a commonly used biomaterial in surgical implants. As far as we know, this is the first reported case of a hypersensitivity reaction to CF-PEEK.

Postoperative Rhabdomyolysis in the Bilateral Shoulder Areas After Cardiac Surgery.

Rhabdomyolysis (RML) is a disease that results from the death of muscle fibers and the release of intracellular contents into the bloodstream as a result of traumatic or non-traumatic muscle injury. Postoperative RML is a rare complication that may result from improper patient positioning, extended surgery time, or unique patient risk factors. We describe a case of a 43-year-old obese male who presented with postoperative bilateral shoulder RML after undergoing cardiothoracic surgery for aortic valve disease. To our knowledge, after a thorough review of the literature using PubMed, Medline, and Google Scholar, no previous studies have reported positioning injuries specific to obese cardiac surgical patients and their relation to RML.