Endoscopic Spinal Fusion

Spinal fusion surgery has the potential to alleviate pain, improve functional ability, and maximize overall quality of life. Recognizing not only the importance to preserve as much normal human anatomy and physiology as possible but also to take into account the overwhelming economic, social, and psychological burden that open surgery may place on both patient and society, the concept of minimally invasive surgery (MIS) was born. The goals of MIS are to achieve the same results as conventional open surgery while striving to minimize soft tissue destruction, decrease intraoperative blood loss, reduce postoperative pain and hospital length of stay, and most importantly accelerate return to preoperative functional status. Endoscopic spinal fusion represents a step in the evolution of minimally invasive spine surgery that now allows us to even perform procedures such as the transforaminal lumbar interbody fusion (TLIF) without general anesthesia, removing yet another possible cause of surgical morbidity. Endoscopic techniques for fusion in the lumbar spine have been developed for every approach, and techniques also exist for both cervical and thoracic applications

Cultural orientations and information systems success in public and private hospitals: preliminary evidences from Italy

Abstract Background The effective adoption and use of digital and computerized systems and records in hospitals are crucial for increasing the overall quality, safety and outcomes of any national health community. Prior research found that hospitals’ dominant cultural orientation affects the adoption of new technology. However, the organizational culture of hospitals can greatly vary between public and private hospitals. Thus, the ownership type of the hospital is likely to affect, to some extent, the aforementioned relationship between culture and information system success. The present article focuses in detail on this issue and attempts to answer the following research question: which cultural orientations are promoting information system success in public and private hospitals? Methods The authors develop and test two hypotheses about this relationship via two regression approaches (single-level and multi-level). The authors collected data from 172 respondents—clinicians and non-clinicians—working in two (one public and one private) hospitals in Campania, one of the largest regions in Italy. Results The findings of this study show clear differences between private and public hospitals. First, a dominant cultural orientation that emphasizes flexibility values (clan and adhocracy cultures) positively influences information systems success in terms of individual impact. Second, the influence of a clan orientation on individual impact is stronger in the public hospital. Third, the influence of an adhocracy orientation is stronger in the private hospital. Overall, the type of ownership—either public or private—of these healthcare organizations affects the link between cultural orientations and IS success. Conclusion Managers of private hospitals should offer to their employees the opportunity to adopt and implement new information systems processes driven by openness towards the external environment in order to benchmark and learn from what was done previously in other organizations. Managers of public hospitals should set up human resource management practices, knowledge creation mechanisms, and internal communication capable of generating a friendly learning environment for their employees when adopting new technology