Comparison of inpatient vs. outpatient anterior cervical discectomy and fusion: a retrospective case series

<p>Abstract</p> <p>Background</p> <p>Spinal surgery is increasingly being done in the outpatient setting. We reviewed our experience with inpatient and outpatient single-level anterior cervical discectomy and fusion with plating (ACDF+P).</p> <p>Methods</p> <p>All patients undergoing single-level anterior cervical discectomy and fusion with plating between August 2005 and May 2007 by two surgeons (RPB or JAF) were retrospectively reviewed. All patients underwent anterior cervical microdiscectomy, arthrodesis using structural allograft, and titanium plating. A planned change from doing ACDF+P on an inpatient basis to doing ACDF+P on an outpatient basis was instituted at the midpoint of the study. There were no other changes in technique, patient selection, instrumentation, facility, or other factors. All procedures were done in full-service hospitals accommodating outpatient and inpatient care.</p> <p>Results</p> <p>64 patients underwent ACDF+P as inpatients, while 45 underwent ACDF+P as outpatients. When outpatient surgery was planned, 17 patients were treated as inpatients due to medical comorbidities (14), older age (1), and patient preference (2). At a mean follow-up of 62.4 days, 90 patients had an excellent outcome, 19 patients had a good outcome, and no patients had a fair or poor outcome. There was no significant difference in outcome between inpatients and outpatients. There were 4 complications, all occurring in inpatients: a hematoma one week post-operatively requiring drainage, a cerebrospinal fluid leak treated with lumbar drainage, syncope of unknown etiology, and moderate dysphagia.</p> <p>Conclusion</p> <p>In this series, outpatient ACDF+P was safe and was not associated with a significant difference in outcome compared with inpatient ACDF+P.</p

π+\pi^+ photoproduction on the proton for photon energies from 0.725 to 2.875 GeV

Differential cross sections for the reaction $\gamma p \to n \pi^+$ have been measured with the CEBAF Large Acceptance Spectrometer (CLAS) and a tagged photon beam with energies from 0.725 to 2.875 GeV. Where available, the results obtained here compare well with previously published results for the reaction. Agreement with the SAID and MAID analyses is found below 1 GeV. The present set of cross sections has been incorporated into the SAID database, and exploratory fits have been made up to 2.7 GeV. Resonance couplings have been extracted and compared to previous determinations. With the addition of these cross sections to the world data set, significant changes have occurred in the high-energy behavior of the SAID cross-section predictions and amplitudes.Comment: 18 pages, 10 figure

Differential cross sections and spin density matrix elements for the reaction gamma p -> p omega

High-statistics differential cross sections and spin density matrix elements for the reaction gamma p -> p omega have been measured using the CLAS at Jefferson Lab for center-of-mass (CM) energies from threshold up to 2.84 GeV. Results are reported in 112 10-MeV wide CM energy bins, each subdivided into cos(theta_CM) bins of width 0.1. These are the most precise and extensive omega photoproduction measurements to date. A number of prominent structures are clearly present in the data. Many of these have not previously been observed due to limited statistics in earlier measurements

Exclusive ρ0\rho^0 electroproduction on the proton at CLAS

The $e p\to e^\prime p \rho^0$ reaction has been measured, using the 5.754 GeV electron beam of Jefferson Lab and the CLAS detector. This represents the largest ever set of data for this reaction in the valence region. Integrated and differential cross sections are presented. The $W$, $Q^2$ and $t$ dependences of the cross section are compared to theoretical calculations based on $t$-channel meson-exchange Regge theory on the one hand and on quark handbag diagrams related to Generalized Parton Distributions (GPDs) on the other hand. The Regge approach can describe at the $\approx$ 30% level most of the features of the present data while the two GPD calculations that are presented in this article which succesfully reproduce the high energy data strongly underestimate the present data. The question is then raised whether this discrepancy originates from an incomplete or inexact way of modelling the GPDs or the associated hard scattering amplitude or whether the GPD formalism is simply inapplicable in this region due to higher-twists contributions, incalculable at present.Comment: 29 pages, 29 figure

Beam-Recoil Polarization Transfer in the Nucleon Resonance Region in the Exclusive e⃗p→e′K+Λ⃗\vec{e}p \to e'K^+\vec{\Lambda} and e⃗p→e′K+Σ⃗0\vec{e}p \to e'K^+\vec{\Sigma}^0 Reactions at CLAS

Beam-recoil transferred polarizations for the exclusive $\vec{e}p \to e'K^+ \vec{\Lambda},\vec{\Sigma}^0$ reactions have been measured using the CLAS spectrometer at Jefferson Laboratory. New measurements have been completed at beam energies of 4.261 and 5.754 GeV that span a range of momentum transfer $Q^2$ from 0.7 to 5.4 GeV$^2$, invariant energy $W$ from 1.6 to 2.6 GeV, and the full center-of-mass angular range of the $K^+$ meson. These new data add to the existing CLAS $K^+\Lambda$ measurements at 2.567 GeV, and provide the first-ever data for the $K^+\Sigma^0$ channel in electroproduction. Comparisons of the data with several theoretical models are used to study the sensitivity to s-channel resonance contributions and the underlying reaction mechanism. Interpretations within two semi-classical partonic models are made to probe the underlying reaction mechanism and the $s\bar{s}$ quark-pair creation dynamics.Comment: 48 pages, 22 figure

A measurement of the differential cross section for the reaction γn→π−p\gamma n \to \pi^{-} p from deuterium

We report a measurement of the differential cross section for the $\gamma n \to \pi^- p$ process from the CLAS detector at Jefferson Lab in Hall B for photon energies between 1.0 and 3.5 GeV and pion center-of-mass (c.m.) angles ($\theta_{c.m.}$) between 50$^\circ$ and 115$^\circ$. We confirm a previous indication of a broad enhancement around a c.m. energy ($\sqrt{s}$) of 2.2 GeV at $\theta_{c.m.}=90^\circ$ in the scaled differential cross section, $s^7 {\frac{d\sigma}{dt}}$. Our data show the angular dependence of this enhancement as the scaling region is approached in the kinematic region from 70$^\circ$ to 105$^\circ$.Comment: 6 pages, 3 figures. submitted to PR

The extraction of ϕ−N\phi-N total cross section from d(γ,pK+K−)nd(\gamma,pK^{+}K^{-})n

We report on the first measurement of the differential cross section of $\phi$-meson photoproduction for the $d(\gamma,pK^{+}K^{-})n$ exclusive reaction channel. The experiment was performed using a \textcolor{black}{tagged-photon} beam and the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. A combined analysis using data from the $d(\gamma,pK^{+}K^{-})n$ channel and those from a previous publication on coherent $\phi$ production on the deuteron has been carried out to extract the $\phi-N$ total cross section, $\sigma_{\phi N}$. The extracted $\phi-N$ total cross section favors a value above 20 mb. This value is larger than the value extracted using vector-meson dominance models for $\phi$ photoproduction on the proton.Comment: 7 pages 4 figure

First measurement of target and double spin asymmetries for polarized e- polarized p --> e p pi0 in the nucleon resonance region above the Delta(1232)

The exclusive channel polarized proton(polarized e,e prime p)pi0 was studied in the first and second nucleon resonance regions in the Q2 range from 0.187 to 0.770 GeV2 at Jefferson Lab using the CEBAF Large Acceptance Spectrometer (CLAS). Longitudinal target and beam-target asymmetries were extracted over a large range of center-of-mass angles of the pi0 and compared to the unitary isobar model MAID, the dynamic model by Sato and Lee, and the dynamic model DMT. A strong sensitivity to individual models was observed, in particular for the target asymmetry and in the higher invariant mass region. This data set, once included in the global fits of the above models, is expected to place strong constraints on the electrocoupling amplitudes A_{1/2} and S_{1/2} for the Roper resonance N(1400)P11, and the N(1535)S11 and N(1520)D13 states.Comment: 13 pages, 13 figure