chung chek Wong - Academia.edu (original) (raw)

Papers by chung chek Wong

Research paper thumbnail of Three Level Thoracolumbar Spondylectomy for Recurrent Giant Cell Tumour of the Spine: A Case Report

Malaysian Orthopaedic Journal, 2018

Giant cell tumour (GCT) is a benign tumour but can be locally aggressive and with the potential t... more Giant cell tumour (GCT) is a benign tumour but can be locally aggressive and with the potential to metastasise especially to the lungs. Successful treatments have been reported for long bone lesions; however, optimal surgical and medical treatment for spinal and sacral lesions are not well established. In treating spinal GCTs, the aim is to achieve complete tumour excision, restore spinal stability and decompress the neural tissues. The ideal surgical procedure is an en bloc spondylectomy or vertebrectomy, where all tumour cells are removed as recurrence is closely related to the extent of initial surgical excision. However, such a surgery has a high complication rate, such as dura tear and massive blood loss. We report a patient with a missed pathological fracture of T12 treated initially with a posterior subtraction osteotomy, who had recurrence three years after the index surgery and subsequently underwent a three level vertebrectomy and posterior spinal fusion.

Research paper thumbnail of Experiences of early air travel with pneumothorax after anterior spinal surgery

BMJ Case Reports

Anterior thoracic or thoracolumbar spinal surgery by retropleural approach always carries a risk ... more Anterior thoracic or thoracolumbar spinal surgery by retropleural approach always carries a risk of pneumothorax as its consequence. Conventionally, the Aerospace Medicine Association and the British Thoracic Society recommend 2 weeks delay of air travel for a patient with resolved postoperative pneumothorax. They also label active pneumothorax as an absolute contraindication for commercial air travel. Such a delay always causes psychological and financial stress to patients and family who are far from home. Here, we report three patients with postoperative pneumothorax, who insisted on early air travel despite being informed of the possible consequences.

Research paper thumbnail of Supplemental Material, Appendix_1_to_5 - Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review

Supplemental Material, Appendix_1_to_5 for Anterior-Alone Surgical Treatment for Subaxial Cervica... more Supplemental Material, Appendix_1_to_5 for Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review by Wendy Lee and Chung Chek Wong in Global Spine Journal

Research paper thumbnail of Validation Study of Rajasekaran’s Kyphosis Classification System: Do We Clearly Understand Single- and Two-Column Deficiencies?

Asian Spine Journal, 2020

Study Design: Multicenter validation study.Purpose: To evaluate the inter-rater reliability of Ra... more Study Design: Multicenter validation study.Purpose: To evaluate the inter-rater reliability of Rajasekaran’s kyphosis classification through a multicenter validation study.Overview of Literature: The classification of kyphosis, developed by Rajasekaran, incorporates factors related to curve characteristics, including column deficiency, disc mobility, curve magnitude, and osteotomy requirements. Although the classification offers significant benefits in determining prognosis and management decisions, it has not been subjected to multicenter validation.Methods: A total of 30 sets of images, including plain radiographs, computed tomography scans, and magnetic resonance imaging scans, were randomly selected from our hospital patient database. All patients had undergone deformity correction surgery for kyphosis. Twelve spine surgeons from the Asia-Pacific region (six different countries) independently evaluated and classified the deformity types and proposed their surgical recommendation...

Research paper thumbnail of Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review

Global Spine Journal, 2020

Study Design: Systematic review. Objective: Anterior-alone surgery has gained wider reception for... more Study Design: Systematic review. Objective: Anterior-alone surgery has gained wider reception for subaxial cervical spine facets dislocation. Questions remain on its efficacy and safety as a stand-alone entity within the contexts of concurrent facet fractures, unilateral versus bilateral dislocations, anterior open reduction, and old dislocation. Methods: A systematic review was performed with search strategy using translatable MESH terms across MEDLINE, EMBASE, VHL Regional Portal, and CENTRAL databases on patients with subaxial cervical dislocation intervened via anterior-alone approach. Two reviewers independently screened for eligible studies. PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) flow chart was adhered to. Nine retrospective studies were included. Narrative synthesis was performed to determine primary outcomes on spinal fusion and revisions and secondary outcomes on new occurrence or deterioration of neurology and infection rate. Results: No...

Research paper thumbnail of The Global Spine Care Initiative: resources to implement a spine care program

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

The purpose of this report is to describe the development of a list of resources necessary to imp... more The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries. Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed for self-care and community-based settings for a wide variety of spine concerns (e.g., back and neck pain, deformity, spine injury, neurological conditions, pathology and spinal diseases). An iterative expert consensus process was used using electronic surveys. Thirty-five experts completed the process. An iterative consensus process was used through an electronic survey. A consensus was reached after two rou...

Research paper thumbnail of The Global Spine Care Initiative: model of care and implementation

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

Spine-related disorders are a leading cause of global disability and are a burden on society and ... more Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine care; (2) an evidence-based model that could be applied globally; and (3) implementation suggestions. The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final model of care and implementation steps. Sixty-six experts representing 24 countries participated. The GSCI model of care has eight core principles: person-centered, people-ce...

Research paper thumbnail of The Global Spine Care Initiative: methodology, contributors, and disclosures

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, d... more The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. World Spine Care convened the GSCI to develop an evidence-based, practical, and sustainable healthcare model for spinal care. The initiative aims to improve the management, prevention, and public health for spine-related disorders worldwide; thus, global representation was essential. A series of meetings established the initiative's mission and goals. Electronic surveys collected contributorship and demographic information, and experiences with spinal conditions to better understand perceptions and potential biases that were contributing to the model of care. Sixty-eight clinicians and scientists participated in the deliberations and are authors of one or more of the GSCI articles. Of these experts, 57 reported providing spine care in 34 countries, (i.e., low-, middle-, and high-income count...

Research paper thumbnail of The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

Spinal disorders, including back and neck pain, are major causes of disability, economic hardship... more Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources. Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders. Literature reviews on the burden of spinal disorders and six categor...

Research paper thumbnail of The Global Spine Care Initiative: care pathway for people with spine-related concerns

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

The purpose of this report is to describe the development of an evidence-based care pathway that ... more The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally. The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. An iterative consensus process was used. After three rounds of review, 46 experts from 16 countries reached consensus for the care pathway that includes five decision steps: awareness, initial triage, provider assessment, interventions (e.g., non-invasive treatment; invasive treatment; psychological and social intervention; prevention and public health; specialty care and interprofessional management), and outcomes. The care pathway can be used to guide the management of ...

Research paper thumbnail of Worldwide Steroid Prescription for Acute Spinal Cord Injury

Global spine journal, 2018

Cross-sectional study. To continue the line of a previous publication using steroid for acute spi... more Cross-sectional study. To continue the line of a previous publication using steroid for acute spinal cord injury (SCI) by spine surgeons from Latin America (LA) and assess the current status of methylprednisolone (MP) prescription in Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) to determine targets for educational activities suitable for each region. The English version of a previously published questionnaire was used to evaluate opinions about MP administration in acute SCI in LA, EU, AP, NA, and ME. This Internet-based survey was conducted by members of AOSpine. The questionnaire asked about demographic features, background with management of spine trauma patients, routine administration of MP in acute SCI, and reasons for MP administration. A total of 2659 responses were obtained for the electronic questionnaire from LA, EU, AP, NA, and ME. The number of spine surgeons that treat SCI was 2206 (83%). The steroid was used by 1198 (52.9%) surgeons. The us...

Research paper thumbnail of Commentary: Worldwide Knowledge and Attitude of Spine Surgeons Regarding Radiation Exposure

Neurosurgery, Jan 7, 2018

Categorical data were presented as counts and percentages. Attitudes and knowledge were compared ... more Categorical data were presented as counts and percentages. Attitudes and knowledge were compared among countries if the number of responses was above 40. Comparisons were conducted using Chi-square test or Fisher's exact test. Post hoc comparisons were adjusted by Bonferroni procedure. The significance level was set at P < .05. Data were processed and analyzed using SPSS version 22.0 (IMB Corp,

Research paper thumbnail of Current Status of Worldwide Use of Patient-Reported Outcome Measures (PROMs) in Spine Care

World Neurosurgery, 2017

Objectives: Patient-reported outcome measures PROMs are the most widely accepted means of measuri... more Objectives: Patient-reported outcome measures PROMs are the most widely accepted means of measuring outcomes following spine procedures. We sought to determine the current status of worldwide use of PROMs in Latin America (LA), Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) in order to determine the barrier to its full implementation.

Research paper thumbnail of What the mind does not know, the eyes do not see: a rare congenital fusion of the odontoid process to the atlantal hemiarch

Research paper thumbnail of Spine Surgeons Burnout and Quality of Life

Spine, 2021

Our research evaluates the prevalence of burnout using Maslach Burnout Inventory and EuroQol 5-di... more Our research evaluates the prevalence of burnout using Maslach Burnout Inventory and EuroQol 5-dimensions to assess the quality of life. Our results showed that burnout is a common condition among spine surgeons worldwide and there is a significant association between burnout scores and decreased general quality of life. Study Design. Cross-sectional survey study. Objective. To evaluate the prevalence of burnout, assess the personal and professional characteristics associated with burnout in spine surgeons and determine their quality of life. Summary of Background Data. Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and decreased sense of accomplishment that leads to decreased effectiveness at work. To date, there has been a lack of information on the prevalence of burnout among spine surgeons worldwide and the risk factors associated with this condition. Methods. An electronic survey with members of AO Spine was performed in May 2018. The survey evaluated demographic variables, practice characteristics, burnout, and quality of life. Maslach Burnout Inventory (MBI) and EuroQol 5-dimensions (EQ5D) were used to evaluate burnout and quality of life, respectively. Results. A total of 818 surgeons from 86 countries completed the survey. The prevalence of burnout was 30.6%. In the multiple linear model, emotional fatigue was independently associated with younger age (B = –0.17, CI95% = –0.26 to –0.07, P < 0.0001), and longer working hours per week (B = –2.71, CI95% = –4.34 to –1.07, P = 0.001); depersonalization was independently associated with younger age (B = –0.13, CI95% = –0.19 to –0.07, P < 0.0001), practicing outside Latin America (LA) (B = 0.71, CI95% = 0.41–1.01, P < 0.0001) and currently being a fellow (B = 0.54, CI95% = 0.06–1.02, P = 0.02); and higher scores of personal fulfilment was associated with practicing in LA (B = –1.27, CI95% = –1.69 to –0.85, P < 0.0001). Conclusion. Burnout is a common condition among spine surgeons worldwide. There is a significant association between burnout scores and decreased general quality of life. These results highlight the need to develop interventional programs to better identify, prevent, and manage this condition among practicing spine surgeons. Level of Evidence: 4

Research paper thumbnail of Three Level Thoracolumbar Spondylectomy for Recurrent Giant Cell Tumour of the Spine: A Case Report

Malaysian Orthopaedic Journal, 2018

Giant cell tumour (GCT) is a benign tumour but can be locally aggressive and with the potential t... more Giant cell tumour (GCT) is a benign tumour but can be locally aggressive and with the potential to metastasise especially to the lungs. Successful treatments have been reported for long bone lesions; however, optimal surgical and medical treatment for spinal and sacral lesions are not well established. In treating spinal GCTs, the aim is to achieve complete tumour excision, restore spinal stability and decompress the neural tissues. The ideal surgical procedure is an en bloc spondylectomy or vertebrectomy, where all tumour cells are removed as recurrence is closely related to the extent of initial surgical excision. However, such a surgery has a high complication rate, such as dura tear and massive blood loss. We report a patient with a missed pathological fracture of T12 treated initially with a posterior subtraction osteotomy, who had recurrence three years after the index surgery and subsequently underwent a three level vertebrectomy and posterior spinal fusion.

Research paper thumbnail of Experiences of early air travel with pneumothorax after anterior spinal surgery

BMJ Case Reports

Anterior thoracic or thoracolumbar spinal surgery by retropleural approach always carries a risk ... more Anterior thoracic or thoracolumbar spinal surgery by retropleural approach always carries a risk of pneumothorax as its consequence. Conventionally, the Aerospace Medicine Association and the British Thoracic Society recommend 2 weeks delay of air travel for a patient with resolved postoperative pneumothorax. They also label active pneumothorax as an absolute contraindication for commercial air travel. Such a delay always causes psychological and financial stress to patients and family who are far from home. Here, we report three patients with postoperative pneumothorax, who insisted on early air travel despite being informed of the possible consequences.

Research paper thumbnail of Supplemental Material, Appendix_1_to_5 - Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review

Supplemental Material, Appendix_1_to_5 for Anterior-Alone Surgical Treatment for Subaxial Cervica... more Supplemental Material, Appendix_1_to_5 for Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review by Wendy Lee and Chung Chek Wong in Global Spine Journal

Research paper thumbnail of Validation Study of Rajasekaran’s Kyphosis Classification System: Do We Clearly Understand Single- and Two-Column Deficiencies?

Asian Spine Journal, 2020

Study Design: Multicenter validation study.Purpose: To evaluate the inter-rater reliability of Ra... more Study Design: Multicenter validation study.Purpose: To evaluate the inter-rater reliability of Rajasekaran’s kyphosis classification through a multicenter validation study.Overview of Literature: The classification of kyphosis, developed by Rajasekaran, incorporates factors related to curve characteristics, including column deficiency, disc mobility, curve magnitude, and osteotomy requirements. Although the classification offers significant benefits in determining prognosis and management decisions, it has not been subjected to multicenter validation.Methods: A total of 30 sets of images, including plain radiographs, computed tomography scans, and magnetic resonance imaging scans, were randomly selected from our hospital patient database. All patients had undergone deformity correction surgery for kyphosis. Twelve spine surgeons from the Asia-Pacific region (six different countries) independently evaluated and classified the deformity types and proposed their surgical recommendation...

Research paper thumbnail of Anterior-Alone Surgical Treatment for Subaxial Cervical Spine Facet Dislocation: A Systematic Review

Global Spine Journal, 2020

Study Design: Systematic review. Objective: Anterior-alone surgery has gained wider reception for... more Study Design: Systematic review. Objective: Anterior-alone surgery has gained wider reception for subaxial cervical spine facets dislocation. Questions remain on its efficacy and safety as a stand-alone entity within the contexts of concurrent facet fractures, unilateral versus bilateral dislocations, anterior open reduction, and old dislocation. Methods: A systematic review was performed with search strategy using translatable MESH terms across MEDLINE, EMBASE, VHL Regional Portal, and CENTRAL databases on patients with subaxial cervical dislocation intervened via anterior-alone approach. Two reviewers independently screened for eligible studies. PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) flow chart was adhered to. Nine retrospective studies were included. Narrative synthesis was performed to determine primary outcomes on spinal fusion and revisions and secondary outcomes on new occurrence or deterioration of neurology and infection rate. Results: No...

Research paper thumbnail of The Global Spine Care Initiative: resources to implement a spine care program

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

The purpose of this report is to describe the development of a list of resources necessary to imp... more The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries. Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed for self-care and community-based settings for a wide variety of spine concerns (e.g., back and neck pain, deformity, spine injury, neurological conditions, pathology and spinal diseases). An iterative expert consensus process was used using electronic surveys. Thirty-five experts completed the process. An iterative consensus process was used through an electronic survey. A consensus was reached after two rou...

Research paper thumbnail of The Global Spine Care Initiative: model of care and implementation

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

Spine-related disorders are a leading cause of global disability and are a burden on society and ... more Spine-related disorders are a leading cause of global disability and are a burden on society and to public health. Currently, there is no comprehensive, evidence-based model of care for spine-related disorders, which includes back and neck pain, deformity, spine injury, neurological conditions, spinal diseases, and pathology, that could be applied in global health care settings. The purposes of this paper are to propose: (1) principles to transform the delivery of spine care; (2) an evidence-based model that could be applied globally; and (3) implementation suggestions. The Global Spine Care Initiative (GSCI) meetings and literature reviews were synthesized into a seed document and distributed to spine care experts. After three rounds of a modified Delphi process, all participants reached consensus on the final model of care and implementation steps. Sixty-six experts representing 24 countries participated. The GSCI model of care has eight core principles: person-centered, people-ce...

Research paper thumbnail of The Global Spine Care Initiative: methodology, contributors, and disclosures

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, d... more The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. World Spine Care convened the GSCI to develop an evidence-based, practical, and sustainable healthcare model for spinal care. The initiative aims to improve the management, prevention, and public health for spine-related disorders worldwide; thus, global representation was essential. A series of meetings established the initiative's mission and goals. Electronic surveys collected contributorship and demographic information, and experiences with spinal conditions to better understand perceptions and potential biases that were contributing to the model of care. Sixty-eight clinicians and scientists participated in the deliberations and are authors of one or more of the GSCI articles. Of these experts, 57 reported providing spine care in 34 countries, (i.e., low-, middle-, and high-income count...

Research paper thumbnail of The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

Spinal disorders, including back and neck pain, are major causes of disability, economic hardship... more Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources. Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders. Literature reviews on the burden of spinal disorders and six categor...

Research paper thumbnail of The Global Spine Care Initiative: care pathway for people with spine-related concerns

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, Jan 27, 2018

The purpose of this report is to describe the development of an evidence-based care pathway that ... more The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally. The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. An iterative consensus process was used. After three rounds of review, 46 experts from 16 countries reached consensus for the care pathway that includes five decision steps: awareness, initial triage, provider assessment, interventions (e.g., non-invasive treatment; invasive treatment; psychological and social intervention; prevention and public health; specialty care and interprofessional management), and outcomes. The care pathway can be used to guide the management of ...

Research paper thumbnail of Worldwide Steroid Prescription for Acute Spinal Cord Injury

Global spine journal, 2018

Cross-sectional study. To continue the line of a previous publication using steroid for acute spi... more Cross-sectional study. To continue the line of a previous publication using steroid for acute spinal cord injury (SCI) by spine surgeons from Latin America (LA) and assess the current status of methylprednisolone (MP) prescription in Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) to determine targets for educational activities suitable for each region. The English version of a previously published questionnaire was used to evaluate opinions about MP administration in acute SCI in LA, EU, AP, NA, and ME. This Internet-based survey was conducted by members of AOSpine. The questionnaire asked about demographic features, background with management of spine trauma patients, routine administration of MP in acute SCI, and reasons for MP administration. A total of 2659 responses were obtained for the electronic questionnaire from LA, EU, AP, NA, and ME. The number of spine surgeons that treat SCI was 2206 (83%). The steroid was used by 1198 (52.9%) surgeons. The us...

Research paper thumbnail of Commentary: Worldwide Knowledge and Attitude of Spine Surgeons Regarding Radiation Exposure

Neurosurgery, Jan 7, 2018

Categorical data were presented as counts and percentages. Attitudes and knowledge were compared ... more Categorical data were presented as counts and percentages. Attitudes and knowledge were compared among countries if the number of responses was above 40. Comparisons were conducted using Chi-square test or Fisher's exact test. Post hoc comparisons were adjusted by Bonferroni procedure. The significance level was set at P < .05. Data were processed and analyzed using SPSS version 22.0 (IMB Corp,

Research paper thumbnail of Current Status of Worldwide Use of Patient-Reported Outcome Measures (PROMs) in Spine Care

World Neurosurgery, 2017

Objectives: Patient-reported outcome measures PROMs are the most widely accepted means of measuri... more Objectives: Patient-reported outcome measures PROMs are the most widely accepted means of measuring outcomes following spine procedures. We sought to determine the current status of worldwide use of PROMs in Latin America (LA), Europe (EU), Asia Pacific (AP), North America (NA), and Middle East (ME) in order to determine the barrier to its full implementation.

Research paper thumbnail of What the mind does not know, the eyes do not see: a rare congenital fusion of the odontoid process to the atlantal hemiarch

Research paper thumbnail of Spine Surgeons Burnout and Quality of Life

Spine, 2021

Our research evaluates the prevalence of burnout using Maslach Burnout Inventory and EuroQol 5-di... more Our research evaluates the prevalence of burnout using Maslach Burnout Inventory and EuroQol 5-dimensions to assess the quality of life. Our results showed that burnout is a common condition among spine surgeons worldwide and there is a significant association between burnout scores and decreased general quality of life. Study Design. Cross-sectional survey study. Objective. To evaluate the prevalence of burnout, assess the personal and professional characteristics associated with burnout in spine surgeons and determine their quality of life. Summary of Background Data. Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and decreased sense of accomplishment that leads to decreased effectiveness at work. To date, there has been a lack of information on the prevalence of burnout among spine surgeons worldwide and the risk factors associated with this condition. Methods. An electronic survey with members of AO Spine was performed in May 2018. The survey evaluated demographic variables, practice characteristics, burnout, and quality of life. Maslach Burnout Inventory (MBI) and EuroQol 5-dimensions (EQ5D) were used to evaluate burnout and quality of life, respectively. Results. A total of 818 surgeons from 86 countries completed the survey. The prevalence of burnout was 30.6%. In the multiple linear model, emotional fatigue was independently associated with younger age (B = –0.17, CI95% = –0.26 to –0.07, P < 0.0001), and longer working hours per week (B = –2.71, CI95% = –4.34 to –1.07, P = 0.001); depersonalization was independently associated with younger age (B = –0.13, CI95% = –0.19 to –0.07, P < 0.0001), practicing outside Latin America (LA) (B = 0.71, CI95% = 0.41–1.01, P < 0.0001) and currently being a fellow (B = 0.54, CI95% = 0.06–1.02, P = 0.02); and higher scores of personal fulfilment was associated with practicing in LA (B = –1.27, CI95% = –1.69 to –0.85, P < 0.0001). Conclusion. Burnout is a common condition among spine surgeons worldwide. There is a significant association between burnout scores and decreased general quality of life. These results highlight the need to develop interventional programs to better identify, prevent, and manage this condition among practicing spine surgeons. Level of Evidence: 4