Objective The use of social media applications to disseminate information has substantially risen in recent decades. Spine and back pain-related hashtags have garnered several billion views on TikTok. As such, these videos, which share experiences, offer entertainment, and educate users about spinal surgery, have become increasingly influential. Herein, we assess the quality of spine surgery content TikTok from providers and patients.
Methods Fifty hashtags encompassing spine surgery (“#spinalfusion,” “#scoliosissurgery,” and “#spinaldecompression”) were searched using TikTok’s algorithm and included. Two independent reviewers rated the quality of each video via the DISCERN questionnaire. Video metadata (likes, shares, comments, views, length) were all collected; type of content creator (musculoskeletal, layperson) and content category (educational, patient experience, entertainment) were determined.
Results The overall DISCERN score was, on average, 24.4. #Spinalfusion videos demonstrated greater engagement, higher average likes (p = 0.02), and more comments (p < 0.001) compared to #spinaldecompression and #scoliosissurgery. #Spinaldecompression had the highest DISCERN score (p < 0.001), likely explained by the higher percentage of videos that were educational (p < 0.001) and created by musculoskeletal (MSK) professionals (p < 0.001). Compared to laypersons, MSK professionals had significantly higher quality videos (p < 0.001). Similarly, the educational category demonstrated higher quality videos (p < 0.001). Video interaction trended lower with MSK videos and educational videos had the lowest interaction of the content categories (likes: p = 0.023, comments: p = 0.005).
Conclusion The quality of spine surgery videos on TikTok is low. As the influence of the new social media landscape governs how the average person consumes information, MSK providers should participate in disseminating high-quality content.
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Objective Despite growing interest in cervical disc replacement (CDR) for conditions such as cervical radiculopathy, limited data exists describing the impact of obesity on early postoperative outcomes and complications. These data are especially important as nearly half of the adult population in the United States is expected to become obese (body mass index [BMI] ≥ 30 kg/m2) by 2030. The goal of this study was to compare the demographics, perioperative variables, and complication rates following CDR.
Methods The 2005–2020 American College of Surgeons National Surgical Quality Improvement Program datasets were queried for patients who underwent primary 1- or 2-level CDR. Patients were divided into 3 cohorts: Nonobese (BMI: 18.5–29.9 kg/m2), Obese class-I (BMI: 30–34.9 kg/m2), Obese class-II/III (BMI ≥ 35 kg/m2). Morbidity was defined as the presence of any complication within 30 days postoperatively. Rates of 30-day readmission, reoperation, morbidity, individual complications, length of stay, frequency of nonhome discharge disposition were collected.
Results A total of 5,397 patients were included for analysis: 3,130 were nonobese, 1,348 were obese class I, and 919 were obese class II/III. There were more 2-level CDRs performed in the class II/III cohort compared to the nonobese group (25.7% vs. 21.5%, respectively; p < 0.05). Class-II/III had more nonhome discharges than class I and nonobese (2.1% vs. 0.5% vs. 0.7%, respectively; p < 0.001). Readmission rates differed as well (nonobese: 0.5%, class I: 1.1%, class II/III: 2.1%; p < 0.001) with pairwise significance between class II/II and nonobese. Class II/III obesity was an independent risk factor for both readmission (odds ratio [OR], 3.32; p = 0.002) and nonhome discharge (OR, 2.51; p = 0.02). Neither 30-day reoperation nor morbidity rates demonstrated significance. No mortalities were reported.
Conclusion Although obese class-II/III were risk factors for 30-day readmission and nonhome discharge, there was no significant difference in reoperation rates or morbidity. CDR procedures can continue to be safely preformed independent of obesity status.
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Objective The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis.
Methods Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery. Statistical significance was defined by p-values <0.05. The factors considered were age, sex, body mass index (BMI), smoking status, American Society of Anesthesiologists physical status classification, and comorbidities including hypertension, diabetes, history of dyspnea or chronic obstructive pulmonary disease, previous cardiac intervention or surgery, steroid usage, and history of bleeding. In addition, whether the operation was performed by an orthopedic or neurosurgical specialist was analyzed.
Results The number of 2-level CDA procedures increased from 6 cases reported in 2014 to 142 in 2016, although a statistically significant increase in the number of outpatient cases performed was not seen (p=0.2). The factors found to be significantly associated with inpatient status following surgery were BMI (p=0.019) and diabetes mellitus requiring insulin (p=0.043). There were no significant differences in complication and readmission rates between the inpatient and outpatient groups.
Conclusion Patients undergoing inpatient 2-level CDA had significantly higher rates of obesity and diabetes requiring insulin than did patients undergoing the same procedure in the outpatient setting. With no difference in complication or readmission rates, 2-level CDA may be considered safe in the outpatient setting in appropriately selected patients.
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